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The procedure Dr Oates performs facelift procedures either at a hospital under general anaesthesia (fully asleep) or in our state government licensed, Academy Day Hospital (on site at Academy Facial Plastics) under sedation. It takes 3 – 4 hours. The incisions are well hidden within the hairline and the natural curve of the ear. Through these incisions, the SMAS is tightened and the skin is then redraped into an uplifted position. Immediately after the procedure, bandages are applied to the peripheral areas of the face. Most patients will stay in the hospital for one night if done under general anaesthetic or go home if done under sedation. How long will I need off work? Most facelift patients will take between two and three weeks off work, depending on the amount of physical activity involved in their line of work. The recovery On the day after the surgery the bandages are removed and a specially designed facial garment will be worn for 7 to 14 days. On the fifth or sixth day after surgery, your stitches are removed. Swelling and bruising may still be present so camouflage makeup can be applied. Depending on the amount of swelling, Dr Oates may also recommend you wear the facial garment for a further five to seven days or just at night while sleeping. Is there discomfort? Most patients will describe the feeling as mild to moderate discomfort (this is mainly due to the swelling). This discomfort can be eased with Panadol or Panadeine Forte. Pre and Post-Operative Care Included in the cost for a full facelift is a pre-operative care program delivered by our fully qualified Dermal Therapists. This entails a course of three, weekly glycolic peels and home care products are recommended to help prepare and treat your skin prior to surgery. Post-operatively, your Dermal Therapist will recommend a maintenance program for you skin. POST FACELIFT INFORMATION The facelift procedure is major surgery, tailored from patient to patient. It is important to understand how you will look and feel following the procedure and the potential risks and complications associated this type of surgery. Bandages
When you wake up from surgery there will be a large turban like bandage going around your head and under the chin. This bandage is removed the day after surgery at the same time as the drain is removed. Your hair will be washed prior to having this bandage put on, however it is likely to be slightly matted and stuck down. Usually some further rinsing of the hair will be done before putting on any support dressing, which is sometimes known as a 'face bra'. The face bra helps to support and compress and will help decrease any swelling. The face bra is attached with velcro and most people find it easy to put on. Swelling and bruising
Depending on the extent of the surgery there will generally be a considerable amount of swelling and some bruising. If other procedures are combined with a facelift then the swelling is usually more. Do not be concerned about the swelling, there are certain measures to help reduce it more quickly and are important, such as, keeping the head elevated as much as possible, using ice packs for at least 30 minutes each hour for the first 2-3 days. Often there is some bruising that tends to extend down into the neck. It is important to remember that bruising goes through a range of colours from purple, through to green and then yellow. After about 1 week you may be reasonably presentable however most people feel they are not ready to return to work for at least two weeks. Some swelling may persist for 6-8 weeks. The incision line
It is important to keep incision lines clean so wash them gently 3-4 times a day with salt water and a cotton wool ball. In the first 48 hours there is generally some oozing and crusting around the incision lines. A thin layer of Vaseline may be applied to keep the incision site moist until there is no crusting. If you have dissolving sutures, these are usually behind the ears and in the hairline. You may have staples in the hair line which are easier to look after. You will find it easier if you do not wear any shirts which require being pulled over the head, so shirts which button up in the front are much better. It will be useful to dedicate some face washers and towels to the cleaning up procedures, as these will tend to get soiled. Usually non-dissolving sutures will be removed at/around 5 days. If you have been consistent with the cleaning procedure usually the dissolving stitches will be dropping off at approximately the same time. Pain
Surprisingly pain is usually not a significant feature of facelift surgery. There is certainly some discomfort and some patients notice an element of tightness. This tightness may be especially noticeable under the chin. Some people however notice that the cheeks and ears are numb, this is a normal part of the healing process of a facelift and usually this will return completely to normal, however it may take some weeks. This feeling can often be disturbing to some patients in the initial period and the patient may feel that they cannot lie on their ears. As the healing continues some patients experience a feeling resembling insects crawling on the skin, this is nothing to be concerned about. For the management of any pain usually simple Panadol or Panadeine Forte is all that is required. Blood collection under the skin
A collection of blood under the skin is known as a haematoma, this is a potential complication of facelift surgery because an extensive amount of skin may have been elevated off the deeper structures. It is rare and occurs in about 1% of facelifts. If the haematoma is minor then it may be simply aspirated with a needle. However, occasionally larger haematomas occur which may need to be removed in theatre. Haematomas generally only occur in the first day or two after surgery. If a fluid accumulation occurs later on, it is known as a seroma, rather than blood, as it is a collection of tissue fluid. If this does occur it is treated by simple aspiration with a needle. Sometimes multiple aspirations are required until it settles completely. Infection
Infection is possible whenever the skin is cut. It is unusual in a facelift and antibiotics are given to minimise this risk. Skin loss
Superficial or full thickness skin loss is a risk with facelifting. It is rare, but increased in smokers and diabetics and people who have radiation to the face. The area most frequently affected by this is the hairless skin behind the ear. If it does occur it is dressed and allowed to heal. It may leave a more noticeable, pale scar. Please make sure that you inform Dr Oates if you are a smoker or diabetic. Scars
Any incision in the skin will always leave a scar, however the secret of facelift surgery is to hide the scar where it is less noticeable and fine scars as such are almost invisible. The scars in front of the ears can usually be hidden in the natural crease that occurs there. Those behind the ears are hidden deep in the crease of the ear and then extend into the hairline at the point where the ear and the ear line meet thus effectively hiding them. Some people do have increased tendency towards abnormal scarring. If you have any history of hypertrophic or keloid scarring please let Dr.Oates know prior to surgery. Dark skin races can also be prone to increased risk of keloid scarring. On rare occasions it can occur in people with no history of predisposition. If abnormal scarring has occurred then it may be possible to manage this with an injection of steroids into the scar. It is important to remember that the scar maturation process takes place over 6-12 months. In the first 6-12 weeks often the scars are quite pink and may have some feeling of thickness to them. This is not abnormal, gentle massage will help to settle them down more quickly, in 6 months they are expected to be flat and fine lines. Alteration of the hairline
This primarily occurs to the side burn area. Dr Oates preferred incision does not normally go above the ears thus minimising this problem in women. However with men the beard will be pulled closer to the front of the ear and occasionally some hair bearing skin will be pulled further behind the ear. Temporary hair loss where the incisions go into the hair is quite normal. Numbness
Making incisions and elevating skin tends to lead to areas of numb skin, this usually includes the ears and skin in front of them. However, over a period of weeks this numbness will resolve. Asymmetry
After surgery the two sides of the face appear asymmetrical, this is because one side is completed before the second side is started. Thus there is a couple of hours difference before the onset of swelling. Also it is not unusual for one side to develop slightly more swelling than the other, perhaps this is because of the way people sleep. However, it has no significant effect on the final outcome. People often notice that there is some slight lumpiness to the skin following surgery, this is due to little pockets of increased swelling under the skin. This is nothing to be concerned about and is in fact expected in the first 6-8 weeks. Gentle massage will help to settle this down more quickly, as will wearing the face bra. Occasionally there is mild long-term asymmetry, this is usually as a result of pre-existing facial asymmetry and asymmetry of the underlying facial bones. Sometimes when this is noted pre-operatively, slight improvement and corrections can be made. However it is not reasonable to expect perfect symmetry of the face when it was not in existence pre-operatively. Facial weakness
With modern facial techniques the deep tissue layers are addressed as well as the skin, thus getting a natural and longer lasting result. However this adjustment of the deeper tissues does bring us closer to the facial nerve, the nerve that controls all movement of the face. It is extremely rare for this nerve to be damaged, however it certainly has been recorded. Usually the nerve recovers spontaneously however, it is possible to have some permanent facial weakness if the facial nerve is damaged. If I am interested, what now? Step 1
Your first step is an initial consultation with Dr Oates, you do not need a GPs referral for this consultation. Or you can have a complementary consultation with one of our Dermal Therapists or Nurses. Step 2
If Dr Oates decides that you are suitable candidate for a facelift and you want to go ahead with the surgery, a booking for the surgery and the pre-operative care is scheduled. The usual waiting period is approximately three to four weeks. Complimentary Consultations You may wish to speak with one of our qualified Dermal Therapists or Nurse prior to seeing Dr Oates. During this free consultation, a Dermal Therapist/Nurse can discuss both surgical and non-surgical options to treat your cosmetic concern(s). Please note: Asprin, Nurofen, Vitamin E and blood thinning medications tend to significantly increase bruising and should not be taken for two weeks prior to and one week after facial plastic surgery.
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