"Mini Face Lift" or "Neck Lift" - Minimal Access Cranial Suspension Lift

Often called either a 'neck lift' or 'mini face lift' a minimal access cranial suspension lift procedure offers a much less invasive way to improve the appearance of your neck and jaw area.

Advantages of a 'Mini Face Lift'

The advantage of this operation is that it is minimally invasive compared to a formal facelift leaving nothing but an inconspicuous scar in the crease in front of the ear. It can be undertaken under local anaesthetic alone making it an office based procedure (with or without oral sedation) or under intravenous sedation for those not amenable to the idea of local anaesthetic injections. For those choosing the local anaesthetic method only an oral sedative can be prescribed which will be most effective at the time of the injections. Postoperatively, the first night is uncomfortable but this discomfort is usually adequately controlled with paracetamol. Within one week, the bruising has largely settled and with a little makeup, patients are happy to be seen in public again.

The Neck Lift Procedure

In this operation, an area of skin is elevated in front of the ear and this is undertaken through an incision in front of the ear and extending in an inverted “L” under the sideboard. The tissue underneath the skin is then tightened using a suture technique using permanent suture material which has largely vertical direction of pull. This eliminates the sagging that occurs on the side of the jaw (the jowls) and the upper neck area. An extension of this operation can also be used to elevate the cheeks. Usually, a small amount of skin excision is required and this is mainly under the sideboard area further facilitating a vertical pulling action. This is where the operation differs from previous forms of facelift which frequently left the "wind tunnel" look because of its backward pull. The incision is then closed over a small drain which facilitates the removal of blood to prevent it collecting under the skin. The wound is then dressed appropriately and cooling is applied to the face to reduce swelling and the risk of bleeding and the cooling should be applied for as long as feasible immediately following surgery. There may be some advantage in applying cooling even on the days following surgery. Your face will look stretched immediately after surgery but this improves extremely rapidly. You will be able to wash your hair and face after 36 hours following surgery as long as ointment is applied to the wounds immediately thereafter.

I strongly advise that you do not smoke for two weeks prior to surgery has all wound healing is worsened in smokers making all complications more likely. Generally speaking, all herbal remedies, high doses of vitamin E and medications containing aspirin should be avoided for two weeks before and after surgery.

Immediate postoperative advice

Maintain the light compression bandage on until the following day. Keep the cooling applied to your face for a minimum of two hours.

Do not lie down flat for two hours - sit up erect or in a semi recumbent position. Do not take any blood thinning agents such as aspirin. Pain/discomfort is a feature and paracetamol is advised.

Take oral antibiotics as prescribed. The dressings can be removed on the day following surgery. You can then wash your face and your hair gently, it to your wounds dry and apply ointment.

Postoperative bleeding is very uncommon but any swelling or bleeding from the wound should be reported to me immediately. Make sure that you eat a soft diet - you will find chewing uncomfortable around your jaw joint. Do not smoke as this will cause slow wound healing and wound infections.

Long-term postoperative advice

Bruising and swelling in the operative field is expected but will settle over several days.

Wound infection may be noted by increasing pain over your face.

Numbness will be experienced over the area of the operation and the ear lobe but that should recover in weeks.

Excessive scar formation along the lines of incision is very uncommon but may need revision.

Excessive skin gathering may be noted behind the ear and this may also require revision.

Complications

Excessive bleeding rarely is a problem but it is important to avoid aspirin and homeopathic medications (many of which have anticoagulant activity) preoperatively.

Injury to branches of the facial nerve controlling movement on the side of your face ears is theoretically possible but extremely unlikely.

Discomfort during the procedure is remedied by further local anaesthetic injections.

Areas of numbness from the incision are rarely long-lasting. Pain on the first night is common and can be controlled by paracetamol.

Bleeding can occur very uncommonly and becomes evident with excessive blood loss, associated pain and may require returned back to the operating theatre.

Bleeding can prolong the recovery phase by weeks. Infection of the wound is similarly very uncommon as the blood supply to the head and neck is excellent. To reduce this possibility, oral antibiotics are administered before surgery and for a few days thereafter.

Scarring is minimised in this procedure as there is very little tension on the skin following wound closure and most of the tension is on the subcutaneous tissues. Very occasionally, the scars need revision. A fold of skin can form behind the ear because of the upward traction in front of the ear. This fold will settle within two months.

The sutures pulling the subcutaneous tissue in an upward direction can impede chewing which may be uncomfortable for a few days to a week following surgery.

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