While the standard facelift addresses the lower two thirds of the face and upper neck, it is often combined with additional procedures such as eyelid surgery, a forehead or Brow-lift, liplift, suction liposculpture to remove fat (especially in the upper neck), nose reshaping, removal of skin blemishes, dermabrasion or chemical peel treatment of the skin, laser resurfacing and lipostructure (or fat grafting) to areas of facial fat atrophy and hollowing.
Results can also be enhanced and prolonged with the use of dermal fillers and Botox™.
Newer techniques have been developed over recent years to produce a more natural look and avoid excess skin tension. These use similar skin incisions and involve the dissection and tightening of the suspensory supporting soft tissue structure of the face and neck (the SMAS), as well as tightening muscles and their attachments to the bony skeleton. A further advance is the endoscopic brow lift which avoids the traditional long scars of open Brow-lift. Short scar techniques, sometimes known as mini facelifts, S-lifts or MACS lifts are sometimes recommended for younger patients or for those unsuitable for more extensive surgery or requiring a minimum of post operative recovery time.
Fatty tissue, especially in the neck, can be removed through a small transverse incision hidden under the chin, or by suction-assisted liposculpture. (SAL).
Using these techniques, the deeper supporting structures of the face and neck are tightened and the skin is gently redraped to give a natural, fresh, rejuvenated appearance with normal facial expression and a smooth, more youthful jaw line without jowls.
These procedures give a longer lasting result, but require a high degree of specialised surgical skill and are more time demanding. Depending on the individual situation, either a general anaesthetic or sedative anaesthesia is used. The anaesthetist will talk to you prior to the operation and explain what is best.
Simple operations can be done as a day case, but patients usually stay one or two nights in hospital.