As seen in MAIL ON SUNDAY'S YOU MAGAZINE
WATCH Karen Hogan's transforming surgical journey below...
As people age, the effects of gravity, exposure to the sun and the stresses of daily life begin to take their toll on the face. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds, loose skin and fat deposits appear around the neck.
A face-lift is a surgical procedure performed to improve the most visible
signs of the ageing process, by eliminating excess fat, tightening the
muscles beneath the skin of the face and neck, and remove any sagging
skin. Many times this procedure is performed in conjunction with eyelid, forehead or other surgery.
A well-performed face lift should revitalise the face without distorting or changing ones facial features. A facelift can make you look younger and fresher, and it may enhance your self-confidence in the process. However it can't, and shouldn't, give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them at your consultation.
The Face Lift FAQ's
Am I suitable for a face lift?
The best candidate for a face lift has early signs of sagging on the face and neck with some elasticity. There is no need to wait beyond this time before opting for a face lift, as irreversible changes have already been made.
This treatment is mostly sought after by those who are aged over 40, however, the procedure is increasingly being carried out on younger patients, who prefer to maintain their youthful appearance rather than going through a period of looking ‘old and tired’.
It is public knowledge that celebrities will choose a face lift to delay the effects of ageing, although the vast majority of patients are those normal people who take pride in their appearance and feel younger than they look.
It is important to remember that, although the treatment will remove some signs of ageing, it cannot erase permanent creases, particularly around the lips and mouth – fillers and chemical peels may be better suited for this. A face lift just “sets the clock back”; it does not stop it running.
During the consultation, Mr.Karidis will ask you about your general medical history, to determine any medical conditions that may cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or a tendency to form excessive scars.
If you are a smoker you will be asked to stop smoking well in advance of surgery as well as for a period after the operation (generally 4 weeks before and 4 weeks after). Smoking seriously constricts blood vessels, decreasing blood flow to a given area, which will result in poor healing. Aspirin and other medications should also be avoided as they can cause an increase in bleeding, however, this will also be discussed during the consultation.
Are there different types of face lifts?
The classical (skin only) face lift has undergone several modifications over the years to improve the overall results, and a longer lasting effect. These modifications not only lift the skin, but now also address the underlying structures (i.e. muscles or SMAS), which were equally subjected to the effects of the ageing process.
The SMAS face lift is one that is favoured by many competent surgeons, although there are now many variations of the procedure. These are the extended SMAS lift, Composite face lift and Sub – periosteal face lift, which can be tailored to suit individual needs.
More recently there have been newer ‘mini face lift’ techniques that have been popularised to help minimise scars and generally shorten recovery times. These mini face lift treatments include MACS lift, S-lift and thread lifts. However, they have limited spectrum of facial improvement and don’t tend to last as long as the classic face lift. Of course, it’s a great deal for the surgeon – lots of repeat business – but not such a great deal for the patient, because if you keep pulling on the skin, before long your face will look over stretched, giving you that “face lift look.”
Generally speaking, Mr.Karidis feels that ‘less’ will always be ‘less’, and the effectiveness, and longevity is always compromised with these minimal techniques. mini face lift techniques or surgery generally gives you ‘mini’ results.
If you have decided to have a face lift surgery to address any ageing aspects of your face, then you should deter from looking at the immediate short term (quick recovery and minimal swelling) because 3 or 6 months later, you will more than likely be disappointed with your decision to ‘cut corners’. Unfortunately, a face lift is like anything else in life, if you want more out of it then you have to put more into it. Our advice is to be patient with the recovery period – to look your best over the long haul it is better to have a face lift less often and more thoroughly.
How long does a face lift last?
It is impossible to provide a straight answer for this question, as everyone has different skin quality and texture. The quality of your skin tissues will help to maintain the results of a face lift, so if a patient has a good amount of elasticity then the face lift will tend to last much longer than a patient who has lost a lot of elasticity. If you think of it like a rubber band – a rubber band will become brittle and less elastic. Pulling on this excessively will result in the band snapping, where as a fresher rubber band has the ability to stretch and hold much better than one that has been weathered over time. Another way you can look at the lasting effects of a face lift is to imagine you have an identical twin. If you were to have a face lift and your twin sister or brother does not, in ten years time you will look better than your twin. So in that sense the effects and benefits of the facial surgery will be permanent.
Patients will occasionally start to panic 4-5 months after a face lift surgery because they notice slight laxity or loosening on their face and neck. In the first few months after the initial face lift surgery, skin loosening is normal – it’s just the natural settling process that occurs and contrasts with the initial tightening and swelling from the first few days after surgery. At this stage there is no need to panic, it does not mean that your face will completely drop again, it just means that your facial muscles and skin are adjusting to the new contours of the face lift.
It is important to remember that we cannot stop the clock altogether and therefore your face will continue to age with time. Many patients will just have one face lift, while others may desire further surgery seven to 15 years later.
What does the face lift procedure involve?
Generally speaking, the incision used for both men and women is the same. The only thing that differs is the incision on men starts slighting higher in the temple area (hidden within the hair at this point) then courses down in front of the ear, round the earlobe and up behind the ear before curving back into the hairline of the neck. However, sometimes it may be necessary to add an incision in under the chin.
Mr Karidis has modified his face lift technique over the years to minimise the extent of scarring, but at the same time not compromise the anti ageing effects and longevity of the face lift surgery. He has developed and adopted only those techniques to deliver a highly predictable and above all, natural result.
The skin is then lifted forwards onto the cheeks and down as far as the jawline and into the neck. The underlying muscles are then lifted accordingly to ensure a longer lasting effect. Having repositioned the deep tissues, any leaking blood vessels are then sealed using cautery. Loose skin is then expanded and elevated upwards and any overlapping or excess skin is trimmed. The wound is then closed entirely with dissolving sutures. On completion of the face lift procedure, a bandage dressing is then gently applied around the face in order to apply light pressure over the wound area.
What type of anaesthesia is used for a face lift and how long does the surgery take?
Mr. Karidis prefers to perform face lifts with a full general anaesthetic, however, this can also be performed with a local anaesthetic. This may also depend on whether you will be having extra work done to the eyes or brow area. Generally, the longer the surgery the better it is for the patient to have a general anaesthetic, so as to avoid feeling any discomfort from lying still for a long period of time under local anaesthetic.
Surgery for a face lift can take between 2-3 hours, although this takes longer when combined with additional surgery i.e. eyelid surgery.
What happens after the face lift surgery?
It is important to understand that the period following a face lift can be quite daunting.
The bandages are fastened tight due to the muscle tightening that will take place at the time of the face lift procedure. Once these are removed, your face will still feel tight and will continue to do so over the following first few days, particularly as the swelling starts to set in place. As a result, you may feel that you are unable to open and close your mouth properly.
When you look in the mirror, you will be shocked that you don’t look any fresher than before. During this time, many patients actually hate both themselves and their surgeon for having done this, however, this is quite normal, and this will settle within the following next 2-3 weeks.
Once the bandages are removed, your hair will be washed carefully and then you may return home.
Over the next few days your hair should be washed daily with a gentle shampoo, and great care should be taken when doing this. After 6-7 days afterwards, you will return to the surgery and your progress will be assessed.
What kind of after effects should I expect?
As mentioned previously, following a face lift surgery you will experience swelling, lumpiness and bruising over the face, which will last up to 3 weeks. This will reduce and a much lesser version will remain for a somewhat longer period. Swelling may produce some temporary lag in the normal function of facial muscles, however, this will gradually subside without permanent change.
You may experience a loss of feeling and tension in the neck and cheek areas. This is a result of the small sensory nerve fibres in the skin being separated during the face lift surgery – feeling will usually return to normal within a period of 9-12 months.
What are the scars like?
A scar will obviously form at the incision sites. This is always red and slightly lumpy in the first few months following a face lift. Of course light makeup applied over the scars in the early phase will help hide them. One must remember of course, it is always impossible to ultimately predict how any individual's scar will appear. However, sometimes behind the ears, and rarely in front of them, scars of certain skin types can stretch. These skin types cannot be identified prior to surgery. Often, these can easily be hidden by longer hairstyles but may become visible if the hair is cut short or lifted. Very occasionally a small bald strip can develop adjacent to the scar that is situated above the ear in the temple area.
Although as mentioned scars are unpredictable, the vast majority of patients operated by Mr. Karidis do not experience problems with their scars. As a result of careful planning and meticulous technique, Mr. Karidis aim is to preserve your ability and right to be able to put your hair up comfortably without worrying about your scars in front or behind your ears being visible.
Is a face lift painful?
As a result of the bandages used, you will experience a tight sensation around your face. This will be present more so in the first 10 days as a result of the initial swelling which makes the face feel tighter. However, it is safe to say that the majority of patients experience a surprisingly small amount of actual pain following a face lift. In fact most patients experience a numb sensation once the bandages are removed. This of course improves with time.
What could go wrong with a face lift?
All surgery carries some uncertainty and risk. When a face lift is performed by a qualified Plastic Surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. Conditions such as high blood pressure, bleeding disorders and smoking increase the chances of complications and therefore will be discussed in greater detail at the consultation.
Complications that can occur with a face lift include a haematoma (a collection of blood under the skin that must be drained by the surgeon), injury to the nerves that control facial muscles (usually temporary and less than 1% chance), infection (less than 1%), delayed wound healing, skin lumpiness, necrosis (skin loss), occasional hair loss in the temple region along the scar or distortion (usually temporary).
Risks such as leg and lung blood clots are rare. Early mobilisation by moving around as soon after the surgery as possible reduces this considerably. Mr. Karidis regularly deploys anti-clotting measures such as special stockings (TEDS) and compression devices (Flowtron) during surgery to minimise this.
You can reduce your risks by closely following Mr. Karidis's advice both before and after surgery.
How many face lifts does Mr.Karidis perform?
In accordance with the National Healthcare commission guidelines, according to the last five years of annual audit figures submitted to the Hospital of St. John and St. Elizabeth in London, Mr. Karidis performed on average 120 face lift procedures per year. In the last 10 years he has performed over 900 face lift procedures.
How long before I can get back to normal?
You should be up and about in a day or two, but plan on taking it easy for the first week after a face lift surgery. Be especially gentle with your face and hair, since your skin may be both tender and numb, and may not respond normally at first. Avoid strenuous activity, including sex, and heavy housework, for at least two weeks. Mild stretching and walking are fine. Above all, get plenty of rest and allow your body to spend its energy on healing.
Remember, at the beginning your face will look and feel rather strange. Your features will be distorted from the swelling, and your facial movements may be slightly stiff and you'll probably be self-conscious about your scars and bruising. It's not surprising therefore that most patients are disappointed and depressed in the first couple of weeks. However you must try to stay positive and understand that things WILL get better! The face lift will be worth it!!
From about two weeks after the face lift you can probably get out and about without scaring anybody, however you won't fool anyone either about what you have had done. From the third and fourth week, things get decidedly better, with most of the signs of surgery, i.e. bruising and swelling mostly gone. You can therefore start to get around without most people knowing that you've had some surgery. From this point onwards, you'll look and feel much better. You must remember however that for all the swelling to entirely disappear and for you to look entirely 100% normal will take up to six or even nine months. For all intents and purposes however most patients are back to work from about the third week after surgery. Every week that goes by will be slightly better. If you need it, camouflage makeup can mask any residual bruising that remains. However depending on everyone’s individual sensitivities some people might feel more comfortable about returning to work after 4 or even five weeks. Remember we are all-different and heal differently. Have some flexibility within your anticipated return to work schedule.
The chances are excellent that you'll be happy with your face lift, especially if you realise that the results will not be immediately apparent. In the properly selected individual it is very likely to boost ones self-confidence and self-image.
The results of any properly carried out face lift should be lasting but remember the procedure cannot halt the ageing process. The clock can be turned back but you cannot stop it ticking. However, it is reasonable to say that the reversal in ageing made available to the average face lift patient is undoubtedly successful enough to be recommended as a solution to many of the ageing signs that some individuals find objectionable.
MAIL ON SUNDAY'S YOU MAGAZINE
"Would a Facelift Bring Back the Real Me?"