Facelift and neck tightening

The surgery on the face and neck can be considered in a couple of steps; the skin incisions, the management of the deeper layers of the face known as the SMAS layer and volumetric enhancement.

Laxity in the central part of the neck under the chin area is due to the loose muscle and skin as well as fatty deposits which lead to the classic turkey neck or platysmal folds.

For most patients it is important to tighten the platysma muscle in the middle of the neck. This is known as a corset platysmaplasty. This involves making an incision underneath the chin, dissecting down, removing any extra fat and then joining in the muscle together in a corset fashion. By doing this and then by pulling out the back the procedure creates a very smooth and firm jawline.

The scar in front of the ear and underneath the chin normally heals extremely well and is almost imperceptible. The scar that most individuals are aware of, is the one that runs up behind the ear as it crosses the hairless area and can often be noted by hairdressers when cutting hair.

The most common procedure for Facial Rejuvenation that I offer is

• Deep Plane Face and Neck Lift (DPNFL) with Submental Incision, Submental Fat Removal, Corset Platysmaplasty and Bilateral Jowl Liposuction.

There are other techniques available such as a MACS lift, Thread lifts, Subperiosteal lifts and Skin-Only Lifts. I have tried these techniques in the distant past and I found they were not able to give reliable and long lasting results.

From both my own experience and from overseas research, the DPFNL offers a safe, reliable and cost-effective procedure for facial rejuvenation for all patients undergoing a primary (first time) Facial Rejuvenation.

For those patients needing secondary or revision facelifts, I usually offer a SMAS plication as it is safer in terms of protecting the facial nerve and it is effective in those who have already had a SMAS-Lift.

Procedures that can be combined with a Facelift:

• Browlift via a temporoparietal fascial approach
• Upper lid blepharoplasties
• Lower lid blepharoplasties
• Fat Grafting to facial areas

The advantage of adding other procedures means an individual has a single recovery period and the cost is overall less than the expense of doing the procedures at separate times

The aim of the surgery is to create a rejuvenated and natural appearance.  The goal of surgery is not necessarily to remove every wrinkle (as this may look unnatural) but rather to create an appearance of someone who is rested and youthful.

The short answer is ‘forever’!

The rejuvenating effect ‘resets’ the clock but the ageing process does continue. A person who had a Facelift at the age of 50 will still look more youthful at age 65 than if they had not had the Facelift. Studies from overseas show that using a deep plane facelift technique similar to how I perform Facelifts, decreases the visual age of a person by a decade.

In practice, a common time when I see individuals who would like a second facelift is usually around 15 years from their first facelift.

The most common age for a facelift is mid-late 50’s to 60’s when the full effects of ageing are seen but also a time when people feel vital and youthful but their face may not reflect that vitality.

The oldest person for a facelift has been 78 but I do suggest to individuals that they have a lift earlier to get the most benefit from the procedure.

There are people in their 30’s who have early age-related changes who have benefited from a mid face lift. For those younger than 30, some have heavy necks and may need removal of the fat from this area and others may benefit from liposuction of the jowl area.

Facelift surgery can take anywhere between two and seven hours depending on the elements of surgery that have been incorporated. For longer surgeries patients do require a night in hospital afterwards. There will be a bandage placed over the ears and sometimes under the neck following the surgery. Small silicon drains may be used in order to reduce the amount of fluid collecting at the front of the neck after the surgery. The drains and the head bandages are removed at day two following the operation. Dissolving stitches are used behind the ear. The stitches that need to be removed after the surgery are usually in front of the ear and these come out at day seven following the surgery. Patients will notice some bruising on the face and neck which can last up to two weeks and occasionally longer. There will be swelling of the face which is partly due to the operation and partly natural swelling that occurs after surgery. I reinforce to patients that when they wake up the face will feel tight. This can be a sensation that can be distressing (as it feels like an anxious sensation) but it does get better over three or four weeks and that tight feeling is good, as it reflects the type of surgery you’ve had. Please see the section on after-care for more information

The cost of face and neck lift surgery depends on the expected time for the operation and whether someone needs to stay in hospital overnight. The total cost of a surgery includes hospital and operating room fees, anaesthetist and surgeon fees.

For a deep plane face and neck lift (DPFNL) with submental incision, removal of fat under the chin, joining the muscle together and liposuction of the jowls, the approximate cost is $38,000. If further procedures are added in, such as upper eyelid surgery, the cost might be around $46,000 for the longer time needed.

Overseas the cost of facelift surgery can vary considerably. Thailand or Philippines offer facelift surgery for about half the value that we can here. The reason for the much lower values are for the same reasons why travelling in those countries is much cheaper than in NZ – staff, rent, equipment and regulatory requirements are all less costly.

The flip side to the cost of surgery here is that in other countries the cost is much greater. In the US the cost of a facelift can be up to USD $200,000.