Facelift Surgery for Men

Assessment

Suitability for surgery depends on a number of factors that must be assessed by your surgeon. Anyone considering facelift surgery should be:

• Medically fit
• Non-smoking
• Psychologically stable
• Have clear goals and realistic expectations
• Be prepared for some ‘downtime’

Facelift surgery is a personalised procedure and the technique used is greatly dependent upon the quality, texture and elasticity of the skin, the degree of sun exposure, the appearance of jowling in the neckline, and the amount of fat present in the face. Your consultant cosmetic plastic surgeon will carry out a thorough consultation and examination to determine the best option for you. Before surgery your health will be assessed including heart and lung function, blood pressure, tendency to bleed, allergies and medication. Facelift surgery is not advisable for smokers due to risk of bleeding and poor quality healing. Patients over 50 need to have both a blood and Electrocardiography (ECG) test before having this procedure.

The Procedure

A facelift is usually performed under general anaesthetic in a hospital environment with an overnight stay. It is possible to have the procedure under local anaesthesia or sedation. Often, a solution of anaesthetic and adrenaline is injected into the face to reduce bleeding and swelling. After the skin of the face has been elevated, the underlying muscles are tightened by various techniques. Extra skin is then removed and the wounds closed. Drains are usually placed and removed the following day. The face may be dressed with a bandage, which is normally removed the following day. The patient is nursed in a sitting position and may be gently sedated. Some swelling and bruising is inevitable, giving a shiny, swollen effect that resolves after a week or two. Painkillers and antibiotics may be prescribed for 10 days or so.

Post-operative care

The vast majority of facelift procedures produce a scar that runs in front of and behind the ear. The scars are designed to follow the skin’s natural creases and usually heal very well. They should be discreet enough to be invisible to others – although they may not escape the attention of your hairdresser. For the first few months after surgery, the scars may be a little red and raised requiring make-up to conceal them. Usually, the healing process can be helped by using specific topical gels that contain silicone. Very occasionally, a thicker scar may occur, which can be treated by local steroid injections. For men considering a facelift, there are specific issues to consider regarding the scar. Short hair limits the options for hiding the scars in the first few months after surgery. Moving the hair-bearing or beard areas of the skin may necessitate shaving behind the ear and around the front of the ear. It is possible to depilate these areas with electrolysis or laser. The scar behind the ear may cause a ‘step’ in the hairline. Occasionally a wide scar in this area can be very effectively concealed by hair transplants or grafts. Anxiety about scars has attracted interest in a number of techniques that can be carried out to result in shorter scars. These include options that have no scar behind the ear, the so-called ‘short scar’ facelift. Another type of facelift limits scars to within the mouth and the scalp in the temporal region. These operations are often called ‘endoscopic’ facelifts as some of the surgery can be done using a camera through small incisions or cuts. As with all surgery, there is a recovery period (downtime) that will restrict work, social and sporting activity for a minimum of two weeks. Specific information on post-operative care is provided to optimise a quick recovery. Patients should avoid:

•  Lifting, straining, bending or coughing
•  Any form of sexual activity
•  Excessive use of mobile phones

Patients should:

•  Sleep on three pillows for a week after surgery
•  Be in a warm, cigarette smoke-free environment
•  Take all of their prescribed medication

Minimising bruising in the immediate post-operative period usually results in a rapid and uncomplicated recovery. A degree of swelling and bruising is usual and may vary between individuals. It is normal for the cheeks to be numb for up to three months after surgery. Stitches are removed between five and ten days after surgery. Most patients will need two to three weeks’ recovery before they feel able to go out socially or return to work. Exercise and sexual activity should be avoided for four to six weeks after surgery. The healing process continues for a month or so and the final result is often at its best after three months. A good result should be natural with no obvious signs of surgery. Patients usually report that friends and colleagues say they look ‘well’. Often they will be asked if they have lost weight, had their hair done or changed their make-up. It should not be evident that they have had ‘work done’. To achieve a balanced look it is often very effective to perform a facelift in conjunction with other surgeries, particular the eye area, which can display prominent tell-tale signs of ageing.