A facelift (also known as meloplasty or rhytidectomy) is a type of cosmetic surgery that removes excess skin from the face. The aim is to reduce the signs of ageing in the face and neck, such as wrinkles and sagging skin. Sometimes, underlying facial muscles are also tightened.
A facelift can reduce flabby jowls and smooth the jawline. Most people find that they look younger after a facelift. The scars of the operation will be permanent, although they are generally hidden – usually by your hair. A suture facelift (thread lift) can tighten or smooth out the skin around the eyes, cheeks or chin. This treatment will leave no obvious scars, but will not dramatically alter your facial shape.
Other treatments often performed along with a facelift are a brow or forehead lift (to correct a sagging or deeply furrowed brow), and eyelid surgery to rejuvenate ageing eyes.
If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives. These may include other surgical and non-surgical treatments, or accepting yourself the way you are.
Things to consider before deciding to have a facelift
Before you opt for a facelift, some important issues to keep in mind include:
- While a facelift should make you look younger, it will not raise sagging eyebrows, remove deep frown lines in the forehead, change your upper or lower eyelids, or get rid of wrinkles around the mouth.
- Suture facelift, or thread lifting, is best suited to younger and middle-aged patients whose tissues have sagged with time or sun damage. It is not recommended for people with very thin or dry skin. Your surgeon will need to assess your individual suitability for this type of treatment.
- Think about the financial cost. Cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance companies.
- Smokers are at increased risk of complications. If you are serious about undergoing surgery, you should try to quit smoking.
Finding a cosmetic surgeon
Ask your doctor for advice on a suitable specialist surgeon or hospital where facelift surgery is performed. At your first consultation, you should ask the surgeon about their training and experience.
It is preferable to have this procedure done by a surgeon who is specially trained to perform facelift surgery and has a lot of experience in carrying out this type of surgery.
Medical issues and having a facelift
Before the operation, you need to discuss a range of medical issues with your doctor or surgeon. They will talk to you about your:
- Physical health – an examination will help your doctor or surgeon decide if the treatment is appropriate.
- Medical history – some pre-existing medical conditions and surgery you’ve had in the past may influence decisions about this operation, including the type of anaesthetic used.
- Risks and possible complications – it is important that you understand the risks and complications so that you can weigh up whether a facelift is right for you.
- Medications – tell your surgeon about any medications that you take on a regular basis or have recently taken, including over-the-counter preparations such as fish oils and vitamin supplements.
- Past reactions to medications – tell the surgeon if you have ever had a bad reaction or side effects from any medications, including anaesthetics.
- Preparation for surgery – the surgeon will give you detailed instructions on what you should do at home to prepare for surgery. For example, you may be advised to take a particular drug or alter the dose of an existing medication. Follow all instructions carefully.
Facelift surgery is usually performed under a general anaesthetic. The length of the operation will depend on the type and extent of the surgery, but could take anywhere from two to four hours.
The three main types of facelift include:
- Traditional facelift – the surgeon makes an incision (cut) in the hairline from the temple, around and behind the ear, and back into the hairline. The skin is lifted away from the underlying tissues. Muscles are tightened and fat is removed. The surgeon pulls the skin up and back towards the scalp, removes any excess then stitches or staples the skin into its new position.
- Limited incision facelift – the surgeon makes smaller incisions at the temples and around the ears.
- Neck lift – the surgeon makes an incision in front of the ear and back into the hairline. The skin of the jaw and neck is lifted and tightened.
Suture facelift surgery
An alternative form of facelift surgery that is often done using local anaesthetic is a suture facelift (thread lift). The surgeon inserts fine threads through very thin tubes (cannulae) so no cuts are made in the skin.
These threads are made of a non-absorbable medical polypropylene fibre (Prolene®
), which has been used safely for many years in surgical operations. Once the threads have been positioned through the tiny puncture sites, the threads are then gently tightened and secured to the facial tissue and skin.
Immediately after a facelift
After the operation, you may expect:
- a drainage tube in the wound to help prevent fluid build-up
- bruising and swelling
- to be given antibiotics to prevent infection
- possible numbness
- pain and discomfort
- dressings or bandages on your face
- a compression garment to help minimise swelling.
Complications of a facelift
All surgery carries some degree of risk. Some of the possible complications of a facelift include:
- allergic reaction to anaesthetic, which may (rarely) be fatal
- bleeding or infection
- blood clots, which may cause potentially fatal cardiovascular complications such as heart attack, deep vein thrombosis or stroke
- collapsed lung
- hair loss along the wound
- tissue death along the wound, or skin loss
- severe or inflamed, itchy scarring
- rough skin
- surfacing of stitches through the skin
- uneven skin contours
- permanent facial pain
- nerve damage, which can cause temporary or permanent paralysis of part or all of the movement of the facial muscles
- numbness of the face, which may be temporary or permanent
- uneven results – for example, eyes are asymmetrical or features don’t line up.
Further surgery may be required to treat complications.
Some of the possible additional complications of a suture facelift include:
- thread movement – this may lead to the thread extruding, breaking or losing its hold on the skin
- puckered skin
- discomfort, if the threads are felt under the skin
- skin irregularities or a loss of facial symmetry
- infection (this is rare).
More extensive surgery may be required if removal is necessary because of infection, discomfort or an unsightly appearance.
This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. Speak to your surgeon for more information.
Self-care after a facelift
Be guided by your surgeon, but general self-care suggestions include:
- Follow all instructions on looking after your wounds.
- Don’t bend over for at least three weeks.
- Avoid unnecessary stress on your wounds – for example, don’t wear tops that must be pulled over your head.
- If you have had a suture facelift, take care to avoid excessive facial movements in the first few weeks to make sure the very fine threads stay in their original position. This is necessary until the body develops a tissue reaction around the fibre, which strengthens and holds the facial tissue into its new position.
- Report any bleeding, severe pain or unusual symptoms to your surgeon.
- If necessary, take pain-relieving medication (strictly as directed).
Long-term outlook after a facelift
After a traditional or limited incision facelift and neck lift, the swelling may take months to subside. Scarring will be permanent, but should fade in time. Be patient – improvements to scars may take around a year.
After a suture facelift, some pain may be experienced, but the discomfort usually settles within 24 hours. Some people experience more severe pain after the procedure. There may be slight swelling and bruising for four to 10 days.
Remember, a facelift does not change your fundamental appearance and cannot stop the ageing process. Although the results are permanent, your skin will continue to age. A healthy lifestyle and minimising your daily exposure to sunlight will help maintain the results of your facelift.
Alternatives to facelifts
Alternatives to a facelift can include:
- dermal fillers or injections, such as Botox®, into wrinkles
- injections of botulinum toxin Type A
- laser resurfacing
- facial implants
- accepting yourself – talking to a counsellor or psychologist may help you overcome your concerns and you may decide that you like yourself the way you are.
Where to get help
This page has been produced in consultation with and approved by:
Australian Society of Plastic Surgeons
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