Face lift (Meloplasty)

About meloplasty

What is a face lift?

  • As we age, our facial skin becomes thinner, less elastic, and the fat and support structures shift and weaken. This can make us look tired or older than we feel. A facelift (also called a "meloplasty") is surgery that lifts and repositions these tissues to restore a more youthful appearance.

  • Facelift and necklift can target different areas of the face and neck. In some cases, other procedures like eyelid surgery (blepharoplasty), brow lift, or lip lift, skin resurfacing procedures (microneedling, chemical peel, laser) may be done at the same time.

How does a face lift work?

  • The face has several layers – skin, fat, connective tissue (called SMAS), muscle, and bone. Most facelifts focus on tightening the SMAS layer for long-lasting, natural results, rather than just pulling the skin tighter.

  • Ideal candidates for a facelift are usually between 40 to 70 years old, though younger or older patients may benefit from a facelift too.

  • A facelift can help you look refreshed and more youthful, but it is important to remember that the facelift itself does not stop the ageing process.

What are the different types of face lift?

  • Skin only facelift: an old technique pioneered around 100 years ago, which relied upon lifting the facial skin only. In some cases, this may be useful but this technique cannot be relied upon to provide long lasting results.

  • SMAS facelift: this is currently one of the mainstays of face lifting. The thin muscle and soft tissues over the cheek, jaw, and upper neck is tightened and skin is re-draped over it.

  • Deep plane facelift: this procedure was introduced in an attempt to improve sagging cheeks and deep nose-to-mouth lines. This technique is more demanding and the risk of nerve injury is greater.

  • MACS lift: this technique addresses the SMAS layer which is tightened and lifted by sutures. It is a less invasive procedure, with faster recovery times. 

  • Sub-periosteal facelift: this technique is designed to lift the forehead and mid-face through incisions in the scalp. There is a higher risk of nerve damage and the downtime is significantly greater with more swelling and takes some considerable time to recover. The results of this technique can be variable.

What adjunctive procedures can be done with facelifting?

  • There are a number of useful procedures that can be employed to enhance the effects of a facelift, including:

    • Lipofilling (facial fat grafting) to restore volume loss to the cheeks, eye area, and to soften deep grooves in the face (nose-to-mouth groove).

    • Chemical peeling to improve the appearance of moderate to deep wrinkles.

    • Nanofat microneedling to improve skin quality and texture.

    • Other facial cosmetic procedures like brow lifting and eyelid surgery which harmonises the overall facial rejuvenation.

About blepharoplasty

    • The eyes are often the first thing people notice when they meet you – and also the first place where signs of aging appear.

    • Blepharoplasty is one of the most common cosmetic procedures in plastic surgery. While it might seem like a simple operation, obtaining a very good surgical result requires a deep understanding of facial anatomy, ageing, and surgical techniques.

    • Older techniques often removed too much tissue, sometimes leaving the eyes looking hollow. The way Dr Law approaches blepharoplasty is to reduce the excess skin around the eyelids, but also to restore the volume that has been lost around the eyes during the ageing process. By combining these steps, a more natural and youthful look can be achieved - without the hollowed or “overdone” appearance.

Surgery

    • Consultation:

      • You’ll have at least two consultations with Dr Law to assess your face and plan your surgery. Photographs may be taken.

    • Before surgery:

      • Stop taking aspirin or medications that makes you bleed, if medically cleared to do so for 1 week before the surgery.

      • Stop smoking for at least 6 weeks before surgery and until all wounds have healed.

      • Avoid alcohol for five days before surgery.

      • You will be given fasting times for surgery.

      • Please arrive at the hospital on the day of surgery with no makeup or creams on your face.

    • For a facelift: incisions are usually hidden in natural skin creases – along the hairline, around and behind the ears. Sometimes, a shorter scar (called a short-scar facelift) may be possible if your neck doesn’t need lifting.

    • For a facelift combined with necklift: additional incisions may be made including under the chin.

    • Scars fade over time but won’t disappear completely. Most are well hidden, though some areas (like behind the ears) may take longer to settle. If needed, minor scar revisions can be done later under local anaesthetic.

    • Facelifts are usually done under general anaesthetic, and you’ll stay in hospital overnight.

    • After surgery:

      • Your face may be wrapped in a bandage

      • Small drains may be placed to collect fluid.

      • You’ll be propped up in bed and encouraged to stay calm.

      • At home, rest with your head elevated on four pillows.

      • Avoid smoking and alcohol while healing.

      • Expect swelling, bruising, and tightness for a few weeks.

      • Pain is usually mild and managed with paracetamol.

      • Stitches and hair staples are removed between 7–10 days after surgery.

      • You can wear makeup after your stitches are out.

      • Most people return to normal activities in about three weeks.

      • Please note that the exact recovery will differ depending on the adjunctive surgeries performed at the time of face lifting.

  • The effects of a facelift last many years, but a facelift doesn’t stop the ageing process. Some people choose to have another facelift 8–10 years later. Maintaining good skin care and sun protection can help the facelift results last longer.

Risks & complications

    • Drug reactions: You can have reactions to anaesthesia. However a fully qualified anaesthetist will speak to you before surgery to ensure your anaesthetic will be as safe and smooth as possible.

    • Allergic reactions: Allergic reactions to materials such as sutures, dressings, or antiseptic solutions are possible. We will ask about any known allergies beforehand to help avoid exposure during surgery.

    • Infection: This is a rare complication. You will be given antibiotics at the start of your surgery (as you go to sleep), as well as a course of oral antibiotics afterwards, to help minimise this risk. 

    • Bleeding and haematoma (blood clot): a bit of bleeding onto the dressing is common and usually stops on its own. There is a very small risk of blood clots, requiring drainage.

  • Most complications are rare but all surgery carries risks. These include:

    • Swelling and bruising: common but usually mild.

    • Temporary nerve weakness or numbness: usually improves over 12–18 months. But in very rare cases, this may be permanent.

    • Scars: generally settle well, but some may stretch or become raised (especially in red-haired or sun-exposed skin).

    • Small cysts or hair regrowth behind the ear: usually resolve on their own.

    Choosing a specialist plastic surgeon with proper anaesthetic support helps minimise these risks.

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