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Facelift surgery

Key points

  • Facelift surgery lifts up the skin of your face to make it look younger and more alert.
  • Alternatives to facelift surgery include Botox, dermal fillers, chemical peels and laser treatment.
  • The side-effects of facelift surgery include bruising, swelling and pain. Complications can include damage to the nerves in your face.
  • It’s important to get good advice before you commit to facelift surgery, you can do this by talking to your GP and surgeon.

Facelift surgery lifts up the skin, deeper tissues and/or the underlying muscle, to make the face tighter and smoother.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs..

About facelift surgery

As you get older, the muscles in your face get looser and your skin becomes less elastic. This leads to wrinkles and then to skin folds and lines. Losing a lot of weight can also cause sagging skin whatever your age.

A facelift operation can give you a more alert appearance and make you look younger by reducing sagging skin and wrinkles.

A facelift works best for the lower half of your face - your cheeks, neck and jawline. You can also have a brow lift which deals with loose skin around your eyebrows and forehead wrinkles.

Having a facelift doesn’t stop your face from ageing, but it does help you to look younger than you would if you had not had the operation. You will get the best results if you maintain a stable body weight, don’t smoke, have good bone structure and skin with good levels of elasticity.

Getting advice about facelift surgery

It’s important not to rush into the decision to have this type of surgery. Talk to your GP about your options. He or she may be able to refer you to a reputable surgeon or advise you about how to choose a hospital.

Before deciding on a facelift, talk to your surgeon about what you're hoping to gain from the operation and the results you can realistically expect.

There are five main things to think about and do:

  • think about what you want to change - find out all you can about the treatment/s you want
  • research potential surgeons, check they have the right qualifications and that they regularly do the type of procedure you want
  • have a thorough consultation - ask questions and make sure you understand the risks of surgery
  • take time to reflect before you make a final decision
  • think about your care after your operation, for example how you will be looked after, especially if there are any problems after your surgery

What are the alternatives to facelift surgery?

You can have other treatments as an alternative to, or in combination with, a facelift. The main ones are listed below.

  • Resurfacing techniques can help to reduce fine wrinkles and can smooth your skin by removing damaged outer layers. Options include chemical peels and facial laser resurfacing.
  • Dermal fillers plump out deep wrinkles with injections of hyaluronic acid, collagen or other types of filler. This type of treatment may last for three to 18 months.
  • Botulinum toxin (eg Botox) injections can flatten out wrinkles in your skin caused by muscle movement, for example frown lines, forehead lines and crows' feet. However, it won't help with sagging or wrinkles caused by ageing. You will need to have Botox injections every three to six months to keep the effects.

Preparing for facelift surgery

Your surgeon will examine your face and may take photographs, so that the results of your surgery can be compared with how you looked before.

Your surgeon will explain how to prepare for your operation. If you smoke you will be asked to stop, as smoking increases your risk of getting a chest and wound infection. It also reduces the skin circulation so healing may be slower.

You will usually need to stay overnight in hospital after your operation. Most facelift surgery is done under general anaesthesia. This means you will be asleep during the operation. However, you can have the operation done using local anaesthesia and sedation to relax you. This means you will be awake during the procedure.

If you’re having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your anaesthetist’s or surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you may have. This is your opportunity to understand what will happen. You can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed so you can give your consent for the procedure to go ahead. You may be asked to do by signing a consent form.

Two weeks before your surgery, your surgeon may ask you to stop taking tablets containing aspirin or non-steroidal anti-inflammatory drugs such as Voltarol. This is because they may make bleeding more likely. Your surgeon will tell you when to stop taking these medicines.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.

What happens during facelift surgery?

The operation can take three to four hours, depending on what you're having done. Your surgeon will explain the options suitable for you and each procedure. You may have other procedures such as a brow-lift or eyelid surgery done at the same time.

Your surgeon will make a cut in your hairline, down past the front of your ears and up into your hairline again behind your ears. Your surgeon may also make cuts under your chin if you’re having your jawline lifted.

Your skin is carefully separated from the underlying tissues. Your surgeon will then remove or reposition the excess fat and tighten the muscles or surrounding tissues. The skin will then be pulled back and any leftover skin trimmed.

With some techniques, your surgeon may leave permanent stitches under your skin that hold the deep tissues in the lifted position. These may reduce the tension on the skin when it’s closed. Your skin is stitched back to the line where the cut was first made.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

Your face will be wrapped in bandages to help reduce bruising and swelling. Depending on the exact procedure, these may run under your chin, around your ears and/or over your head. These usually stay in place for about 24–48 hours, follow your surgeon’s advice.

You may have thin tubes coming out of the wound and into a bag. These help any blood or fluid to drain away. They are usually removed before you go home.

You may also be wearing compression stockings on your legs to help maintain circulation. You will be encouraged to get out of bed and move around as this helps prevent chest infections and blood clots in your legs.

You will need to arrange for someone to take you home. Try to have a friend or relative stay with you for the first 24 hours after your operation.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for at least 24 hours afterwards. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice.

Your nurse will give you some advice about caring for your healing wounds and a date for a follow-up appointment before you go home.

The length of time dissolvable stitches will take to disappear depends on what type you have. Your surgeon will tell you how long they take to dissolve. Non-dissolvable stitches are usually removed about a week after facelift surgery. Your surgeon will advise you what type of stitches have been used in your procedure.

Recovering from facelift surgery

It usually takes about two weeks to make a full recovery from facelift surgery. But this varies between individuals and also depends on the techniques used, so it’s important to follow your surgeon’s advice. You should be able to take part in your usual activities and go back to work at this time.

Your face may be swollen after the operation. You can help to ease the swelling by keeping your head propped up when you’re lying down.

You should not do strenuous activity, for at least two weeks after your operation. Your surgeon or nurse will be able to give you more information.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

What are the risks?

As with every procedure, there are some risks associated with facelift surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted, but mostly temporary effects, you may get after having the procedure.

Side-effects of facelift surgery include:

  • pain, swelling and bruising on and around your face
  • a change in skin sensation, for instance numbness of your cheeks and ears – this usually disappears in a few weeks or months
  • scarring– the scars will fade, but won’t completely disappear
  • raised hairline in front of and behind your ears – in men, your beard may lie closer to your ear and you might need to shave slightly differently

Complications

Complications are when problems occur during or after the procedure.

The possible complications of any operation include:

  • an unexpected reaction to the anaesthetic
  • excessive bleeding
  • developing a blood clot, usually in a vein in the leg (deep vein thrombosis)

Complications of facelift surgery can include:

  • infection
  • damage to the nerves in your face – this can cause numbness and muscle weakness in your face
  • hair loss around your scars
  • thick and obvious scars, called hypertrophic scars – these can be quite noticeable and are most likely to develop behind your ears
  • an uneven or asymmetrical appearance.

It’s possible that you may not be completely happy with your appearance after facelift surgery.

It’s important to know that it can take six to nine months to see the full effects of facelift surgery.


Reviewed by Sarah Smith, Bupa Health Information Team, October 2013.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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