A facelift is a surgical procedure to repair sagging, drooping, and wrinkled skin of the face and neck.
Rhytidectomy; Facialplasty; Cosmetic surgery of the face
While you are sleepy (sedated) and pain-free (local anesthesia), or deep asleep and pain-free (general anesthesia), the plastic surgeon will make surgical cuts that begin above the hairline at the temples, extend behind the earlobe, and to the lower scalp. Often, this is one cut. An incision may be made beneath your chin.
Many different techniques exist. The outcomes for each one are similar but how long the improvement lasts may vary.
During a facelift, the surgeon may:
Why the Procedure Is Performed
Sagging or wrinkled skin occurs naturally as you get older. Folds and fat deposits appear around the neck. Deep creases form between the nose and mouth. The jawline grows "jowly" and slack. Genes, poor diet, smoking, or obesity can make skin problems start sooner or get worse faster.
A facelift can help repair some of the visible signs of aging. Fixing damage to skin, fat, and muscles can restore a "younger," more refreshed and less tired look.
People have a facelift because they are not satisfied with the signs of aging on their face, but they are in otherwise good health.
Risks of anesthesia and surgery in general are:
Risks of face lift surgery include:
Although most people are happy with the outcomes, poor cosmetic results that may need more surgery include:
Before the Procedure
Before your surgery, you will have a patient consultation. This will include a history, physical exam, and a psychological evaluation. You may want to bring someone (such as your spouse) with you during the visit.
Feel free to ask questions. Be sure you understand the answers to your questions. You must understand fully the preoperative preparations, the facelift procedure, the improvement that can be expected, and the care after surgery.
For the one week before surgery, you may be asked to stop taking blood thinners. These medicines may cause increased bleeding during the surgery.
During the days before your surgery:
On the day of your surgery:
Be sure to follow any other specific instructions from your surgeon.
After the Procedure
The surgeon may temporarily place a small, thin drainage tube under the skin behind the ear to drain any blood that might collect there. Your head will be wrapped loosely in bandages to reduce bruising and swelling.
You should not have much discomfort after surgery. You can relieve any discomfort you do feel with pain medicine the surgeon prescribes. Some numbness of the skin is normal and will disappear in a few weeks or months.
Your head needs to be raised on 2 pillows (or at a 30-degree angle) for a couple of days after surgery to keep the swelling down. The drainage tube will be removed 1 to 2 days after surgery if one was inserted. Bandages are usually removed after 1 to 5 days. Your face will look pale, bruised, and puffy, but in 4 to 6 weeks it will look normal.
Some of the stitches will be removed in 5 days. The stitches or metal clips in the hairline might be left in for a few extra days if the scalp takes longer to heal.
You should avoid:
Follow instructions about using concealing makeup after the first week. Mild swelling may continue for several weeks. You may also have numbness of the face for up to several months.
Most people are pleased with the results.
You will have swelling, bruising, skin discoloration, tenderness, and numbness for 10 to 14 days after the surgery. Most of the surgical scars are hidden in the hairline or the natural lines of the face and will fade over time. Your surgeon will probably advise you to limit your sun exposure.
McLain L. Facial cosmetic surgery. In: Hupp JR, Ellis E, Tucker MR, eds. Contemporary Oral and Maxillofacial Surgery. 6th ed. St Louis, MO: Elsevier Mosby; 2014:chap 27.
Warren RJ. Facelift: principles of and surgical approaches to facelift. In: Rubin JP, Neligan PC, eds. Plastic Surgery: Volume 2: Aesthetic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 6.2.
Review Date: 11/15/2017
Reviewed By: Tang Ho, MD, Assistant Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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