The success and safety of your facial surgery depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and previous medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries

Professor Coombs will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine and measure your face
• Take photographs for your medical record
• Discuss your options and recommend a course of facial rejuvenation surgery
• Discuss likely outcomes of nose surgery and any risks or potential complications
• Discuss the type of anaesthesia that will be used

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the night before and the morning of surgery
• The use of anaesthesia during your facial rejuvenation surgery
• Post-operative care and follow-up

Professor Coombs will also discuss where your procedure will be performed.

The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Professor Coombs will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

• Unfavourable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anaesthesia risks
• Correctable hair loss at the incisions
• Facial nerve injury with weakness
• Facial asymmetry
• Skin loss
• Numbness or other changes in skin sensation
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation
• Pain, which may persist
• Skin contour irregularities
• Skin discolouration, sensitivity or swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

Be sure to ask questions: It’s very important to ask Professor Coombs questions about your facelift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Professor Coombs.

A special note about the use of fibrin sealants (tissue glue). Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising following surgery.

This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing surgical bleeding and by adhering layers of tissue together.

It may take several months for swelling to fully dissipate and up to 6 months for incision lines to mature.

Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.

Cost is always a consideration in elective surgery. Prices for facelifts can vary widely. A surgeon’s cost for facelift surgery may vary based on his or her experience as well as geographic office location.

Cost may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anaesthesia fees
• Prescriptions for medication
• Post-surgery garments, and
• Medical tests

Your satisfaction involves more than a fee

When choosing a plastic surgeon for facelift surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Most health insurance does not cover cosmetic surgery or its complications.

Use this checklist as a guide during your consultation

• Are you a member of the Australian Society of Plastic Surgeons?
• Were you specifically trained in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure?
• If so, at which hospitals?
• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Where and how will you perform my procedure?
• What surgical technique is recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with a facelift?
• How are complications handled?
• How can I expect my face to look over time?
• What are my options if I am dissatisfied with the cosmetic outcome of my facelift?
• Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me

(This information is courtesy of the American Society of Plastic Surgeons)

Step 1 – Anaesthesia

Medications are administered for your comfort during the surgical procedure. Facelifting surgery is performed under general anaesthesia.

A variety of other procedures can further enhance the outcome of a facelift. They include:

•Facial implants
•Soft tissue augmentation, usually with fat grafting, to re-contour the facial structure
•Resurfacing techniques to improve the tone and texture of facial skin
•Wrinkle reduction by injection

Step 2 – The incision

Depending on the degree of change you’d like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.

A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted.

Skin is re-draped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

Traditional Facelift

An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear and possibly within the lower eyelids or under the upper lip.

Limited Incision

Neck Lift

Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.

Step 3 – Closing the incisions

Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Step 4 – See the results

The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.

Important facts about the safety and risks of facelift surgery
The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Professor Coombs will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalisation and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

When your procedure is completed, a bandage could gently be placed around your face to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.

You will be given specific instructions that may include: 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 overall health, and when to follow up with Professor Coombs.

Be sure to ask Professor Coombs specific questions about what you can expect during your individual recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?