As we age, the skin loses water and collagen, which reduces its firmness and makes it more flabby. As the skin and subcutaneous connective tissue atrophy, the skin becomes loose and sags. The loss of elasticity leads to the formation of more wrinkles. All this is compounded by exposure to sunlight, pollution, stress, smoking, sudden weight loss and disease, all of which can leave their mark on the skin, accelerating the ageing process.
Facial and neck surgery is the most commonly performed procedure, involving the surgical correction of the ageing face and neck from the temples to the jaw – there are several types of surgery. Partial or full treatments allow the correction of disturbing features that appear on the face and neck with age.
The aim of the surgery is to excise excess sagging, flabby facial and neck skin, tighten sagging, flabby muscles and fat, and treat the lack of subcutaneous fat. The aim of the operation is also to preserve the original shape and appearance of the face, while restoring the various anatomical structures of the neck and face (skin, muscles and fatty tissue), so that the patient looks a few years younger.
During the first consultation, a physical examination is performed during which the plastic surgeon will assess which surgery and which area needs correction, and will also outline the expected scar size after surgery.
The surgery requires a full examination, which we provide at our clinic. Blood thinners should not be taken in the 10 days prior to surgery, but if this is necessary, a cardiology consultation must be carried out. Smoking may cause scar healing disturbance and skin necrosis and increases the possibility of infection, therefore smoking cessation is recommended 15 days prior to surgery.
The surgery can be performed under local anaesthesia or general anaesthesia.
Each surgeon uses his or her own special technique, based on basic principles to achieve the best results.
After the incisions are made, the surgeon lifts the skin away from the underlying areas to a greater or lesser extent, depending on the degree of sagging of the skin. He then carefully and cautiously tightens the muscle layer to correct the sagging without altering the normal appearance of the face. Any localised fat deposits on the cheeks, chin, chin or neck are removed by liposuction or mechanical technique.
Otherwise, if there is a lack of fatty tissue, liposuction, a liposculpture with autologous fat fillers, is used to achieve the desired result. The lifted skin is put back in place over the repositioned muscles, and the excess skin from liposuction is removed and sutured to fix the scar.
At the end of the operation, surgeons usually prefer a bandage covering the whole head , a special headband, meaning that only the centre of the face is left free. In men, the thicker skin and the shape of the beard can make the procedure more cumbersome, and it is more difficult to hide the scars if the hair is thin or bald.
The surgeon will provide information on these problems during the consultation. Depending on the surgical technique used and the extent of the correction, the procedure takes approximately 2-5 hours.
You can leave the day after surgery or within 1-2 days of surgery. For the first 10 days, you should rest as much as possible and avoid major physical exertion. Stitches will usually break in 14-21 days.
During this time it is quite natural to experience the following:
– Edema (swelling), which may be worse on the second day than the first day
– Bruising around the face and neck.
– Painful tightness behind the ears and around the neck.
– Rarely, there may be an uncomfortable tightness or heaviness that lasts for a few weeks and then goes away after a while.
– The ears and face may not regain their normal sensitivity for several months. The bruising and swelling will subside in the 2 weeks following surgery, and usually after a month the signs of oedema will have disappeared. The areas from which the skin was removed may feel harder to the touch, but minimal lesions can be felt on the skin. The scars are covered by hair and are only visible around the ears, but can be covered by make-up for the first few months.
The healing of surgical scars varies evenly. An injection of an anticoagulant before or after surgery may be necessary.
Complications after face and neck surgery are rare (3-5%):
– Post-operative bleeding, haematoma or acid reflux.
– Wound healing, wound infection, abscess formation.
– Tissue damage, skin necrosis.
– Damage to sensory and motor nerve fibres. Temporary or permanent dysfunction of facial nerve branches (sensation, movement disorders)
– Hair loss in scars in the hairy scalp.
The outcome and durability of the surgery depends on age, conformation and other factors. The final result is seen after 1 year.
Scars may still be pale pink and painful to the touch 2-3 months after surgery. Thanks to advanced pre- and post-operative care and surgical techniques, the patient undergoes a comprehensive rejuvenation that gives a completely natural appearance. The improvement in physical appearance is usually accompanied by psychological development.
The aim of surgery is to achieve rejuvenation, but not at the cost of perfection. It does not eliminate deep wrinkles in the skin. Patients will be satisfied with the results if they have realistic expectations. Facial and neck surgery delays the visible signs of ageing in the long term, but the ageing process continues. If necessary, the surgery can be repeated years later, even several times.
