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«FACIAL PLASTIC SURGERY Mini facelift Mr Jonathan Hayter FRCS, FDSRCS Consultant Maxillofacial Surgeon Spire Leicester Hospital Gartree Road Oadby ...»

FACIAL PLASTIC SURGERY

Mini facelift

Mr Jonathan Hayter FRCS, FDSRCS

Consultant Maxillofacial Surgeon

Spire Leicester Hospital

Gartree Road

Oadby

Leicester LE2 2FF

Nuffield Health BMI Meriden Hospital

Leicester Hospital University Hospital Site

Scraptoft Lane Clifford Bridge Road

Leicester LE5 1HY Coventry CV2 2LQ

Telephone: 0116 265 3037 / 3687

Email: kim.ward@spirehealthcare.com Website: www.jonathanhayter.co.uk Mr Jonathan Hayter FRCS, FDSRCS Consultant Maxillofacial Surgeon Spire Leicester Hospital Secretary: Kim Ward Gartree Road Tel: 0116 265 3037 / 3687 Oadby email: kim.ward@spirehealthcare.com Leicester LE2 2FF Mini facelift information As we get older the skin and soft tissues of our face lose their elasticity and droop. On the face, this may cause the lines around the mouth to deepen, the jaw-line to sag and the neck skin to develop folds. The aim of a facelift is to reposition the skin and underlying tissues to restore a more youthful appearance.

What causes these age changes?

It is a natural part of ageing for skin to become less elastic and the muscles underneath the skin to slacken. Weight changes, sun exposure and regular smoking may accelerate these age-related effects.

What facial tissues can be affected?

These changes may affect most parts of the face and neck to different extents. For instance the brows may lower, the eyelids bulge or develop skin folds, jowls can soften the jaw line and wrinkles develop under the chin and around the neck Which areas can a facelift help?

A facelift mainly smoothes out the skin of the cheeks, enhances the cheekbone areas, reduces the lines around the mouth and reduces the jowls – improving the jaw-line, and also improves the upper part of the neck.

How is a mini facelift different from a full facelift?

This approach is used where the main concern is about the facial lines around the mouth, the jowls and the jaw-line and the when the more widespread changes that a full facelift can produce are not required.

This enhanced mini facelift is particularly helpful for early to moderate age changes. There is both lifting of the deeper tissues underlying the jowls as well as tightening and repositioning of the facial skin. This works well for patients who have sagging skin in the lower face, with lines around the mouth and softening of the jaw line.

Mini facelift – information sheet/3 The advantages of the mini facelift include the option of using local anaesthetic with sedation, instead of general anaesthetic, smaller incisions and less swelling and bruising.

Recovery is rapid with less down time; typically return to work is within 2 to 3 weeks.

What about other areas of the face?

This enhanced mini facelift can easily be combined with additional procedures to help improve other areas of the face. For instance, eyelid surgery can reduce the folds of skin of the upper eyelids and reduce the bags underneath the eyes. In addition, an upper neck lift operation can further enhance the appearance of your neck.

In this way, treatment can be tailored to provide the answer to your particular concerns.

How do you find out if a mini facelift is suitable?

One of the most important parts of facial cosmetic surgery is the consultation. The initial consultation visit has several purposes.

Firstly, it will help establish what your concerns are, what you hope to gain from a mini facelift and whether this is the correct treatment for you. Sometimes, although you may be interested in a mini facelift, the result would not address all of your concerns and a normal facelift would be a better option. Your concerns and aims will be discussed in detail.

Secondly, it allows discussion of your medical details and a full facial assessment to help ensure that an operation is the correct treatment, and allow treatment planning.

Photographs for medical records may be taken at this stage.

Finally, it allows you to be informed about all treatment possibilities and answer any questions arising at this stage.

What if you want to go ahead with a mini facelift?

The information discussed at the initial consultation needs to be carefully considered. If you wish to proceed, a second consultation is essential to make sure that this is the right treatment plan and to answer any remaining questions. If no photographs were taken at the initial consultation, they will be obtained at this consultation for medical records. Further visits may be required to clarify any details and answer any further questions.

What preparations are required before the operation?

If you intend to lose weight this should be done before the operation. Smoking can interfere with the healing process and smokers should preferably stop smoking months before the operation, this will be discussed in detail. Certain medicines, such as aspirin or anticoagulants, may interfere with healing. It may be necessary to adjust these medications or change the timing of the operation; this would be fully discussed in the preoperative visits.

Mini facelift – information sheet/4

What happens during a mini facelift?

The operation is often performed under general anaesthesia or can be carried out with local anaesthetic and sedation for patients who prefer to avoid a general anaesthetic.





Incisions are made around the ear skin folds and in the hairline close to the ear. The cheek skin in front of the ear is loosened. In this enhanced mini facelift the underlying muscle layer is raised and tightened. Next the folds of skin are smoothed out and any excess, around the ears, removed. Stitches are then placed in the incision lines.

What is it like immediately after the operation?

It is likely that there will be some facial discomfort that can be treated with painkillers.

There will be dressing bandages around the face for the first day and there will be some bruising and swelling.

How do you reduce the swelling and bruising?

Some swelling and bruising will always occur after a mini facelift operation.

There will be a drain placed on either side to prevent blood clot or fluid collecting. The dressing bandages limit swelling and these would normally be changed after one day. It is important to sleep with the head and shoulders raised on pillows to help limit further swelling and bruising. Pillows should definitely be used for the first two weeks and it is a good idea to continue this for the first two months.

How long will the swelling and bruising last?

Most swelling and bruising will resolve after two weeks. All swelling, particularly facial puffiness when you wake up, may take two to three months to settle. If you are prone to bruising then fading bruises may take three weeks to completely resolve.

When do you return to work?

Stitches around the ear and hairline will usually be removed after one week. It takes about two weeks to get over the operation, when most of the bruising and swelling will have subsided.

Therefore, it is sensible to allow at least two weeks for the main post-operative effects to settle down before returning to work.

Mini facelift – information sheet/5 Are there any side effects following a mini facelift?

All operations carry some risk of side effect.

Branches of the nerve that move the facial muscles can be bruised and this may cause some weakness or lopsidedness in an area, perhaps around an eye or towards one side of the mouth. This is uncommon and if this occurs, it tends to be temporary and normal facial movements are usually restored within the first few weeks. Rarely, a small area of weakness lasts longer and may even be permanent. Although I haven’t seen this with a mini facelift it remains a possibility.

Are there any other side effects?

The scars are discreet and hidden within the hairline or in skin creases and fade over the first six months. The incisions usually heal well but healing is sometimes delayed; this is more likely in smokers and patients who suffer from diabetes. Occasionally, a small area of scar tissue may become lumpy or stretched – this may require local treatment.

The sensation of the skin raised by the mini facelift will be reduced initially. Sensation returns to normal gradually over the first six months. There may be feeling of lumpiness in the cheeks and neck where the deeper layers have been tightened. This again can take six months to remodel and smooth out.

No face is perfectly symmetrical and minor differences between the two sides may persist after a facelift. These differences are usually too small to be noticed.

How do I care for my face after a mini facelift?

In the early days the face should be washed gently. Hair washing can start about three or four days after the operation. Moisturising cream can be gently applied about two weeks after the operation and this should be continued as part of normal skin care.

It is particularly important to avoid sun exposure in the first six months and a high factor sun cream and sun hat are essential on sunny days. This is good general advice to maintain the health of your skin.

Finally, it is important to avoid smoking for six weeks during the healing period. Again, this is good general advice to maintain healthy skin.

What happens in the years after a mini facelift?

A mini facelift helps restore a more youthful appearance and this benefit will persist.

However, the normal ageing process continues and features of ageing will return gradually with time.

Although previous surgery can make future operations a little more difficult, it is usually possible to repeat a mini or full facelift procedure in the future, if this appears appropriate.

How do you make an appointment to discuss facial cosmetic surgery?

A doctor’s letter is helpful, although not essential, for an initial appointment. Please contact Kim Ward to arrange an appointment either by:

–  –  –

Before your operation Pre-operative consultations.

You will have had at least two consultations prior to a decision to proceed with a minifacelift. If you have any outstanding queries or would just like to go over the ground once again, book a further appointment. It is much better to clarify you understanding of the operation well in advance of the procedure. In addition, if your operation is booked for several months ahead, a pre-operative appointment will be arranged shortly before your operation to refresh your memory of the treatment and recovery periods and to answer any further questions that may have cropped up.

There is only one outpatient consultation charge and that covers all subsequent appointments.

Smoking For smokers, you will have had a discussion about the adverse affects of smoking on healing. Any smoking history can have an effect on healing, the more you have smoked and the more recently you have smoked posing the biggest problem. You will have agreed a no-smoking period before your operation and it is important that this is continued after your operation for at least six weeks during the initial healing period. Ideally, you will be able to stop smoking all together.

Weight change If you are planning any weight change, for most people this would be weight loss, this should be completed before your operation. Notable weight loss after a mini-facelift may lead to slackening of the facial tissues, detracting from the effect of the operation.

Recuperation arrangements.

You need to allow adequate time for recuperation before resuming normal work and social activities. Don’t underestimate the effect that an operation will have on your energy levels, most people will take at least two weeks to get back to normal after a mini-facelift. In addition, normal bruising and swelling may take at least two weeks to diminish so that you don’t look as if you’ve had an operation. Because of this, you should allow at least two weeks before going back to work and socializing.

After your operation Bruising and swelling Bruising and swelling is normal after an operation and, following a mini-facelift, will typically last for at least two weeks. If you bruise easily there may still be some residual bruising present beyond two weeks but this should be faint and usually easily concealed with clothing, such as a neck scarf, or with make up.

Other effects Your face will feel tight with numbness over the cheeks and may feel lumpy where the deeper layers have been tightened. These are effects that you feel rather than others can see.

The tightness relaxes over the first month or two as the soft tissues adapt. The numbness gradually resolves as the nerve endings grow back. Most people get full return of sensation but this can take six to twelve months. Sometimes reduced sensation in the earlobes persists. The lumpy feeling gradually diminishes as the soft tissues remodel, again this can take six to twelve months.

Bathing You can shower and wash your hair following your operation but dry quickly and reapply the ointment that you have been given to any stitch lines over the first couple of weeks.

Prolonged soaking in a bath should be avoided for the first two weeks to allow the incisions to heal.

Exercise Light exercise can be recommenced at two weeks, as healing progresses and you get your energy levels back. Heavy exercise and gym workouts should be avoided for the first month.

Skin care Applying moisturizing cream to the central face, around the forehead, nose and mouth can be started immediately. Massage and moisturizing cream to the cheeks and neck where the operation has taken place should be avoided for three weeks until healing has progressed. Applying hair colour should be avoided for at least one month or longer if there is slow healing of the incisions within the hairline.

Maintenance

Your mini-facelift will improve the appearance of your face and neck. However, if you have notable facial expression lines across your forehead, such as frown lines, these require Botox to soften the muscle action. Also, if you have lines across your lips or would like your lips to have a fuller or better defined shape then dermal fillers are required to add volume to these areas. In order to make the most of your new appearance both Botox and tissue filler



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