in Bangkok, Thailand
What is Facelift Surgery?
Facelift surgery is a cosmetic surgery procedure to create a younger facial appearance. This procedure can reduce the sagging or folding of the skin on the cheeks and jawline, and any changes that resulted from aging.
During a facelift, skin flap on each side of the face is pulled up. The facial soft tissues below the skin become taut, resulting in a more youthful facial shape. The excess skin is removed, and then the flap is suture closed.
A neck tuck (platysmaplasty) is often done as a part of facelift to reduce the sagging skin on the neck.
Some cases may require more maneuvers such as deep muscle tightening, fat transfer, facial bone augmentation, and facial bone contouring to achieve the desired youthful look.
A facelift will not decrease fine wrinkles or creases in the facial skin, which can be addressed by other cosmetic procedures.
Figure 1: Aging changes in the face
Why consider a facelift?
As we age, it is not only the skin that changes, but so do the underlying soft tissue, muscle and bones. The skin becomes less elastic and looser, and fat deposits decrease in some area of the face. Age-related changes to the face that can be corrected by a facelift include sagging skin, excess skin, and the deepening of the fold at the sides of the nose.
Kamol Cosmetic Hospital offers facelift and associated procedures as follows:
1. Skin tightening and removal of excess skin
2. SMAS (Musculoaponeurotic framework of face) tightening underneath the skin
3. Deep muscle suspension with synthetic absorbable materials
4. Neck tuck for under chin muscle repair
5. Eyebrows lift
6. Restoration of facial fat with fat transfer
Risks and Complications of Facelift
Facelift complications will be managed with the right care, medication or surgical correction. The risks include:
Postoperative hematoma under the skin
Scarring. incision scars from a facelift are permanent, but typically will be hidden under the hair. It is rare for the incision to become red, raised scar. Injection of steroid or other treatment will be used to improve the appearance.
Nerve injury and sensory nerve damage, although the effects are self-limiting and usually recover within 6-12 months.
Skin loss, though very rare, could still happen. A facelift surgery may interrupt the blood supply, possibly resulting in partial skin necrosis.
The other risks and complications are similar to those of other major surgeries including, side effects from anesthesia. Lifestyle and preexisting medical conditions may increase risks.
How to prepare for a facelift
After consultations with the surgeons and agreeing to proceed with the surgery, the preparation will be as the following steps;
Physical examination and medical history. The surgeons will require the patient’s medical records. Most patients aged 40 and above need to consult with medical doctor and cardiologist regarding any possibility of heart complications, as this will be necessary when administering anesthesia.
Stop smoking for at least two weeks before surgery
Prior to the procedure, hair wash with germicidal soap
Confirmation of expectations, as the patient should ask any questions they still have regarding the outcome of a facelift, such as the effect on fine wrinkles or symmetry of the face.
This procedure requires general anesthesia, though sometimes local anesthesia and sedation would suffice. A facelift procedure takes approximately 2-4 hours.
At Kamol Cosmetic Hospital, we offer six facelift procedures for those who seek to restore youthfulness to their appearance.
1.Facelift by skin tightening and removal of excess skin
This involves simple skin incision at the temporal hairline, down to front of the ears and ends behind the ears. It is a classic procedure that is still in use today. This tightens excess skin, and relies completely on skin tension to shift the underlying facial soft tissue. This procedure is suitable for the patients who have excess skin, and minimal ptosis of deep soft skin.
Picture 2. shows traditional facelift or “skin only” facelift technique
2. Facelift by SMAS (Musculoaponeurotic framework of the face) tightening underneath the skin.
Our plastic surgeons perform the subcutaneous facelift with separate SMAS Flap and SMASectomy. The SMAS will be pulled upward and backward as tightly as possible. Subcutaneous soft tissue and skin will be moved following the SMAS flap, and then resected to remove the excess skin. This is a more effective technique and the results are longer lasting.
Picture 2. Facelift by "Deep tissue technique with SMASectomy"
3. Facelift by deep muscle suspension with synthetic absorbable materials
We provide a facelift by deep muscle suspension with synthetic absorbable ribbon implant (Endotine). Incision is made in front of the ear up to the temporal area. There are many types of implant such as midface implants, which are assisted by midface fixation located over the zygomatic muscle. The implant will be absorbable within 6 months. This procedure can enhance cheek volume and projection for a natural, rejuvenated look. The patient may feel some discomfort a few months after surgery.
Picture 3. Facelift by deep muscle suspension with synthetic absorbable materials (Endotine)
4. Neck tuck for under chin muscle repair
In this procedure, the surgeon makes a small incision under the chin, carefully lifts the muscles of the neck and removes the excess skin and fat. The incision is then closed and a pressure dressing is applied underneath the chin.
5. Eye brows lift
Eyebrow lift is the repositioning of eyebrow to achieve a more youthful appearance. The incision scar is behind the hairline by 1-2 cm. There are three types of browlift as follows:
- Endoscopic browlift, which results in a minimal scar
- Temporal or limited browlift, where incisions are at the temporal area both right and left
- Coronal or classic browlift, where a long incision is made from ear to ear
6. Restoration of facial fat with fat transfer.
Fat graft injection is performed to support certain areas that need contouring and fulfilling. This is suitable for patients who have slimmer face and loose fat, and have undergone a facelift surgery with unsatisfactory results due to the lack of volume.
Some patients may need more procedure to achieve a desired youthful look. Experienced surgeons can recommend best options, though the final decision remains at the patient’s
Postoperative Care for Facelift:
- Keep the face elevated as much as possible to reduce swelling
- Gentle movement to support blood circulation
- Wear a compression bandage at all times for the first three days, and then at home while sleeping for one month
- Avoid aggressive or strenuous activities for one month after surgery
- Stop smoking or drinking alcohol for at least two weeks after surgery
- Keep any follow-up appointments with your surgeon to check healing process and ask any questions that may concern you
- Stitches are removed seven days after surgery
You can return to work 14 days after surgery, but there may still be some swelling. You start exercise four weeks after surgery.