CONSULTANT PLASTIC SURGEON
FACIAL REJUVENATION
What is facial rejuvenation surgery?
Facial rejuvenation surgery refers to the combination of cosmetic procedures used to restore your facial features to their previous youthful appearance. While a facelift is often the anchor or foundation for many facial rejuvenation surgeries, other procedures can complement and enhance the result. Surgical procedures such as eyelid surgery, brow lift, and facial implants can help correct specific problem areas on the face. Nonsurgical treatments including fillers, botox injections, and fat injections can be used for volume enhancement and wrinkle and fold eradication. Laser skin resurfacing or other light modalities can be utilized to improve skin texture and correct skin blemishes or age spots.
​
Multiple treatments can be combined to give you a more youthful look. The procedures chosen will be tailored to your specific ageing problems and concerns so that they provide you with optimal treatment.
“Facial rejuvenation surgery is a highly individualized procedure. You should do it for yourself, not to fulfil someone else's desires or to try to fit any sort of ideal image, especially those coming from social media. Choosing a procedure based on “what’s new” is never a medically sound decision. Hearing about a procedure on television, through an advertisement or online does not necessarily mean it is the best procedure for you.”
Who is a good candidate for facial rejuvenation surgery?
In general, you may be a good candidate for facial rejuvenation surgery if you want to reverse the signs of ageing and restore a more youthful appearance, your face and neck are sagging, or if you are losing volume in your cheekbones and contour along your jawline, there are crow’s feet at the corners of your eyes, fine lines and folds around your mouth, and frown lines and furrows in your forehead, there is drooping skin and wrinkling changes in your upper eyelids, upper and lower eyelid bags, and dark circles under your eyes, you are in overall good health without chronic medical conditions, such as diabetes or heart disease, you are a nonsmoker or have stopped smoking recently and have realistic expectations of the outcome of your surgery.
What should I expect during a consultation for facial rejuvenation surgery?
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Dr Ricardo will evaluate you as a candidate for facial rejuvenation surgery and clarify what approach is best for you. Alternative and additional treatments may be considered, once he understands your goals and medical condition. It is important to be completely honest during the consultation and be prepared to discuss your medical, drug allergies and medical treatments, current medications, vitamins, herbal supplements, alcohol, tobacco and drug use, previous surgeries, and your history with any noninvasive cosmetic procedures and why you want the procedure, your expectations, and desired outcome.
​
Dr Ricardo will also evaluate your general health status and any pre-existing health conditions or risk factors, evaluate the elasticity of your skin, take photographs, discuss the approach to your surgery, including the type of procedure or combination of procedures and tell you whether your expectations are in line with typical results, discuss any risks or potential complications and share before-and-after photos of cases similar to yours.
​
The success and safety of your facial rejuvenation surgery depend very much on your complete candidness during your consultation. It's very important to understand all aspects of your procedure. It's natural to feel some anxiety, whether it's excitement about your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr Ricardo.
How should I prepare for facial rejuvenation surgery?
In preparing for facial rejuvenation surgery, you may be asked to get lab testing or a medical evaluation, take certain medications or adjust your current medications, stop smoking in advance of surgery and avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.
​
The surgery will be performed in an accredited hospital and requires you to stay overnight for observation unless you and Dr Ricardo have made other plans for your immediate postoperative recovery. You must arrange for a friend or family member to drive you to and from surgery and to stay with you the first night following the hospital’s discharge.
Dr Ricardo and the entire staff will provide thorough preoperative instructions and answer any questions you may have. The goal is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy, comfortable, and safe as possible.​
What are the steps of a facial rejuvenation procedure?
Step 1 – Anaesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anaesthesia. Dr Ricardo will recommend the best choice for you.
Step 2 – Surgical procedure
If volume enhancement using fat transfer is desired for facial rejuvenation, it is typically performed first with fat grafting to deficient regions. The fat is harvested from other areas of the body and then transferred into the desired regions.
​
Depending on the degree of skin laxity (looseness) in the face, either a limited incision (for minimal to moderate laxity) or a more extensive facelift is performed. Eyelid surgery, brow lift, or facial implants can also be performed. For a facelift, the skin flaps are lifted and trimmed or undermined as needed, then the flaps are moved to remove excess skin and secured with sutures.
​
Once the incisions are closed, laser resurfacing can be used to improve the quality of the skin surface, erasing wrinkles around the mouth and the eyes, eliminating blotchy pigmentation, diminishing the appearance of bags under the eyes, and helping to reverse skin damage as a result of sun exposure.
​
After healing from the surgical component of facial rejuvenation, additional refinements can be performed during follow-up office visits such as:
​
-
Botox (neurotoxins) can be injected into the muscles of the forehead to smooth it, eradicate wrinkles, and provide a brow-lift effect.
-
Fillers can be injected to erase the fine lines around the mouth, add volume to the lips, and fill the folds extending from the nose to the mouth.
-
Fat can also be used at this point to add volume to the lips and to camouflage the deep line that runs from the corner of the lip to the jawline (often called the marionette lines).
​
Careful planning and sequencing of procedures are necessary for facial rejuvenation. Dr Ricardo will determine the best order of procedures in your particular case.
Step 3 – Closing the incisions
The facelift incisions will vary, depending on the type of facelift surgery performed. Likewise, eyelid surgery, brow lift, and facial implant surgery come with their own set of incisions. The incisions will be closed with sutures that may dissolve or may need to be removed after a few days. Once healed, the incision lines are well concealed within the hairline and in the natural contours of the face, ear, and eyelids.
Step 4 – See the results
The visible improvements of facial rejuvenation surgery will appear once swelling and bruising subside.
What should I expect during my facial rejuvenation recovery?
Following the completion of a facial rejuvenation surgery, a bulky bandage might be placed around your face to minimize swelling and bruising. Small tubes may be present to draw off any excess blood or fluid but its placement by Dr Ricardo is not common, just for particular cases like those patients who are undergoing secondary surgery. It is important to keep your head elevated above your heart to minimize swelling and to keep your head straight (no excessive twisting or bending of the neck). Do not use ice or heat on the operated area.
​
You will be given specific instructions on how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with Dr Ricardo. Remember to always follow his instructions to ensure the success of your surgery.
​
Cosmetics can help camouflage any bruising. Initial wound healing may take 10 to 14 days. Sutures will be removed when it is appropriate. . the surgical incisions mustn't be subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head.
​
You should be ready to return to work and normal activity after 7-10 days. For Botox injections and dermal fillers treatments, you may resume normal activities immediately. As swelling and bruising subside, the visible improvements of a facelift appear. However, you must realize that the amount of time it takes for recovery varies greatly among individuals.
What results should I expect after my facial rejuvenation surgery?
After Botox injections or filler injections, the results are obvious after a few days. After surgery, most people are presentable to the public within 7-10 days but the recovery time will vary by patient and in relation to the extent of your surgery. It will take 2-3 months for the face to feel "back to normal" in terms of texture, sensibility and loss of tightness.
​
Although it is impossible to totally reverse the pull of gravity and the natural ageing process, the results of facial rejuvenation will be long lasting. The complementary procedures, filler and Botox injections, which can be repeated periodically, will help you to maintain your youthful appearance. The fat grafts are permanent and will age as you age.
​
Life-long sun protection and a healthy lifestyle will help extend the results of your rejuvenated, more youthful appearance. Your final result should not only provide a more youthful and rested appearance but also help you feel more confident about yourself, achieving the most beautiful and natural-looking results.