Project Description

Facial Plastic Surgery

Facelift

Facelifts, also known as rhytidectomy surgery, are one of the many solutions men and women consider to combat the signs of ageing. This procedure will help you retain your youthful appearance and (literally) put your best face forward. My aim is to help patients look natural and refreshed.

The modern shift in facial aesthetics is to approach surgical rejuvenation of the whole face, contouring the areas to regain a natural more youthful and beautiful face. This can only be achieved by lifting the sagging tissue using the traditional face lift techniques in combination with replacing volume. A facelift that is performed with only skin tightening results in the feared wind swept face seen in celebrities in the past.

Combining facelift surgery with midface volume replacement yields dramatic yet natural-looking result. My goals of midface rejuvenation in conjunction with a facelift therefore  involves reestablishing malar volume and smoothing the transition between the eyelids and cheeks using your own fat which I call liquid gold (see structural fat grafting).

The results are therefore a continued youthful appearance that is maintained over many years, by highlighting the cheekbones and redefining the jawline, softening the hollows under the eyes and lifting the brows naturally by volumizing the brows and forehead, and opening the eyes without changing their shape which often resulted with previous surgical procedures.

I have recently  moved beyond a traditional 3D  face lift to a 4D approach  where I discuss  involving the continued treatment of the face lift patients with injectable filler materials and botulinum toxin for years after their surgical procedures. This “four-dimensional” method  achieves persistent, natural-appearing results that can be maintained successfully and dynamically over time.

Most patients will often also require “eyelid correction” and sculpting of the neck with neck liposuction in conjunction with facelift.

A facelift is indicated if you stand in front of the mirror and pull your skin upwards to improve your jowls and neckline. “Don’t we all catch ourselves doing this after a certain age?“

The most ideal patient however is someone who still has some elasticity in the skin and has looked after their face. If your skin is very damaged, I may suggest that I improve the quality of your skin with skin care or Fractionated CO2 laser resurfacing before the final facelift procedure.

In my opinion a youthful face has contours and a fresh glowing skin. Tightening of the sagging skin alone will never achieve a refreshed rejuvenated result. The trend is for patients to embark on facial surgery at a younger age to maintain a youthful appearance, rather than to wait for extensive sagging.

If you’re between the ages of mid 40’s to late 60’s and want to look fresh faced and camera ready, consider undergoing a facelift.

Past patients who’ve undergone a rhytidectomy procedure have reported a boost in self confidence. More often than not, after you’ve undergone a successful facelift you’ll be in a happier and more satisfied state of mind, which leads to overall well-being too.

Not only does this come from seeing a more youthful, relaxed looking reflection, but from a sense that you’ve achieved the impossible of reversing the hands of time.

“A smile is a natural facelift”

While complications are rare, the results of a surgery are not always predictable. This is because no two people have the same anatomy or the same healing abilities. It’s important to know of all the complications that can arise from undergoing a facelift. Dr Wilkinson will ensure that she makes you aware of everything you need to know during your consultations with her.

Some risks that you face when undergoing a rhytidectomy procedure are:

  • Haematoma(collection of blood under the skin that requires removal)
  • Infection
  • Poor wound healing
  • Temporary or permanent hair loss at the site of the scarring
  • An ‘over-pulled’ appearance
  • Nerve damage
  • Loss of facial expression

The Procedure

In order to evaluate your suitability for the procedure, and to make a professional and educated decision regarding your facelift, I will carefully consider your:

  • Age
  • Shape of the face
  • Skin condition

 

Together we will asses your facial features  in a mirror and with photographs taken during your consultation.

During my examination,  I will examine your face for loss of deeper soft tissue, skin excess/laxity and assess the tightness of the underlying muscles. Be frank discussing your expectations. I will describe the different options available and the risks and limitations of each.

It is important for  you to stop smoking well in advance of surgery if you are a smoker (smoking decreases blood flow to the skin and therefore affect the healing process). You will also be advised to avoid certain medications which can increase bleeding prior to surgery. Clinic staff will provide you with any additional pre-op instructions specific for your case. Note that enjoying a healthy eating and exercise regime before and after surgery will result in optimum results. To hide scars, it is advisable that you grow your hair before the procedure.

I encourage my patients to bring photographs from their past. My ultimate challenge is to restore your natural youthful face and not to change your facial features dramatically.

Post-consultation, you need to take into account the reality of the procedure, it’s cost, and the required recovery time.

Additionally, you’re encouraged to ask as many questions as you can and conduct your own research on the topic of rhytidectomy surgery before setting a date for the procedure.

For your rhytidectomy procedure, you’ll be admitted as a day patient at the Renaissance Surgical clinic.I will examine you in the ward and draw on your face  my markings of our planned surgery  and incisions as we have discussed.

The facelift is performed while you’re placed under a conscious sedation, which will make you feel drowsy and relaxed, however you’ll sleep through the entire operation and not be aware of the procedure. The advantage is however that you will wake up feeling refreshed without the side effects of general anaesthesia, though, I may use it to perform some face lifts. In all cases a certified female anaesthetist will be responsible for your wellbeing.

The facelift surgery usually takes between 2 and 5 hours and involves:

  • Incisions – Fine skin incisions are made to hide in the sideburn and extend down a natural crease, in front of the ear. From there, the incision continues underneath the earlobe to behind the ear, ending in the scalp area of the neck.The length of the scar will be determined by how much work your neck requires.  If I need to work on more of your neck, a small incision  is needed under the chin to tighten the neck muscles in the midline.

 

  • Draping and repositioning – Once I have elevated the skin, I am able to treat and elevate the underlying facial muscles. To achieve the best and a longer lasting result it is important to not only remove lax skin but to tighten the muscle layer known as the superficial musculo-aponeurotic system (SMAS). Many techniques have been described to improve the SMAS layer. The most extensive is to dissect under this muscle layer, however this technique is also associated with the highest risk of damage to the facial nerves. Double blind studies have over the past few years confirmed that the results of a SMAS plication has similar results with decreased complications. I therefore use a SMAS plication technique also called the S- Lift. This involves lifting the SMAS muscle layer and suturing the muscle to itself, creating a lift of the jowls and an attractive fullness in the cheek area. This is a very safe technique due to the fact that the facial nerves are not directly exposed. Once the underlying muscles have been secured in the correct position, the excess skin can be redraped.

 

If only the jowls need to be treated , I minimize the scar using a “short scar” technique or MACS Lift ( minimal access cranial suspension).

If your neck however requires more extensive lifting, I make an additional  incision under your chin, I am then able to trim or remove some fat in this area using liposuction and to plicate the neck muscles in the midline, to improve the contour of your neck.

  • Finishing touches – Excess skin is trimmed and then fat grafting  is used to achieve a youthful, natural looking face. I use a combination of stitches and metal clips to close the incisions.  A small drain is placed under the skin for between 1-2 days to remove any blood that collects under your skin. Your face is then lightly wrapped in bandages to promote minimal bruising and swelling.
Most people are admitted as day patients who are discharged to the postoperative care facilities for 1-4 nights.You will be placed under the care of our expert ward nurses who will use ice and light therapy to accelerate your healing process.

My staff are attentive and understand the support you will require, not only medically, but also psychologically. I therefore suggest most patients undergoing any facial rejuvenating surgery to spend a few nights in the after care centre. The drains and bandages are removed within the first 2 days and  you will  will be discharged with the head lightly wrapped in bandages.

For the first 5 days you can anticipate being swollen and uncomfortable, then there will be some discomfort and bruising for the next 2 weeks. At this point most patients are presentable and feel “brave” enough to visit friends and family. If you are traveling to Cape Town for your surgery, I suggest you allow yourself 3 weeks of recovery in the city.  While you should be fine within 3 weeks, there can be some subtle swelling up to 8 weeks after the procedure

You may have a small S-shaped scar around the ear or a full scar around the front of the ear extending to the scalp in the neck. The majority of scarring should fade to thin, white lines after 6 months to a year. Clever hairstyling can minimize the appearance of obvious scars during the first year.

Expect full recovery to take time. Complete healing of the sensation and deeper tissues can take up to 6 months. You should also expect a numbness of the skin and contour irregularities which can vary from day to day. Emotionally you can expect a bit of a “roller coaster” ride. This is normal and my staff and I are prepared to help you through those difficult days. Everyone goes through them, some just more than others.

My professional staff are known for their discretion and compassion and you can always count on their best service and care. More importantly, you don’t have to worry about not being able to recognise yourself by the time your bandages are removed. This is because I believe in enhancing one’s natural features.

I believe that I perform very natural facelifts and a patient will never leave my office looking “wind swept”. I always ask my patients if anyone commented on their surgery. If they mention that no one commented except that they looked like they “were in love” or just returned from a holiday, then I know I have succeeded in my goal.

Contact Dr Wilkinson today to book your facelift surgery consultation.

Testimonials
“This morning I was at the gym and a friend’s husband came to me while I was on the treadmill and said that I’m looking fabulous. And he knew nothing about my procedure! So thank you Nerina. I’m all dressed up with makeup and feel really good.”
L.O, Facelift
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