6 Questions About Facelifts with Dr Claudia Machado

In the 2020s, great medical, scientific and technological developments are contributing to a longer life expectation in the population. Elderly people are getting more active, the average retirement age is increasing across the world as we work longer, changing social behavior is breaking down previous barriers of social inclusion and interaction. However, all the great changes also mean that our modern life style puts more pressure on everybody to look younger, fitter, healthier or simply better.

This explains why more people are turning to cosmetic procedures to boost their looks and confidence. Data released by the American Society of Plastic Surgeons shows that a quarter million more cosmetic procedures were performed in 2018 than the previous years in the United States. And in 2018 alone, more than 1.8 million cosmetic surgical procedures were performed.

The top treatment to address these effects on the face is the facelift, also known as a rhytidectomy. This surgical treatment can improve visible signs of aging on the face and neck, re-placing superficial muscles, soft tissues and skin in a harmonic way, making your face look similar to the way it was many years back.

Getting a facelift can be a big decision and that is why you should know as much as possible about it. Mostly importantly you should choose a really good and experienced Board-Certified Plastic Surgeon with skilled hands to do it.

We talked to a facelift expert Dr Claudia Machado - a Brazilian Board-Certified Plastic Surgeon with over 20 years’ experience, based at Al Shunnar Plastic Surgery in Dubai – about this ever more popular and effective procedure for facial rejuvenation.

Q1. At what age should I consider a facelift?

Dr Claudia. The face changes continuously and signs of aging can start as early as your 30s and progress in your 40s, 50s and beyond. Most people have a face lift between the ages of 40 and 60 as it helps to counter these signs and that’s when most patients feel they need it. Although we have different techniques that can make you look better in your 30s to 40s, you can still have plastic surgery when you’re in your 80s provided you have a Board-Certified Plastic Surgeon who is concerned about your health and screens you prior to any procedure, avoiding potential complications.

Q2. Which are the different types of facelifts?

Dr Claudia. Not all facelifts are the same and the procedure is performed depending on how much laxity of skin, muscles or soft tissue alterations there is, what needs to be treated and the desired outcome. Each case must be evaluated individually to decide the best options of treatments, considering all individual risks and benefits.

A full facelift is considered and appropriate when there are markable signs of aging on the entire face and neck. In this case, the face shows some alterations as eyebrow ptosis, saggy cheeks, a deep nasolabial fold, deep tear through, deep marionette lines and loose skin on face and neck. The surgical approach to the Full facelift I perform is to combine a "video endoscopic technique" to lift the upper and mid face with an "open facelift" to treat the lower face and neck.

The video endoscopic facelift alone is the best technique to improve the upper and the mid face, when there is no need of skin removal. There are no scars left on the face afterwards, just very tiny holes that are made on the scalp and that are not visible after any stitches are removed. This type of facelift is often done on younger patients (30s, 40s), bringing a very natural and fresh look. The improvement is mainly in the area of the eyes, cheeks, tear through and eyebrows, removing the tired or sad look of aging.

The open face- and neck-lifts work mainly on the jowls and saggy skin on the bottom portion of the face, giving some tightening to the jaw contouring and neck. The surgical intervention can be wider or more conservative. The superficial muscles of the face and neck can be treated during the rhytidoplasty. This is the reason why there are a lot of different names and different techniques mentioning this surgery.

Personally, I prefer the techniques that are less aggressive and scarless, and which minimize risks and give more natural looking results.

Usually, the aging process can causes other alterations to the face, such as saggy skin of upper and/or lower eyelids (blepharochalasis), eye fat bags in upper and/or lower eyelids, and a double chin (fat deposit under jaw line and chin). In these cases, complementary procedures should be considered, including upper and/or lower blepharoplasty (eyelid plastic surgery) or a double chin liposuction.

Q3. Are there good and bad candidates for a facelift?

Dr Claudia. Firstly, the aging process involves all layers of the face: skin, fat, muscles and bones. The facelift alone is not sufficient to address all signs of aging. The excess skin removal plus lifting are sometimes not enough, but a good Plastic Surgeon will always advise on the most suitable procedure.

Secondly, the skin quality, meaning the skin texture, elasticity and color are very important to enhance a facelift result. The appearance of the face can be affected in patients with noticeable sun damage and therefore needs special attention before and after a facelift. Usually a candidate would need to combine other treatments and therapies to improve the skin quality as well.

Thirdly, the volume of the face deflates with aging, which happens due to bone and fat reabsorption. Having a good bone structure will likely give you more improvement after a facelift. In some cases, I need to restore this volume through fat transfer or fillers. However, if your facial expressions are very intense, a toxin botulin treatment might be combined to give the most successful outcome.

Fourthly, smokers have a higher risk of skin necrosis after skin dissection. Considering a Video Endoscopic Face lift is the safest option for these patients, as there is no superficial dissection.

Lastly, healthy patients are always the best candidates for plastic surgery but patients with any chronic diseases can also undergo a facelift, provided they have a clearance letter from specialist before any procedure.

Q4. What questions should I ask my doctor during consultation?

Dr Claudia. It is always important that you understand the process. The patient and doctor should discuss all options of treatments and expectations for the outcome. Next, you would want to understand how to prepare for the procedure and what precautions you should take prior to the surgery. Then the doctor should inform you about the recovery time, possible risks and complications and how to minimize those and with any special care or instructions you may need to follow after the procedure.

During the consultation we usually show before-and-after pictures of different cases to help patients visualize and understand the results and time to full recovery. It is possible to have cases with amazing results after as little as 1 or 2 weeks after the procedure, but the final outcome of the facelift can take up to 1 year to show fully.

Q5. What should I expect after the surgery?

Dr Claudia. The post-surgery routine starts in the hospital when patient wakes up from anesthesia and he/she is transferred to the recovery room unity under the care of a medical professional. The position in the bed in 30 degrees head-up is important to avoid extra swollen on the face or bleeding. An ice pack on eyes and some medication might be given to ease discomfort during your recovery period and to ward off any potential infection. We advise a soft diet and avoid facial expressions as wide smile in the first week. Patients typically feel better within 4 days but the swelling and bruising will keep you out of work and social engagements for about two weeks. It is also important to follow the doctor’s aftercare instructions for a good outcome. The doctor will also schedule post-op visits to the clinic to check on you and monitor the progress of the recovery.

Q6. How long will the results of the facelift last?

Dr Claudia. The results of the average facelift last about 10 years but it is important to note that aging is a natural continuous process. Some conditions can affect results, such as weight gain or loss, menopause, other hormonal disorders, stress, skin care and lifestyle.

Would you like to understand more about facelifts or other facial procedures?

Would you like to understand what options are available for you in Dubai? Meet one of the experts at Al Shunnar Plastic Surgery in Dubai for a personal consultation to develop a tailor-made plan for you. You may contact the clinic or book an appointment at +971 4 395 3033 and a patient care coordinator will identify the most suitable expert for you.

Al Shunnar Plastic Surgery is one of the best cosmetic, aesthetic and plastic surgery clinic in Dubai, UAE, which offers a variety of aesthetic and cosmetic surgeries and laser treatments with the team of highly qualified and professional expert derm