Face Lift - Consultation We have outlined below what you can expect from your facelift consultation. Read carefully, as there are many suggestions that will save you time, clear up questions, and help you convey to your plastic surgeon what you want to accomplish. Health History All cosmetic surgery consultations begin with a thorough health history. This is especially true if general anaesthesia is being used, but also applies to local anaesthesia. Facelifts are usually done under general anaesthesia. Prior to meeting with us you will be given a Medical History Questionnaire to fill out. There are several areas of your health you will be asked about. Be sure to answer it with detail so that your surgery and anaesthesia can be optimised for you. General Health General health problems are important to discuss so that your surgery is as safe as possible. Be sure to mention any chronic illness. Of particular concern are: high blood pressure, diabetes, heart problems, liver and kidney disease, stroke, cancer, bleeding problems, and wound healing problems. What will you do if I have medical problems? In short, we will make sure your health is optimised as much as possible to ensure your safety. This may mean referring you to your private physician. If you have a health problem you can often save yourself time by getting a letter from your private physician prior to your cosmetic consultation stating what the health problem is, how it is being treated, and whether or not you are able to tolerate general anaesthesia safely. If you are seeing any specialist (cardiologist, kidney doctor, psychiatrist, etc.) be sure to bring a letter from them stating that you are able to tolerate surgery. Be sure to let us know if you have ever had a blood clot. Past Surgical History On your questionnaire you will be asked about previous surgeries. Be sure to identify any problems you may have had with anaesthesia. Of particular concern are previous cosmetic surgeries especially if you do not like the result and are interested in revision. Medications Be sure to list all medications you take including aspirin and over-the-counter medications. These are important as they may increase bleeding and affect your surgery. It is extremely important to stop taking aspirin and aspirin containing products at least two weeks before surgery. Tylenol is a good alternative. Allergies to Medications Information about medications that cause allergies is very important so that these medications can be avoided. Of particular importance is the reaction you had, especially if you had trouble breathing. Be sure to include this information! Nausea is not an allergy but it is important to mention as well. Smoking, Drinking and Drug Use These three will certainly affect your surgery and MUST be mentioned so that your surgery can be optimised. Smoking causes a profound decrease in wound healing and will lead to worse scarring and a less favourable result. With large procedures such as a face lift, neck lift, tummy tuck, and breast lift smoking must be stopped at least 3 weeks before and after surgery. Otherwise, the results could be disastrous leading to non-healing wounds, poor scarring, and/or infection. With smaller procedures such as eyelid surgery, nose surgery, breast augmentation, and Liposuction smoking will hurt the overall result but this may or may not be noticeable. In this case smoking cessation is strongly advised but is not mandatory. Physical Exam And Treatment The key to the face physical exam is to determine exactly what is causing the problem. Below is a typical sequence that an experienced plastic surgeon uses to evaluate the neck and what can be done to correct problems. Temple With ageing, facial fat either descends or goes away, or a combination of both. In the temple region this causes a sunken area characteristic of ageing droopy skin also is a result. Crow's feet with smiling are not uncommon and are acceptable as long as they are minimal. Permanent wrinkles and/or deep lines during smiling give an aged appearance. A facelift will elevate some of the descended temple fat as well as smooth out the wrinkles. Wrinkles with smiling will not be eliminated but should be improved. Concurrent brow lift and/or lower blepharoplasty may be necessary to treat significant crow's feet. Cheek Similarly, facial fat in the cheek descends or goes away. As it falls it bunches up just above the naso-labial crease giving the typical fallen face appearance. During your consultation, your plastic surgeon will pinch this area and elevate the fat upward, thus, simulating a facelift. During a facelift, the surgeon will reposition this upward by 1 of 3 methods.