Frequently asked questions

Why do we need Facelifts?

As we age the effects of gravity, exposure to the sun and the stresses of daily life begin to take their toll on the face. Creases form between the nose and lips, the jaw line grows slack with the formation of jowls and loose skin; and fat deposits appear more prominently around the neck.

What is a Facelift?

The Facelift is carried out to improve the most obvious signs of the ageing process by tightening the skin and muscles beneath the face and neck and remove any sagging skin. ‘Facelift’ is not quite accurate, it should really be called a ‘Jawline’ lift because that is where the main effect is seen. The procedure is often carried out in conjunction with eyelid surgery. A good facelift revitalises the face without distorting or changing the facial features. The facelift makes you look younger, but does not change your appearance and you will be instantly recognisable as the same person. Others may say ‘you are looking well’ or ‘have you lost weight’ etc. and not ‘Ah, you’ve had a facelift’.

Am I a suitable candidate for a Facelift?

The best candidates have faces and necks that have begun to sag but whose skin still has significant elasticity. Patients who wait until hanging folds or irreversible changes have taken place can sometimes be disappointed. Although the occasional film star may undergo a celebrated facelift the vast majority of patients are those normal people who take a pride in their appearance and feel younger than they look.

How major is Facelift surgery?

People imagine a facelift to be a very major surgical procedure (some techniques are) but in reality most facelift methods need hold no fears. The most modern methods can even be carried out under local anaesthetic on a day-case basis.

How long does it last?

The facelift rewinds the clock but remember, it still keeps running and the ageing processes will continue. Skin type and sun exposure varies from person to person, so some fortunate patients get a long lasting facelift whereas others can feel disappointed because the initial rejuvenation slackens in the first few months. The muscles of facial expression are powerful, so, smiling, laughing, singing, yawning and general facial expressions affect the result. Many patients have repeat facelifts, (usually local anaesthetic ‘facelift retightens’) to wind the clock back again.

What about the neck? - The 'I Guide.

The neck is the most difficult area to achieve a long lasting correction because the skin is thin and the area is very mobile. Some complicated and invasive techniques have been developed to tighten necks and I have tried many of them but have come to the conclusion that patients have to accept that there is no perfect method to treat this area, especially if you have a long slender neck. The 'I  GUIDE' technique has recently been introduced to the UK by the Hoywood surgeon Dr Mueller and can give a dramatic improvement to the area under the chin.  This involves some liposuction and a 'cats cradle' of specially introduced sutures under the jaw (together with a 'mini facelift') and the results are very impressive.  The Daily Mail called it the 'Trampoline Lift' in an article and this is because it's proper name is the 'Trampoline Platysmaplasty' and you can read more about it on

Why are there different types of Facelift and what do these operations involve?

The classical ‘skin-only’ facelift has been carried out for 50 years or more and has produced many excellent results, but has been largely superseded by other types of facelift that also lift the underlying tissues and muscles of the face. The ‘SMAS’ lift was introduced some 20 years ago and has been further refined into ‘Sub-Periostial’, ‘Midface’ and ‘Composite’ lifts. I carried out some of the first ‘Composite’ lifts in Europe some 15 years ago and the results were spectacular. The main problem was, because of the complexity and extent of the surgery, the recovery time was very long. I am not convinced that this procedure was significantly better than the less complex methods and therefore stopped carrying out the ‘Composite’ lift and returned to the ‘SMAS’ lift until 2000, when the ‘S’ or ‘MACS’ lift came onto the scene.

Tell me about the S or MACS Lift?

‘MACS’ means Minimal Access, Cranial Suspension (and is also known as the S lift) and I now routinely use this procedure. In its simple form it may be less effective on the neck but I have modified the technique in order to put additional tension on the neck muscles and skin. The great advantages are the short recovery time, smaller scars and minimal complication rate.

What about 'Mini'/'One Stitch'-Lifts?

I have also developed a ‘mini-facelift’ or ‘facelift re-tighten’ procedure which can be carried out under local anaesthetic and can give a very satisfactory minor lift; or rejuvenation of a previous facelift; and only leaves a 2 cm scar at the top of the ear. Someone called it a 'One Stitch Lift' and the name stuck (although there are 2 stitches really!).  You can see the procedure on You Tube, just type in -one stitch lift-.  There have been a few media reports of unsatisfactory major facelifts and a lot of ladies have been put off and opt for the mini versions, but you must realise that this is not a 'budget miracle' but merely a tidy up of the jawline!

What anaesthetic do I need?

The ‘MACS’ lift can be carried out under local anaesthetic but I and most patients prefer a general anaesthetic with an overnight stay in Hospital. The ‘Mini Facelift’ and ‘Facelift Retighten’ are carried out under local anaesthetic.

What happens in hospital after the surgery?

There will be a simple bandage around your ears and two small drain tubes and most patients say how little pain they experience. It is best for you to rest in Hospital overnight and the following morning I will see you again, remove the bandage and drains and the nurses will help you with a hair wash; and then you can leave Hospital when you are ready.

What about post operative care?

The golden rule with any facial surgery is to ‘keep your head above your heart’, in other words, do not stoop and sleep propped up with extra pillows. Normal swelling occurs during the next few days and settles during the first two or three weeks. Make-up can be applied after one week but a visit to the hairdresser should be delayed for one month (so don’t forget to go just before surgery). The first few days after surgery wash your hair gently every day to keep the suture line clean. The skin sutures dissolve (so do not require removal) and I see you at approximately one week, but you can contact me at any time if you have any worries or problems.

What happens when I get home?

As swelling subsides, irregularities can be felt under the skin and these settle in a few weeks. The crows feet area may be temporarily bunched a little, but this settles in a few days. Severe bruising is rare but slight bruising can show in the neck which can take two or three weeks to fade. There is a feeling of numbness in the cheeks, (because the small sensory nerve fibres are divided) which returns to normal over a few months The neck feels tight initially and occasionally patients experience a ‘tooth-ache’ like pain. The eyebrows may not move fully initially, but they always recover. The scars turn pink and then return to normal skin colour or white over a period of several months.

What can go wrong?

There can be problems with any operation, namely - Bleeding, Infection, Nerve damage and Scars; and the MACS lift is remarkable in that problems are much less common than other methods. The consultation includes a full analysis of all these possibilities, their likelihood and what you can do to minimise the risks.

When can I get back to normal?

Most patients go back to normal between two and three weeks after surgery but we are all different and heal at different rates, so have some flexibility in mind.

What if no-one notices any difference?

You must remember not to be undermined by any negative comments because most people are not very observant. All your friends and family love you the same no matter what you look like and may say you don’t look any different (unless you show them the photos I take for you before the operation!). You will certainly see the difference and feel better about yourself, but your loved ones may be mystified about why you needed to do it!

Summary

The vast majority of patients are very happy with their facelifts and say that the surgery was much easier than they thought it would be. Your self confidence and self image will be boosted but don’t forget, beware negative comments. Your surgeon can wind the clock back but it still keeps running; so you will look 20 years younger immediately following surgery but only 10 years younger when the initial tension has relaxed during the first few weeks.

How Many Facelifts does Mr Levick perform?

In accordance with the National Healthcare Commission guidelines, the annual audit figures of the Priory Hospital show that in the last five years (2004-2008) Mr Levick has carried out 100 (Full) Facelifts and 392 Mini-facelifts