A person’s face is their most important tool in communicating with the world and in projecting their image of ‘self’. For most people their sense of identity is inextricably connected to the face, more so than any other part of the body. An individual’s face is a unique, complex, three-dimensional structure, with foundations of solid bone, supporting soft tissue volumes, held together by visible and invisible ligamentous extensions, upon which the person’s canvas of life is spread. Environment, time and gravity all take their toll, and this canvas in time bears the blemishes of the process from inside and out, leading to the development of wrinkles, a tired look, changes in the shape of the face, and a loose neck and jowls. Facelift surgery seeks to undo some of these blemishes, unwinding the clock on a person’s face, leaving them looking and often feeling refreshed and younger.
Dr Farhadieh has a special interest and expertise in facial aesthetic surgery, and has undertaken two separate aesthetic and reconstructive fellowships with a focus on the face. Recently he has published a chapter on facelift in an international comprehensive plastic surgery textbook: Facelift, in Plastic and Reconstructive Surgery: Approaches and Techniques.
In assessing the face, a clear understanding of the patient’s self-image and needs produces a nuanced and individually tailored approach to rejuvenation rather than a cookbook approach. Maintaining natural character and avoiding the operated look, so often seen in films, is the ultimate goal. Where patients wish to have changes made to their underlying facial appearance Dr Farhadieh will discuss those surgical options with them in detail.
A thorough medical history, including past surgery, medical history, current medications, allergies, family and smoking history are recorded, as these may affect facelift surgery. After discussion of your needs, expectations and analysis of your past and present photographs, Dr Farhadieh will discuss the options with you in detail. Smokers are requested to quit for 3–6 weeks prior to surgery and for at least 3–6 weeks after surgery.
In general, a hairline incision in front of the ear and extending behind it is used to gain access to the face. The underlying structures, including fascia, as well as shifting soft tissues (superficial musculo-aponeurotic system or SMAS), are connected to the underlying bones via an intricate system of ligaments. Some form of surgical manipulation of all these structures is necessary to return the face to a more balanced, harmonious and youthful appearance. Where the neck is also addressed, an incision hidden beneath the chin is often used. In addition to the face, the eyelids and brows can be addressed as part of the same operation. Occasionally, where a mid-face only lift is needed, a single lower eyelid incision hidden in the natural creases suffices.
The operation is performed under general anaesthetic and requires admission overnight. You are discharged the next day. The operation does involve some swelling and bruising. Although you can go back to work within a couple of days, most patients do not return to work for 10–14 days, when most of the swelling has settled and the wounds have healed. You will be seen again in the clinic at day 5–7, for suture removal and postoperative assessment.
Dr Farhadieh will discuss all aspects of the surgery, including possible complications with you during your consultation. His experience with facial nerve reanimation surgery is an additional layer of safety in reducing any risk.
We will organize follow-up appointments at regular intervals after your initial postoperative review. Your relationship with your surgeon is the most important aspect of this journey. We are dedicated to being there with you for every step of the journey.
‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’
Frequently Asked Questions
Will I need general anaesthesia and overnight admission?
Yes, facelift surgery is intricate surgery, which deals with the face. General anaesthesia and overnight admissions are the safest way to undertake this surgery
Will the scars be visible?
Immediately after surgery, yes, but the incisions are placed in such a way that once healed they will not be visible or noticed. From time to time, scar abnormalities or some skin loss might occur as a result of surgery. These can be managed conservatively, occasionally requiring secondary surgery.
How long will the recovery take?
This varies from patient to patient. The majority of swelling resolves within the first 7–10 days. Most patients are out and about by the end of the second week. Any remaining swelling is usually gone within 4 weeks.
Is asymmetry following surgery common?
Although all humans have some intrinsic asymmetry to their face and body, in adequately trained hands noticeable persistent postoperative asymmetry is rare. Occasionally the facial nerve is bruised during surgery, but this tends to recover within a matter of weeks.
Can any surgeon perform facelift surgery?
The face is one of the most intricate parts of the body and its importance in projecting our sense of ‘self’ is clear. Performing facelift surgery is often thought of as a subspecialty amongst plastic surgeons and those who are interested seek further training beyond basic plastic surgical qualifications. Dr Farhadieh has an interest in facial surgery and has undertaken two separate clinical fellowships in London, England, focusing on the face from both cosmetic and reconstructive perspectives. You are in the safest and best-trained hands with us.
What will my follow up include?
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.