The 'MACS' Lift (Minimal Access Cranial Suspension)
Suitable for patients with mild to moderate jowls but no loose skin in the neck. Permanent sutures are used to elevate the soft tissues of the face and suspend them in a more youthful position. This operation has a shorter scar behind the ears and a relatively quick recovery, although it may not be as long lasting as the SMAS type facelifts.
How long does a facelift last?
This is one of the questions most frequently asked by patients. The answer is that this type of surgery puts back the ageing clock by seven to ten years, but of course, cannot stop it from ticking. Ten years after the surgery you will of course look older but will always appear 7-10 years younger than you would have looked without surgery.
Can the scars be hidden?
The scars for all types of facelift are mostly within the hairline and hidden around the ear. The incision for the face extends down from the scalp to the top of the ear and then travels for a short distance just inside the ear canal so as to be hidden from view in the cheek area. It then turns backwards at the bottom of the ear to lie deep in the groove between the back of the ear and the side of the head. When it reaches the top of the ear at the back it turns to enter the scalp where it is again hidden. These scars are designed in such a way that you should be able to wear your hair in any style that you choose once the scars have matured.
What happens after the operation?
In Hospital (1-2 days)
A light padded dressing will usually be applied at the end of the operation which remains in place for 24 hours. You will be nursed in a semi-sitting position in bed immediately after the operation, which helps to reduce swelling. There is not usually much pain or discomfort although this can be subjective. On the day after surgery, the dressings and bandages will be removed and before going home.
At home (2-10 days)
It is helpful to rest/sleep with three or four pillows for the first week after surgery in order for swelling to subside more quickly. Swelling will tend to increase during the first 3-4 days after surgery (this is normal) and then subside over the next two weeks. It may be a little slower to subside in warmer weather. Try not to drink too much water. This is not the time to be drinking 1-2 litres of water each day in the hope of “flushing” out the system. The brain releases a hormone after surgery which tends to retain water and so if you drink a lot you will retain fluid and create more swelling. Please just quench your thirst and then drink fruit juice or tea as these will give less fluid retention and swelling.
It is important to avoid bending forwards as this may cause more swelling. It is better to avoid washing hair unless sitting with the head back like at the hairdresser. You should also avoid very hot drinks for the first week as well as avoiding very chewy foods as this helps facial swelling to settle quicker. It is very helpful to rest as much as possible for the first five days and then return gently to normal activities over seven to ten days
After a week the surgeon will remove any stitches near the eye and then at between 10-14 days to remove the remaining facelift stitches and any clips. Any facial or eyelid stitches run beneath the skin and are not visible except at either end. They will therefore leave no stitch marks so do not worry!
The first 2-6 weeks after surgery
The face (and eyelids if they have also been operated on) may feel a little tight. This is normal and related to swelling and scar maturation. Occasionally the eyes may feel a little “gritty” after surgery and if this is the case then it is helpful to use a lubricating ointment at night. The cheeks and ears will feel numb for about three months after the operation; this is quite normal and recovers spontaneously. In general it is best to continue with your usual facial skin care regime as the risk of sensitivity to a new product is best avoided. You may visit your hairdresser after 10-14 days but as mentioned earlier no colorants should be used for 4 weeks.
You should not drive for at least one week after surgery or until such time as your neck movements are comfortable. Most patients can return to work after 2 weeks although you may wish to avoid major social events for 3-4 weeks until the fine swelling has settled. You may resume your usual sporting activity at 3-4 weeks but prior to that it is best to avoid exercise as it will prolong the swelling in your face.
What are the risks?
These are fortunately rare and when they do occur usually represent a temporary inconvenience rather than a permanent problem.
- Bleeding beneath the skin causing excessive bruising (haematoma) can occur and may, on occasion, require surgical treatment. The overall incidence is approximately 2-3% in all face-lifting procedures. The most common time for it to arise is within the first twelve hours after surgery when you will be in hospital. It normally does not influence the ultimate outcome of the surgery but is a temporary hiccup.
- Infection is extremely uncommon in the face, the incidence being approximately 1-2%.
- Some numbness in the area of surgery, particularly in the cheeks is to be expected for about three months. As this recovers you may notice some tingling or pins and needles.
- Temporary hair loss particularly in the region of the temple is seen occasionally (usually only in smokers) although this invariably recovers over a period of three to six months.
- The scars are normally very fine and well hidden but in some individuals a scar may tend to thicken after 6-12 weeks, such "hypertrophic" scars can be improved and curtailed by appropriate treatment.
- Wound healing in the face is generally very quick and reliable. Occasionally a slow healing wound may be seen. This is usually behind the ear since the skin there is most fragile. Such problems are, fortunately, very uncommon indeed but are known to be more likely in smokers.