As you get older, the skin on your face becomes less elastic and looser. This leads to wrinkles and then to skin folds and lines. Losing a lot of weight can also make the skin on your face sag, whatever your age.
A facelift operation can make you look younger by reducing sagging skin and wrinkles. It works best on the lower half of your face – your cheeks, neck and jawline. You can also have a brow lift which can deal with loose skin around your eyebrows and with forehead wrinkles.
If you have a facelift, it won’t stop your face from ageing, but it will help you to look younger. You’ll get the best results if you keep to a steady weight and don’t smoke. You’ll also get better results if you have good bone structure and skin with good elasticity.
It’s important not to rush into the decision to have this type of surgery. Your GP may be able to refer you to a reputable surgeon for advice. Or they might be able to give you some advice on how to choose a hospital and surgeon.
Before you decide to have a facelift, talk to your surgeon about what you're hoping to gain, and the results you can realistically expect.
Here are some things to think about and do.
- Think about what you want to change – find out all you can about the treatment or treatments you want.
- Research some potential surgeons. Check they have the right qualifications and that they regularly do the type of procedure you want.
- Have a consultation and ask plenty of questions to make sure you understand the risks of surgery. Ask about the scars you should expect, for example, and how you could cover them as you recover.
- Take time to reflect on what you find out before you make a final decision.
- Think about your care after your operation. For example, who to contact if there are any problems after your surgery and how you’ll be looked after.
Your surgeon will explain how to prepare for your operation. If you smoke you’ll need to stop, as it increases your risk of getting a chest and wound infection. It also reduces the circulation to your skin, so it can take longer to heal.
Your surgeon will examine your face and may take some photographs so you can compare the results of your surgery with how you looked before.
You’ll usually need to stay overnight in hospital after a full facelift operation. Most facelift surgery is done under general anaesthesia. This means you will be asleep during the operation. But you can have the operation done using local anaesthesia plus sedation to relax you. This means you’ll be awake but a little sleepy.
An anaesthetic can make you sick so it's important that you don't eat or drink anything for six hours before having a general anaesthetic. Follow your anaesthetist or doctor's advice. If you have any questions, just ask.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your last opportunity to understand exactly what will happen. You should have talked through everything in detail before you’re admitted to hospital, and asked questions about the risks, benefits and alternatives to the procedure. You should then be in a position where you understand everything and can give your consent for it to go ahead. You’ll be asked to sign a consent form before the operation.
Two weeks before your surgery, your surgeon may ask you to stop taking any tablets that contain aspirin or non-steroidal anti-inflammatory drugs. This is because they increase the chance of you bleeding during your operation. Ask your surgeon when to stop taking these medicines.
You may need to wear compression stockings during the operation to help prevent blood clots forming in the veins in your legs.
You can have other wrinkle treatments instead of, or as well as, a facelift. The main ones are listed below.
- Resurfacing procedures 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 anything from three months to around a couple of years.
- Botulinum toxin (eg Botox) injections can flatten out wrinkles in your skin that are caused by moving muscles. Such wrinkles include frown lines, forehead lines and crows' feet. This treatment won't help with sagging or wrinkles caused by ageing. You’ll need to have Botox injections every three to six months to keep the effects.
For more information about these options see our information on wrinkle treatments.
The operation can take from around two to around five hours, depending on what you're having done. You might be able to have other procedures, such as a brow-lift or eyelid surgery, done at the same time. Your surgeon will explain the best options for you and give you details about each of them.
Your surgeon will make a cut in your hairline, past the front of your ears and possibly up into your hairline again behind your ears. They may also make some cuts under your chin if you’re having your jawline lifted.
Your surgeon will carefully separate your skin from the underlying tissues and remove or reposition the excess fat and tighten the muscles or surrounding tissues. Then they’ll pull back your skin and trim to remove any leftover skin.
In some operations, your surgeon may leave permanent stitches under your skin that hold the deep tissues in the lifted position. These may reduce the tension on your skin when it’s closed.
You might have some discomfort as the anaesthetic wears off but you'll be offered pain relief as you need it.
Your surgeon will wrap your face in bandages to help reduce bruising and swelling. The bandages may run under your chin, around your ears and/or over your head. You’ll usually need to keep them in place for a day or two but follow your surgeon’s advice. Prepare yourself so you’re not alarmed by the bruising when you take the bandages off. It will get better.
You may have thin tubes coming out of the wound and into a bag. These will help any blood or fluid to drain away. They’re usually removed before you go home. You may also need to wear compression stockings on your legs to help maintain circulation. Your hospital team will encourage you to get out of bed and move around to help prevent blood clots forming in your legs.
Your nurse will give you some advice about how to care for your healing wounds and a date for a follow-up appointment before you go home. We also have some advice about caring for surgical wounds.
The time it takes for dissolvable stitches to disappear depends on what type you have. Your surgeon will let you know. If you have non-dissolvable stitches, they’re usually removed about a week or two after facelift surgery.
Make sure someone can take you home. And ask someone to stay with you for a day or so while the anaesthetic wears off. Having a general anaesthetic can really take it out of you. You might find that you're not so coordinated or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or sign anything important.
Your face may be swollen after the operation. You can help to ease this by keeping your head propped up when you’re lying down.
It usually takes a couple of weeks for the swelling to go down and for you to feel confident about going out in public. This varies between people and also depends on the techniques your surgeon used, so it’s important to follow their advice. You can use camouflage make-up to help hide any bruising. This is a set of specialist products that cover your skin to hide any blemishes underneath.
You should be able to get back to your usual activities and go back to work after two weeks. Don’t do any strenuous activity during this time. Your surgeon or nurse will 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.
For more information about recovering after a facelift see our FAQ: Healing after a facelift.
As with every procedure, there are some risks associated with facelift surgery. We haven’t included the chances of these happening as they are specific to you and are different for every person. Ask your surgeon to explain how these risks apply to you.
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
- numb cheeks and ears – this usually disappears in a few weeks or months
- scars – these will fade, but won’t completely disappear
- a raised hairline around your ears – if you have a beard, it may lie closer to your ear so you might need to shave differently
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 your leg (deep vein thrombosis)
Complications of facelift surgery can include:
- a build-up of blood under your skin – this is called a haematoma and you may need to have it drained
- an infection
- damage to the nerves in your face – this can cause numbness and muscle weakness in your face
- losing hair 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 might not be completely happy with your appearance after facelift surgery. It can take six to nine months to see the full effects, so give yourself time to heal and then see what you think of the results. If you have any questions, ask your surgeon.
Every person is different but it usually takes several weeks, or even months to heal completely.
You’ll have some bruising and swelling after your operation. This may start in your face and move down to your neck over time. Most bruising and swelling should go within a couple of weeks following your operation. But it can take up to nine months for everything to heal completely.
Propping up your head when you lie down can help to reduce swelling. You can also use ice packs or ice wrapped in a towel to reduce swelling and bruising. Don’t put ice directly on your skin because that can cause damage.
Your skin will probably feel stiff and tight and look puffy at first. It may also feel dry. Your face may feel numb after the surgery, particularly your cheeks and ears. This doesn’t usually last long, but for a very small number of people it can be permanent.
Smoking can affect how your skin heals, so it’s best to stop smoking at least two weeks before your operation.
It’s best to lose weight before you have a facelift as you should get better results. This is because your surgeon will be able to remove more skin, which will improve the outcome. Losing weight after surgery can make your skin slack again so you won’t get such lasting results from your operation.
Your surgeon or nurse will give you information about how to take care of your skin and wounds when you go home. Follow this advice too to make sure you heal well.
- Don’t wash your face or hair until your stitches have been taken out, unless your surgeon says you can.
- Don’t use any styling products, or perm or colour your hair until your skin has healed. This is because the chemicals can irritate your scars. Plan ahead and have anything like this done before your operation.
- Use camouflage make-up only to help hide any bruising. This is a set of specialist products that cover your skin to hide any blemishes underneath.
- Don’t do any strenuous activity for at least two weeks.
- Take care of your skin by using a high-factor sunblock because the sun can affect your skin and new scars. Your surgeon will tell you when you can go back to your usual skin care and sunscreen products.
There’s no single qualification for cosmetic surgery, so you’ll need to do your homework.
It’s best to discuss any sort of surgery with your GP first. They may know of surgeons in your area and will also be able to pass on any important health information from your medical records to the surgeon. If you’d rather not involve your GP, you can find a surgeon yourself but get as much information as possible about their qualifications and experience. Don’t be guided by price, and be wary of advertising claims.
The surgeons who do facelift surgery are usually plastic surgeons. Consultant plastic surgeons are listed as being fully trained on the GMC Specialist Register. This means that they have completed specialist training in plastic surgery (usually for six years). Other surgeons who set up as cosmetic surgeons must also be on the GMC's Specialist Register. You can check this on the General Medical Council’s website (see Other helpful websites).
Don’t be afraid to ask your surgeon about their qualifications and experience. Also ask if they belong to a professional association, such as the British Association of Plastic Reconstructive and Aesthetic Surgeons or the British Association of Aesthetic Plastic Surgeons. Both of these organisations can help you to find a surgeon.
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- Sørensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg 2012; 147(4):373–83. doi:10.1001/archsurg.2012.5
- Venous thromboembolism in adults: reducing the risk in hospital. National Institute for Health and Care Excellence (NICE), 29 June 2010. www.nice.org.uk
- Botulinum toxin injections. British Association of Aesthetic Plastic Surgeons. www.baaps.org.uk, accessed 2 August 2016
- Face and brow lift. British Association of Plastic Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed 2 August 2016
- SMAS facelift rhytidectomy. Medscape. emedicine.medscape.com, updated 31 July 2015
- Product information. British Association of Skin Camouflage. www.skin-camouflage.net, accessed 2 August 2016
- Depth of anaesthesia monitors – bispectral index (BIS), e-entropy and narcotrend-compact M. National Institute for Health and Care Excellence (NICE), 21 November 2012. www.nice.org.uk
- Complications of facelift surgery. Medscape. emedicine.medscape.com, updated 17 March 2016
- Personal communication, Mr A I Attwood, MBBS, FRCS(ed), FFSEM, Consultant Plastic Surgeon, 25 August 2016
- Facial surgery and skin care surgical procedures guide. American Society of Plastic Surgeons. www.plasticsurgery.org, accessed 2 August 2016
- Why use a BAAPS member? British Association of Aesthetic Plastic Surgeons. www.baaps.org.uk, accessed 2 August 2016
- Professional standards for cosmetic surgery. Royal College of Surgeons of England. www.rcseng.ac.uk, published April 2016
- The training pathway. British Association of Plastic Reconstructive and Aesthetic Surgeons. www.bapras.org.uk, accessed 2 August 2016
- List of registered medical practitioners. General Medical Council. www.gmc-uk.org, accessed 2 August 2016
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Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, September 2016.
Peer reviewed by Mr A I Attwood, Consultant Plastic Surgeon, member of British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and British Association of Aesthetic Plastic Surgeons (BAAPS).
Next review due September 2019.
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