'I am happy with my mini facelift, now I want a chin implant'

I AM a plastic surgery nurse and laser specialist, so digging out the newspaper article from the bottom of the draw, I shouldn't have been shocked at how old I looked in the photographs, before my mini facelift procedure.

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Published: Sun 11 Mar 2007, 9:47 PM

Last updated: Sun 5 Apr 2015, 12:25 AM

Now, four months on, after my cheek muscles had been lifted, the difference was amazing. While the old tired face in the article had gone, there were no telltale signs of scars on my face or evidence of surgery.

Reflecting upon my mini facelift, I remembered getting up four hours after the procedure had been done. As the saying goes 'I don't do pain' so the most amazing memory was the total lack of it. I had expected pain on a grand scale but there wasn't any and no bruising either, even though I had had a mini nose job. No drains had been used in my face.

My surgery had been carried out by Plastic surgeon, Dr. Tony Moore from Australian Medical Services on Dubai Health Care City. As instructed by Dr. Tony, I removed the bandage from around my head, had a shower, washed my hair, got dressed and tucked into a fabulous tenderloin steak. This I demolished in no time in front of the television in the hospital's en suite living room, as there was no discomfort. It was all so surreal because I could not believe I was doing this after a mini facelift and a nose job and it was only 4 and a half hours after surgery. I kept pinching myself to make sure I was awake and not dreaming!

Since then my face has changed rapidly. The first few days after the lift, your face is always slightly swollen and you look like you have had your wisdom teeth out. My clips were removed after 5 days and fine sutures after 7 days. No scars can be seen in front of the ears as seen in the photograph of the side of my face. They say it can take up to six months for a face lift to settle but mine took two and it is four months now.

While I am happy with my mini facelift surgery and intend to have a chin implant, there are others the world over, with memories relating to surgery they would rather forget. With this is mind, I have given a quick insight into things you need to consider and ask your plastic surgeon when considering a facelift.

Before having a facelift, make sure you are healthy and have realistic expectations. You will need to be assessed by your plastic surgeon. Always ask if your surgeon is qualified to do this procedure and where he graduated from. Ask to know the risks involved in face lift surgery and take time to make a decision about going ahead with surgery. Always 'sleep on it' as the saying goes and don't be afraid to say no or seek a second opinion.

You may not need surgery or may not be suitable for it. If you are affected by anesthesia, alternative methods may need to be discussed. Likewise, if you scar easily or have a bleeding disorder, you are probably not suitable for facelift surgery. Even your skin type, subcutaneous tissues and bone structure along with elasticity of your skin will all need to be taken into account by a plastic surgeon before he or she agrees to carry out the procedure.

Remember not to take aspirin or smoke before surgery. As there are a number of medications you should not take, please discuss this with your intended surgeon. Tell your surgeon if you are allergic to antibiotics, anaesthetic drugs or any other medicine. Inform him or her of prolonged bleeding or excessive bruising when injured. Mention any long-term or recent illnesses - previous facial surgery - psychological or psychiatric illness.

While facelift surgery can be performed under general or local anaesthesia, general anaesthesia is usually the preferred choice. Although a mixture of sedation and local anaesthetic can be used, a combination of general and local anaesthetic is generally preferred. If local anaesthetic is used, the area to be operated on is widely infiltrated with local anaesthetic. The local anaesthetic helps to constrict the blood vessels, reducing bleeding, pain and bruising after surgery. Although, modern anaesthesia is safe and effective, side effects from an anaesthetic can be life threatening. Therefore it is always best to have a pre-anaesthetic check with your anaesthetist, in order that he can take a full medical history, ask you questions and receive questions from you.

Factors to consider are the amount of time you will spend under anaesthetic and how long the surgery will take. The shorter the time, the less anesthetic risk. Bleeding, trauma to tissue and potential bruising can be significantly reduced by a surgeon who is well versed with the procedure he is carrying out. The average mini facelift takes a plastic reconstruction surgeon 1 hour and up to 1.5 hours for a full facelift with a brow lift and chin implant or minor nose surgery.

An endoscope is a less invasive technique used for brow lifts. It is a small fine tube with a light on the end, which is connected to a video camera. This enables the surgeon to see what he is doing in great detail. The result is a couple of small holes above the hair line that require only a stitch in each, instead of a scar above the forehead, in the hairline that runs from to ear. This said, your plastic surgeon will discuss the most appropriate procedure with you.

Facelift surgery can be undertaken in a hospital or day surgery facility. Some people are out in a day, while others will stay for the night. You would be accompanied home and have someone with you for the first few days.

You can usually drink within two to four hours after surgery, and if you feel up to it, remove the bandages, have a shower and wash your hair. This usually makes you feel so much better. Normally, you will be pain free, so have a good hot meal, rest or enjoy a bit of television. Usually, there is little bleeding and no drains in the face. In some cases bruising will be present. If a drain is inserted it is usually removed within 2 days. If you have had a blethroplasty (eyelid surgery) done at the same time, you can expect some bruising around the eyes for a few days. As previously stated, the swelling from a facelift reduces over a period of time and it is recommended that you do not smoke or exercise for about three weeks. In fact three weeks is the usual time people take off in order to have a facelift.

As for myself, I was back at work in 10 days but that is not the norm. After a week make up can be worn to cover any bruising. In some cases, some minor fine wrinkles may reappear when the swelling has settled but these can be treated.

Ring your surgeon if the following should occur. Although unlikely, complications can occur therefore it is crucial you telephone your surgeon immediately for any of the following: A rise in body temperature to 38 degrees C or shivering, bleeding from the incisions, severe pain, redness around the incisions and if the redness is spreading. Finally, always contact your surgeon if you are worried. He is there for you and would prefer you to contact him.

Modern surgery is very safe, but complications can occur. When a facelift has been performed by a qualified plastic surgeon, serious problems after surgery are rare. However, it is always wise to discuss the risks with your surgeon before surgery. Other risks are heavy bleeding from the incisions, keloid scars, slow healing, separation of wound edges or allergies to anaesthetic agents, antiseptic solutions, suture material or dressings.

Possible risks from any type of surgery can include infection, pain, haematoma (an accumulation of blood around the surgical site that may require drainage), nausea and swelling. Other risks include hair loss around the ears if sutures are used instead of clips. This is usually temporary but can be permanent. People have been known to lose skin due to impaired blood supply, but this is usually minor and does not require skin grafts. A slight difference in the appearance between the right and left sides has been known to occur. There is also the risk of damage to the facial nerve, which occurs in about one patient in every 100. In some cases, further surgery is required. However, these disorders are rare if the surgery is performed by a qualified plastic surgeon. Mild numbness is common for a couple of months but will resolve

Follow up after a procedure is important. Don't forget to see your surgeon a few days after surgery and again on a monthly basis until you and he are happy. This way, your surgeon can monitor your progress and follow your long-term results.

Finally, always remember to ask the full cost of your surgery, to include the hospital package. Remember, reconstruction surgery to the face may be covered by insurance while cosmetic surgery for aesthetic reasons, generally isn't. Most importantly, when considering an elective procedure like a facelift, make sure you are having the procedure done for you and not to please others. If you feel that this surgery will not benefit you physically and mentally don't have it done and if when you see your plastic surgeon, he advises against surgery and does not want to operate, think twice before rushing out to find another surgeon who may do your surgery anyway. There may be sound reasoning behind his decision and taking time to reflect upon a decision is not a bad thing.

The patient, their wellbeing and their care are a surgeon's first priority. If you and your surgeon feel happy with you going ahead and having a face lift then the benefits to be gained and improved looks and self confidence, can be great. At the same time, do not rush into a decision. Remember, while there is always another day to contemplate surgery, you only have one face. Look after it.

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