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The Procedure Dr Oates performs the S-Lift procedure in the state government licensed theatre at Academy Day Hospital (on site at Academy Facial Plastics and Laser Specialist) under a combination of twilight sedation and local anaesthetic. An incision is made in the creases in front of the ear and the deeper layer of soft tissue is elevated and tightened. The procedure takes approximately 2 hours and bandages are then applied. How long do I need off work? Most S-Lift patients will take between 10 to 14 days off work, depending on the amount of physical activity involved in their line of work. The Recovery After the procedure you will remain in the recovery room for one to two hours. You will need a family member or friend to drive you home after this. The next day we ask you return to the clinic and our nurse will remove the bandages and apply a specially designed facial garment. On the fifth or sixth day after surgery, your stitches will be 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 over-the-counter pain medication. Patients rarely report strong pain and in this case, pain can be easily managed with stronger medications. Pre and Post-Operative Care Included in the cost of an S-Lift is a pre-operative care program delivered by our nursing staff and fully qualified dermal therapists. You are given a course of complimentary glycolic peels to help prepare and treat your skin prior to surgery. Post-operatively, your Dermal Therapist will recommend a maintenance program for your skin. POST S-LIFT INFORMATION Although designed to be a less invasive procedure than a full facelift, the 'S-Lift' is still major surgery. It is important to understand how you will look and feel following the procedure and the potential risks and complications. Bandages
A large turban like bandage is placed around your head and under your the chin. The bandage helps to support, compress and decrease swelling. This bandage is removed the day after surgery and replaced with an elastic face garment (as shown to you in the clinic). It is attached with velcro and most people find it easy to apply. There will be a slight discharge of blood stained liquid in the first 48 hours. Swelling & Bruising
Depending on the extent of your surgery there will be a variable amount of swelling and bruising. It is important to keep the head elevated as much as possible and to use ice packs for at least 30 minutes each hour for the first 2-3 days to reduce swelling. 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. As this occurs it sinks with gravity, so expect it to drift lower down to the neck. After about one week you may be reasonably presentable, however, most people feel they are not ready to return to work for two weeks. Some slight swelling may persist for 6-8 weeks. Skin Gathering
Because of the shorter incision of an S-Lift there may be some gathering behind the ear initially. The more the skin is elevated the more the gathering. It also tends to become swollen - do not be too concerned about this. If it worries you we can inject it with a steroid to flatten it down sooner. It always flattens out completely with time. This skin gathering can be avoided by doing a full face lift incision which extends in to the crease behind the ear and into the hair. The Incision Lines
It is important to keep incision lines clean. This will require washing them gently 3 times a day with cotton balls. Usually in the first 48 hours there is some discharge and crusting around the incision lines. You will find it easier if you do not wear any shirts which require being pulled over the head, button up shirts are better. It will be useful to dedicate some face washers and towels to the cleaning up procedures, as they will tend to get soiled. Pain
Surprisingly pain is usually not a significant feature of S-lift surgery. There is certainly some discomfort and some patients notice an element of tightness and numbness of the ears. This is a normal part of the healing process of a facelift and usually will return completely to normal although it will take some weeks. This feeling is often disturbing to some patients in the initial period and they feel they cannot lie on their ears at all. For the management of pain Panadol may be required. Nurofen may be added if required. It is very important to avoid Aspirin in the first week (it may increase bruising). 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. Although less common than in a full facelift, it needs to be considered, if it is minor then it may be simply expressed out through a suture line. However, occasionally larger haematomas occur, which may necessitate return to theatre for removal. Haematomas generally only occur in the first day or two after surgery. If a fluid accumulation occurs later on it is usually what is termed a seroma, rather than blood 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
There is always a possibility of infection following a surgical procedure and antibiotics are given to minimise the risk. Skin Loss
Patients with impaired circulation are not good candidates for a full face lift due to the risk of skin loss. It is especially rare in 'S-Lift', but increased in smokers, diabetics and people who have had facial radiation. If it was to occur it is dressed and allowed to heal. It may leave a more noticeable pale scar. Please inform Dr Oates if you are a smoker or diabetic. Scars
Any incision in the skin will always leave a scar. The secret of facelift surgery is to hide the scars where it is least noticeable and to achieve fine scars such that they are almost invisible. The scars in front of the ears can usually be hidden in the natural crease that occurs there. Some people do have increased propensity towards abnormal scarring. If you have any history of hypertrophic or keloid scarring please advise Dr. Oates prior to surgery. Certain dark skin races are also prone to increased risk of keloid scarring. However on rare occasions it can occur in people with no history of predisposition. If abnormal scarring is occurring then it may be possible to manage this with injection of steroids into the scar. It is important to remember that 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 we expect them to be flat and fine lines. Alteration of the Hairline
Dr Oates' preferred incision does not normally go above the ears thus minimising any alteration of the hairline. Facial hair growth on men will be pulled closer to the front of the ear. Numbness
Making incisions and elevating skin tends to lead to areas of numbness. This usually includes the ears and skin in front of them. Over a period of weeks this numbness will resolve. Asymmetry
After surgery the two sides of the face may appear slightly asymmetrical. This is because one side is completed before the second side is started. It is not unusual for one side to develop slightly more swelling than the other. Perhaps this is because of the way people sleep. It has no significant effect on the final outcome. People often notice that there is a slight lumpiness to the skin following surgery. This is due to little pockets of increased swelling under the skin. This is not of concern and is in fact expected in the first 6-8 weeks, gentle massage will help it to settle down more quickly as will the continued wearing of the face garment provided. 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 improvements and corrections can be made. However it is not reasonable to expect perfect asymmetry of the face when that was not in existence pre-operatively. Facial Weakness
With modern facial techniques, the deep tissue layers are addressed as well as the skin resulting in a more natural and longer lasting effect. 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 an extremely rare event for this nerve to be damaged but it certainly has been recorded. Usually the nerve recovers spontaneously, however, it is possible for some permanent facial weakness to remain if the facial nerve is damaged. How to proceed with your surgery Step 1
Your first step is an initial consultation with Dr Oates, you do not need a GP's referral for this consultation however we do recommend that you, or us, informs your GP. We also offer a complimentary consultation with our nursing staff. Step 2
If you have decided to proceed with an S-Lift and Dr Oates is in agreement, a booking for surgery and the pre-operative care will be scheduled. The usual waiting period is approximately three to four weeks. Complimentary Consultations You may wish to speak with one of our nursing staff prior to seeing Dr Oates. During this complimentary consultation, you are able to discuss both surgical and non-surgical options to treat your cosmetic concern(s).
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