Sydney, Australia Vertical Facelift

Understanding the Vertical Facelift?

With time our face gradually transforms from the upside-down triangle shape of youth to more of a rectangle shape. This is primarily due to the deeper fascia, known as the Superficial Musculoaponeurotic System (SMAS), which elongates and descends. This leaves the face looking different to how it looked during our youth and is responsible for that visible change in the aging face.

A vertical facelift surgery is Dr Turner’s preferred approach to holistically correct ageing changes of the face by using modern facelift techniques. It restores facial contours by lifting the deeper fascial layers in a more anatomically accurate, vertical direction. Rather than relying on the traditional horizontal pull associated with older traditional facelift procedures.

The vertical facelift is designed to reverse gravity-induced aging effects, including visible jowls, neck laxity, diminished cheek volume, and deep nasolabial folds. Covering the upper face, midface, lower face, and neck, this surgery delivers long-lasting results that can span a decade or more.

How is a Vertical Facelift Different from a Traditional Facelift?

This is best demonstrated when you lift your cheeks in a vertical direction towards the temples, there is a major improvement in your jowls, jawline and neck regions. However, this also creates bunching of skin in the temples which creates an unnatural appearance. To overcome in a traditional facelift the skin is removed more in a horizontal direction to alleviate this bunching, however this can result in a “windswept” appearance with flattening of the cheeks.

The benefit of a vertical facelift procedure is it also involves lifting the forehead and brow areas, which smooths out the bunching of skin in the temples and allows a more vertical lift than is possible with a traditional facelift.

Key Differences:

• Holistic Rejuvenation: Addresses the entire face from the brows to the neck.
• Vertical Lifting: Lifts the face vertically, improved ageing correction.
• Comprehensive Correction: Corrects deep tissue issues, addressing the core of facial aging rather than just the surface appearance.

Suitable Candidate for Vertical Facelift?

Suitable candidates for vertical facelift should meet the following criteria:

• Physical Health: Be in good overall health with no underlying medical conditions that could interfere with the wound healing process.
• Emotional Well-being: Have realistic expectations and a positive mindset regarding the outcomes of mastopexy surgery. As of 1st of July 2023, patients are required to have a psychological evaluation to ensure they are suitable to proceed with surgery.
• Stable Weight: It is recommended to be near your target weight before undergoing the procedure, as weight fluctuations can affect the cosmetic results.
• Non-smoker: Smoking or vaping dramatically interferes with the healing process and increases the risk of complications. Therefore, candidates are required to cease smoking for a minimum 6 weeks before and after the surgery

As gravity constantly pulls your facial tissue downward, it creates visible signs of ageing on various areas of your face, including:

• The upper segment of the face: the temple and outer brow area that can droop Rand cause hooding around the eyes.
• The midface segment: where you might have heavy nasolabial folds and deflated or sunken cheeks.
• The lower segment of the face: where you might have skin sagging that leads to droopy or jowls in the jawline.
• The neck: laxity in the neck that can make the neck look heavy and blur out your face contour

It is important to note that surgery outcomes may vary from patient to patient. It is important to have realistic expectations and understand that individual results depend on various factors such as skin quality, age, and overall health. Dr. Turner will discuss your specific case and potential outcomes during your consultation.

How Is a Vertical Facelift Performed?

Vertical facelift surgery is always performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. Depending on the complexity of the procedure it may take 4 to 6 hours, and Dr Turner recommends patient rest in hospital overnight before being discharged home the next day.

A vertical facelift surgery typically involves the following steps:

Incision Placement

This involves making strategically placed incisions to access the deeper layers of the face. These incisions are designed to be as discreet as possible to minimize visible scarring.

• Hairline Incisions: Typically, the incision starts at the temple within the hairline, extending around the natural curves of the ear and behind the ear to keep the scars hidden.
• Ear and Crease Placement: The incisions are carefully placed in the natural folds and creases around the ears, which makes them difficult to detect once healed.

The location and length of the incisions may vary depending on the areas of the face being treated, but the goal is always to make them as inconspicuous as possible.

Deep Plane – SMAS Layer

The SMAS layer is a fibrous network of tissue that covers and supports the muscles responsible for facial expressions. Over time, this layer weakens and droops, contributing to the sagging appearance of the face.

• Vertical Lift of the SMAS: The SMAS layer is elevated in an upward (vertical) direction, rather than pulling it horizontally. This upward movement restores the contours of the face, particularly around the cheeks, jawline, and midface.
• Securing the SMAS: Once the SMAS has been repositioned, it is carefully secured with sutures to maintain the new position, ensuring long-lasting results.

Skin Redraping

After the deep layers of the face have been lifted, the skin is redraped over the newly positioned SMAS layer.

• Natural Skin Alignment: Gently repositions the skin in line with the vertical lift, smoothing it without creating unnecessary tension. Excess skin is carefully trimmed to remove sagging without overstretching the remaining skin.
• Avoiding a Stretched Look: Because the underlying tissue has already been lifted, the skin can be redraped without tension, avoiding the pulled or stretched appearance that was more common in older facelift techniques.

Fat Redistribution and Volume Restoration

The vertical facelift addresses this by restoring facial volume in a balanced way.

• Fat Grafting: If necessary, facial fat grafting, a process where fat is harvested from other parts of the patient’s body and injected into areas of the face that have lost volume, such as the cheeks or temples.
• Fat Correction: Excess fat in areas like the neck, or under the chin (submental) may be removed through liposuction or direct excision, further enhancing the definition of the jawline and overall facial structure.

Contouring the Neck

Sagging skin, fat accumulation, and muscle banding in the neck can be addressed during the same procedure.

• Platysmaplasty: In cases where the neck muscles have weakened or separated, Dr Turner will perform a platysmaplasty, a technique that tightens and sutures the neck muscles (platysma) to create a smoother, firmer neck contour.
• Excess Fat Removal: If excess fat has accumulated in the neck or under the chin, liposuction may be used to remove it, creating a more defined neck and jawline.
• Neck Skin Redraping: Similar to the face, any excess neck skin is carefully redraped and trimmed to create a smooth, natural appearance without over-pulling.

Reshaping the Brows and Eyelids

Once Dr Turner has corrected the face and neck, the next step is elevating and reshaping the upper face.

• Browlift: Small incision in the frontal hairline allows lifting and reshaping of the lateral eyebrow.
• Upper Blepharoplasty: Excess skin and fat is removed to define the upper eyelid crease.
• Lower Blepharoplasty: Fat bulges are corrected, and pinch blepharoplasty will smooth any excess skin the lower eyelid area.

Lifting the upper lip

Finally correcting the elongated lip via a bullhorn incision at the base of the nose can improve the upper lip shape and fullness.

Recovery After Facelift Surgery

Recovery from a vertical facelift is a gradual process that varies for each individual. Initially, you may experience swelling, bruising, and discomfort during the first week, but these symptoms typically subside within two to three weeks. Most patients can resume regular activities within this period, although strenuous activities and heavy lifting should be avoided for at least four to six weeks to ensure proper healing. Complete recovery and the final results may take several months as the tissues settle into.

Following your surgeon’s post-operative care instructions is crucial for a smooth recovery. This may include managing discomfort with prescribed medications, keeping your head elevated to reduce swelling, and engaging in light walking to promote circulation. Protecting your skin from sun exposure and attending all follow-up appointments are essential steps for preventing complications and and achieving lasting results.

For a more detailed overview of the recovery process and tips to optimize your healing, please refer to our comprehensive guide on recovery after facelift surgery.

Risk and Complications of Facelift Surgery

Like any surgical procedure, a vertical facelift carries certain risks and potential complications. It is important for patients to be fully aware of these before deciding to undergo surgery. Your surgeon will discuss them in detail during your consultation, ensuring you have realistic expectations and a clear understanding of the potential risks.

Common risks include infection, bleeding, scarring, and temporary numbness or swelling, which typically subside during recovery. Less common but possible complications involve nerve damage, which could affect facial sensation or movement, and reactions to anaesthesia. Rarely, patients may experience hair loss at incision sites, skin discoloration, or delayed wound healing, leading to more noticeable sc. Adhering to post-operative care instructions is essential for minimizing complications and ensuring a smooth recovery.

See our detailed guide on risks and complications after facelift surgery.