Facelift surgery

Why have a facelift?

You might choose to have a facelift if you’ve noticed the skin on your face starting to sag due to age. Your skin may also sag if you’ve lost a lot of weight. It’s particularly helpful for skin around your jawline, and is often combined with a neck lift . Your surgeon will explain which procedure will work best for you.

It’s best to have a facelift while your skin has started to sag, but still has some elasticity – for most people, this is between the ages of 40 and 60. You can still have a facelift when you’re older than this though.

How to get a facelift

As a cosmetic procedure, a facelift wouldn’t be covered by the NHS so you’ll need to have it done privately. You can find a consultant surgeon using the search function on our website. Even though it’s done privately, it’s still important to let your GP know you’re thinking about having a facelift.

Deciding on a facelift

You’ll have an initial consultation with a consultant surgeon to talk about what types of facelift might be suitable for you. They’ll go through the benefits and possible risks, as well as discussing any alternatives. Non-surgical alternatives to facelift might include Botox for treating wrinkles around your eyes or forehead, and skin resurfacing techniques to improve the texture and look of your skin.

Preparing for a facelift

It’s important that you’re as healthy as possible before having a facelift and that your weight is steady. If you’re planning on losing weight, it’s better to do this before your surgery as it can affect the results. If you smoke or use other forms of nicotine, you’ll be asked to stop, usually at least six weeks beforehand. Nicotine has a negative effect on wound healing, and smoking significantly increases the risk of other complications too.

You might have a facelift under general anaesthesia (meaning you’ll be asleep) or a local anaesthetic (where the area being treated is numbed), with the option of sedation, which makes you drowsy. If you have a general anaesthetic or sedative, you’ll need to stay in overnight. If you do go home on the same day, you’ll need someone who can stay with you overnight. Either way, you won’t be able to drive after the procedure, so arrange for someone to take you home.

What happens during facelift?

In a standard facelift operation, your surgeon will make cuts on both sides of your face, just in front and just behind your ears, and often extending up along your hairline. They will lift the skin on your face and tighten a layer of muscles underneath. Excess skin is trimmed away and remaining skin is repositioned and sewn into place.

This technique is most helpful if it’s mainly your jowls (the skin around your chin and jawline) that’s the problem. There are many variations in facelift techniques, including the following. Your surgeon will explain what is most appropriate for you.

• Deep-plane facelift. This involves lifting your skin and muscles together, rather than separately. It can help if you’re looking to improve more areas of your face than just around your jowls. 
• Mini facelift. This involves making much smaller incisions around your ears or hairline. Your skin is lifted via these incisions, and excess skin removed.
• MACS (Minimal Access Cranial Suspension) facelift. In this procedure, your surgeon uses special stitches inserted via small incisions to tighten the muscles underneath your skin.

Recovery and what to expect after a facelift

Your face will feel tight and sore after the surgery. You’ll be given painkillers to help manage this. You’re likely to have bandages around your face to reduce bruising and swelling. These will be removed after a day or two, and your stitches removed after around a week.

You should be out of bed and mobile on the day of your surgery, and back to doing light activities within a couple of weeks. You’ll need to avoid strenuous activities and heavy lifting for longer. Don’t drive until you feel safe to do so. You should be comfortable wearing a seatbelt and able to do an emergency stop. There should also be no problems with your vision.

You’ll have scars from the surgery, but these should be mainly hidden within your hairline. It can take several weeks for the skin on your face to settle down, and you may need to give it up to nine months to judge the final results.

Complications of facelift

All surgical procedures carry some risk of complications. Here are some of the most common complications associated with facelift.

• Bleeding, including blood collecting in the tissues in your face.
• Infection.
• Problems with wound healing. 
• Changes to sensation or colour of your skin. 
• Loss of blood supply to areas of your skin, causing the tissue to die.
• Nerve damage, including to your facial nerve, which can affect movement of your eyebrow and lip, and to the nerve supplying sensation to your ear.

More serious complications include allergic reactions to the anaesthetic and blood clots developing in your legs or lungs.

There’s also a risk that you might not be happy with the end result. You also need to bear in mind that the appearance of the areas you had treated will change over time as a natural result of ageing. Changes in weight may also alter your appearance.

You’ll be given information on what to look out for and what to do if you develop any complications. Your doctor can also tell you how likely they are to affect you.

Facelift costs and fees

As a cosmetic procedure, a facelift wouldn’t typically be available through private medical insurance. You’ll usually need to self-fund this treatment. Facelift costs in the UK vary. Costs of different techniques – such as mini-facelift – will also differ.

Typically, an initial consultation with the surgeon will cost between £100 and £250, depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.

• An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this. 
• A ‘fee-per-service’ deal, where you receive different invoices from the surgeon, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.

For more information, you can read our guide on self-pay.

Sources

• Face and brow lift. British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS). www.bapras.org.uk (accessed 7 April 2021).
• Facelift and neck lift. British Association of Aesthetic Plastic Surgeons (BAAPS). baaps.org.uk (accessed 7 April 2021).
• Yang AJ & Hohman MH. Rhytidectomy. StatPearls. www.ncbi.nlm.nih.gov, last updated 17 February 2021.
• McDaniel JC, Browning KK. Smoking, chronic wound healing, and implications for evidence-based practice. J Wound Ostomy Continence Nurs 2014;41(5): 415-23.
• SMAS facelift rhytidectomy. Medscape. emedicine.medscape.com, updated 31 October 2018.
• Deep plane rhytidectomy. Medscape. emedicine.medscape.com, updated 2 March 2021.
• Cherney K. Everything you need to know about a mini facelift. Healthline. www.healthline.com, 28 April 2020.
• Complications of facelift surgery. Medscape. emedicine.medscape.com, updated 23 June 2020.