Facial rejuvenation: how do I know which procedure is right for me?

Leading consultant craniofacial plastic surgeon Mr Niall Kirkpatrick answers some of the most common questions and doubts surrounding the well-known 'facelift' procedure, or facial rejuvenation as it should be more accurately known. 

What is a facelift? 

The term 'facelift' really is a rather historical term to describe the facial rejuvenation techniques that were available in the early 1900s, and these predominantly consisted of tightening the skin of the face. Since that time, over the last hundred years, there’s been an explosion of different techniques which can be used to rejuvenate the face and really one shouldn’t use the term facelift, but use the expression 'facial rejuvenation'. While the expression 'facelift' is still in common use, it’s probably not very helpful these days.

Why might people decide they need facial rejuvenation?

The question as to who 'needs' facial rejuvenation really is difficult to answer because people age at different rates and people perceive their ageing at different times. It’s really a question for any individual to answer when they feel that they haven’t got the face that they used to have and that they want to have. The decision making often comes - for ladies in particular - around the time of the menopause, when the hormonal changes often cause ligamentous laxity in the face and so the face starts to drop more quickly with gravity. The actual age one might decide to get facial rejucenation, however, varies very much from person to person. The techniques involved vary depending on how a person ages.

How do I know which procedure is right for me? 

Because people age in different ways, it’s important to analyse, together with your surgeon, what areas of your face have aged the most or bother you the most and pick procedures that work particularly well. For example, a lot of people age predominantly around their eyes and might benefit from brow lifting procedures or upper blepharoplasty procedures, where skin is taken out of the upper eyelid. Other people age more in the lower eyelids and the anterior part of the cheek, or the front of their face. They might benefit more from complex mid face procedures or lower eyelid surgery on its own.

There are those who develop more jowl or neck problems and they predominantly will benefit from procedures that are called 'SMAS procedures' which affect the cheek area and the neck. There are many types of SMAS procedure, and it’s important to choose the one that would work best for you with a surgeon who knows the range of procedures that can be applied. If you go to somebody who has a very limited repertoire of techniques, you may not get a surgery that adequately addresses the problems that bother you.

How long can I expect the results of the procedure to last?

Facial rejuvenation lasts, on average, for about 10 years and sets your facial rejuvenation back about 10 years. However, that’s a very broad brush stroke opinion and actually, patients will get longer lasting results with more complex procedures. The difficulty from that point of view is that the more complex procedures have more risks associated with them and usually a longer recovery time. It’s very important therefore to decide what you want to achieve, what risks you’re prepared to take to achieve it, and what time you’re prepared to accept as the recovery time. If you can pick those things that treat the area that you want in an acceptable way, then you may get much longer lasting results.