The facelift is a surgery that “lifts” areas of the face or neck. Depending on the areas involved, a frontal, temporal, midface, face or neck lift is identified and each area can be treated individually or together with others.
In mature age or following significant weight loss, many people complain about the progressive decline in the definition of the oval of the face. Due to gravity and reduction in tone, the skin tends to go downwards, accentuating the nasolabial furrows and the so-called marionette lines and creating a discontinuity of the mandibular line between the chin region and that of the mandibular extension. At the same time, skin folds are formed at the level of the neck produced by the collapse of the mimic muscles.
The ideal candidate for a facelift is a patient with a clear reduction in skin tone and more superficial facial muscles. This procedure may be more or less moderate depending on the needs of the patient, provided that the naturalness of the result is often inversely proportional to the intensity of rejuvenation.
Technically, incisions are made in possibly hidden areas which obviously depend on the area concerned. In the case of face and neck lift, an incision is made at the front or all around the ears and sometimes below the chin, in the lower palpebral margin to lift the midface area and in the scalp for the frontal and temporal area. Through these incisions, the surgeon performs a cutaneous or muscular disconnection by relocating the structures in the most suitable position and concluding the work by removing the excess skin.
We often learn about alleged innovations in this area: we read about the soft lift, “lunch hour” facelift, endoscopic facelift, thread facelift, vertical facelift; this heterogeneous terminology describes a procedure that in its implementation, can involve different technical resolutions with different levels of surgical engagement and result. Which strategy to choose is rather simple: the outcome of a facelift is almost always proportional to the level of invasiveness of the technique but minor techniques should not be taken into consideration for this reason. A moderate procedure produces a more natural result, it lasts for a shorter time but it enables patients to go out in public quicker. More invasive techniques have more stable results over time, involving a longer post-operative recovery.
The complications are rather rare and are typical of all surgery: bad scarring, bruising, possible infections or nerve damage.
The duration of the procedure, the hospitalisation and the type of anaesthesia depend on the extent of the procedure planned and the areas involved. It can be from half an hour under local anaesthesia in an outpatient procedure for the application of subcutaneous wires to four hours under general anaesthesia with twenty-four hours hospitalisation for a complete facelift.
With regard to this topic, patients often ask what age facelift should be done, but it is clear how difficult it is to answer this question. The “need” to have a facelift is born and matures in a patient who is no longer in harmony with his/her physical appearance and in particular with his/her own face. What is certain is that resorting to aggressive surgery in later life is becoming more rare, as patients prefer two or three more modest procedures along their lives.