Facelift Surgery in India

Facelift surgery in India is become one of the most popular required among the world! The reason of popularity of Facelift surgery in India is cost! At almost 3000 USD one can get deep plane Facelift surgery in India

What is facelift surgery?

Ideal facelift surgery is a procedure that attempts to reverse visible signs of ageing in face and neck such as sagging skin, jowl formation, loss of neck contour, skin wrinkling, perioral wrinkling, and prominent frown lines. It is a surgical procedure which may include removing excess skin, lifting facial muscles and skin tightening.

All these help to make face appear younger. Although additional procedures to supplement facelift may be necessary for better results.

What are the advantages of facelift surgery over Botox and fillers?

 The results seen after facelift surgery are far more superior and longer lasting. Results last as long as 10 years or more. They are almost permanent and not temporary like Botox and fillers which last for at the most 3 to 6 months and require consistent maintenance.

A facelift can treat more serious issues like sagging skin, jowl formation which injectable cannot. Overusing fillers can give a weird unnatural appearance. Any younger individual below 50 who do not have significant loose cheek and neck skin may do well with Botox and fillers but anyone above 50 with sagging skin will require more appropriate and durable treatment.

Are Cervicofacialrhytidectomy and facelift surgery different or same?

‘Rhytidectomy’, this word is derived from Greek words ‘rhytis’ and ‘ektome’ which literally means the removal of wrinkles in English. ‘Cervicofacial’ refers to the area of neck and face. Although inaccurate it is a technical term for a facelift. They both mean the same. Facelift remains the ultimate rejuvenating cosmetic procedure which is different for every patient and situation depending upon ageing, general health and personal habits of the patient.

How facelift surgery is performed?

A facelift is a customized procedure and is different for every patient and situation. It varies from extremely conservative to aggressive and specific procedure determined by the amount of ageing, general health, personal habits such as smoking, drinking alcohol and eating habits. This surgery is mostly done under general anaesthesia. Pt can go back home the same day.

Incision placement is determined by the surgeon’s judgment. In many cases, incision is started inside the hairline at the side of the head and continued in a natural skin line around the ear lobe and extends at the back of the scalp. After initial incision skin is separated from underlying fat and muscle. Skin is generally stretched upwards and backwards and excess skin is removed. Suspending the skin in the right direction can make a facelift appear normal. The operated look is frequently caused by pulling the skin in an incorrect vector. In some cases, a small incision is frequently necessary under the chin and fat deposits beneath the chin and neck may be removed and deeper layer of neck tissue maybe corrected.

After the excess skin and fat are removed remaining skin is gently laid back over the rejuvenated facial tissues without over tightening the skin. Incisions may have dissolvable sutures or you might have to return to the surgeon to have stitches removed. Normally patients will have drainage tube after surgery as well as bandages wrapping on their face.

We take all precautions to place scars in the most hidden areas and spend time using plastic closure techniques to ensure best possible scar. Occasionally we need to perform minor revision or laser of the scar to improve their appearance.

A facelift is primarily performed to improve sagging tissues of the lower portion of face and neck, therefore multiple simultaneous procedures such as eyelid tuck, brow lift, skin resurfacing and facial implants are done along with facelift in order to address all aspects of the ageing face.

What should one expect after facelift surgery?

Word facelift means different things to different people. Proper communication between doctor and patient plays a very important role in overall happiness after the treatment. People think facelift involves complete rejuvenation of the face when in reality facelift primarily treats the lower portion of the face and neck. It will have little effect on generalized upper face wrinkling and additional procedures such as eyelid tuck, bow lift, skin resurfacing and facial implants may be required. Clinical results also vary among patients due to factors such as facial shape, lean body weight, and position of throat, floor of the mouth and facial features.

After surgery pressure type bandages and drains are normally placed and these are removed after a day or two under the guidance of the doctor. Patients that undergo facelift surgery are likely to swell and bruise especially when performed with multiple other procedures. They should not be alarmed when after removal of the dressing if the face appears swollen. It goes down quickly. Numbness is also very common with most facelift procedures and will resolve naturally over the coming weeks.

Facelift scars generally heal in an excellent manner but they look worse before they look better. Scars will go through multiple stages of healing and at times look better or worse. It may take a few months to begin seeing the final results of a facelift. Patience is the virtue to be kept at all times here.

How to choose the right surgeon for facelift surgery?

Contemporary facelift surgery is a combination of art and science and requires significant experience to become proficient. Many subtle technique sensitive steps and nuances must be appreciated by the surgeon to provide predictable results with few complications. It is an ultimate feel younger cosmetic procedure and a surgeon attempting this procedure should be very comfortable dissecting a

SMAS (superficial musculoaponeurotic system) flap. Thorough understanding of the anatomy of nerves, restraining facial ligaments, musculature and submandibular gland relative to dissection is essential.

Cosmetic surgeons can have many subspecialties within the field. Therefore basically a surgeon who has a thorough knowledge and is well versed with the anatomy of the maxillofacial region is important to give great results. His years of training in this area of expertise and also experience of performing this particular procedure are important. Every facelift patient is a walking advertisement therefore very important to look at the before and after pictures of the patients operated by him.

In general, things to consider while walking into a facial cosmetic surgeon’s office are his qualification, his training, his experience, his success rate, his operating room facilities, and his team which must include certified anesthesiologist, dermatologist and support staff. All play a crucial role in the smooth functioning of the surgery and aftercare.

At the end doctor who is willing to listen and answer all the queries of the patient and who gives correct and honest information and expectation to the patient makes for a good surgeon.

What is the downtime or recovery period after facelift surgery?

A facelift is the most dramatic procedure for looking younger and attention must be paid to the recovery process as well.

The first day after surgery patient may feel unsteady, sleepy. Complete rest is absolutely necessary during this time. Elevate the head and talk as little as possible. An adult caretaker alongside you is necessary during the first 24 hrs. Pain medication will continue for 5 days after surgery. After that, you might no longer need them.

During the first postoperative week, any activity must be kept to a bare minimum,only what is required to take care of oneself. Surgical dressing and drains will be evaluated by the doctor and changed or removed in a day or two. Patient that undergoes facelift is likely to swell and bruise. Don’t be alarmed if the face appears swollen after the dressing is removed. It goes down quickly. Bruising on the neck and around mouth and eyes are also common.

During the second week, the patient may still have some swelling and bruising around affected areas and also feel numbness which is very common in such surgeries and will eventually resolve naturally over the upcoming weeks. Stitches might be removed anytime during this period depending on the nature of the surgery and healing process. Strenuous activities should still be avoided although many patients start feeling normal and are ready to resume work and begin doing a light form of exercise like walking.

After 4 to 6 weeks normal activities can be resumed. This is also the time when patients begin to see real improvements in their facial contour. Scars go through multiple stages of healing. They look worse before but eventually begin to fade with time.

In short, patient can start normal activities within two weeks but final settled in result is a month or so away.

What is the downtime or recovery period after facelift surgery?

A thorough history and physical examination are necessary before proceeding with any aesthetic procedure. Patient medical condition, current medicines, prior surgical history and allergies all part of pre-op evaluation. Thorough physical examination in a well-lit room should be carried out to evaluate each anatomical subunit of the face as well as conditions of the skin.

Detailed examination of facial nerve function for comparison postoperatively. A pre-operative workshop should include pre-op photographs in 3 views (lateral, Anterio- posterior and oblique) Age appropriate laboratory test as per hospital guidelines are done like CBC, Coagulation panel, HIV, Hepatitis C, TSH, LFT, RFT, ECG and chest x ray. The routine pre-op screening will uncover cases of undiagnosed disease such as diabetes. Myocardial function, thyroid disorders, anaemia and likewise. Special factors have to be considered in such cases as patients having hypertension or taking aspirin may cause postoperative hematomas. Chronic smoking may also contribute to post-operative skin necrosis in some cases. Therefore patient preparation must include avoidance of sun exposure, alcohol, tobacco for 2 weeks before surgery. Use of aspirin, non-steroidal anti-inflammatory drugs, estrogens and anti-coagulants should be stopped two weeks before surgery. Facelift is an elective surgery. Therefore all such precautions are mandatory. Also psychological status is extremely important for many factors including stress and ability to adequately follow instructions.

What are post-operative instructions after facelift surgery?

Postoperative care is equally important for the success of the surgery. Unnecessary pain and other complications may be minimized if instructions are followed carefully.

1. Take pain medications as prescribed by the doctor.
2. After general anaesthesia or IV sedation clear fluids should be initially taken. Over the next several days; high calorie, high protein intake is very important.
3. For the first 24 hrs, total rest is absolutely necessary. Pt should be accompanied by an adult caretaker during this time.
4. Elevate the head and talk as little as possible. Do not sleep on the side of your face for about 2 weeks.
5. Small gauze wrap dressing is given to the patient which will be removed the next day. Drains might also be placed which will be removed in a day’s time. Antibiotic ointment should be applied to the incision line after removal of the dressing. Keep the incision area clean to prevent any kind of infection.
6. Pt can take bath and head wash after 48 hrs. Hair color should be avoided until 3 weeks from the time of suture removal
7. For the first week after surgery face and neck are likely to swell and bruise and feel very tight, this is normal. It may also be difficult to open your mouth for the first several days. Do not force head turning or mouth opening as it could tear stitches. Avoid any extreme movements of face, neck and mouth.
8. Driving should not be resumed until it is comfortable to move the Head without any restrictions.
9. Any form of exercise other than walking should be avoided for at least 4 weeks after surgery. Normal activities can be resumed slowly after 6 to 8 weeks.
10. Please come for a regular checkup as scheduled by your doctor. In case of any doubt or to obtain urgent care, call the operating office at the given no.
11.  

Facelift is a surgical procedure?

Yes, the face lift surgery is considered to be a major surgery. It is a surgical procedure, it is performed under the general anesthesia. It is best for the patient who has the double chin double or very loose skin on neck and giving appearance of “Turkey face”.

Surgery on a face?  Does it leave scars and marks?

The face lift surgery is being performed through the envelope flap, the incision is placed just around the ear and in a subcutaneous plane means the surgical plane is just below the skin is addressed.  We do have a superficial musculoaponeurotic system (SMAS) which is greatly responsible for the youthful look of the face. This particular superficial musculoaponeurotic system is tighten up and excess amount of a skin is being removed.  The scars and the marks are just around the ear after a few month of a surgery which is almost invisible or rarely visible.

 After doing a face lift the double chin issue or sagging of a skin below the chin which is very common can be addressed?

Definitely yes.  The excess skin is being pulled from both the sides around the ear which actually addresses the lower half of the face (Nek) and after doing a procedure one actually get a prominent jawline.  Also, the sagging and a bagging or a jowl formation like a laughing lines can be addressed the best.

How exactly the facelift is performed?

First of all patient is taken into the general anesthesia. The careful evaluation prior to the surgery is really a key role.  Just beneath the chin which is also called as a shadow area of the face, tumescent solution is injected. Tumescent solution dissolve the underlying fat. After tumescent solution injections Cannulation is done. Cannulation is more like breaking the fat lobules into tiny pieces so one can easily suck it out. There are different cannula available to breakdown fat, according to patient need we have to use correct one. Also, after breaking fat in to small pieces, with the help of high vacuum suction device, fat is sucked out of the Face. Such facial liposuction helps to reduce the volume over the neck. After proper liposuction on Neck area muscle which is like curtain on neck “Platysma” is tighten up using Sutures. Tightening the Platysma is called as “Pltysma Plication”. Platysma plication is greatly helpful to get tight skin over neck.   After the closure in neck area, we lift the face from the sides. Such dissolving of fat is done on both the sides of cheek also from Mandibular jaw line using tumescent solution and liposuction unit. After liposuction over the face, in right surgical plane skin layer is separated from underlying SMAS layer. After which I trim the some amount of SMAS layer to lift the face. Make sure, you trim the correct amount of SMAS and pull the SMAS in right vector. Tightening the SMAS layer makes your Facelift really long lasting one. Right vector of tightening SMAS layer can only give you Natural looking Facelift. After which excess skin is removed from both sides which is around the ears. Make sure there is no active bleeding. Close the flap with sutures. I personally prefer to put drains for surgical site which helps for faster recovery and helps to reduce swelling.

Do I need to get admitted for the face lift surgery?

No. Dr.  Vaibhav Shah Clinic perform the surgery in the morning hours and till night we make sure the patient is under observation. At night along with the qualified nurse we send back to the patient to their home or hotel the respective locations. We make sure the qualified person is with the patient at least for the coming 72 hours in case of any problem and emergency. Our Centre is always open and well equipped to deal with any complications.

Do I get any bandages after the surgery?

Yes. To cover of the suture lines and closure we do give bandages around the ears also below the chin.  We usually remove after the two days of the surgery, while removing the drains.

How much age difference does it make after doing the face lift surgery?

Generally what we have seen after doing the proper cervicofacial facelift surgery you can start looking younger by at least 10 to 15 years.  The biggest advantage of this particular procedure is it is permanent unlike Botox and fillers. One no need to do it again and again after every 12 to 15 months or 18 months so once you go for the face lift surgery, it is by and large a permanent procedure.

How will I look after the face lift surgery?

Believe me, this is one of the most common question.  We get this question from everybody. Everyone like to know as they are going for the one specific procedure which is only for the Youthfulness of the face.  It's very important from the patient point of view. How they will look after the surgical procedure? One can actually just sleep down on the bed and tried to pull the chin upwards and then you must see yourself in a mirror, it's important that you keep a mirror in your hand and then see yourself. Kind of looks you get, same looks you will get after the Facelift.  We are actually putting the gravitational force in the same direction like facelift. This is one of the simplest method to understand how much amount of a difference will be created after the facelift surgery, also most of the software which predict the face lift surgery are not accurate and there is always a chances of error. When you opt for any software to predict your look after the surgery, it is misguiding.  The above mentioned method is one of the easiest tool and one can easily understand how much amount of a difference it will be created.

Why do we need to facelift surgery?

I mean why we starts looking so old on face with age?

Well along with the age, that is change in a bone level as we have a more amount of osteoclast cells than your osteoblast cells, so there is a change in hard tissue or at the bone level due to the factor which is responsible for the aging. We do lose the collagen fiber which is just beneath the skin at the subcutaneous level, so we get the distribution of a fat in a localized area which gives the begging on a one specific area and deep lines or a wrinkles on counter pert. Such localized accumulation of fat, changes in bone cells, loss of collagen fibers gives you the appearance of old looking face.  To correct this there are many procedure but only surgical facelift actually addresses the superficial musculoaponeurotic system as well as it removes the excess amount of sagging skin which is actually responsible for the older looks. Undoubtedly, the facelift is not a mandatory procedure it's always a willingness of a person but someone who is regularly going for the Botox and dermal filler for the youthfulness for the face are the most ideal candidate to go for the face lift surgery as they already experience the charm and the glamour of a youthfulness. The right understanding of a surgery is also equally important as we do not claim that the hundred percent of the wrinkles goes out of the face but definitely we can achieve the best possible result under the sky by doing this particular procedure.

Rather than a big face lift may just go for a “mini lift”?

Well, here we have to understand the difference between the Mini lift and the proper lift. It is very important we have to do the undermining of a tissue or we remove the excess amount of a fat from the deep wrinkles and the begging from face.  Somebody has a very mild laughing lines are probably few strings on a neck which is sagging up can think of a mini lift, as a mini lift is the undermining of a tissue is done only till four inches but if somebody has lot of fat over and neck (“Turkey Neck”) and it is like a lot of Jowl on the chin area or having a double chin are not a right candidate for the Mini lift. should depending upon the amount of fat deposition the amount of a permanent wrinkles what one habit on a face the actual procedure can be done it is very important that you select the right surgeon and you do the proper evaluation before going for the facelift.

Is there any complications of a facelift?

Not a single major surgery is without a complication.  Yes, mild numbness around the ear is one of the commonest problem which usually get settle down within 6 to 9 months after the surgery.  The bruising and the swelling is something which is common after the facelift surgery which also get settle down in 8 to 10 days after the surgery. The scarring around the ear is also sometime very prominent invisible if it does not settle down after the 90 days of a surgery one can do the scar revision. Probably just the carbon dioxide laser over the incision which makes it really less visible.  But whenever you with the experience surgeon and proper set up and somebody who is regularly doing the facelift surgery such problems can be avoided and one get the happy outcome.

Surgical facelift is permanent?

Yes, unlike the any other lift like vampire lift, liquid lift, thread lift, filler and Botox lift, surgical facelift is only procedure where we remove the excess amount of skin. The right cannulation and remove the excess amount of a fat and we give rejuvenation to the superficial musculoaponeurotic system. We actually cut the some amount of face mash layer, can be produced the tightness over the face.

Why do someone get a mask like appearance after the facelift?

It’s basically the wrong vector in which skin and SMAS layer is lifted, which is responsible for such appearance.  It is very important when you reach beneath the skin in a which particular direction you have pulled the skin, if you have pulled the skin in superior direction or direction towards the temporal bone then probably one get the mask like an appearance.  For the most natural outcome one need to pull the skin towards the ears in natural vector, which gives the best r the face lift surgery results. These are the very minute points but it makes a really huge difference. Definitely the understanding of a surgeon regarding the face lift surgery plays the key role for giving the most natural face lift surgery outcome.

Message from Dr Vaibhav Shah

I am basically a maxillofacial surgeon and trained myself into the facial cosmetic surgery under really knowledgeable and skillful surgeon Dr Joe niamtu. Would like to address to the anyone and everyone who are thinking of any facial cosmetic surgery or procedure.  I do believe being a doctor we need to give back to the society, if you have any questions regarding the any procedure for facial cosmetic or hair transplant you are always free to approach me on email or you can also approach me on my What’s app number as and when I get the time I make sure I give you my honest possible advice. The money doesn't make a difference to me but to help the community is my basic Motto.  To give such an advice or opinion on any electronic media I do not charge anything. My intention is just to help you and help the community as the community and the society has given a lot to me. Thank you