A facelift is a procedure that tightens and lifts the skin and muscles of the face. The medical name for a facelift is a rhytidectomy. This gives the face a more youthful appearance. It is one of the most commonly requested procedures by both men and women. Often, it can be combined with other procedures such as a neck lift or brow lift, to rejuvenate the overall facial appearance.
Facelift Surgery Overview
What Can a Facelift Achieve?
A facelift (rhytidectomy) can give you a more youthful, rejuvenated appearance. As we age, our skin gradually loses its elasticity and our facial muscles slacken. This creates the appearance of wrinkled, sagging skin, especially on the face. Lifestyle factors such as sun exposure, smoking and stress can also contribute to these changes. This can affect confidence and make patients look older than they feel. Thus, a facelift aims to restore the vitality in facial appearance.
By lifting and pulling back the skin and soft tissues of your face, a facelift can:
- Smooth the skin on the face.
- Reduce the appearance of fine lines and wrinkles.
- Reduce flabby or sagging skin around the face.
- Restore definition in the face.
- Give a more youthful appearance.
How Much Does Facelift Surgery Cost?
Facelift Surgery usually costs between £5,000 and £12,000. Prices can vary significantly depending on a number of factors. These factors include:
- Surgeon experience
- Anaesthetist experience
- Which hospital or clinic is chosen for the procedure
- The complexity of the individual procedure
- Surgical techniques (for example, SMAS Facelift or the MACS Facelift)
- Combination surgeries (like a Facelift & Neck Lift)
- The time required in surgery for each patient’s case
During the free consultation, each patient has the opportunity to explain to their surgeon what they are hoping to achieve from the surgery. The surgeon will, in turn, offer suggestions on how best to achieve those goals, together they will go through the list above to create a personally tailored procedure package. Only after the consultation, can a fixed price be determined, which is reflective of the decisions met during the consultation
Once a price is set, there are no hidden fees. The price covers:
- Surgeon and anaesthetist costs
- Hospital costs
- Overnight stays (if required)
- Aftercare and follow-up appointments
The facelift procedure involves raising and repositioning the soft tissues of the face. The surgeon will do this by firstly making an incision on both sides of the face, in front of the ears. They will then remove excess skin and fat and then tighten the muscles and soft tissues. Finally, they will lift and pull back the skin before closing the incision.
The surgeon will perform the facelift using one of several techniques. The most common techniques are the following:
Using this method, the surgeon makes a deep incision that goes below a layer of tissue called the Superficial Musculoaponeurotic System (SMAS). By making a deep incision, the surgeon can improve more severe facial sagging and problem areas, and achieve long-lasting results.
Minimal Access Cranial Suspension (MACS) Facelift
With this method, the surgeon will make smaller incisions that do not go as deep as a SMAS facelift. This technique may be best for patients if they only have mild problem areas, as they will have smaller scars and a shorter recovery period.
Facelift Surgery Candidates
Why Choose to Have a Facelift?
Ageing is a natural process and gradually signs of this will show on the face. However, often lifestyle factors can lead to premature wrinkles and lines, leaving some people unhappy about their appearance. If this is the case, patients may be considering a facelift. To know if a facelift procedure is the right choice, think about the main concerns. The best facelift candidates will have features and concerns that a BAAPS/ BAPRAS approved surgeon can improve through this procedure. Patients may be suited for a facelift if:
- The appearance of the face is making the patient look older than they feel.
- The face is showing visible signs of ageing, such as fine lines and wrinkles.
- The patient wants to restore a youthful, more fresh appearance.
- The patient wants to redefine the face by reducing loose, sagging skin.
Who are the Best Candidates for a Facelift?
Some patients are more suited than others to a facelift procedure. This depends on a variety of factors. The ideal candidates for a facelift will have the following features:
Good Skin Elasticity & Strong Bone Structure
It is best if the skin still has some natural elasticity and suppleness as it will be able to conform to its new, improved contours. A well-defined bone structure also contributes to satisfying results.
Good General Health
It is important to be in good general health before having facelift surgery. This may mean stopping smoking before surgery or losing weight before the procedure. This will reduce the risk of complications and help patients achieve better results from the surgery.
Loose skin, Wrinkles & Deep Creases
A facelift is an excellent way to reduce flabby or sagging skin, reduce wrinkles, and smooth out deep creases.
What a Facelift Will Not Resolve
A facelift will only smooth and tighten the skin of the lower half of the face. However, often the surgeon can combine a facelift with the following procedures to address other concerns you may have:
- Brow lift – this can reduce wrinkles on the forehead.
- Blepharoplasty – this can correct sagging of the eyelids.
- Neck lift – this tightens and lifts the skin of the neck.
The surgeon can perform these procedures at the same time as the facelift. Patients can discuss all options with the surgeon during the consultation.
The Facelift Surgery Procedure
How is a Facelift Procedure Performed?
There are a number of different techniques the surgeon can use for a facelift procedure. Patients will have met with their BAAPS/BAPRAS surgeon for a consultation prior to the surgery to discuss the different options, and what technique would be most suitable for them to achieve their goals. A facelift can take anything between 2 to 5 hours. This also depends on whether patients will have additional procedures, such as a neck lift, performed at the same time. Below is an overview of what will happen on the day of the facelift procedure.
Patients will need to give consent for the operation in the form of writing. Patients will do this before the surgery. This ensures that they have had enough time to obtain information about the facelift procedure, including the benefits, risks, and complications involved. Before patients sign the consent form, they should also make sure that they have asked the surgeon any questions they have regarding the procedure. Once patients have done this, the surgeon will demonstrate where they will be making the incisions by drawing lines on the procedure area.
Patients will meet the anaesthetist. This is the doctor who will be responsible for giving the anaesthetic. The surgeon will have discussed what type of anaesthetic the patient will. This will either be a general or a local anaesthetic. A general anaesthetic will put the patient safely to sleep throughout the entire procedure. A local anaesthetic will numb the surgical area, and the anaesthetist will also give a sedative medication at the same time. This will help to keep the patient to be relaxed throughout the operation.
In the operating theatre, the surgeon will prepare for the operation by cleaning the treatment area and draping over a sterile sheet. The surgeon will then make an incision. The incisions will vary slightly in size and location according to the technique used. The general technique involves the surgeon separating the skin from the underlying tissue, before removing the excess fat and tightening the tissues. The surgeon will then use stitches to fixate the lifted tissue to its new position. Afterwards, they may reposition the excess fat to enhance the contours of the face. If there is not enough excess fat, the surgeon can also retrieve fat using liposuction.
The different areas the surgeon may perform the facelift include the following:
If patients are only just beginning to show signs of ageing, they may not need a full facelift surgery. A mini facelift may be an ideal alternative. This technique involves the surgeon making small incisions in front of or behind the ear. Depending on the degree of lift needed, the surgeon may also make a small incision along the hairline. They will then insert a stitch just under the skin and into the underlying fibrous tissue. The surgeon will use this stitch to lift the cheeks, jowls and the upper neck.
Whilst the above techniques mainly focus on sagging around the jowls and jawline, a mid-facelift can address laxity and flatten the skin in the middle segment of the face. This includes the cheek area below the eyelids and next to the nose. The surgeon will make small incisions in the hairline and either the mouth or lower eyelid. The surgeon can then tighten the muscles and reposition the fatty tissue upwards. This restores volume in the cheeks to create a natural, youthful contour to the face. This technique is ideal for patients who want to achieve a subtle but noticeable lift and fullness to their cheeks.
A full facelift is more suitable for older patients looking for a more dramatic final result. The full facelift targets the cheeks, jowls, temples and upper neck. Often, it does not include the brow area or neck area and a brow lift or neck lift may need to be added on. The surgeon will discuss if the patient is a candidate for a full facelift or a mini facelift.
There are also different techniques that the surgeon may use which include the following:
This is the traditional facelift technique and involves the manipulation of the Superficial Musculo Aponeurotic System (SMAS). This is a deep layer of tissue that contains muscles and support structures of the face. In this technique, the incision is made along the hairline, past the front of the ears to below the earlobe, and behind the ears. The incision is deep and extends under the SMAS layer. The surgeon is able to elevate and tighten the tissue of the SMAS and uses stitches to fixate it to its new position. Although it is a longer procedure with a longer recovery time, this technique produces long-lasting results. It is also more suitable for men and women who have more severe sagging of facial skin.
Minimal Access Cranial Suspension (MACS) Facelift
With this technique, the surgeon will make a smaller incision that does not extend to the ear. The incision is more superficial and does not go under the SMAS layer. This technique is less extensive than the SMAS technique, so is better suited to correcting milder laxity of facial skin. The advantages of this method are smaller scars and a shorter recovery time.
Closing of Incisions
The surgeon will lift and pull back the remaining skin and stitch it to its new position. They will use absorbable and non-absorbable sutures to close the incision. Afterwards, they will apply a light dressing to your face to help minimise bruising and swelling. These bandages will come off after a couple of days. Patients may also have a small drainage tube placed under the skin behind the ear to drain any fluid.
Return to the Ward
At the end of the surgery, the nurses will move the patient to a recovery room. Here, patients will gradually wake up from the anaesthetic under close supervision.
The Facelift Surgery Consultation
What to Expect From a Facelift Consultation?
The facelift consultation is an opportunity for patients to meet with their prospective surgeon to discuss the procedure and what they would like to achieve from it. This will last 15 minutes to an hour. Patients will talk with the BAAPS/BAPRAS surgeon about their concerns, and they will assess the patient's face and the problem areas. The surgeon can then discuss with the patient the best surgical approach to the problems they have expressed. If appropriate, they may suggest procedures for other parts of the face such as the eyelids or brows. Often, these can be performed at the same time as a facelift. The surgeon will also discuss the potential risks and complications that come with a facelift procedure. It is important to be aware of these so that patients can make an informed decision on whether or not they wish to go ahead with the procedure.
To assess suitability for surgery, the surgeon may ask you about the following:
- Any current medical conditions.
- Past medical history.
- Previous surgeries
- Medications (including over-the-counter and herbal remedies).
- Intake of alcohol.
- Smoking history.
- Any allergies.
During the facelift consultation, it is recommended that patients are as open as possible with the surgeon. Be honest about all expectations and desired outcomes. The surgeon is there to listen carefully and to help achieve the goals the patient wants. This also means letting the patient know if their expectations are not realistic. In this case, they may suggest better alternatives.
Questions to Ask During a Facelift Consultation
Patients can ask the surgeon any questions they have about the procedure during the free facelift consultation. The following are some examples of questions that patients may consider asking:
- Will a facelift correct the concerns I have expressed?
- What scars will I be left with?
- What other options are available for me?
- Will I benefit from a neck lift/browlift/eyelid surgery too?
- Do you have any before and after pictures of previous facelift procedures you have performed?
- Will I be in pain after the surgery?
- How soon after a facelift can I return to work?
Facelift Surgery Risks & complications
What are the Main Facelift Risks and Complications?
With any surgery, there are risks and complications that can occur. It is really important for patients to be aware of what these are so that they can feel fully confident in choosing to go ahead with the surgery. Below is listed the main facelift risks and complications. Patients should read these through carefully and take a while to think about them. The surgeon may also give a two-week “cooling-off” period after discussing the facelift risks and any of the concerns during the consultation. This will give patients time to decide if they are happy to proceed with the surgery.
Bruising & Bleeding
Some bruising of the treated area is common after surgery. This should resolve over the first couple of weeks. Patients may also experience slight bleeding from the incision site. This typically occurs right after surgery but may occur a few weeks later. However, if patients notice significant bruising, pain, and facial swelling, inform the surgeon immediately. It is possible that patients may have a haematoma, which is a solid collection of blood under the skin. These usually occur within 24 hours of surgery and require medical attention to treat.
Facelift surgery involves cutting into the skin and the underlying tissues of the face. Therefore, although uncommon, some areas of the skin or tissue can lose its blood supply during the operation. This can result in these areas of the tissue to necrose, or die, after the surgery. As this will affect the results, patients may need to have another operation to treat this.
Although every effort is made to minimise the risk of infection during surgery, it is still possible for an infection to occur in the treated area. Therefore, it is important that patients are aware of the signs of infection. Signs to watch out for:
- Feeling feverish with a temperature over 38° C.
- Redness at the incision line that is spreading after the first 48 hours.
- Yellow pus-like or foul-smelling fluid seeping from the incision.
- Increased pain or discomfort that your pain medication does not resolve.
Unfortunately, it is not possible to avoid scarring where the surgeon has made incisions. The size and location of the scars will vary according to the technique used. Be sure to have discussed with the surgeon what scarring you can expect. Most scars will be minimal and the surgeon will make them as discreet as possible. Remember that scars will also fade with time. How much they fade will depend on the healing ability of the skin. The surgeon can also give you some tips on how you should care for the wounds, to minimise the scarring.
Sometimes the skin where the surgeon has operated on can change colour slightly after the surgery. This should settle over a few months. Patients should be able to easily cover this with makeup if it concerns them.
If during the surgery, the nerves in your face are injured, patients may lose some feeling or movement in their face. For most cases, this is temporary. However, rarely, more long-term loss of sensation or movement can occur. Choosing a highly skilled and experience BAAPS/BAPRAS surgeons will minimise this risk.
Hair loss & Hairline Distortion
Hair loss can occur at the site of or around the incisions. This may be temporary, and the hair may grow back. However, it can also lead to a permanent reduction of hair growth. It is also possible for the hairline to become distorted after facelift surgery, depending on where the surgeon makes the incisions. In men, as a facelift procedure involves trimming, lifting and tightening the skin under the beard area, it is possible that your beard may grow closer to your ears. Generally, this will only be noticeable to the patient, and should not make a large difference.
After cosmetic surgery, there is always the possibility that patients find they are unhappy with the results of the procedure. There is also a risk that after a facelift, a patient's facial features will look asymmetrical. For example, the position of the earlobe may be slightly higher up than the other side. Most of the time, this will not be noticeable to anyone other than the patient. To ensure patients are not displeased with the results, it is advised that they talk openly with their surgeon during the consultation about desired outcomes, and make sure they understand all expectations.
General Surgical Complications
All surgeries carry some common risks. These include the development of a blood clot, nausea and vomiting, and postoperative pain. As the surgery involves the use of an anaesthetic agent, it is also possible that patients may develop anaesthetic complications.
Facelift Surgery Preparation
How to Prepare for a Facelift?
Preparation is key for a smooth and speedy recovery. Doing some household chores and planning ahead will make the patient's life easier for after the surgery when they will need to take things slow as the wounds heal. Below are some simple facelift preparation tips that can help you make a smooth recovery:
Patients might want to do certain tasks like cleaning the house, taking the bins out, or doing the washing, before the day of the operation. This way, you won’t have to do these chores during the recovery period. Coming home to a clean and tidy house is sure to make patients feel more comfortable and at ease.
It’s good to stock up on some key food items that can be kept in the cupboard or the fridge. Patients may not feel like leaving the house for a couple of days after the surgery, so this will save patients from having to go to the supermarkets when they return home. Another good idea is to buy some frozen ready-meals or cooking meals ahead of the surgery and freezing them for later use
Children and Pets
Looking after pets and young children can often be a handful! After a surgical procedure such a facelift, it is understandable to be tired and lacking the usual energy. Asking friends or family to mind child or pets can, therefore, help lift some of the stress involved with this. As another option, patients might wish to get a babysitter or nanny to help you with little ones for a short time during recovery.
After the surgery, patients will not be able to drive as the effects of the anaesthesia wear off. Therefore, be sure to have organised for someone to be on pick up duty. It's recommended to ask a friend or family member, rather than a taxi service, as patients generally, will feel more at ease having someone familiar with them.
A healthy diet is an important factor in helping to heal and recover after a facelift. Eat lots of healthy green vegetables, fresh fruit, and high-protein foods such as chicken, fish and legumes. Drink plenty of fluids – water is best. Tea and coffee are high in caffeine, so try to keep those to a minimum. Also, try to avoid foods that are high in sugar and salt as much as possible.
Try to get clothing that fastens in the front or the back. Clothes that have to be pulled over the head will make contact with the treated area of the face and might cause friction against the wounds. Loose clothing such as jogging bottoms will be comfortable to relax at home in during the recovery.
The face might feel delicate the first few days after surgery so patients may find it uncomfortable sleeping face down. Patients may, therefore, want to have some extra pillows prepared for after surgery so they can sleep propped up, on their back. Resting in an inclined position on pillows also has the benefit of reducing swelling around the treated area.
Facelift Surgery Aftercare
What to Expect After a Facelift?
Knowing what to expect after a facelift surgery can help to make patients feel more comfortable and at ease on the day of surgery. The surgeon will discuss the details of the facelift aftercare process during the consultation. They will provide information on how best to take care during the recovery.
As part of the facelift aftercare, the surgeon will also organise a follow-up appointment. This often takes place within two weeks of the surgery. During this appointment, the surgeon will check all wounds to see how they are healing, remove any non-dissolvable stitches, and remove or replace any dressings if necessary. They will also address any complications.
Waking Up After Surgery
If patients were put to sleep with a general anaesthetic, they will gradually wake up following surgery under close supervision. Patients will have dressings around their face and may also have drainage tubes in place. The nurses will often remove any drainage tubes before patients go home. The bandages will normally stay in place for one or two days. If a local anaesthetic was used, patients may feel a change in sensation in the treated area of the face. This will eventually wear off. The treatment area may also feel slightly tight and tender. The surgeon or the nurses in the recovery room will offer painkillers which patients can take if necessary.
The First 24 Hours
It is important that patients have a responsible adult to stay over for at least 24 hours after the surgery. This is because after a general anaesthetic patients will feel tired and groggy. The anaesthetic can also affect memory and concentration for a few hours to up to 2 days. It is good to have someone there to help if at any point the patient feels dizzy or unsteady. It is, therefore, recommended patients ask a friend or relative in advance. Patients can also ask them to drive home after the surgery, as patients will not be able to drive themselves.
Time Off Work
The recovery period may depend on which surgical technique the surgeon uses and how extensive the particular facelift procedure is. In general, patients will need to take around 2 weeks off work. Some patients may need longer if their job is more active. Patients should therefore listen to the exact time frames that the surgeon provides.
Exercise and Sports
Patients should avoid any strenuous activity and contact sports for at least 4 to 6 weeks after facelift surgery. However, patients should be fine to resume some light physical activity after two weeks. Start off gently, with light aerobic activity such as walking on a treadmill. Do not do any exercise during the first week, as this can increase the amount of swelling and bruising.
Swelling & Bruising
This is common around the treated area for the first couple of weeks after facelift surgery. Generally, this will be at its worst 3 to 4 days after the operation, and will then gradually begin to settle. Sleeping and resting with the head propped up with pillows for the first 10 to 14 days can also help to reduce any swelling.
For the first few weeks, scars typically appear raised. They will eventually fade to faint lines. Avoid too much sun exposure to the treatment area as this can cause permanent darkening of the area.
Saunas and Heat
Avoid anything that may promote facial flushing for 4 to 6 weeks. This includes saunas, steam rooms, and steam face masks.
The surgeon may advise wearing a compression bandage around the face for the first initial weeks post-operatively. The length of time the patient will need to wear this bandage will depend on the individual surgeon’s specific advice.
There will, of course, be a noticeable difference to the face immediately after surgery, but it is important to remember that patients may not be able to appreciate the final cosmetic results until 6 to 9 months after surgery. This is because often there is some residual swelling, some scarring may take longer to fade, and it may take a while for the area to fully heal. Immediately after the surgery, the skin on the face may at first look and feel too tight. This will gradually settle within 6 weeks. After some weeks patients will gradually feel more like themselves and be able to appreciate a rejuvenated and youthful look.
Locations in the UK Where Facelift Surgery is OfferedFacelift Surgery in London
Facelift Surgery FAQs
Find below a compiled list of the most common facelift FAQs
Do I need a GP referral for facelift surgery?
When can I shower and wash my hair after facelift surgery?
Can I wear makeup after facelift surgery?
When will I feel comfortable attending major events after facelift surgery?
How long will my facelift last for?
What are the effects of smoking, drugs, and alcohol on facelift surgery?