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Facelift Sydney / Necklift & Brow Temporal Lift

Dr Kourosh Tavakoli Member Of Australian Society Of Plastic Surgeons, International Society of Aesthetic Plastic Surgery, Australasian Society of Aesthetic Plastic Surgery, UNSW Australia, Fellow of the Royal Australasian College of Surgeons

Facelift Sydney / Necklift & Brow Temporal Lift by Dr Tavakoli

Summary of available treatment in 2017

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.

Dr Tavakoli’s Philosophy:

1. Non Surgical Liquid Face Lift

Facial ageing reflects the cumulative effects of decreased tissue elasticity, gravity, bone reabsorption, and the loss of subcutaneous fat and hyaluronic acid. Subcutaneous fat plays an important role by providing volume and support to our face. Volume decrease creates areas of flatness and hollows, giving an aged and tired look. A liquid face lift involves improvement of every area of the face. Combining treatments of dermal fillers and anti wrinkle injections, the end result is a significantly more youthful and refreshed 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 enabling clients to return to work and 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. 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.

Case Study: 51 year old female. Before and After, Full Face and Neck Lift, Blepharoplasty and Rhinoplasty. Fat grafting to mid and lower face.

51yo female, Before and After, Full Face and Neck Lift, Blepharoplasty and Rhinoplasty. Fat grafting to mid and lower face.
51yo female, Before and After, Full Face and Neck Lift, Blepharoplasty and Rhinoplasty. Fat grafting to mid and lower face.

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 anaesthesia is recommended for this procedure. General anaesthesia is now much gentler and shorter acting with very effective medications to combat nausea and discomfort.

Face Lift Neck Lift Procedure Diagram 1 By Dr Kourosh Tavakoli Face Lift Neck Lift Procedure Diagram 2 By Dr Kourosh Tavakoli Face Lift Neck Lift Procedure Diagram 3 By Dr Kourosh Tavakoli

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

3. Brow Lift & Temporal Lift

Indications: For brow lift center around correcting three problems

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, centered around correcting three problems

  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.

Elevation of the lateral forehead [brow lift] will diminish crow’s feet but will not eliminate them; the cause of crow’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 lift surgery 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.

Return to work

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 is minimal, the return to work after having a brow lift can be even earlier.