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The Facelift Procedure

Written by: Dr Kristie McNealy                                      Reviewed 28 June 2010

A facelift may be performed with either a general anaesthetic or a local anaesthetic with intravenous sedation. The procedure usually takes between three to four hours.

The incisions are made along the lines previously marked out. There are three layers of tissue involved; skin, fat and subcutaneous tissue, and the deeper muscles or SMAS layer.

The skin is gradually lifted and peeled off the deeper tissues in front of the ears, the temple, behind the ears and over the side of the head above the hairline, while carefully preserving the important nerves and blood vessels.

Bleeding is controlled by sealing the blood vessels with diathermy.

Usually the surgeon will decide to tighten the deeper tissues (SMAS) overlying the facial muscles to produce a more defined jawline.

Excess fat beneath the chin or jawline is either suctioned or excised. The superficial muscles of the neck may be tightened by a variety of techniques to define the angle of the jaw and neck.

The loose skin is then carefully redraped, rather than tightened, in front of and behind the ear. The amount of tension applied to the skin should be just enough to make the face look firm and taught without making it look mask like and without changing the shape of the eyes or mouth.

The skin is carefully trimmed and tailored to fit its new position along and behind the ear and sutured with minimal tension.

Soft suction drains are usually placed under the skin to drain away any blood or fluid that may accumulate after the operation. These may be left in place for the first few days.

After all the wounds have been sutured, the head and neck will be wrapped in soft cotton dressings and bandages and you will be returned to the ward in a semi-sitting position.

Next: After Facelift Surgery

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