Too many men and women, facial ageing is a very real concern. There are several reasons for someone desiring corrective facial surgery and thus there are many factors a plastic surgeon must take into consideration when evaluating a patient for surgery. These can be discussed in a consultation with the doctor, but the following can answer a few basic questions generally sought after by someone considering this type of surgery. In plastic surgery terms, the face is considered to be divided into 3 segments:
The upper face.
The mid face.
The lower face and neck.
The upper face consists of forehead, eyebrow and eyelid area. Drooping brows and deep furrows in the forehead area can be corrected by an incision behind the hairline followed by elevation of the skin, which is then pulled tight and excess trimmed away. This tightens the forehead and widens the eye-opening, muscles can be freed to release wrinkles and frown lines. Only a fine scar is left behind the hairline.
The mid face involves eyelids, nose and cheeks, down to the jaw line. The lax skin and muscle in this area produce deep wrinkles and folds running down from the nose and jowl formation. An incision extends from the temple downwards over the small cartilage bump in front of the ear to the earlobe. The skin is then freed and gently pulled back to give a youthful appearance. A SMAS procedure can be performed which combines tightening of sagging facial muscles with the overlying skin which gives a more natural, longer lasting appearance. The scars are again hidden in the temple hair around the ear.
The lower face and neck ageing problems include formation of jowls – “turkey neck”, double chins and fatty deposits in the neck area. The incision begins around the earlobe and extends behind the ear and in the hairline without being evident even with the hair pulled back. An excision below the chin line with subsequent tightening of the vertical neck muscle is usually performed at the same time. Liposuction to the neck and jowls is possible to remove the fatty deposits. Post-operative recovery is usually relatively pain-free. A firm bandage is applied for at least five days after surgery to prevent swelling and occasionally a small drainage tube will be insitu for 24 hours. Pain relief and after-care is provided by the nursing staff at the clinic. The procedure can be performed here in the clinic under twilight sedation with local anaesthesia and the patient is able to go home with a relative or other responsible carer.
S-LIFT – MELOPLASTY
The S-Lift Meloplasty is a mini-facelift that provides a partial lift to your neck and the lower third of your face. Compared to a traditional facelift, it is a quicker operation with fewer complications and a much faster recovery. The S-Lift is particularly well suited for middle-aged and younger patients and can make a dramatic change in the way you look by tightening sagging muscles and skin of the cheeks, chin and neck. An S-Lift is performed using local anaesthesia and sedation in the day clinic and may be combined with facial and neck liposuction and possibly facial implants. Results from your S-Lift can be further enhanced with subsequent laser resurfacing to smooth wrinkles and provide greater skin contraction.
The best candidates for an S-Lift are those patients who:-
Range between 40 – 60 years old
Enjoy relatively good health
Have mild to moderate facial and/or neck laxity
Have realistic expectations
A consultation with your Doctor will inform you as to your suitability for this procedure or whether you may need a more comprehensive face lift. The incision on the face is in the form of a narrow “S” shape section from the area forward and above the ear in the hairline and extends down along the curved cartilage of the ear itself (the tragus) and around under the earlobe for perhaps a centimeter or two behind the ear. The underlying muscle and tissues are repositioned and excess fat and skin removed. The procedure can take less than 2 hours.
The main benefits of an S-Lift include:-
Less recovery time
A natural look
Following surgery, the normal ageing process resumes. Your lifestyle choices, bone structure, skin type, sun exposure and heredity all play a part in determining how many years can be removed by an S-Lift and for how long. In general, younger patients enjoy longer-lasting results. The post-operative procedure is much like any other face-lift surgery but with less down time and patients love the fact that they don’t look like they have had surgery but just look much fresher and great for their age.
Before & After
The eyes are the focal point of the face and are generally the first to show signs of ageing because they contribute substantially to your overall facial appearance. When the eyes become wrinkled, puffy and droopy the eyebrows sag, and the entire face tends to have a perpetually tired or sad expression. Even when you are feeling well and rested and revitalised, constant comments about your appearance can become disturbing. The two main problems which confront us with the eyes are excessive skin in the upper and lower eyelids and secondly the accumulation of fat which causes the puffy appearance. This tendency is inherited and may appear very early in life before the ageing process becomes obvious. With eyelid surgery, the removal of the excess skin and fat pads give the rested, youthful appearance, but does very little to change the fine lines and crow’s feet surrounding the eyes. The surgical incisions follow the natural contour lines of the eyes in the upper eyelids. The incisions are made in the fold of the lids and in the lower eyelids the incisions are made in the natural creases directly below the eyelash lines. In certain cases where the skin excess is not the overriding problem and puffiness is, the incision is made inside the lower lid itself. This is known as a transconjunctival incision and is for the removal of fat pads only. This technique leaves no visible scaring. Care must be taken with amount of fat removed to prevent hollowing of the eyes. Blepharoplastyor eyelid reduction may be done as an independent procedure, or it may be done in conjunction with other facial rejuvenating surgery. Often a brow lift is done to compliment this procedure to improve sagging of the eyebrows. Laser resurfacing of the skin on the lower eyelids can also be performed to reduce the appearance of fine lines. The procedure is performed here at our clinic under local anesthetic with or without sedation as a day case, or in hospital.
These can include:
Brow contouring implants
The above implants can all be done in conjunction with face-lift surgery or as separate procedures. These implants can change facial contouring dramatically or give minimal change, but may be a necessary addition to the surgical operation to give a patient the desired result. The implants consist of biological material, which is acceptable to the patient’s tissue and will blend in with the bony structures of the face, giving a natural appearance.
OTOPLASTY (BAT EAR)
Prominent or protruding ears can be a source of embarrassment and mental anguish for many people, especially children. A surgical procedure called Otoplasty or “pinning back” of the ears can help physically as well as psychologically. The operation is designed to change the shape and contour of the ears. It may be performed on anyone over the age of 5 or 6 years, at which the growth is almost complete. The procedure can be performed under either general anaesthetic in hospital, or local anaesthetic with sedation in the clinic. There are a variety of different methods for “pinning” the ears back. They include suturing the cartilage back, removing excess cartilage or “scoring” the cartilage. All these will be discussed at length during the consultation with the surgeon. Scarring is minimal and is at the back of the ear so is almost impossible to detect. Post-operatively, a firm bandage is applied around the head and taped in place. And this remains insitu for 5 days. The sutures are dissolving and pain connected to the surgery is minimal to moderate and controlled with oral medication. Bruising and swelling may last up to 2 weeks and can be disguised with a headband if necessary.