What are the main risks of Facelift Surgery?

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Our face forms such a pivotal part of our sense of self that when considering any surgery, it is only natural to be concerned about the possible complications. Facelift surgery is performed routinely by facial aesthetic trained plastic surgeons. Given the intricacy of the anatomy and the vital requirements for meticulous surgery in close proximity to the facial nerve, the risk profile of the surgery often involves the surrounding anatomical structures.

Large-scale studies indicate that up to 1% of patients suffer irreversible damage to professional branches. Between 1 to 5% of patients end up with post-operative haematoma or bleeding which often happens within the first 24 hours requiring surgery for evacuation. Minor complications such as wound dehiscence and skin loss are more common in patients who smoke. These form some of the main complications associated with facelift surgery.

Where manipulation of the Superfical Musculo-Aponeurotic System(SMAS)layer using one of a multitude of facelift surgery is undertaken, the risks to the facial nerve are higher. Improved knowledge of the anatomy of the small branches of the facial nerve in the face over the last 40 years has made the surgery safer. However, in the small group of patients wind up with facial nerve injury as a result of facelift surgery, the options involve symmetrisation using muscle paralysing agents on the opposite side. This allows balancing of the face as after all it is symmetry that in large determines the ultimate outcome of facial rejuvenation surgery.

Figure 1 (Schematic representation of facial nerve in the face).


All illustrations are reproduced with permission Farhadieh RD, Bulstrode N, Cugno S: Plastic and Reconstructive Surgery: Approaches and Techniques,Mendelson B & Farhadieh Facelift, Wiley & Blackwell, London, UK, 2015.


Dr Ross Farhadieh
Dr Farhadieh is an internationally renowned Australian qualified and trained Plastic Surgery. He holds fellowship qualifications in Plastic Surgery from Royal Australian College of Surgeons, Royal College of Surgeons (England) as well the European Board of Plastic Reconstructive Aesthetic Surgery. He has multiple clinical subspecialty fellowships in Cosmetic, Pediatrics as well as Microsurgery from World Leading institutes in London.
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