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Facelift Surgery

Time and gravity take their tolls on our facial beauty. Tissues lose their youthful tone and sag. Sun and the environment etch the lines of time into the surface of the face with wrinkles and lines. For some cultures these effects represent the earned years of wisdom and respect. For other cultures the aging process is a loss of youth and possible competitive edge. More and more people, both men and women, want to look as young as they feel.

Facelifts are very individualised procedures. In your initial consultation, Dr Fok will evaluate your face, including the skin and underlying bones, and discuss your goals for the surgery. Your health conditions could cause problems during or after surgery such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. We need to know your medical history, other health conditions, and if you use any form of nicotine or tobacco products. Bring a list of any medicines you take, especially aspirin or other drugs that affect clotting.

During this consultation various types of anaesthesia for facelift surgery will be discussed. The type of anaesthesia used will depend on the problem being treated and other factors. Do not hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results.

A facelift can improve deep cheek folds, jowls, and tightens loose skin around the neck that come with age. It can be done alone, or in combination with other procedures such as a forehead lift (browlift), eyelid surgery (blepharoplasty), or nose reshaping (rhinoplasty). If you are considering a facelift, this page will give you a basic understanding of the procedure. It cannot answer all of your questions and does not replace the in office consultation. During such an examination and evaluation, we can focus on your specific problems and concerns. Each operation must be individualized to that patient's needs.

Who is suitable for a facelift?

The best person for a facelift would have a face and neck skin that has begun to sag, but still has some elasticity, well defined and strong bone structure. Most patients who ask for this procedure are in their forties to sixties. Dr Fok has also done facelifts successfully for patients in their sixties and seventies.

What does the surgery involves? 

Dr Fok performs most of his facelifts surgery in his office based ambulatory surgery centre as an outpatient procedure under local anesthesia combined with twilight sedation. You will be drowsy but relaxed throughout the surgery and your face insensitive to pain.

The surgery usually takes 3 hours or longer if you have more than one procedure done at the same time. Typically the incisions starts above the hairline at the temples, extend in a natural line just at the cartilage in front of the ear and continue behind the earlobe to the lower scalp. Sometimes a small incision is made under the chin if the neck needs extra work. Generally, the fat and muscle under the skin is separated and lifted. The extra skin and sometimes fat are removed and tightened.

How is the recovery like and how long before I look presentable?

You should be up and about the next day after surgery. Dr Fok will review you in his clinic, nurses will check on your dressings. With an improved method used by Dr Fok, there are no head bandages or drains to be removed. The compression bandage is only put on while you are recovering from the sedation in our clinic immediately after surgery.

Patients are generally comfortable during the recovery phase with the usual pain medication prescribed by Dr Fok. With the use of Tissel glue, most of our patients experience minimal post surgery swelling and bruising. Many patients are surprised themselves, with minimal camouflage they are back to work in 7-10 days time.

Gradually resume your normal activities and avoid strenuous activities for 2 weeks and. Avoid alcohol, steam baths and saunas for 2-3 months.

Will there be visible scars?

The incision usually starts above the hairline at the temples and extends in a natural line just at the cartilage in front of the ears and continues behind the earlobes to the lower scalp. Most stitches are removed after 5 days, those behind the ears and at the scalp take longer to heal; they are removed in the next 3-5 days time.

Individual healing ability is the main factor contributing to the final outcome of the scars. Other factors include infection and smoking that delays the healing of the skin and may later affect the appearance of the scars.

Antibiotics and some other medication to help in skin healing are prescribed and Dr Fok and his team take care in handling the skin and wound during the surgery and healing phase. Smokers have to stop smoking at least 2 weeks before and after the surgery to ensure proper healing of the wounds.

What are the risks involved?

When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. However, individuals vary greatly in their anatomy, physical reactions and healing abilities, hence the outcome is never completely predictable.

Complications that can happen include hematoma, temporary injury to the nerves that control facial muscles, infection and reactions to the anesthesia. The risk of permanent nerve injury is very small, less than 1%. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following your surgeon's advice before and after surgery.