The facelift is the operation which can truly reverse the changes of ageing in a significant and permanent fashion. Unlike injectables which can make the face appear full, paralysed or just very unnatural, a well performed facelift can reverse the effects of gravity on the face which have occurred over many years. This can restore a youthful appearance which closely resembles the person’s natural younger face. The results from a facelift can be quite amazing and patient satisfaction rates for this cosmetic surgery procedure are very high.
Dr Jason A Roth BSc(Med) MBBS AMusA FRACS (ORL-HNS) IBCFPRS
Facial Plastic and Reconstructive Surgeon
Dr Roth is one of a small, elite group of specialised facial plastic surgeons. That is, he only performs plastic surgery on the face, neck and nose. His specialties are rhinoplasty and the revolutionary facelift technique called the Deep Plane Facelift which involves repositioning the facial tissue rather than the skin. Benefits of this technique include a natural and longer lasting result with minimal to no pain after surgery, only mild discomfort and a recuperation time of approximately two weeks, after which one can resume a “public life”. This technique focuses on the deeper facial structure and there is no unnatural tightening or pulling of the facial skin that used to typify older style facelift techniques. The Deep Plane Facelift is the most sophisticated procedure available today and has won the devotion of patients and acclaim from the plastic surgery community.
Dr Roth’s credentials are superior. After graduating from the Univeristy of New South Wales, Dr Roth completed his residency in Otolaryngology, Head and Neck Surgery at the Royal Australasian College of Surgeons. He then went on to complete a prestigious American Rhinologic Society fellowship in advanced rhinology and facial plastic surgery at Rush Univeristy in Chicago. He received instruction from a number of world leaders in facial plastic surgery. He then studied with Nolst Trenite and Dirk Menger at the Bergman clinics and Academic Medical Institute in the Netherlands. He went on to complete the International Board Certification in Facial Plastic and Reconstruction Surgery in Washington DC. He has studied with Dr Neil A Gordon in Connecticut, one of the pioneers and acknowledged world leaders in facelift surgery. He is currently a member of the American Academy of Facial Plastic and Reconstructive Surgery and the Australian Association of Facial Plastic Surgery, the Australian Society of Otolaryngology Head and Neck Surgery, the Australian and American Rhinologic Soceties and the Royal Australasian College of Surgeons. He is currently the president of the Warringah District Medical Association.
In addition to his formal training, Dr Roth takes great care and pride in the journey of each of his facial plastic surgery patients who come under his care. He invests an immense amount of time and energy to ensure that his patients experience only the very best in care leading up to their surgery, during their hospital stay and during their recovery. He strongly believes that all these aspects of a patient’s journey are important to obtaining the very best results. He is personally involved in all his patient’s pre and post-operative care visits. He currently sits on the medical advisory committee for two of his primary hospitals.
Dr Roth’s services are frequently sought by patients from out of state or overseas. His staff are only too happy to assist with making the surgical journey as seamless as possible for his patients. He operates at a select number of private surgical facilities that meet only the highest standards of patient care, privacy and comfort.
Facelift – an operation which has evolved over the past 100 years
The facelift operation has evolved significantly over time. The early facelifts were done by tightening skin. This led to a “tight”, windswept appearance to the face that appeared unnatural. The results did not tend to last for more than a couple of years. Further research determined that a more permanent and natural results could be obtained by tightening a deeper layer in the face, the SMAS. The “SMAS lift” is a commonly practiced facelift procedure across the world with good results. The deep plane facelift was the next evolution. Even better results can now be obtained with a deep plane facelift. The deep plane facelift offers a more natural, permanent lift with a faster recovery time than the SMAS lift.
What about injectables?
If you think of the face as a container, as it ages the container simply gets bigger. The facial tissues become stretched like pizza dough over a larger area. This makes the face appear like it has lost volume but really the volume is there but just spread out over a larger area. Adding volume (like hyaluronic acid fillers or fat) can camouflage some of the early changes of ageing but as time progresses just adding more volume into a larger container creates a very unnatural appearance, as we sometimes see in Hollywood actors and celebrities. Injectables can be helpful to hide some changes of ageing but others require surgery.
The deep plane facelift
The deep plane facelift elevates the face as a single unit. This leads to less bruising and swelling and much faster recovery. As there is little to no tension placed on the skin only very fine almost invisible scars are created. The face assumes a very natural appearance avoiding the “windswept” look of old. The lift is also more permanent than a SMAS lift.
Dr Roth has trained with Dr Neil Gordon, the recognised world leader of the deep plane facelift at his institution in Connecticut, USA. There he observed the amazing results of the deep plane lift and learnt many of the nuances that make it successful. Dr Gordon is renowned within surgical circles for his private work on the rich and famous.
Read more about the deep plane facelift technique here.
When the mid and lower face is lifted as a unit it is frequently necessary to perform a browlift at the same time. This ensures that the entire face is rejuvenated rather than only parts. The browlift incision is hidden in the hairline and does not change the shape of the eyebrows, only the skin of the brow and temple areas. It can also be used to lower the hairline in men with a receeding hairline.
Ageing can produce marked changes in the neck. A neck lift is essentially part of the facelift. Gravity has caused the tissues of the face and neck to have dropped as a single unit. A deep plane facelift will appropriately reposition these tissues using the platysma muscle as a sling.
How do I choose the right cosmetic surgeon for my facelift?
It is important to choose a surgeon comfortable in the head and neck area. Some general plastic surgeons specialise in body work. A facial plastic surgeon is a head and neck trained surgeon who specialises only in facial surgery. It is also important to recognise the benefits of the deep plane facelift over lesser lifts.
The consultation process
When you are ready to discuss your facelift further, the next step is a consultation. This is typically a 45 to 90 minute appointment where Dr Roth will carefully listen to your concerns. He will then examine your facial skin and soft tissues to assess the effects of ageing. Dr Roth will then explain what components of the surgery are necessary in your case and where the incisions will be placed (typically hidden in skin folds and in the hairline).
Photographs will be taken. These are helpful in discussion and in planning. Computer image morphing is not performed for facelift surgery.
Our practice does not publish before and after photos on the internet for facelift surgery. The main reason behind this is privacy. A facelift is generally a very personal decision and our patients generally do not want this broadcast over the internet where they can be used for any purpose. Our patients are often high-end consumers and we respect their privacy.
Facelift Instructions Before Surgery
- For two weeks prior to surgery
- No aspirin
- No ibuprofen or similar non-steroidal anti-inflammatory medications
- No vitamin E, garlic, gingko or niacin tablets
- All the above medications can cause excessive bleeding. If you have any other medications that you are taking that you are concerned about please call either your GP or check with us directly.
- Paracetamol (Panadol) is safe
- We make every effort to make your surgical experience and recovery as seemless and uneventful as possible. Healing is jeopardised if you continue to smoke before and after your surgery.
- It is important that you avoid smoking for 2 weeks before and after your procedure.
- Smoking can severely effect the healing process of facelift surgery.
- After surgery please arrange transportation home. You will need a responsible adult with you for 24 hours after surgery if you are not staying in hospital overnight. If you are coming from out of town please make sure you remain in Sydney for at least 24 hours after your surgery. If you do not have someone to stay with you we can give you the name of a company which provides this service at a hotel or in your home.
- After your surgery you will be given prescriptions for antibiotic ointments, oral antibiotic tablets and strong pain relief tablets. You will also need a few over-the-counter medications and products that you can purchase beforehand.
- 3% hydrogen peroxide
- Cotton buds
- White petroleum jelly (eg Vaseline)
- Paracetamol (panadol)
- Please also read the Facelift After Surgery instructions sheet prior to surgery as it contains essential information about what can be done with regard to exercise, bathing, use of makeup, diet and sun exposure following surgery. You should be aware of these guidelines beforehand as you may need to plan for them.
- For two weeks prior to surgery
Facelift Instructions After SurgeryAfter surgery, you will have a dressing wrapped around your head. Your facial tissues will react in the form of swelling and a feeling of tightness. This will be responsible for the discomfort you feel. The headband dressing will be removed the day after surgery. You will then be given a chin sling to wear for support. This should be worn all the time for the week following your surgery then at night for the next two weeks. You may remove this to shower.Your bruising and swelling will peak at 48-72 hours. You need to keep your head and shoulders elevated at 45 degrees. To achieve this use two pillows behind your head when sleeping for ten days. It is advised not to lie on your side as this can cause uneven swelling.Apply cold compresses to the face and neck for 20 minutes per hour while awake for 3 days following surgery.
Care of your incisions:
- Cleanse the incisions with cotton buds as needed with 3% hydrogen peroxide diluted 50/50 with water. It important to keep the incision lines free of any dry blood or crusting.
- Antibiotic ointment prescribed should be applied to the wound four times daily in the first week. Thereafter apply white petroleum jelly (Vaseline), four times a day for a further week.
- Do not rub your incision as there is risk of pulling open the incisions.
Avoid foods that are hard to chew and ensure you increase your fluid intake to avoid dehydration (6-8 glasses of water or juice per day). Begin with liquids and light food gradually progressing to a normal diet.
Use prescription medications for pain as directed. Avoid consuming alcohol or driving while taking pain medications. Your pain medication can make you constipated. You may use an over-the-counter stool softener if needed.
Tips for comfort:
Turn your head, neck and shoulders as one for one week following surgery.
Avoid strenuous activity for 14 days including:
- Aerobic exercise
- Heavy lifting
- Excessive face and neck motions
- Work, exercise, sport or any activity likely to raise your blood pressure for the first 7 days.
- You may do some gentle walking in the second week.
Do not drive for one week.
For 24 hrs after anaesthesia do not drink alcoholic beverages, travel by public transport without an accompanying adult, drive or operate complex machinery, sign legal documents or make important decisions.
You may bathe 48 hours after your surgery. A bath is advised rather than a shower.
Avoid the sun for one month. Wear a sunscreen SPF 30 or higher.
Avoid aspirin, ibuprofen, naproxen, Vitamin E and herbal medications as these can all cause bleeding.
Contact Dr Roth or the hospital where you had your operation if you experience:
- Severe pain
- Excessive swelling especially if greater on one side than the other.
- A fever of 38 degrees or more
- You will be seen the day after surgery to remove the dressing.
- Sutures in front of the ear and under the chin are removed 5-7 days after surgery. The remaining sutures are removed at 9-10 days. There will be some absorbable sutures behind the ear.
- Make-up may be worn beginning day 7 using caution not to use make-up over the incision lines.