A facelift lifts the soft tissue of the face and neck that has descended with age, and removes the skin that no longer fits it. It changes the jawline and the neck, not the surface of the skin.
The operation treats looseness, not wrinkles. It suits someone whose weight has been stable, whose skin still has some elasticity, and who wants to look like themselves, rested.
A facelift does not stop ageing: the face continues to change at the same rate afterwards. Fine lines, pigment and sun damage are treated by other means — laser, peels or botulinum toxin — and are often combined with surgery rather than replaced by it.
The plan is made from the tissue, the bone and the neck — examined in person, with the face at rest and in movement. A photograph does not show laxity.
The deeper layers of the face are released and lifted as one unit, so the pull is carried by strong tissue rather than by skin. It gives the most natural jawline and the longest-lasting result, and it is the technique used when the mid-face has descended.
The muscle layer is tightened through a shorter incision, without the deeper release. Less operating time and less swelling, and a good option for earlier laxity — but it addresses the lower face more than the mid-face.
The neck muscles are brought together in the midline and the loose skin removed, through a small incision under the chin and the incision behind the ear. Often the part of the operation patients notice most.
The face is examined sitting and lying, the neck and the hairline are assessed, and photographs are taken. Blood tests, and where relevant a cardiology opinion, are arranged before a date is fixed. The scar and its position are agreed in advance.
Smoking stops at least four weeks before surgery — it is the single biggest factor in wound healing on the face. Blood thinners and some supplements are paused about ten days before, and you fast for six to eight hours. Arrange help at home for the first week.
Under general anaesthesia, usually two to four hours. The incision runs in front of and behind the ear and into the hairline at the temple, so it is hidden by the ear and by hair. A drain is often left on each side for a day or two, and most patients stay one or two nights.
Swelling and bruising peak around day two to four and then settle. The head is kept raised, cold compresses are used for the first days, and the drain is removed at the clinic. Most patients feel able to go out — with sunglasses — after seven to ten days.
Make-up and hair colouring resume after about two weeks, exercise after four to six. The scar is firm and pink for two to three months, then fades over twelve to eighteen months; it sits behind the ear and inside the hairline wherever possible.
This is real surgery near the facial nerve, and the risks should be heard before the decision, not after it.
Tell us about smoking, diabetes, blood pressure, blood thinners and any previous facial surgery or filler in the face. Fillers and threads change the anatomy and the plan, and hiding them is the fastest way to a complicated operation.
The aim is that you look like yourself, rested. A facelift lifts tissue that has dropped; it does not change the shape of the nose, the eyes or the character of the face. An obviously operated look usually comes from lifting the skin too tightly, which is why the deeper layers carry the tension here.
Most patients see the change for seven to ten years, and the neck often longer. It is not permanent, because the face keeps ageing at its own rate. Keeping weight stable and protecting the skin from the sun both help.
Most people are comfortable after ten to fourteen days, with residual swelling that is easy to cover. The face continues to settle for three to six months, and the final shape of the jawline is judged around then.
Often, yes — upper or lower eyelid surgery, a brow lift or fat grafting to the cheeks are commonly done in the same session. Whether that is safe depends on the total operating time and on your health, and it is decided at the consultation.
Three photographs — front, three-quarter and profile — are enough for a surgeon to say whether a lift is the right operation, and which technique would suit. A coordinator comes back with a plan, a date and a written quote.
This page is general information, not medical advice. Suitability, technique and risks are decided in a consultation with a surgeon.
