Facelift Surgery or Facial Reconstruction Rhytidectomy Surgery in Thailand

Face lift Before and After, Procedures and Post-Op Care

Rhytidectomy or Face Lift Surgery is a cosmetic surgery procedure designed to help give people a more youthful appearance. Through this medical treatment, plastic surgeons can reduce sagging and folding of the skin on the patient’s face, cheek area, or around the jaws.

Cases are analyzed individually as each patient’s needs are unique. Sometimes patients may need a face, eye, and neck lift simultaneously to achieve a refreshed and younger look. Often, the facelift procedure is accompanied by fat transfer in areas where volume was lost, facial contouring, and facial augmentation to get the best results possible.

Plastic surgeons and patients will discuss together what type of face lifting procedure will be done, in order to achieve the desired look.

• Mini-facelift/Mid facelift Skin
• Full Facelift with SMAS
• Mid Facelift by synthetic absorbable materials
• Neck lift and Neck tuck
• Forehead lift/ Browlift
• Facial fat restoration by fat transfer

Who Are Good Candidates For Face Lift Surgery?

During the initial consultation, plastic surgeons are likely to examine a patient’s medical history and lifestyle choices. The surgeon may also request a physical examination to determine whether a person is physically fit for the cosmetic surgery.Generally, the best candidates for face lift are:

Generally, the best candidates for face lift are:

• Patients who have signs of aging on their face.
• Patients who are physically healthy for sedation or general anesthesia.
• Patients who possess a positive attitude with realistic expectations.
• Patients who are committed to maintaining good skin care.

These types of cosmetic surgery procedures work best for people in their 40s, 50s, and 60s. This is because visible signs of the aging process are more prevalent on their facial features, including deep lines, fine lines, loose skin, and double chin.

Having said that, there is no specific age at which a person should consider getting medical treatments to achieve a more youthful appearance or correct loose facial skin. During the consultation, plastic surgeons will advise the patient whether non-surgical treatments are still possible to improve their fundamental appearance.

Facelift Preparations

After the consultation with the surgeon, these are the steps to follow to prepare for the facelift surgery.

• The patient must stop smoking and drinking alcohol at least 2 weeks before the procedure.
• All blood-thinning medications like Aspirin, Ibuprofen, hormones, and herbal supplements must be stopped 2 weeks before the surgery.
• .Physical examination, including blood tests and chest X-Ray. Patients who are 40 years old and above often need to consult with other medical doctors like cardiologists to mitigate potential heart complications.
• Facial exam and facial profile analysis.
• Before the surgery, the patient must wash their hair with germicidal soap.

Questions To Ask Your Surgeon Before Facelift Surgery

Dedicated and experienced surgeons will take care to answer every question that a patient may pose before and after performing any procedures. It is often advised for a patient to list the questions on a paper in advance of a consultation.

Some key questions to ask a surgeon before any plastic surgery include:

• Are you a board-certified plastic surgeon?
• How many years of experience do you have in cosmetic surgery?
• Do you have specific experiences with facial rejuvenation surgery, such as eyelid surgery and neck lift?
• Are the results I am seeking realistic?
• What are the limitations of this cosmetic procedure?
• Will there be visible scarring?
• How long is the healing process?
• Would I need pain medication during my recovery period?
• What are the possible risks?
• What are my treatment options?
• Are there any concerns that I should be aware of?
• How much does face lift surgery cost?
• When would I be able to resume my normal activities?
• Will I be placed under local anaesthesia or general anaesthesia?

 Facelift Procedure

The Facelift surgery is done under general anesthesia, though in some cases sedation or local anesthesia can be used. The surgery takes about 2 to 4 hours depending on the type of facelift surgery performed. For a more complete result, procedures for both face and neck are usually recommended to be done together.

There are six facelift procedures:

Mini-facelift / Mid-facelift

This type of facelift procedure requires two incisions. The first incision is a skin incision to be made at the temporal hairline, going down to the front of the ears and ending at the earlobe. The excess skin is then tightened to shift underlying facial soft tissue along with the cheeks muscles.

This type of facelift procedure is recommended to patients with minimal excess skin and ptosis. It takes around 2 hours with either general anesthesia or sedation.

Full facelift with SMAS

For the subcutaneous facelift with SMAS Flap and SMAS-ectomy, the incision begins at the temporal hairline, goes down to the front of the ears, and ends right behind the ears. The SMAS will then be pulled tightly upward and backward. The subcutaneous soft tissue and skin will follow the SMAS flap and then be resected to remove the excess skin.  

This type of facelift is more effective and has longer-lasting results. It is suitable for patients with substantial sagging skin, facial muscle ptosis, as it helps to restore a smoother, more youthful, and firmer facial appearance. The procedure is done under general anesthesia or sedation and it takes about 3 to 4 hours.

Facelift with synthetic absorbable materials

This type of facelift is done by deep muscle suspension with a synthetic absorbable ribbon called Endotine®. The incision is made in front of the ear and extends to the temporal area. The ribbon will be absorbed within six months of the surgery. This type of facelift can enhance cheek volume for a rejuvenated and natural look. Patients may experience some discomfort for a few months post-surgery.  

This type of facelift is best for patients with midface or inner face minimal skin ptosis and to those who need more cheek volume. It takes approximately 2 hours under general anesthesia or sedation.

Neck Lift/Neck Tuck

This surgery is for patients with sagging, wrinkled, or thick necks. Depending on the needs of the patients, the surgeon may opt to perform one or both of these methods together. 

For the neck tuck, the surgeon makes a small incision under the chin at the neckline. From there, the surgeon will lift and tighten the loose muscles. This is called Platysmaplasty.  

For the neck lift, the surgeon makes an incision behind each ear. The surgeon may also opt for a longer incision to stretch the neck muscles with the SMAS. After tightening the muscles, the excess sagging skin is removed to restore a firmer and smoother neck. This is often done in tandem with the full facelift.

These procedures take around 2to 4 hours under general anesthesia or sedation.

Forehead lift/Browlift

A brow lift involves the repositioning of the eyebrows to create a more vibrant youthful appearance. The incision is made behind the hairline and is about 1-2cm in length. There are currently three types of brow lifts available: 

1. Endoscopic brow lift – Minimal scar
2. Temporal or Limited brow lift – Incisions are made at the right and left temporal areas.
3. Classic brow lift – 1-2 cm incision is made at the hairline.

Facial Restoration with Fat Transfer

In this type of facial procedure, fat transfer as a nano-graft or micrograft is done to areas that need some filling or contouring. This is the best procedure for patients who have lost fat and have skinny faces. It is also a good option for patients who underwent a facelift procedure but were unhappy with the results due to a lack of volume

 Postoperative Facelift Care

After surgery, the patients should follow these steps:

• Keep the face elevated to help reduce the swelling.
• Try to gently massage the face to support blood circulation.
• Wear the compression garment for the first three days after the surgery. After that, continue to wear the compression bandage at least 8 hours per day.
• Avoid all strenuous activities for at least 2 weeks after the surgery.
• Stop drinking alcohol and smoking for at least 2 weeks post-operation.
• Sutures will be removed approximately 5 to 10 days after the surgery.
• Be sure to keep all follow-up appointments with the surgeon

Facelift Risks and Complications

Most potential complications for facelift procedures can be properly managed with adequate care, medication, or surgical correction. Some of these risks include:

• Postoperative hematoma
• Potential scarring. Scars from facelifts are permanent but are usually hidden under the hair.
• Nerve injury or sensory nerve damage. These usually resolve within 6-12 months.
• Skin necrosis (very rare)
• Other risks and complications associated with major surgeries.
• Risks associated with anesthesia

Pre-existing medical conditions and patient lifestyle may increase the chances of complications.

Facelift Recovery

Most potential complications for facelift procedures can be properly managed with adequate care, medication, or surgical correction. Some of these risks include:

• After surgery, bruising, swelling, numbness, and hypersensitivity may cause discomfort for a few days.
• Face and neck appearance will improve after a couple of weeks post surgery.
• Once bruising and swelling have begun to subside, a gentle face massage can be done, to promote lymphatic drainage and reduce the swelling.
• Patients may return to work about 14 days after the surgery although swelling may still be present.
• Patients may begin exercising again one month after surgery.
• Final results won’t be seen until around 6 to 12 months post-surgery.