Facelift

A facelift is a surgical procedure that corrects the signs of facial ageing caused by sagging tissues: descended cheeks, an irregular jawline (“jowls”), deep folds between the nose and mouth and skin laxity in the lower third of the face.

Unlike procedures that act only on the skin, a facelift also repositions the deeper supporting layers of the face and then removes excess skin without placing it under too much tension. The aim is a rested, natural appearance, not a change in features. At Detalii Med, in Baia Mare, facelifts are performed by the clinic's plastic surgeons.

A facelift may be suitable for people who:

• notice sagging of the cheeks and loss of a clear jawline;
• have skin laxity in the lower part of the face and, often, in the neck;
• are in good general health, with any chronic conditions under control;
• do not smoke or are willing to stop smoking before and after the procedure;
• have realistic expectations about the result.

There is no fixed age; what matters is the degree of tissue sagging and the quality of the skin.

A facelift can lift and reposition the tissues of the cheeks, redefine the jawline, soften the deep folds around the mouth and reduce excess skin. It is often combined with a neck lift for a harmonious result between face and neck.

The procedure does not treat fine lines, pigmentation or skin texture, which can be improved with dermatological treatments. It does not correct the eyelids or forehead; these require separate procedures, which can be combined. A facelift does not stop the natural ageing process.

At the consultation, the plastic surgeon analyses the structure of the face, skin quality, the degree of tissue sagging and any asymmetries. The medical history, current medication (especially medicines that affect blood clotting), smoking and previous aesthetic procedures are discussed.

The doctor explains the suitable technique, the position of the future scars, recovery and the result the patient can expect. Blood tests and a pre-anaesthetic assessment may be recommended. Medical photographs are taken for planning and later comparison.

The incisions are usually placed in the temple area, in the creases in front of the ear, around the earlobe and in the hair-bearing skin behind it, so that the scars are as discreet as possible. Through these incisions, the surgeon repositions the deeper layers of the face and, if needed, removes or redistributes fat.

The skin is then redraped over the new contour, the excess is removed and the incisions are carefully sutured. Sometimes thin drains are placed for a day or two. As a guide, the procedure lasts between three and five hours, depending on its extent and any combined procedures.

A facelift is usually performed under general anaesthesia. In certain cases, for more limited procedures, local anaesthesia combined with sedation may be used. The type of anaesthesia is decided together with the anaesthetist, after the pre-operative assessment.

After the procedure, the patient wears a dressing or compression band and sometimes stays in hospital overnight. In the first days there is swelling, bruising and a feeling of tightness, managed with medication and by keeping the head raised. Stitches are usually removed after about seven to ten days.

Most patients return to social activities after two to three weeks. Strenuous exercise, sun exposure and excessive heat are avoided for a few weeks. Numbness of the skin around the ears may last for a few months and improves gradually.

The risks of a facelift are discussed openly at the consultation. They include:

• haematoma, the most common early complication, which may require a further procedure;
• infection or delayed healing, with a higher risk in smokers;
• compromised skin in certain areas;
• injury to nerve branches, causing weakness or numbness, usually temporary;
• visible scars, hair loss in the incision areas, asymmetry;
• the general risks of anaesthesia.

Following instructions before and after surgery reduces the risk of complications.

The first results can be seen once the swelling subsides, within a few weeks, and the final appearance is usually assessed after three to six months. The effect usually lasts for many years, but the face continues to age naturally. How long the effect lasts depends on skin quality, lifestyle, sun exposure and changes in weight.

A facelift is a procedure that can give the face a more defined contour and a more rested look, with natural results when it is well indicated. The decision is made after a detailed consultation with the plastic surgeon, who determines whether a facelift is suitable and which procedures can complement it.