Also known as rhytidectomy
A facelift is the most comprehensive approach to treating facial wrinkles and sagging caused by aging. The surgery varies in range from minimally invasive ‘lunchtime lifts’ to more extensive, sophisticated surgery. A facelift removes excess skin, tightens underlying tissues and muscle and redrapes skin on the face and neck. It can correct midface sagging, marionette lines, jowls and a double chin, maintaining its reputation as the ‘gold standard’ for facial rejuvenation. Every year, thousands of people undergo successful facelift surgery and are pleased with the results.
These are the top three pros and cons to weigh when considering a facelift. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.
Are you a good candidate for a facelift?
The following are some common facial characteristics that make you an appropriate candidate for a facelift:
If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
Most facelift techniques focus on the lower facial areas, such as the jawline, jowls and cheeks. A facelift can also focus on the midface or the forehead. In some techniques, deeper facial tissues may be repositioned or tightened to restore a more youthful contour. In other techniques, removal or addition of fat or other soft-tissue fillers may be necessary to achieve the best results. Today, many different techniques exist with outcomes that can be consistently reliable, safe, and durable. Your incisions will depend on the area of the face that is targeted and the amount of change you want.
Once the incisions are made, various degrees of ‘undermining’ of your skin is performed, and the deeper layers of your face are lifted. Undermining separates the overlying skin of the face and neck from the muscles and tissues deep to the skin. This frees or loosens facial and neck skin so it can be redraped at the end of the procedure, making sure skin is smooth.
Then, your surgeon will raise the skin from the temples, cheeks, and neck, and lift and reposition the underlying connective tissue, removing excess fat and skin. If this procedure is performed in conjunction with a neck lift, the surgeon will draw the neck muscles together, stitching them together at the midline to form a strong sling of muscles that supports the entire neck and jaw. Your surgeon may also include liposuction of the neck and jowls. Facial implants may be added to increase cheek or chin volume.
Finally, your surgeon redrapes the skin over the new underlying structure and closes the incisions with stitches and/or small metal clips. Where needed, drainage tubes may be inserted. A padded, supportive dressing is usually applied.
The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, and to make your surgical experience as easy and comfortable as possible.
There are several approaches to facelift surgery (see How is a facelift performed?). Your plastic surgeon will recommend an approach based on your goals and facial characteristics, including the shape of your face. The placement and length of incisions vary, depending on the facelift technique that best suits you. Your surgeon might find you appropriate for a ‘short scar’ facelift procedure in which a short incision is usually limited to the area around the ear.
Brand name procedures for facelift such as the ‘LifeStyle Lift’ or ‘Quick Lift’ are still a form of facelift. One method is not superior over another and the best treatment for you will be determined during your consultation with a board-certified plastic surgeon.
Regardless of the type of facelift you undergo, you will have incisions that involve the skin around your ear.
Traditional facelift: Your surgeon will make incisions in your hairline at the temples, continuing down and around the front of your ears and hidden in the natural creases behind your ears in your lower hair-bearing scalp.
Limited-incision facelift: Your surgeon will make short incisions in your hairline, starting at your temples and continuing down and around the front of your ears, hidden in the natural creases. There may also be incisions in the lower eyelids, temporal area, or under the upper lip.
Neck lift: Your surgeon will make incisions starting in front of your earlobes and continuing around behind your ears in your lower scalp. There will also be a small incision underneath your chin.
Modified incisions include variations of the short scar with shorter incisions around the ear.
Facelift scars can be virtually invisible: narrow, flat, and well placed behind the ear so you can wear your hair close-cropped.
Your board-certified surgeon will place the incision in areas that are hidden and in areas where the scars look like natural wrinkles. Incision healing depends on surgical technique, infection prevention, reduction of tension, your nutrition, any known or unknown underlying medical conditions, no smoking, and your genetic tendencies.
There is a risk of 'hypertrophic scars' and 'keloids' anytime the skin is cut. This risk is greater in darker-skinned people such as African Americans and Hispanics. Injections of a corticosteroid medication or other treatments, might be used to improve scar appearance.
It’s important to choose your surgeon based on:
Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a Surgeon.
After finding a board-certified plastic surgeon in your area who is experienced in performing facelift surgery, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for a facelift and clarify what a facelift can do for you. Alternative and additional treatments may be considered, once the surgeon understands your goals and medical condition. (See related procedures.)
It is important to be completely honest during the consultation. Also, bring pictures of yourself at an earlier age; they may serve as a good point of reference for discussing your goals. It’s a good idea to be fully prepared to answer these questions:
Your surgeon may also:
Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:
For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety, and to plan your procedure, visit the Planning Toolkit.
We developed these questions to help you:
It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.
Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery. You may also be required to obtain medical clearance from your personal family physician or internist.
Preparation for surgery begins after the surgeon examines you and discusses the details of the procedure. If he recommends that you stabilize your weight before surgery or makes other lifestyle suggestions, do your best to follow them to ensure the best results and minimize complications.
In advance of your procedure, your surgeon will ask you to:
Your facelift may be performed in a hospital or an outpatient surgical facility. If it is outpatient, be sure to arrange for someone to drive you home after surgery and stay with you for the first twenty-four to forty-eight hours, unless you and your surgeon have decided on other postoperative recovery options.
For the easiest recovery period, prepare carefully:
What can I expect on the day of facelift surgery?
Facelift surgery, which may be performed in a hospital, freestanding ambulatory facility or office-based surgical suite, requires at least several hours to complete, though more extensive procedures may take longer.
What will my recovery and healing from a facelift be like?
Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:
See options for short-term recovery locations in Aftercare and Recovery (Planning Toolkit).
Immediately after your facelift surgery
Recovery time frame after a facelift
Follow all postoperative instructions, including information about bandages, drains, taking an antibiotic (if prescribed), and the level of activity that is safe. Your doctor will let you know the signs of problems to watch for, such as signs of infection. Recovery time will vary by patient and in relation to the extent of your surgery.
The first week
Two to six weeks
You may ease into your regular fitness routine. However, wear protective eyewear and a hat. Discomfort or tightness and tingling in your face will resolve. Be prepared to wait at least six months for your facelift to completely heal inside and out. It is important to see your doctor as scheduled.
Your genes, skin quality, and maintenance routine are important factors in the longevity of your facelift, but the facelift technique is the number one factor in determining how long the result will last.
Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you have any questions about your facelift healing and results.
The cost of a facelift varies from doctor to doctor, from one geographic area to another, and based on the facelift technique that is performed.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments, or other miscellaneous costs related to facelift surgery.
Because a facelift is elective surgery, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.
Choose your surgeon based on quality, training, and experience—not cost.
See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.
Fortunately, significant complications from facelift surgery are infrequent. This surgery remains the gold standard for facial rejuvenation and is usually performed without any major problems.
Risks and potential complications of surgery should be discussed during your consultation. The risks in most surgeries are similar. Some of the potential complications of all surgeries are:
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your facelift surgery.