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Last updated July 28, 2020. 6 minute read

Facelift: types of procedures, cost, and complications

While facelifts can address the visible signs of facial aging to give you a more youthful appearance, they cannot slow down the aging process. During this procedure, the facial skin is generally lifted while the underlying tissue and muscles are tightened.

Linnea Zielinski Written by Linnea Zielinski
Reviewed by Yael Cooperman, MD

While there used to be plenty of stigma around surgical cosmetic procedures, you may notice that the more people are comfortable talking about the work they’ve had done. The American Society of Plastic Surgeons reported a 169% increase in procedures from 2000 to 2019 (ASPS, 2020). Most cosmetic surgery patients feel better about themselves post-procedure, studies show—and not in insignificant ways. 

Vitals

  • A facelift is a plastic surgery procedure that aims to reduce signs of aging in the face and neck.
  • Facelifts can address sagging skin, jowls, and wrinkles but will not stop or slow the aging process.
  • Facelifts vary based on the particular concerns being addressed and what procedures, if any, are being performed at the same time.
  • Some less invasive options may delay your desire for a traditional facelift.

In fact, these procedures can improve a patient’s feelings of distress and shyness, boost their quality of life, and even increase their sense of self-worth (Castle, 2002). But though no one should deter you from getting a facelift if that’s what you want, it’s important to know what to expect and keep in mind that there are less-invasive options that can delay your desire for surgical procedures.

What is a facelift and how does it work?

A facelift, also called a rhytidectomy, is a procedure in plastic surgery that can reduce signs of aging in the face and neck regions. During a facelift, excess skin is removed in order to reduce the look of wrinkles. There are several different methods for performing this procedure, but they all focus on helping the patient reclaim tighter looking skin, which tends to get wrinkled and sag as we age. 

But wrinkles aren’t the only concerns addressed during this procedure. A facelift may include some elements of reconstructive surgery and overall aims to lessen the look of multiple signs of aging, including (American Society of Plastic Surgeons, n.d.):

  • Skin sagging due to the natural loss of elastin and collagen as we age
  • Double chin or “turkey neck” caused by fat and loose skin around the chin
  • Displacement of fat (like under the eyes), resulting in a loss of volume and tone
  • Jowls developing around the cheeks and/or jawline
  • Deepening of folds, especially between the corners of the nose and mouth

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While there are many contributors to skin aging, such as genetics and sun exposure, most of them work in the same ways and form these characteristics of aging skin with which we’re all too familiar. 

Under the top layer of skin, known as the epidermis, is a structure called the dermis, which is the layer of your skin containing collagen and elastin fibers. These elements form scaffolding that gives your skin that plump, voluminous look we associate with youth and health. As we age, these fibers break down, and external factors such as sun damage speed up that process (Ganceviciene, 2012).

The top layer, too, is affected by the aging process. Though we naturally produce hyaluronic acid, which helps keep our skin hydrated by attracting and holding onto water molecules, production decreases over time, leading to dry skin. Dry skin can accentuate the look of fine lines and wrinkles.

Types of facelifts

While facelifts can address the visible signs of facial aging to give you a more youthful appearance, they cannot slow down the aging process. During this procedure, the facial skin is generally lifted while the underlying tissue and muscles are tightened. 

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Fat can be redistributed or injected to create a plumper, more youthful appearance. The skin is then draped over these structures, and excess skin is removed before the incisions are repaired. A traditional facelift requires an incision starting in the hairline at the temples, extending all the way to the temple on the other side of your head.

Although surgical techniques are constantly evolving, most facelift patients will experience an incision type that falls into one of these two categories:

  • Traditional facelift incisions 
  • Limited incisions also begin above and typically run in front of the ear, but they are shorter incisions.

Although procedures to improve the appearance of the neck are technically distinct from facelifts, patients often choose to have them performed simultaneously with other cosmetic procedures such as full facelifts and mini facelifts. Mini facelifts (also known as mini lifts) are facelifts that focus on a smaller portion of the face – typically the cheek area – and therefore often only require incisions in front of the ears (Duminy, 1997). 

Who’s a good candidate for a facelift?

First and foremost, there is a range of less invasive options that can provide excellent results and perhaps even quell your desire for a facelift in the near future. Consulting with a cosmetic surgeon can be a great way to explore the various options and address your specific concerns. Options such as fillers and Botox can be effective at eliminating fine lines in the short term until you’re ready to take the dive into more invasive procedures. 

If your surgeon agrees that a facelift is the proper next step, they’ll look to see if you’re a good candidate. Good candidates for this procedure are generally in good health and don’t have any medical conditions or nutritional deficiencies that might slow wound healing. But it’s not only nutritional deficiencies that can impair your recovery. 

Smoking has been shown to impair wound healing by affecting oxygen supply to our tissues. Past studies have found that even one cigarette can impair this ability, affecting wound healing (McDaniel, 2014). Last but certainly not least, your surgeon may check to see that you have realistic expectations for the outcome of the procedure. 

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A review of studies on the psychological effects of cosmetic surgery showed that proper management of patients’ expectations can offer more favorable results, and failure to do this can result in an increase in disappointment, psychological stress, and repeated requests for additional procedures (Honigman, 2004). As mentioned, facelifts cannot slow or reverse the aging process, and some people find that one procedure is not enough to reach their desired results. 

How long does a facelift last?

While the results of a facelift are permanent, as you continue to age, the structures in your face will continue to become laxer resulting in further sagging and drooping. There is a range of treatments that can diminish the appearance of these progressive changes, but some people find that additional surgeries are required to maintain their new, more youthful appearance.  

In addition, different surgical procedures in the head/neck region can further improve the results of a facelift, and many of these can be done at the same time as your facelift surgery. Facelift procedures are commonly done simultaneously with other facial plastic surgeries such as neck lifts (platysmaplasty), eyelid surgery (blepharoplasty) done on the upper or lower eyelids, and brow lifts (also called forehead lifts). 

It’s also worth noting that it takes some time to truly see the results of a facelift. While it’s generally possible to go out in public and return to some of your usual activities within 10-14 days, it may take 2-3 months for your face to feel normal again. This transition period may include feeling as if the texture, tightness, or sensitivity of your skin has changed (American Society of Plastic Surgeons, n.d.-b).

Safety considerations/possible complications

Facelifts are invasive and come with possible complications similar to other low-risk surgical procedures in which general anesthesia is used. Anesthesia comes with its own risks and is not suggested for certain groups of people. The most common risks are bleeding, infection, problems with wound healing, blood clots, and cardiac events. But there may also be pain, scarring, prolonged swelling, or bruising at the incision sites. In some rare cases, there may also be hair loss at incision sites.

Your individual recovery time may vary based on your medical history and how well you follow post-surgical instructions from your plastic surgeon. In some cases, pain medication may be prescribed to help with some of the side effects of the surgery, such as incision site pain, swelling, and bruising.