May 2013 - Facelift and Necklift

Everyone wants to look their best, and facial rejuvenation is one way of helping to achieve this. Spire Washington Hospital’s newest consultant Mr Ahmed Ali-Khan FRCS (Plast.) looks at the surgical options available when you want to turn back the hands of time, with specific reference to facelifts and neck lifts.


Who is most likely to approach you about a facelift or neck lift?
People come to me when the ageing process has started in earnest and they have specific issues they want addressing. Depending on what those issues are, options can include facelifts, which improve certain areas of the face and neck, or neck lifts which are more specialised. Due to the nature of cosmetic surgery, I tend to find individuals have done a lot of research before making an appointment so are well prepared for the consultation.

What type of questions are you asked most frequently?
Patient history and eligibility form a key part of early discussions, but most people want to know which procedures lead to the most natural results with minimal downtime and scarring. There used to be a trend for slightly over tightening the skin to provide longevity but this made it obvious that the person had ‘had work done’, quite the opposite of what people want today.

Which procedure do you perform most frequently?
Bearing in mind that people usually prioritise safety with natural looking results, one of my preferred procedures is the MACS Lift, a technique that addresses the cheek and neck in most patients. The fact it has a fairly short recovery time, provides noticeable and sustained results, is slightly less invasive than a traditional facelift and has a shorter scar means it is quite popular.

With the MACS lift, patients have a minimum of an overnight stay and the procedure is performed under general anaesthetic. The scar is left as short and discreet as possible, usually hidden in the hair of the temple down to the lower part of the ear. The face looks and feels a little tight on the day but this soon eases off and the final results can be seen within about 7-14 days, as any bruising and swelling fades.  Patients appreciate the look because it is fresh and subtle.

Tell us about neck lifts
Interestingly enough we are seeing an increase in enquiries from men, although a neck lift remains a female-dominated procedure.  As the face and neck are related, I tend to find the MACS lift will often address the issue adequately, but if there is an isolated problem, we can look at liposuction to take the weight out of the neck. Sometimes the neck muscle needs repositioning slightly or muscle relaxing injections may be used to achieve the desired result.  It all depends on the individual requirements. With regards to men, the tissues can be much heavier and therefore a different, slightly more aggressive approach may be required. Fortunately men are more likely to tolerate a discreet scar on the neck (only really visible from directly below) and following a traditional neck tightening this is positioned no lower than the Adam’s apple, up the midline of the neck.

Why do patients need two consultations before surgery?
I always offer a minimum of two consultations because no cosmetic surgery should be taken lightly. At the first, the aim is to establish the patient history, talk through the options and provide literature that the patient can take away. The second meeting allows the individual time to have absorbed all the details and ask any further questions. They are welcome to bring close friends or family who often provide a useful external perspective. A cooling off period is a necessity and nobody should ever feel pressurised into proceeding.

Any final tips?
Patients should feel able to ask any question of their surgeon, including their background, because no respectable consultant will ever be offended by that. Effectively the patient needs to develop a bond of trust with the person carrying out their procedure. Anyone considering cosmetic surgery should check that their consultant is on the specialist register of the General Medical Council (GMC). This way they can be confident their surgeon is one of the most highly trained in the field and adheres to very stringent guidelines about patient care and safety.

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