Cosmetic And Reconstructive Plastic Surgery
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Facelift Surgery

What is a Facelift?

A Facelift is an operation designed to restore the youthful contours and skin tone of the lower face and neck, lost through ageing and environmental exposures. It can be combined with a brow lift to improve the upper face, blepharoplasty to improve the orbital area, and often is combined with additional procedures like fat grafting to further rejuvenate facial contours. It does not change the quality of skin, but can be combined with skin treatments like chemical peel to improve the skin.

Who is a good candidate for a Facelift?

Anyone whois in good general health,is at a stable weight, and is concerned with facial ageing can be considered. Some obtain surgery in their 40s to avoid early signs of ageing, and some wait until their 70s when they realize that they still feel youthful but are being treated like an old person. Some of our patients have suffered premature ageing as a result of medical illness, medications or smoking. If we have your complete medical history we can design a treatment approach that minimizes the risks of your procedure.

At your Consultation

Facelift surgery is particularly vulnerable to the effects of smoking, so it is very important that your smoking history be discussed at consultation. We will ask to see examples of any previous scars (from surgery, accidents, even chicken pox), as these can give a clue to your potential for unusual scarring. Any history of skin cancer will also be a consideration.
It is very helpful to have with you your complete medical history and list of current medications, and any current (past three months) blood test results. You can call our office before your consultation and we would be happy to assist you in preparing for your visit. Bring your calendar as well so we can help you choose a date should we agree to proceed.

Alternatives to Facelift Surgery

Injectable hyaluronic acid fillers (e.g. Juvederm, Restylane) can mask some of the early signs of ageing, but if used to plump out the skin result in so-called ‘Pillow face’ deformity. Tissue-tightening procedures (RF and Ultherapy) rely on the heating of facial subcutaneous tissue and risk loss of fat and thus an older appearance! Treatments that target the skin (peels, laser, radio-frequency heating) can improve skin quality especially from sun damage, but unlike a facelift do not address the loss of volume and tone in the underlying tissues. Your facelift consultation must include a consideration of all the possible tools that could help achieve your best result possible.

Costs of Facelift Surgery

Fees for facelift surgery at our Toronto Cosmetic Plastic Surgery office (including facility and anesthetist) range from $10,000 to $15,000, depending on the extent of surgery that is necessary. In the unlikely event of requiring a ‘touch-up’ procedure for optimal results, no surgeon fee is charged.

Preparation for surgery

We need you to be healthy and at a stable weight before surgery. We provide written instructions on all aspects of preparation, and will review these with you in the weeks before surgery. Your procedure will be performed as day surgery. A driver will be necessary to bring you home after surgery. We will generally need to see you the day after surgery to remove initial dressings and evaluate early healing.

Surgery

Your operation can be performed under general anesthetic (asleep) or with intravenous sedation. Surgery will be performed either at our accredited office-based surgical facility, or at the hospital if medical concerns are conspicuous.
We customize each procedure to your priorities. A facelift incision (see below) often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted from the lower face, jowls and neck, and underlying tissue is repositioned, commonly with the deeper layers of the face (the ‘SMAS’) lifted. Skin is re-draped over the uplifted contours and excess skin is trimmed away. Fat-grafting is performed to add volume to the upper face and cheeks. A second incision under the chin may be necessary to further improve an aging neck. Sutures close the incisions.
Our goal is to achieve a natural ‘non-operated’ appearance, 5-10 years of rejuvenation, and a rapid recovery to normal activities. We do not perform thread lifts, but will recommend a short-scar facelift technique for patients who do not have a significant problem with loose neck skin.

Facelift Surgery 1

Rhytidectomy patient shown before surgery with deep cheek folds, jowls, ptotic soft tissues, and loose skin on the front and side of neck.

Facelift Surgery 2

Incisions are variable, made on either side of the face from inside the hairline at the temples (see photo) or more commonly a trichophytic incision in front of the hairline, in front of or partially within the ear, around the earlobe, in the crease behind the ear and into the lower scalp.

Facelift Surgery 3

Loose skin is pulled up and backward, and the excess is removed. In many patients, the underlying tissues (SMAS) are used to reposition soft tissues from the lower face jowls back up to the mid-face cheeks, restoring more youthful facial contours.

Facelift Surgery 4

The postoperative patient following a facelift with smoother, firmer skin on the face and neck, and fullness restored to upper cheeks.

Safety and Risks

In the short term, risks are those typical of surgery and anesthesia. Bleeding under the skin is a concern but this risk can be minimized with simple precautions.

Recovery process

We do not use drains, you can shower the day after surgery, and we begin suture removal 5 days after surgery. Final suture removal is 12 days post-op. To minimize the risk of bleeding, we ask that you avoid activities that ‘make your face red’ (e.g. vigorous exercise, bending over to tie shoelaces) for 10 days after surgery.Most patients have returned to work undetected by two weeks.

Results

You can expect to be impressed by an improved appearance by 10 days after surgery. Surgery turns back the clock but does not stop the ageing process, however the operation is designed to allow a repeat procedure (typically 10 years later).

Bottom Line

We believe that our practice offers the best facelift surgery results in Toronto. Come in for a consultation, and you will leave wiser, and perhaps scheduled for a beautiful transformation.



Frequently Asked Questions

What is the best age for a facelift?

The optimal age range is around 45-55, as you want to perserve what you have already without having an immediate and drastic change that everyone will notice.

Do you need fillers after a facelift?

Fillers are not necessary after a facelift, but can be used in the many areas that are not corrected by facelift surgery. They are generally more effective after a facelift because the skin tone has been improved by the surgery. This means the filler can be used specifically to correct volume defecits rather than lift sagging tissues.

Can a facelift tighten sagging jowls?

Yes, correction of sagging jowls is the most obvious improvement seen with facelift surgery.

Where are the scars from a facelift?

In the past, facelift scars were 'hidden' behind the hairline, but this resulted in the loss of hair-bearing scalp, and a deformity made even worse if the facelift was repeated. It is more common now for incisions to be designed to be hidden along the edge of the hairline and other natural features. The incision used is customized for each patient.

How do you sleep after a facelift?

We recommend a position with an elevated chest and head. A pile of pillows can be used if a lounge chair is not available. Sleeping with your neck alone flexed by a pillow is not helpful- both chest and head need to be elevated to encourage blood flow, avoid swelling, and minimize pressure and contamination along the incision lines.

How do you wash your hair after a facelift?

You can go in a shower the day after a facelift. It is best to have someone with you, and a chair or bench to sit on if you feel dizzy - we have known people to faint the first time they shower after surgery. Expect to have a little bleeding, but don't be alarmed. Use of an antibacterial agent like chlorhexidine as a shampoo is our recommendation until scabs along the incision lines are gone.

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