SMAS Surgical Facelift / Rhytidectomy
A surgical facelift, also known as a rhytidectomy or a SMAS facelift, is a plastic surgery procedure for lifting the facial tissue aimed to address symptoms of aging skin like a sagging face. The surgery mainly involves the skin around the mid-to-lower cheeks, as well as the Superficial Musculoaponeurotic system (SMAS) underneath, which is how the name came about.
How does surgical facelift/rhytidectomy work?
As we age, our skin naturally loses elasticity and becomes loose. This is because production of supporting structures like collagen and elastin slow down, and the skin loses volume. Over time, the skin will sag due to gravity, giving a “tired” look stereotypically associated with old age.
The surgical facelift is performed specifically to address sagging skin in the face. Using fine adjustments to the tissues in the face and trimming of excess skin, the face can be “lifted” as the skin becomes tighter. This has the certain effects including:
- Reducing wrinkles and fine lines
- “Filling out” hollow-looking cheeks
- Reducing/removing jowls
- Tightening loose skin under the chin and jawline.
Facelift surgery is performed under local or general anaesthesia
The surgeon begins by making an incision starting at the temple area, along the hairline and down the skin along the ear. This skin flap is carefully separated from the SMAS and carefully lifted off the muscles in the face. The tissue beneath the skin surface is adjusted and trimmed as necessary, and repositioned higher up the face. Fat deposits in the cheeks may also be removed as required. The skin flap is then carefully trimmed and re-draped over the facial tissue, and any open incisions are closed with sutures.
Possible risks and complications
Facelift surgery, like most other surgeries, carries some risks. Although most of them can be avoided with good technique in experienced hands, it is important to understand them before going through the surgery.
- Hematoma, which is a collection of blood under the skin that can damage facial tissue if not immediately corrected with follow-up surgery. This is the most common complication associated with facelift surgeries and usually occurs within the first 24 hours post-surgery
- Facial nerves, muscles and other tissue can get disturbed or damaged during the surgery, causing temporary or long-term numbness and stiffness of the face.
- Some parts of the skin may die if blood supply to the area becomes disrupted
- Hair loss can occur at the incision sites temporarily or permanently. This is a relatively minor concern which can be addressed with hair transplant.
To minimise the chances of serious complications, be sure to consult an experienced plastic surgeon for your surgical facelift.
The procedure typically takes about 2 to 4 hours to complete, depending on individual conditions and requirements.
The downtime of is typically around 2 weeks. During this time, you will experience some swelling, soreness and tightness. A compression dressing will be wrapped around the operated areas to reduce swelling for a week or more.
Most patients are able to return to sedentary work after 2 weeks of recovery.
Incisions are mostly made in or above the hairline so scars will be well-concealed in the hair. Those along the side of the head are at inconspicuous regions around ears, and will be hidden in the natural creases of the face, or otherwise non-noticeable.
Results of surgical facelift are long-term but not permanent as our skin will continue to sag as we age, even after surgically tightening it. Nevertheless, they typically last 10 to 15 years, or possibly more than 20 years if you take care of your skin and health.
Even if there is weight gain, the fat will be deposited usually in areas where there are existing fat cells. So, areas treated with liposuction will typically gain fat slower than other non-treated areas.
Despite all these, be sure to maintain a healthy diet and exercise after recovery as poor health habits can still eventually allow fat to reaccumulate, and revert the effects of liposuction.
Consumption of cigarettes and other tobacco products should cease about 4 weeks before the surgery to reduce the risk of complications.
Please inform our surgeon of any medication or health supplements you are currently taking during the consultation. To prevent excessive bleeding, you may be asked to stop consumption of certain blood thinning medication 2 weeks before the surgery.
Avoid turning the head by the neck for about 2 weeks post-surgery. This will put strain on the surgical wounds and may cause them to open.
A small tube may be inserted under your skin for the first few days to help drain any excess fluid/blood.
A compression bandage will be put around your head to reduce swelling. This may be needed for 1 to 2 weeks depending on individual recovery
Strenuous activities and exercises should be avoided for at least 6 weeks
Our surgeon and clinic staff will give you more detailed post-care instructions. Please adhere to them closely.
If you are unwilling to go under the knife, you may want to consider the Silhouette Face Threadlift offered at The Clifford Clinic. This is a minimally invasive face lifting procedure using fine, dissolvable threads to provide structure to the face and lift it.
The Silhouette Face Threadlift takes about 30 minutes to complete, and produces results lasting for about 18 months.