Pain after a deep plane facelift is usually minimal because the deeper layer (SMAS) is lifted after dividing its underlying attachments (retaining ligaments) which means the procedure is performed without the tension. This contrasts with older type SMAS facelifts where underlying release was limited which meant that tension in the face was more likely. Most deep plane facelift patients will say after surgery that it was not painful although some have a tight feeling in the neck initially which improves over the first few days as the swelling settles, usually resolving by a month. Patients undergoing facelift surgery with Mr Grover are sent home on Paracetamol which is usually all that is required to keep them comfortable
Most definitely yes. Nicotine within cigarette smoke is a potent vasoconstrictor (i.e. makes blood vessels constrict) which therefore reduces blood supply in the skin and increases the risk of infection and wound healing problems. Mr Grover will recommend having no nicotine for a minimum of two months before surgery and one month after. This includes cigarettes, cigars, nicotine inhaler, nicotine patches, nicotine chewing gum and vaping.
Facelifting puts the ageing clock back by 8-10 years on average, but of course, cannot stop it from ticking. Ten years after your facelift you will certainly have aged but will still look younger than if you did not have the surgery. Please remember that ageing is not a linear process but can occur in spurts which follow periods of stress, illness, or weight loss. Consequently, no surgeon can honestly predict exactly how long the improvement will last which is why the figure of 8-10 years is quoted as an honest average. There are some patients for whom the rejuvenation can be 15 years but equally some for whom it is less than the average because they may have suffered an ageing spurt. Mr Grover exclusively performs the Deep Plane Facelift technique which has been shown to have a greater longevity than other SMAS facelifting techniques.
The key to deep plane facelifting is repositioning the deeper layer (SMAS) without tension. This requires releasing the underlying attachments of the SMAS to its retaining ligaments. The SMAS is continuous with the platysma muscle in the neck which is the deeper layer of the neck that supports its shape. If a deep plane facelift is correctly performed and the retaining ligaments are released, then moving the SMAS automatically moves the platysma in the neck at the same time. In general, if a deep plane facelift is being performed it will automatically lift the neck so the two are inevitably a combined procedure.
The requirements for a successful facelift are that there has been gravitational descent and laxity within the soft tissues. Losing weight impacts the face as fat is lost from under the skin (superficial fat compartment). This can exaggerate the effects of gravitational descent as the face empties and also increases laxity. For both reasons losing weight before facelift surgery can help make the operation more effective. Conversely to loose significant weight after surgery is unhelpful and may cause some skin relaxation. If you are planning to lose weight please do it before facelift surgery and definitely not afterwards.
Swelling is usually at its maximum 2-3 days after surgery. It is very important to follow the guidelines for keeping swelling to a minimum because it has a tendency to come on quickly but resolve very slowly. Sleeping elevated, cooling the face, and avoiding exertion will help swelling reduce faster. After one week most patients are starting to see the swelling begin to resolve, this reduces by 50% at 2 weeks and 75% at 4 weeks. Swelling is generally gone by 3 months in most patients.
Vitamins and supplements are blood thinners so they increase the risk of bleeding with surgery. Mr Grover will advise you stop vitamins at least two weeks before your operation but they can be re-started after the procedure when the risk window of bleeding has ended. This is after your stitches have been removed which is approximately 10-12 days post facelift.
In a word – Essential! Rajiv uses your younger photographs firstly to do some detective work to determine whether your face has aged by volume loss, gravity, or bone loss. This helps to establish what is possible surgically and what is realistic. Secondly, he uses your younger photographs as a road map to plan and guide surgery so you keep looking like YOU. This technique is termed Facelift Couture and was developed in collaboration with Alexander McQueen to help customise facelift surgery for each individual patient.
This is so common in the early stages of facelift recovery please consider this normal. The two sides of the face do not swell equally after surgery and following this the healing rate also differs. As healing progresses both sides even up but it is important to remember that no two sides of the face are ever symmetrical so if there was asymmetry to start with (often related to the bony skeleton under the soft tissues) the two sides will never be entirely symmetrical after surgery. This reflects what the underlying structure of the face was like before surgery.
The day after surgery Mr Grover will come to remove your bandages. The nurses in the hospital will then wash your hair gently later that day. Following this it is best to avoid washing hair till after your first appointment with Rajiv at 5-6 days. You will then be given instructions how you can wash your hair at home twice before you see him again at 12-13 days post-surgery for your second visit.