Facelift
A facelift repositions the deeper support layer of the face — not just the skin — to restore the jawline and midface. Pulling skin alone is what produced the tight, windswept results of decades past; modern technique works underneath it.
What is a facelift?
A facelift (rhytidectomy) treats the lower two-thirds of the face: the jowls, the jawline and the folds running from nose to mouth. Beneath the skin lies a fibrous sheet called the SMAS, which carries the facial muscles. With age this layer descends; a facelift lifts and secures it, and the skin follows.
It does not treat the forehead, the eyelids or skin texture. Fine lines, sun damage and pigmentation need resurfacing or injectables — which is why a facelift is often combined with blepharoplasty or fat grafting rather than done alone.
Techniques
Who is a good candidate?
- Visible laxity of the jawline, jowls or neck — usually from the late forties onwards
- Reasonable skin elasticity and a defined underlying bone structure
- Stable weight; significant weight loss after surgery undoes part of the result
- Non-smoker, or able to stop for at least four weeks before and after — smoking markedly raises the risk of skin loss
- Blood pressure well controlled, as hypertension is the main driver of post-operative bleeding
- Expectations of looking rested rather than looking like a different person
Preparation
- Photographic analysis from standard angles and agreement on which areas will and will not change
- Blood tests, ECG and anaesthetic review; blood pressure optimised beforehand
- Stopping aspirin, anti-inflammatories, fish oil and vitamin E about ten days before
- Stopping smoking and all nicotine at least four weeks before
- Arranging hair colouring before surgery, not after — dye must wait several weeks
- A companion for the first night and loose front-fastening clothing for discharge
How the operation is performed
The incision starts in the temporal hairline, runs in front of the ear following its natural creases, curves around the earlobe and continues behind the ear into the hairline. The skin is lifted, the SMAS is repositioned and fixed with sutures, excess skin is trimmed, and the wound is closed without tension — tension is what produces a stretched look and widened scars.
A thin drain is often left overnight to prevent fluid collecting, and a supportive dressing is wrapped around the head. Where a neck lift is included, a small incision is made under the chin to tighten the neck muscles directly.
Anaesthesia, duration and hospital stay
- Anaesthesia: general, or sedation with local anaesthesia for limited lifts
- Operating time: 3–4 hours for a SMAS lift; 4–6 hours for deep plane or combined procedures
- Hospital stay: one night, so the drain and dressing can be checked before discharge
- Stay in the country: 10–14 days, until sutures are out and the first swelling has settled
- Time off work: about two weeks for desk work; longer if you are publicly visible
Recovery, week by week
Results and how long they last
A well-executed facelift typically sets the clock back by around ten years, and that advantage is broadly maintained — you continue to age, but from a lower starting point. Most patients are satisfied for eight to twelve years before considering anything further.
Skin quality is not addressed by lifting. Sun protection, and where appropriate resurfacing or injectables, do more for texture and pigmentation than any surgical manoeuvre — and they are what keeps the result looking fresh rather than merely tight.
Risks and complications
- Haematoma — a collection of blood needing drainage; the most common early complication, and strongly linked to uncontrolled blood pressure
- Temporary numbness in front of and behind the ears, resolving over months
- Injury to a branch of the facial nerve — uncommon, usually temporary, rarely permanent
- Skin healing problems behind the ear, markedly more likely in smokers
- Widened, raised or visible scars, particularly with tension on closure
- Changes in earlobe position or hairline if planning was imprecise
- Asymmetry, and the usual anaesthetic and clotting risks of any operation
Cost and what should be included
Price is driven mainly by technique and operating time: a deep-plane lift combined with a neck lift and blepharoplasty is a very different operation from an isolated short-scar lift, and quotes should say which one you are being offered.
- Named surgeon's fee, and which specific technique is planned
- Anaesthesia and the anaesthetist's fee
- Operating theatre and the overnight stay
- Pre-operative tests, ECG and cardiology clearance if required
- Drains, dressings, compression garment and medication
- All follow-up visits during your stay, including suture removal
- The written policy on revision and on treating a haematoma if one occurs
Blood pressure matters more than you would expect
Haematoma is the commonest early complication of a facelift, and uncontrolled blood pressure is its strongest predictor. If your blood pressure is borderline, treating it properly before surgery does more for your safety than any choice between techniques.
Frequently asked questions
Will the scars be visible?
They are placed in the hairline and along the natural creases of the ear, so they are hidden in most views and settle to fine pale lines within a year. They are permanent, however, and become more noticeable if the skin was closed under tension or if you smoke. Ask to see photographs of healed scars, not just front-facing results.
Will I look like a different person?
No — a facelift repositions your own tissue rather than adding anything, so the aim is that people notice you look well without knowing why. The unnatural look associated with facelifts comes from pulling skin sideways under tension, which modern deep-layer technique specifically avoids.
How old should I be?
There is no correct age — it depends on how much laxity you have, not on the number. Most patients are between their late forties and their seventies. Operating earlier, on limited laxity, gives a subtler change and an easier recovery, but does not mean you will never need anything again.
Can I have a facelift instead of fillers?
They solve different problems. Fillers add volume; a facelift repositions tissue that has descended. If your concern is a heavy jawline or a loose neck, no amount of filler will fix it, and repeated filling can make the face look overfull. If your concern is hollowing, surgery alone will not restore volume.
Related reading
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Get a FREE Second OpinionThis page provides general information about this procedure; it is not medical advice, a diagnosis, or a treatment recommendation. Capital Oncology Group is a care-coordination service and not a medical provider. All procedures are performed by independent, accredited hospitals and licensed physicians, and the decision to operate must be made by a qualified surgeon after examining you individually.