Verve visited three of Auckland’s top plastic surgeons to get the lowdown on facelifts — what’s involved, approximate costs and recovery time. Because when it comes to plastic surgery, research is crucial.
Tristan de Chalain began his plastic surgery career as a craniofacial surgeon. Originally from Canada, he grew up in South Africa and has been in New Zealand since 1997. He’s developed a system of facelifting he believes is the safest available.
Looking In The Mirror
Fran underwent a consultation with Tristan who began by saying that facelifting is a family of procedures with ancillary bits and pieces like fat injections, PRP (patelet rich plasma)and dermabrasion. “It’s tailored to the individual so the first thing I will do is hand you a mirror and ask you what you’d like to change.”
How A Surgeon Looks At A Face
“I look at a face in thirds: upper—eye to brow, middle—eye to mouth, lower—jawline and neck. If you look at pictures of yourself as a child your cheek will be sitting high. As we age the fat pad dissolves and the cheek slides down revealing the orbital margin, and the sliding tissue creates a nose to mouth crease (nasolabial fold) and jowls.”
Lifting The Face
“When I do a full facelift of the face and neck I address the lower portion of the face and the mid-face so we get a vertical lift. I go inside the mouth and free the ligaments from the bone in an area called the SMAS (superficial muscular aponeurotic system), put a deep stitch underneath, and pull them up and anchor them to the fascia which holds them until they reattach. There’s only a small incision in the hairline with this technique. I think I’m one of the few people in town using this method but I want to keep surgery as safe as possible. If you work underneath the SMAS there’s the possibility of hitting a nerve.
“This midface procedure is an operation I think is unbelievably powerful and gives longevity and best results.
“We could just make an incision and pull the skin tight but skin is elastic, and it won’t hold, it will drift down again. Tissue hates tension. So we need to mobilise tissue and free it before moving it so it will stay where we put it. Think of a column of jelly with the skin on top. If I move it to the side the whole column will lean but I can suture it in place. Or, I can pick up the column and move it, and that’s going to be much more effective.”
Lifting The Neck
“We tighten a muscle in the neck called the platysma. The platysma flows up into the SMAS layer, which flows over the face so working with the SMAS and platysma is great for getting the shape we want. Once we’ve got these where we want them we can redrape the skin with just the right tension avoiding that ‘I’ve been through a wind tunnel look’.”
Creating Volume
“As we age the fat pads in our faces melt away and bone and muscles recede. The skin loses elasticity, doesn’t drape as well and tends to hang. Think of a pumped-up football – if it loses air it gets saggy. We can reduce the covering or fill it up again. Often we do both in facelifting.”
Fat Transfer
“We’re using fat injections more and more not just to plump up lips but to restore the volume and shape of the face. Fat contains stem cells which has a beneficial effect on the skin. We’re only talking about a tablespoon or two of fat that we get from your tummy or your inner thighs. It gives permanent results.”
PRP (Platelet Rich Plasma)
“We also use PRP where we take some blood, separate the platelets from the plasma and inject it. PRP contains little packets of growth factors and promotes healing after surgery and the survival of any transplanted fat.”
How Long Does A Facelift Take?
It’s careful, precise, delicate surgery and the mid-face procedure takes about two hours in my hands together with the lower face and neck, which takes about 4-4.5 hours and 30 minutes for fat transfer.
Is it Painful?
The first night after surgery you’re wrapped up like a mummy. Some people say it’s sore others not at all, but a lot say it feels very tight. Pain doesn’t seem to be the issue, it’s more a tightness.
How Long Does Recovery Take?
I advise taking two weeks off work. After six weeks most people get to the point where their first thought in the morning isn’t their face and how funny it feels.
How Long Will Results Last?
Seven to 10 years.
What Advice Would You Give To Someone Considering Surgery?
Have a consultation. If you’re going to have a procedure you need to be fully informed. Post-surgery you will feel like you’ve been run over by a bus and if you’re informed you will understand it better.
Don’t gamble. Make sure whoever you see is a bona fide plastic surgeon, not a cosmetic surgeon.
How Much Does A Facelift Cost?
It depends on what you have done and there’s the surgeon’s fee, the hospital fees and the anaesthetist’s fee. As a broad guideline a fully comprehensive facelift is approximately $30,000-35,000.
It’s not inexpensive or for the faint-hearted but I can’t think of anything else that delivers the bang that this does.
