Aging of the skin is the result of a multitude of factors: heredity, age, the environment (sun, wind, cold), variations in weight, excessive facial expressions. This aging process includes different components: skin alterations (fine lines, thicker skin, etc.), drooping and loss of elasticity of the skin and muscles, thinning of the bones and fatty padding. Facelifting doesn’t stop the aging process but modifies some consequences of aging so as to impart rejuvenated looks.
What Can We Treat with Facelifting?
Facial rhytidectomy involves retightening the slackened skin of the middle and lower third of the face and neck.
Volume defects such as the accumulated fat in the jowls and neck will benefit from liposuction. For changes to the centre of the face (eyes, forehead, lips) and temples, other techniques (endoscopic frontal lifting, blepharoplasty) will have to be used along with facelifting, either concurrently or shortly thereafter. Although a facelift will tighten the skin, it will not change its texture or surface defects (pigmentation, fissures, fine lines, etc.). For these defects complementary techniques can be used ( peeling , short- and long-term injectable implants , microdermabrasion , Radiophotorejuvenation , etc.).
In the case of expression wrinkles that are noticeable only during facial expressions, therefore inexistent in a relaxed state, injections of Botox® are the recommended treatment.
Facelifting has regained popularity since the improvement of surgical techniques, such as liposuction, endoscopy, tissue sealants, shorter and less visible scars, local anaesthesia, etc.
Is It for Me?
The aging process is an individual phenomenon, which is influenced by controllable variables (skin care, protection against the sun, ideal weight) as well as uncontrollable variables (genetics, age). What determines the ideal moment for resorting to corrective measures remains your own appreciation when looking into a mirror and not your real age. The younger the person with good health and good tissues, the lesser the extent of corrections to be performed. Healing will be easier and the results superior. The older the person, the more significant the corrections required. and the more gratifying the results.
Before the Procedure
In preparation for the procedure, you will receive specific instructions in order to maximize the results and minimize the complications. Accordingly, since tobacco reduces blood circulation of the skin, it will be necessary to stop smoking to ensure proper healing.
Also, several substances can cause bleeding (alcohol, aspirin, etc.). Dr. Bernier’s team will give you a complete list of substances to avoid. During consultation, an evaluation of your health will determine the relevance of undergoing preoperative lab tests. The night before your procedure, as well as the same morning, you will need to shampoo your hair and thoroughly cleanse your skin using an antiseptic soap. Furthermore, some medication may be required prior to your procedure.
During the Procedure
The one-day procedure will take place in a private clinic. Normally, facelifting is performed under local anaesthesia preceded by a relaxing medication when necessary. This type of anaesthesia allows us to better assess the tonus and the effect of facial expressions on the lifting.
In the front part, the incision starts at the root of the hair, passes in front of the upper perimeter of the ear, continues inside it (sometimes in front for men), then passes in the furrow of the lobe’s perimeter, continues to the back of the ear, to end up in the scalp.
After the incision, the surgeon separates from the face and neck the skin that will be tightened. Then the fat surpluses are trimmed and thinned, and the muscles tightened and redirected upwards. Finally, after making extra sure that there is no bleeding, the surgeon repositions the skin by cutting out the surplus so that it will mould the natural shape of your face. Different sutures will be made. In the exposed areas (in front of the ears), these sutures will be tucked under the skin, thus invisible, while threads or wires will be used at the scalp level.
The surgeon works on one side of the face then on the other. The whole procedure takes between 2 and 4 hours depending on the complexity of the job. A bandage is applied by the surgeon around the face and head, which is removed the following day during the first postoperative visit. A lightweight genial (chin) support is worn for a few days.
After the Procedure
The following is information concerning the first postoperative days :
Facelifting per se does not cause much pain. It is more a question of slight discomfort. You can nevertheless manage your personal hygiene and carry out your routine activities (making sure not to exert yourself). A slight feeling of taut skin (especially behind the ears and in the neck) is normal for 3 to 4 weeks.
As with any face procedure, it is possible that ecchymoses (bruises) and swelling of the tissues will occur. These will peak on the second or third postoperative day then gradually disappear over a 10- to 14-day period.
Although shampooing is allowed on the day following the procedure, it is important to ensure that it be done with gentleness. The same goes for skin care of the face since it is possible that local sensitivity will be temporarily diminished for a few days. It is advisable to wait for your surgeon’s authorization before proceeding to colouring or otherwise altering your hair. Usually a waiting period of 2 to 3 weeks is recommended.
The incision sites cannot be covered with makeup before the sutures have been removed, about 7 days after the procedure. Earrings can be worn as soon as the earlobes have recovered their normal sensitivity.
It is normal to feel in a bad mood after a procedure of this nature. Your face may seem strange, you may feel more tired (the healing process takes its toll in energy), and you may wonder what the final result will be. Do not fret unnecessarily: your face needs time to go through the different phases of healing that can sometimes take up to several months.
You will be able to resume your social activities soon enough (7 to 14 days). However, you should avoid strenuous exercise (bodybuilding, climbing, judo, karate, etc.) for 4 to 6 weeks.
In the Long Run
We nevertheless have to recognize that major muscular and cutaneous drooping could be incompletely corrected in one single procedure. Some relaxation can also occur during the first months. Some secondary techniques may be associated with the procedure in order to achieve optimum results.
The addition of liposuction or muscular lifting has proven generally satisfying as well as very popular.
The signs of aging cannot be completely erased, however, they can certainly be lessened with an objective of overall improvement.
Bear in mind that the healing process is gradual and therefore can, according to the individual patient, age, heredity and overall health, take up to one year. At the end of that healing period, you will be able to appreciate your new rejuvenated look and the effect it has on your wellbeing.
Other Procedure Options
Facelifting is a recognized medical procedure that aims at correcting certain signs of aging. It has its potential as well as its limitations. Sometimes complementary or alternative techniques may prove useful.
Some situations (health problems, difficulty to leave the job, fear of a major procedure, etc.) require alternatives that provide improvements while not being so invasive.
Several new techniques have been introduced over the recent years for the sole purpose of meetings such needs:
- Radiophotorejuvenation (radiophotorejuvenation)
- Dynamic photorejuvenation
- Botox ®
- Fat implants
Frequently Asked Questions about Facelifting
What are the risks or complications?
Although relatively infrequent, the risks and complications are similar to those of any procedure: bleeding, infection, swelling of tissues, scarring defects, asymmetry.
To minimize risks and complications it is vital to closely adhere to the preoperative recommendations and to observe the postoperative follow-up. If you have any medical questions in this regard, none is in a better position to answer them than your surgeon. Don’t trust people who are not at all familiar with this type of procedure.
A complication can prolong the healing time without necessarily compromising the achievement of satisfying results. For instance, a haematoma can be drained, an unsightly scar or asymmetry can be reviewed. Consequently the final result is sure to meet your expectations.
Are the results lasting?
The facelift may make you look 10 to 15 years younger but the results are not forever; the aging process never takes a break. This benefit will be maintained more or less over the next years depending on the care and precautions against photoaging that are taken and if smoking is abandoned for those who still have the habit.