Lifting is a surgical operation undertaken to correct the relaxation of soft tissue and to restore a more youthful appearance.
This radical but definitive procedure is carried out in order of time after other treatments such as fillers, botulinum and stem cell transplants that, being less invasive and less expensive, are often tried first to contrast the signs of time.
Facelift nevertheless continue to be the most definitive, long-lasting anti-aging procedure, which cannot be satisfactorily replaced by any other kind of intervention: guaranteeing results that can last at least 10 years.
Precisely for this reason facelifts must be considered to be, to all effects, a surgical intervention and considering the ambitious results desired, must be allotted an adequate healing period.
Typical signs of ageing are:
  • appearance of nose-lip and nose-cheek grooves, wrinkles around eyes and lips
  • skin spots or other skin discolourations
  • facial fat redistribution
  • skin elasticity loss
Although some of these signs can be treated, at least temporarily, using certain techniques or substances, the problem of skin relaxation and the effects gravity can only be properly remedied by a facelift.
Perfect candidates for facelifts are patients whose facial skin has started to sag and relax, with effects noticeable along the jaw line and under the chin.
The effect of lifting is an improvement in:
  • deep wrinkles under lower eyelids
  • deep folds along nose and mouth sides
  • sagging skin and familiar double-chin
  • fat redistribution flaws
The first step after deciding to undergo a facelift operation is to arrange a consultation with a cosmetic surgeon to assess various factors, such as skin elasticity, facial structure and the extent of wrinkles and folds present, that influence the choice of facelift operation to be performed, taking into account also the patient’s expectations.
Preparing for Surgery
During the two weeks preceding surgery it is necessary to inform the surgeon of all medicines you are taking and, where possible, suspend some in order to avoid complications of any kind arising. In some cases, specific cures are prescribed that must be adopted as a precaution to reduce the risk of bruises and swelling that may result from the operation.
It is strongly advised not to smoke during the months before and after the operation, and to follow a special diet that encourages correct healing of tissue.
Surgical techniques
Operating techniques have evolved over years, passing from simple superficial facelifts to lower depth (deep plane) interventions. Today, different techniques exist including deep lifting that involves the SMAS (Superficial Muscular Aponeurotic System), endoscopic lifting, and mini-lifting.
Initially, this type of intervention was of interest mainly to a female public, however today facelifts are also very popular with male clients, with the adoption of certain changes in technique to take into account the presence of beards.
Surgical phases
The type of anaesthesia used varies according to operation type, ranging from a simple local anaesthetic to cases where administration of general anaesthesia is advisable.
To perform a facelift it is necessary to make a couple of incisions at the front of and behind the ear, at times extending into the scalp. Where possible, these incisions are made to coincide with natural skin folds so as to be least noticeable. It is advisable to adopt a long hair style so as to conceal better the marks during the healing period. In the case of facelifts for men, incisions are made to coincide with the natural folds of the beard.

After incisions are made, the skin is gradually separated and the deepest layers of the face in the deep plane are raised. Excess tissue is removed and the skin sown again with the right tension. A facelift is normally performed in outpatients surgery, and takes from 2 to 4 hours.
Occasionally it may be advisable to stay overnight at the clinic.

Post-surgery treatment
After the operation, a light medication is applied as a protection to the area subjected to the intervention.
Discomfort experienced after the operation varies from person to person and can be handled by means of pain killers and ice applications.
During the following 24 hours, various degrees of bruising appear on many patients: it is therefore necessary to abstain from tiring activities during the healing period until swelling has completely subsided. This period varies from 4 to 6 weeks, however even after the first 2 weeks it is normally possible to notice a marked reduction in swelling.
In any case it is advisable that you schedule your facelift operation at least one month before any important social events you would like to attend.
For up to 2 months after the operation, skin may appear rough and dry.
Facelifts, likes all surgical operations, bring with them a certain number of risks that vary according to the type of operation executed, patient’s state of health and correct observance of the surgeon’s recommendations during pre and post-surgery phases.

Generally-speaking, the types of risks that may be encountered are:
  • pain and haematomas
  • infections
  • hypertrophy scars
  • scarce healing of incisions
  • facial nerve damage
  • sensitivity alterations
  • incision site hair loss
  • dissatisfaction with cosmetic results
Many risks can be minimised by resorting to mini-invasive surgical methods, while to prevent post-surgery bleeding it is fundamental not to take medicines and painkillers that the surgeon has warned against.
It is also important to be able to recognise instantly symptoms of post-surgery infections, such as fever or excessive pain, in which case you must contact your surgeon immediately.

In any case, the best way to strongly reduce any risks associated with facelifts is to choose to have your operation performed in Italy, at a clinic with leading edge facilities, and where there are doctors you can rely on, with proven experience and skills, and really possessing a specialisation in plastic surgery. To check this, the list of registered medical practitioners is available on the port of the National Federation for the Orders of Doctors and Dentists (Federazione Nazionale degli Ordini dei Medici Chirurghi e degli Odontoiatri).
Recovery times
The time required for full recovery after a facelift depends on the dimension of the area involved: mini-lifting operations require much less healing time than operations involving the SMAS. In cases where a facelift is carried out at the same time as other operations, such as eyelid surgery or nose shaping, a longer time of course will be required for recovery.
Although the healing process varies from person to person, there are certain common effects.
In case of a general anaesthetic, nausea and light-headedness may be experienced after surgery.
A soft dressing is applied to the face at the end of the operation, which must be removed the next day and replaced with an elasticised garment. Some tiny tubes may issue out of the medication for the purpose of assisting the blood to drain: it is essential that you obtain precise information from your surgeon on all steps to take to manage post-surgery medication.
In the days following your facelift it is advisable to avoid rotating your neck excessively, and you must keep your head raised for at least two weeks, even during sleep: to make this easier it is advised to support yourself with a number of cushions when resting.
Make-up can be used again about one week after surgery, while you should avoid exposing your skin to the sunlight and, even more importantly, avoid breathing in smoke either through passive and/or active smoking.
Complete results can be seen normally 3 to 4 weeks after surgery, after which time facial contours will have been redefined and the patient will feel comfortable again. However, a few months will be necessary before all swelling and residual numbness subside, and also for scars to completely disappear.
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