Face Lift :

The reason for choosing this operation is that it is the most effective way of reducing the loose skin that has developed on your face over the years. This is as a result of the pull of gravity, hereditary factors, personal habits such as smoking and sun exposure. If your jaw line has softened into jowls, or beneath your chin another is appearing, it may be that these factors are beginning to affect your self confidence. The main reason our patients choose to have a face lift is to boost their self confidence. We live in an ageing population, which is growing, and we expect to look as well as feel good about ourselves for a lot longer.

The principle of a face lift is to lift the tissues, take up the slack and remove surplus tissue. Mr Solomons will usually start the incision high in the temple area (hidden by the hair at this point) and continue down following the curves in front of your ear, round the ear lobe and up behind the ear before curving gently back into the hair of the neck. The incision is closed with very fine stitches and some metal clips. A small amount of hair is shaved from the incision site but this is not noticeable following the surgery. It may on occasion be necessary to add an incision under the chin.

A general anaesthetic is required. You will be seen by a Consultant Anaesthetist prior to your surgery and will have the opportunity to discuss any concerns then. However, if you have any worries or previous anaesthetic complication, these should be discussed with Mr Solomons beforehand.

Pre Treatment Protocol:

If you are a smoker now is the time to seriously try and give up. Apart from reducing the cancer risks that you are already aware of, not everyone is aware of how much it reduces the blood and oxygen supply to the skin. For the face to heal the tissues need a good oxygen supply, post-operative complications can be reduced and healing will be much quicker if you don't smoke.

Some patients are advised to commence a skin preparation which involves a morning and evening regime using the Environ skin products. They contain glycolic acid, vitamin A and antioxidants. The method of application should be as follows:

• Every morning
  Cleanse the face and neck with Environ Cleansing Cream/Gel
  Apply Environ Alpha Toner to the face and neck
  Apply Environ Mild Day Cream to the face and neck
  Apply Environ Eye Gel to the upper and lower eyelids



• Every night
  Repeat the morning regime but change the Environ Mild Day Cream to the
  Environ Mild Night Cream



• Arnica
  Five days prior to surgery take 2 tablets 3 times daily
  Five days after surgery take 2 tablets 3 times daily


Do let us know if you start any new medications after your initial consultation, especially if they contain aspirin or any other anti-inflammatory preparations. These may increase the risk of bleeding or bruising after surgery.

On the Day of Surgery:

You will be advised about eating and drinking according to the time of your surgery. Have a shower or bath and wash your hair thoroughly. Do not use hairspray. Make up can be removed when you change into your theatre gown on the ward. Initially you will have dressings covering the incision areas (as described above). There will be a thin mesh covering your face to keep the dressings in place and this will stay on overnight. You will have a wound drain in place behind each ear and a thin strip of dressing on your eyelids if you are undergoing eyelid surgery as well. You will look swollen and may be bruised. This is to be expected and will subside with time. The discomfort described by most patients is minimal. However everyone's pain threshold is different. Some patients describe a feeling of tightness after the dressings have been removed. This is normal and will subside with time. Pain relief medication will be given during the hospital stay if needed and a supply will be made available to take home. Aspirin must not be taken.

Post Treatment Protocol:

The day after surgery you will be up and walking about. Once Mr Solomons has examined you, your two drains will be removed along with the thin mesh dressing. You need to keep yourself as upright as possible and avoid bending down for any length of time. Maintaining an upright position will help reduce the swelling on your face. This includes sleeping at night propped up with pillows. Vigorous activities should be avoided otherwise post operative bleeding could result. There may be some oozing from the incision sites. This is to be expected and will subside quickly. Your face and neck may look discoloured in some areas due to bruising. This is normal and to be expected following this type of surgery.

You may bath or shower the day after surgery but do not wash your hair as you will need the keep the wound sites dry for the next week. You can go out and wear make up whenever you feel ready but you should take it easy during the first week after surgery. Not only are you recovering from lengthy surgery but also an anaesthetic. Concealing make up can be worn to cover any bruising on the face and my Aesthetic Nurse can advise you on this. Sunglasses are useful following eye surgery.

Mr Solomons will see you approximately one week following your surgery to remove the stitches and clips. This is not a painful procedure but can take up to an hour. Occasionally some stitches may need to be left in. This should not cause concern as they will be removed only a few days later.

Risks:

All operations can have some side effects and with it their complications. The most common for this type of surgery are:


• Swelling and reduced sensitivity - Several weeks may pass before the swelling has subsided completely. A feeling of tightness and reduced sensitivity in and around the stitched area may take some months to settle.



• Bruising - Blue, yellow and green discolouration of the skin due to bruising may occur and last for several weeks. Bruising tends to settle on the lower eyelids (following eyelid surgery), around the jaw line and sometimes on the neck. Although rarely painful this prompts a concerned response in others.



• Scarring - The operation cannot be done without leaving scars. However the necessary incisions are made in such a manner that the scars will be as unnoticeable as possible and are well hidden. Some thickening and reddening of scars may be expected, possibly for some months, but this invariably fades to a natural skin colour and texture. The scars in the hairline may stretch a little as this is where the tension is carried. Massage of the scars speeds up the maturation process and is recommended with oil such as Vitamin E. They can become visible if you decide to wear your hair up but with the help of make up and care with the choice of hairstyle, it is not obvious.



• Altered Sensation - Where incisions are made there may be areas of altered sensation. This usually results in the area feeling slightly numb. This almost always recovers but small areas of reduced sensation may persist.



Rare Complications


• Haemorrhage (Bleeding) - In spite of the greatest care, it is possible that even with wound drains in place following surgery that a second procedure may be necessary to staunch haemorrhage or remove a haematoma (blood clot).



• Wound Infection - Although very rare, an infection of the wounds could lead to a delay in the healing process. Abscess and fistula formation are extremely rare.



• Nerve Damage - During surgery injury to the facial nerve can lead to temporary or permanent paralysis to the affected part of the face. It is a very rare complication.



Any concerns or fears about complications can and will always be discussed with Mr Solomons and his team.

Post Surgery Tips:

It takes at least three months after surgery before the success can be judged. Deep nose and cheek wrinkles and vertical wrinkles, especially on the upper lip, cannot be smoothed completely by means of a face lift because the original elasticity of the skin cannot be restored through the surgery. Additional options are available for this and can be discussed with Mr Solomons.


• Avoid T-Shirts, sweaters and nightwear that have to be pulled over your face. Button up clothing is much easier in the first few days after surgery.



• A triangular pillow (shaped like an upside down 'V') is very comfortable to sleep against in the first week.



• If you have your hair tinted or permed, you may consider having this done a few days before admission to hospital. It is advisable not to apply any strong hair chemicals for four weeks following surgery.



• If you are having problems sleeping the prescribed painkiller (usually Tylex) will help you have a more restful sleep.



• A balanced diet is important to assist your body during the healing process. We recommend that supplement of 1g of Vitamin C daily be taken for a month following surgery as this will aid the healing process.



• Drinking plenty of water will not only maintain your hydration but will help prevent constipation, a possible side effect of some painkillers.



• You will need to have some help during the first few days after surgery so try and organise family and friends to support you.
If you are worried or unsure about any of the above information please do not hesitate to ask us. In the event of an emergency please call 01483 451473.