Risks of face lift

General anaesthetic

Many face lift surgeries are carried out under general anaesthesia which can provoke an adverse reaction in some patients.

Where a history of problems with anaesthesia exists it may be possible to make alternative arrangements for surgery.

Some face lift surgeries can be carried out with intravenous sedation local anaesthetic, with a possible reduction in the risks of deep vein thrombosis.

Deep vein thrombosis (DVT)

Deep vein thrombosis, or clots in the leg veins, is a risk whenever the body is immobilised, such as when under general anaesthesia.

Patients are given only as much anaesthesia as is necessary for the procedure so as to encourage mobility quickly after surgery.

Even simple leg stretches or ankle pumps can help get the blood flowing properly again after the operation and the use of surgical stockings and, on occasion, medications, may also reduce the risks of blood clots forming in the deep veins of the legs.

Staying hydrated after surgery also helps reduce DVT risks.

It is very important to signal before the surgery any family history related to deep vein thrombosis, as it may warrant special investigation or more significant protective measures during and after the operation.

Travelling is also associated with the mobility, and a 3 hour journey on the day of the surgery is known to be a contributing factor to deep vein thrombosis. It is better to avoid also long haul flights for a least a month but better for 6 weeks after the operation to minimise the chance of deep vein thrombosis.

Blood loss, pain and discomfort

There is always a slight amount of bleeding and bruising of with face lift surgery but for most patients this remains unproblematic.

Surgical drains may be put in place to help prevent a build up of fluid under the skin in the first day or so after surgery and patients will be shown how to empty these as well as what possible signs of problems to watch out for.

Some pain and discomfort is normal after face lift surgery although this varies between patients due to differences in general health, the type of procedure carried out, and other factors.

Most often the pain is minimal and dissipates quickly, with some residual discomfort for a little while longer as the swelling and bruising subsides.

Infection

There are a number of ways in which the probability of infection after face lift surgery can be reduced, all of which will be carefully discussed with patients to promote the best possible surgical outcome.

In our practice, we only use dressings for facelift surgery during the first night, and encouraged patients to wash their hair the next day and ideally daily afterwards for the first week to 10 days. Gentle cleaning around the scars is important to avoid trauma, but the wounds are kept very clean with a light wash, and this has very good impact on the healing process. The easiest approach is to apply some shampoo on the hair and rinse it off, so that the water runs also over the scars.

Severe infection after facelift surgery is fortunately very rare, but may lead to damage to the skin over the infection and scarring. It is very important to report immediately to your surgeon any suspicion that you might have regarding infection, either in relation to increased redness, pain, swelling or temperature.

Asymmetry and scarring

Every part of the human body is slightly different on the right and left sides, and surgery cannot overcome this aspect. 3-D imaging and planning assists with improvement in the degree of symmetry, and it is possible to enhance this outcome after the surgery using injectable fillers once the tissue swelling has subsided better.

The placement and extent of the scars is discussed in the preoperative setting, and in most people visibility of the scars is very limited, but has to be considered carefully when deciding about surgery.

Stretched scars are more common related to excess tension being applied to the skin, and in terms of the scars behind the ears, it is also possible to see a degree of thickening of the scars, which may require treatment to produce a better result. If you notice thickening of the scars behind the years, it is important to bring it to the attention of the surgeon promptly, as this will help speed up the recovery.

Sensory changes and facial nerve injury

The involvement of facial muscles, fatty tissue, and the skin in face lift surgery can cause trauma to the nerves in the face that may take a little time to heal. Injury to the facial nerve branches which move the face is rated to be approximately 1% in the international literature on facelift surgery, and it is inclusive of temporary and permanent damage. Temporary injuries will typically take a few weeks to settle down. In case of permanent injury, which is also fortunately very rare, additional treatment may be necessary, the most common of which would be to use botulinum toxin on the strong side such that facial symmetry is improved.

Some sensory changes, such as numbness, tingling, or hypersensitivity may occur but often resolve quickly as swelling and bruising subside.

In a rare few cases however it may be that the changes in sensation become permanent with the nerves, and this is most frequently described as a change in the quality of sensation over the cheeks or in the underside of the chin, where it is possible to feel light touch but with a slightly different characteristic than before the operation.