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21st Century Facelift

Sydney plastic surgeon Dr Darryl Hodgkinson explains the modern approach to facelifting surgery. Aimee Surtenich reports.

Before and after facelift by Dr Hodgkinson (with makeup)
Before and after facelift by Dr Hodgkinson (with makeup)

With experience in virtually every facelifting technique, Dr Darryl Hodgkinson believes the newest approach, the modified Fogli technique, offers the most natural appearance he has seen in his extensive 30 years of practice in plastic surgery. He believes the Fogli technique, which he has refined over the past five years, is also likely to produce the longest-lasting results.

An ageing face has a more square appearance compared with the oval face of youth. As such, Dr Hodgkinson restores a more youthful appearance by paying meticulous attention to the reestablishment of an oval jawline and a taut, firm, tall and smooth neck.

‘The jowl and the neck are adjacent to each other and the surgery involves rejuvenation of both,’ he says. ‘Patients often just want a neck lift – and the neck certainly is the area which many patients are most concerned about – but when they evaluate themselves and it is pointed out to them, nearly all of them also see that the jowl and some of the mid-face cheek are sagging.’

The newer facelift addresses the underlying problems of the ageing face by using the Superficial Muscular Aponeurotic System, referred to as the SMAS. This structure attaches to all the facial musculature, and as a composite can be moved superiorly and obliquely to re-drape the structures underneath the skin.
The Fogli technique, developed by French plastic surgeon Dr Alain Fogli, involves not only advancing the SMAS but also elevating the platysma muscle, or ‘turkey’ neck, it to its previous youthful position. This significantly reduces horizontal wrinkles on the neck while effectively lengthening the neck as well.

Bruising and swelling after a facelift depend very much on the healing response of each patient but they can generally be minimised by intensive overnight care with one of Dr Hodgkinson’s specialised one-on-one nurses. Both the early application of ice and reduction of blood pressure are essential in the post-operative period. ‘Most of my patients are back at work in two weeks and many of them who are in the public eye are able to resume their everyday activities within 10 days,’ he explains.

In a review of over 300 of Dr Hodgkinson’s cases, complications from facelift surgery have been rare. Only one patient had a small bleed which was immediately rectified.

Dr Hodgkinson says patients should be aware that it is quite common to feel a bit down the first week after a facelift. This is because of the amount of surgery performed as well as the patient not being able to go about their normal routines for the first week or so. ‘Once the healing process is complete, however, my patients are typically elated at their significantly younger, fresher looking appearance,’ he concludes.