Summary of what's available in 2013?

Aging is unavoidable; unfortunately the outward signs usually appear while you still feel young and have productive years ahead.The appearance of an aging face can interfere with a happy, full life in these valuable years. the outward manifestations of aging need not be accepted as a matter of course. Facial rejuvenating procedures are highly rewarding and satisfying procedures for appropriate patients.

Face lift is an operative procedure designed to remove the major folds or sagging of the skin on the face and neck that naturally occur with aging. It frequently is done in conjunction with a similar procedure for the eyelids called blepharoplasty since the aging process is usually present in this region also. A forehead lift may be recommended to elevate the eyebrows and remove deep creases.

Dr Tavakoli's Philosophy:

1. Non Surgical Liquid Face Lift

Facial ageing reflects the cumulative effects of decreased tissue elasticity, gravity, bone reabsorbtion, and the loss of subcutaneous fat and hyaluronic acid.

Subcataneous fat plays a very important role by providing volume, hence support to our face. Volume decrease creates areas of flatness and hollows, giving an aged and tired look.

Liquid face lift involves improvement of every area of the face. Combining the treatments of dermal fillers used for volumising, and muscle relaxants, the end result is a significantly more youthful appearance.

The objective of the treatment is to replace or enhance facial volume and restore the youthful contours of the face. Our aim is to help clients make educated decisions about non-surgical liquid facial rejuvenation.

Treatments can be performed quickly and efficiently, requiring very little down time and clients can return to work and resume daily activities almost immediately after treatment.


Areas of the face that can be rejuvenated:

Upper face:
Temple hollowing
Brow enhancement
Crows feet
Frown lines

Mid face:
Tear troughs
Cheek enhancement
Nasolabial folds

Lower face:
Smile lines
Lips
Corners of the mouth
Chin
Jowls

2. Mini Facelift / Short Scar Facelift

Mini- facelift is a surgical technique for facial rejuvenation, developed in Europe. The aim of the procedure is to obtain a harmonious and natural rejuvenation of the facial features.

This procedure is designed more specifically for younger patients that are seeking a very natural and subtle change. Please note that a mini-facelift has only limited effect on the ageing neck. For neck rejuvenation please see info on Full Face-neck lift.

Surgeon's Fee (Dr Tavakoli, Cosmetic Plastic Surgeon) and Surgical Assistant Fee
Anaesthetic Doctor's Fee
Theatre Fee (Only Prestigious Fully licensed facilities)
Day Bed Fee
50% off FRAXEL laser sessions

The Short Scar Facelift is a surgical technique for facial rejuvenation, developed in Europe. The aim of the procedure is to obtain a harmonious and natural rejuvenation of the facial features. This procedure is designed more specifically for younger patients that are seeking a very natural and subtle change.

Short Scar Facelift is a technique characterized by two features: first, a short scar, which does not go behind the ear, and second, the use of deep plicating sutures to lift the deep tissues called Lateral "SMAS-ectomy". Both of these features contribute to an operation that takes less time to perform, and requires less recovery time. This means less expense and less downtime for the busy patient population seeking facial rejuvenation and a shorter time back to normal activities. Dr Tavakoli has based this operation on the philosophy and technique of renowned New York Plastic Surgeon: Dr Dan Baker.

The deep tissues are elevated and the extra skin removed, so that the operation has the usual overall effect. However, there is less of a tendency for a "windswept" look a less severe and dramatic result. The outcome seems to last as long as the traditional facelift, and the patients who have had it are very pleased. With less operative time, less recovery time, less risk of complications, and a comparable result, it is Dr. Tavakoli's preferred technique.


Short-scar facelift or Mini-facelift also means reduced recovering period. You can go home the same day. The swelling will disappear after 7 to 10 days. And after one week you will be able to resume all your social activities.

It's also important to realise that a mini-facelift will not stop the skin from stretching or losing its elasticity as you grow older. A new mini-facelift can be performed after 5 to 10 years but the effect is for life. If you have a facelift, you will certainly look better after ten years in comparison to the ones who didn't have one. Sometimes, during the operation a mini-liposuction around the chin is performed. Also eyelid surgery can be performed at the same time.


Therefore, in summary there are a number of advantages to the Short-scar Facelift:

1. Quick procedure (an average of 2 hours compared to 5 or 6 hours for a traditional face-lift).
2. Operation performed with the patient under light anaesthesia.
3. Quick rehabillitation after the operation (14 days compared to 3 to 6 weeks for a traditional face-lift).
4. Inconspicuous, short scar.
5. No unnatural changes in the appearance (wind tunnel effect, too tight skin, changed expression, altered implantation of the hair lines in front and behind the ear.


Short Scar Facelift Case Study

Gail, a 51-year-old female patient describes the process she underwent when Sydney plastic surgeon Dr Kourosh Tavakoli performed a combination of procedures to give her a fresh new look.
Click here for the Face Lift Case Study

3. Face Lift / Neck Lift

The Full face and Neck Lift is designed to produce a maximum benefit in the appearance of the face by removing major wrinkles and sagging of the skin. It is impossible to remove every wrinkle regardless of the treatment, and too much surgery would result in a pulled or plastic look. Fine wrinkles, particularly those about the mouth, may require additional treatment, such as laser, dermabrasion, chemical peeling or fat injection. The face lift operation should give an improved appearance for several years.

Skin aging will continue after the operations, but this process of aging neither speeds up or slows down because of the procedure. A face lift can be done in combination with removal of fat from beneath the chin (submental liposuction) and/or rearrangement of the platysma muscle of the neck to give a more youthful chin line called Platysmaplasty.

FREQUENTLY ASKED QUESTIONS

Where are the incisions?

These vary to some degree depending upon whether the patient is male or female, the hairstyles, hairline, age, previous surgery, etc. Generally the incision starts in the temple, in front or within the hairline. It continues in front of the ear, sometimes partially hidden within the ear (tragus). It then goes under the earlobe, behind the earfold and ends either within the hairline or at the hairline behind the ear. Frequently, another incision is made under the chin in a natural skin fold. This allows fat removal and tightening of the platysma muscle in the neck.


Where is the surgery performed?

Face lifts and ancillary procedures are always performed in an operating facility. A one-night stay in a post-operative care facility may be advisable in some cases. General anesthesia is recommended for this procedure. General anesthesia is now much gentler and shorter acting with very effective medications to combat nausea and discomfort.




How will I look after surgery?

You should expect swelling, discoloration, and bruising of the skin for several weeks after a face lift. Individuals vary a great deal in their responses, but commonly the patient will be presentable within 3 weeks. However, there is usually some residual swelling which gradually subsides over a number of weeks. Make-up can be applied shortly after surgery. The marks left by the incisions are often noticeable during the first few months, but these gradually improve as the wounds mature. The scars are not usually mature for about 6-12 months. A face lift will reduce the sagging and loose skin and give a more youthful appearance to the face. The facial features themselves are generally not appreciably changed. The fine lines and wrinkles of the face are usually not much affected by a face lift. Laser or chemical peel of the skin are sometimes used to reduce fine lines during or after a face lift. Fat injections may also be recommended.

How long will it last? Because people vary so much, an exact time is difficult to give. An average figure given is 5 to 10 years. You may repeat the face lift procedure at that time if you wish. There is an improvement, compared to not having the procedure, even though the aging process continues. In occasional patients with very loose skin, early sagging may be seen as soon as the first year and require a secondary procedure to tighten the loose skin.

4. Brow Lift & Temporal Lift

It is no secret with the arrival of Anti-Wrinkle Injections in the treatment of the forehead region, the number of patients needing the procedure known medically as an endoscopic brow lift or foreheadplasty and shortened commonly to brow lift surgery has dropped.
However, there are still a few good indications for proceeding with a brow lift:

1. Lateral fullness of the upper eyelid and lower brow; common complaint from patients: looking tired. It's caused by gravitational descent of the forehead and brow skin over the orbital bony rim.

2. Frown lines are caused by contraction of the corrugator muscles between the eyebrows over the bridge or root of the nose.

3. Transverse forehead wrinkles are caused by muscle activity in raising or lowering the eyebrows themselves.

These are some typical complaints from patients wishing to surgically correct problem areas by undergoing endoscopic brow lift surgery.

Indications: For brow lift center around correcting three problems.

Lateral fullness of the upper eyelid and lower brow; common complaint from patients: looking tired. It's caused by gravitational descent of the forehead and brow skin over the orbital bony rim.
Frown lines are caused by contraction of the corrugator muscles between the eyebrows over the bridge or root of the nose.
Transverse forehead wrinkles are caused by muscle activity in raising or lowering the eyebrows themselves



Elevation of the lateral forehead [brow lift] will diminish crow's feet but will not eliminate them; the cause o fcrow's feet is squinting and wrinkling of the skin which the brow lift itself will not address.
 

The usual age range for brow lift candidates starts in the early-to-mid-40s; however subtle endoscopic techniques have been performed on patients in their late 30's .

Goals: Subtly elevating the brow

The goal on any face lifting procedure is to avoid an "operated" look. The endoscopic brow lift approach can be done by itself or in conjunction with face lifting procedures. Multiple small incisions are made on the scalp and the muscles are removed (partially by forceps) when being viewed by the endoscope. This minimizes the incision and maximizes the preservation of sensation... but a loss of sensation from the brow lift is still possible when utilizing the endoscopic brow lift procedure. The brow suspension is carried out by securing the deep fascia layer (that layer that surrounds the muscle) and is secured typically to a small resorbable bone anchor device secured in the skull above the lateral eyebrow behind the scalp. This achieves a nice result in young patients undergoing endoscopic brow lift surgery who need just subtle elevation and have very little vertical/horizontal forehead lines. The open approach typically extends the face-lift incisions to connect over the scalp. This fact--in and of itself--causes concern for some women, since it frequently results in a more predictable numbness that can last for approximately one year after the brow lift surgery. This small strip of numbness is posterior (or behind) the incision, covering an area approximately 1-2" wide. This is the one disadvantage in the open brow lift technique. A predictable and consistent resolution in the forehead and frown lines can be assured.

Recovery:

Pain- Pain is typically not a significant problem in brow lifts. While there's some discomfort and tightness from ear to ear across the top of their head and across the brow, it's usually not a significant problem in brow lifts. Drains- Drains are usually not needed in the brow area when doing a brow lift or even when used in combination with brow and face-lift. Swelling- Maximum swelling occurs 48-72 hours post-surgery and begins to subside on the fourth or fifth post-operative day.

Bruising- Interestingly bruising on a brow lift appears in the most dependent areas. As a result, any bleeding resulting from a brow lift usually collects below the eyelids and bruises the lower lids...even if the lower lids are not operated upon. Bruising's usually maximized on the third to fifth day and resolves over 2-3 weeks.

Driving- You can resume driving when you can drive to the level you were able to pre-operatively...and this is your call. You've got to be able to brake and respond quickly, as well as quickly and easily turn to eliminate your blind spot. When these conditions are met you may resume driving... typically the second or third week into recovery from brow lift surgery.

Social return- Most patients feel very comfortable in returning to work (physically, anyway) a few days after an isolated brow lift. But socially is a different matter...and you might have to keep your dance card clear for 2-3 weeks.

The average patient can return to work within 10 days, with the help of a little make-up. There may be some and some (mild) residual bruising. If bruising's minimal, the return to work after having a brow lift can be even earlier.

What are the risks of surgery after Face Lift Surgery?

Contrary to some articles in popular newspapers and lay journals, a face lift is not as simple as having a hair cut. The procedure is accomplished by an operation and as in all operations, there is risk involved. Cosmetic surgery is an art and not a science; consequently no assurance or guarantee of results can be given. All surgery has a possibility of complications and poor results; cosmetic surgery is no exception.

1. GENERAL RISKSof surgery include infection, pain, delayed wound healing, hematoma ( a collection of blood at the surgical site), bleeding, reactions to anaesthetic.

2. BLEEDING:When blood collects beneath the skin it causes excessive discoloration. Sometimes lumpswhich last many months, may occur. If blood collection is discovered, it is usually removed by taking out a few stitches and squeezing the clot out, or inserting a needle and aspirating it. If bleeding continues, it is sometimes necessary to return to the operating room to stitch the bleeding vessels. This risk is increased in people who take aspirin or who bruise easily. Let your doctor know if this is the case. Do not use aspirin or aspirin-containing products for two weeks before and two weeks after surgery. (See list of medications that may increase bleeding.

3. LOSS OF SKIN:The skin will sometimes lose its blood supply. When this happens, an area of skin will fail to survive and a number of weeks are needed for healing. Rarely, a skin graft may be needed to obtain healing. This risk is increased in smokers; therefore, you must stop smoking at least 4 weeks before and 4 weeks following surgery.

4. INFECTION:Infection in facial surgery is uncommon but can occur. This requires antibiotics, possible hospitalization. There is an increased risk toward skin loss as mentioned above.

5. FACIAL NERVE INJURY:Permanent injury to the facial nerve is very rare. It is not uncommon for branches of the facial nerve to be bruised from the operation and for the muscles of the forehead or the corner of the mouth to lose some or even a great deal of their activity temporarily. Activity usually returns to normal within a few weeks. In extremely rare instances, it may take months or more.

6. DISCOLORATION:Sometimes the skin remains discolored for many months. This may be related to the absorption of blood pigments during the healing process. Permanent discoloration is rare.

7. ASYMMETRY:Every effort is made to keep both sides even, but since no face is symmetrical to begin, mild asymmetry may remain after surgery. Some changes in the earlobe shape may occur as result of skin tension and scars. The redraping of neck skin may also result in asymmetry or differences in fullness in the submental areas.

8. NUMBNESS:Parts of the face, forehead, eyes, ears, and scalp may feel numb for weeks or months aftersurgery; this is normal and expected. On occasion, loss of sensation may be prolonged or permanent.

9. SCARS:Every operation creates some type of scar. Facelift incisions are planned to hide and minimize visible scarring. However, scars are not predictable and infrequently patients will develop scars that arewidened, thickened, raised, more red or generally more visible than anticipated (hypertrophic or keloid).Normally, scars go through a maturation process which take months. This includes an expected period of thickness redness and firmness, during the first 4-6 months. (More information on scars is available upon request).

10. HAIR LOSS:On occasion, hair loss in the temple area or behind the ear may occur. This is usually temporary and the hair re-grows in several months Rarely, hair loss is permanent.

11. PAIN:Generally facial operations have surprising little pain, however, pain is very subjective. On occasion a patient will experience tightness and discomfort for a prolonged period of time. Scars may remain sensitive for months. These situations are more the exception than the rule but they do occur.

12. DEPRESSION:Some patients may experience an emotional let down after this surgery. This may be related to the normal chemical changes after extensive surgery, or overly high expectations. It is usually self limited and does not require treatment.

13. ALTERNATIVES:Other procedures that may improve an aging face but are less extensive includechemical peels, collagen or fat injections or liposuction technique.

14. PHOTOGRAPHY:Photography isfor educational or diagnostic use is a standard and required part of patient care.

15. NO GUARANTEE:The practice of medicine and surgery is not an exact science. Although good results are expected, there cannot be any guarantee, nor warranty, expressed or implied, by anyone as to the results that may be obtained.

16. COMPLICATIONS AND ADDITIONAL SURGERY:Any of these problems noted above may require additional surgery, hospitalization, and time away from work. If this occurs, there will be additional costs for surgical fees, supplies, anesthesia, etc, depending upon the required operation.