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Facing Up To Reality

Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson explains how outstanding results for older patients can be achieved with a facelift. Tara Casey reports.

BEFORE & AFTER pan-facial rejuvenation by Dr Hodgkinson using the Baker/Fogli technique

According to Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson, many patients find the idea of a surgical facelift daunting. However, he believes a facelift is the only procedure which can address a multitude of concerns at once.

A contemporary facelift can correct sagging jowls, neck wrinkling, chin laxity and decreased facial volume. ‘It can also restore youthful tone to the skin where less invasive procedures would generally not achieve such a satisfactory result,’ he says.

Dr Hodgkinson says that partial facelift procedures may not deliver the results of a full facelift, particularly in older patients. He says that for many of these patients a partial lift will only improve part of the face and eventually a full facelift will be required.

The key to a successful facelift, he says, is understanding the superficial muscular aponeurotic system (SMAS) platysma muscle complex. This is the set of muscles responsible for the intricate coordination of the range of facial expressions and it can be manipulated to redefine the appearance of the neck, jowls and cheeks, he says.

To help him visualise the end result, Dr Hodgkinson asks his patients to come to their first consultation with photos of themselves at ages 30 and 40. This helps him to understand the exact areas of degeneration and how they can be surgically corrected.

In his opinion, a more harmonious result can be achieved by combining a facelift with eyelid and brow surgery, a procedure known as pan-facial rejuvenation, rather than performing the procedures one at a time.

Dr Hodgkinson performs facelifts in his fully licensed day surgery facility. The entire procedure takes around three to four hours, and he recommends that patients remain under the care of the clinic’s nurses for between 24 and 48 hours after the procedure.

Dr Hodgkinson uses the Baker/Fogli technique (named after two surgeons who specialise in short-scar facelifts) for pan-facial rejuvenation. He says the technique, which suspends the deep structures of the face and ‘rivets’ them back to their middle-aged position, gives a natural-looking result that is not tight and maintains the position of the ear and hairline.