Plastic Surgery Singapore

What is facelift surgery?

If you are bothered by signs of aging and sagging in your face, facelift surgery may be right for you. The other name for a facelift is rhytidectomy. A facelift is a surgical procedure to improve visible signs of aging in the face and neck. These may manifest as sagging in the middle portion of the face, at the cheeks. This causes the appearance of deep creases below the lower eyelids, deep creases along the nose extending to the corner of the mouth (nasolabial line) and appearance of fats sagging in the jowls. In addition, there may be
loose skin and excess fatty deposits under the chin and jaw can which make even a person of normal weight appear to have a double chin

Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes. The appearance of the brow sagging is shown as droopiness of the eyebrows, leading to a droopy eyelid appearance and what most people term as “excess upper eyelid fats”.

In essence, what is happening is actually the laxity of the muscles and ligaments of the face, leading to sagging. Many people expect or think that a sagging face is due to poor skin elasticity. That’s only a small part of the truth. True face sagging is most of the time due to laxity of muscles like the SMAS – the anatomical name of the submuscular aponeurotic system. Because this muscle is quite deep below the skin, no amount of skin tightening procedures can create the significant improvement that a surgical facelift can achieve. Some procedures like Ulthera and Thermage may be able to achieve moderate skin tightening, but in order to really create a significant, long lasting lift, facelift surgery like rhytidectomy and brow lift surgery is needed.

What happens during a facelift surgery?

During the facelift, a small and concealed incision is made in the hairline around the ears, and a sliver of excess skin is removed. The skin is freed up from its deeper attachments, and the muscular layer is tightened with sutures. After this tightening is performed, the skin is closed with very fine and thin sutures in order to create a well concealed scar. Because the skin on the face heals well, the scar of the facelift is only visible upon close scrutiny, and in some cases is so well hidden that most people will not notice it.

How long is the downtime?

Usually stitches on the face are removed after a week post surgery. There may be swelling and bruising on the face which will last approximately 1 to 2 weeks. The skin may be slightly puckered at areas near the scar, but this will resolve spontaneously.

What are the possible complications of facelift surgery?

The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

Facelift risks include:
Unfavorable scarring
Bleeding (hematoma)
Infection
Poor wound healing
Anesthesia risks
Correctable hair loss at the incisions
Facial nerve injury with weakness
Facial asymmetry
Skin loss
Numbness or other changes in skin sensation
Fatty tissue found deep in the skin might die (fat necrosis)
Fluid accumulation
Pain, which may persist
Skin contour irregularities
Skin discoloration, sensitivity or swelling
Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
Deep vein thrombosis, cardiac and pulmonary complications
Possibility of revisional surgery

(Source: American Society of Plastic Surgeons)

Brow Lift

Brow Lift surgery is performed to reduce the appearance of a sagging brow. The common signs of a sagging brow are descent of the brow, droopiness of the upper eyelids, with reduction of the size of the eyes. Early brow sagging is also manifest as narrowing of the double eyelid line and perceived accumulation of “fats” or puffiness of the upper eyelids.

The brow lift is able to minimize the creases on the forehead, as well as to lift up the eyebrows and open the eyes wider to create a more refreshed and less droopy look.

There are both minimally invasive and invasive methods of brow lifts. The minimally invasive method involves using an endoscope to identify and lift the specific areas of the brow needed, and has a lot smaller scars which are hidden in the hairline. Using the endoscope is also safer compared to a non-endoscopic technique as vision using the endoscope allows the surgeon to avoid cutting important nerves and blood vessels during the surgery.

The invasive method is employed when shortening of a high brow is desired. In this situation, the incision stretches from ear to ear, and is usually hidden by the hairline. Excess skin is removed during this procedure, resulting in tighter and less wrinkled skin on the forehead.

Incisions are closed either with fine sutures or tissue glue, and usually the stitches are removed after 5-7 days.

In some cases, your surgeon may even employ devices such as an Endotine, which is used to suspend the forehead skin at various points to distribute the forces and achieve better suspension and lifting. These address the challenges of getting enough suspension points for minimally invasive techniques like endoscopic surgery.