A facelift repositions the tissues that have dropped over the years — the cheek, the jawline, the neck — and removes the skin left over once they are back in place. It is not a skin stretch: if only the skin were tightened, the result would be a taut face that slackens within months.
The real work happens in a deep layer called the SMAS, which is what holds up the cheek and the neck. Repositioning it is what allows the jawline to be recovered without the skin being left under tension, and it is also what makes the result last years rather than months.
There is something worth knowing before deciding: a facelift works on the position of the tissues, not on the quality of the skin. Pigmentation, texture, fine lines around the lips or the eyes are not corrected by lifting tissue, and they need other treatments, which can be combined or done separately.
It usually helps when there is
- A dropped cheek that deepens the fold between nose and mouth.
- Loss of the jawline, with jowls either side of the chin.
- Loose skin and muscle bands in the neck.
- A face that looks tired or stern at rest, without being either.
- Changes after significant weight loss that has now stabilised.
Worth discussing first if
- What bothers you is pigmentation, texture or fine lines: a facelift does not fix that.
- The expectation is a different face, rather than getting your own back.
- Smoking: it is the single factor that adds most complications to this operation.
- Uncontrolled high blood pressure, which multiplies the risk of a haematoma.
- Treatment with blood thinners or a clotting disorder.
- A moment with little availability: it asks for two to three weeks out of view.
None of these rules the procedure out on its own; all of them change the conversation.
Face, neck or both
Not all facelifts have the same reach. Which one your case calls for depends on which area has dropped and by how much, and that is exactly what the consultation is for.
Cervicofacial lift
The most complete: it works on the middle and lower thirds of the face and on the neck in one session. It is what suits when the drop affects the cheek and the jaw together.
Neck lift
Focuses on the neck angle, the loose skin and the bands of the platysma muscle. Indicated when the face has aged little but the neck gives the age away.
Limited lift
Smaller in reach, for early drop in younger people. Less scarring and a shorter recovery, but also less effect: it does not replace a full facelift when that is what is indicated.
Why the vector matters
The direction in which the tissues are repositioned is what separates a rested face from an operated one. Ageing makes tissue fall downwards and forwards, so the correction has to go upwards and backwards, along the reverse path. Pulling only backwards, horizontally, produces the stretched face everyone recognises.
The incisions are designed to follow the natural creases in front of and behind the ear, and inside the hairline. They are also planned so as not to shift the hairline or distort the earlobe — two details that give the surgery away more than the scar itself.
The facelift is often combined with other work in the same session — blepharoplasty, fat grafting to replace lost volume — because the face ages by dropping and by emptying at the same time. Correcting only one of the two leaves the result half done.
From consultation to discharge
This is the facial surgery that asks for most planning beforehand and most discipline in the first two weeks.
Consultation and planning
The position of the tissues, the quality of the skin and the volume lost are assessed, and the extent of the lift is decided. You leave with the alternatives explained, their risks, and a written quote.
Pre-operative work-up
Laboratory tests, assessment by the anaesthetist and blood-pressure control, which matters especially here. You are told to stop smoking weeks in advance, not days.
The surgery
In a licensed surgical facility, under general anaesthesia and with an anaesthetist present throughout. A compression dressing is applied at the end and, depending on the case, drains.
Follow-up
A check-up the next day, removal of drains and stitches over the first and second weeks, and scheduled check-ups through the first year.
Recovery, week by week
This is a recovery that is more visible than painful. The first ten days are spent out of view, and it is worth planning them around work and family before setting a date.
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First 48 hours
Dressing, significant swelling and a feeling of tightness and numbness rather than pain. Rest with the head raised. This is the period of closest watch, because of the risk of a haematoma.
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Week 1
Drains and some of the stitches come out. The bruising is at its worst between the third and fifth day and then starts to turn. The face still does not look like itself.
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Weeks 2 to 3
Back to social life with make-up and to desk work. Uneven swelling and numb areas persist, especially in front of the ears, which is normal and temporary.
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Months 1 to 3
The swelling clearly settles and the jawline appears. The scars are at their reddest and are looked after with strict sun protection.
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Around 6 to 12 months
Settled result and mature scars. Sensation in the numb areas finishes returning to normal over this period.
Risks, and what is not promised
All surgery carries risks, and a facelift is no exception: haematoma — the most frequent complication, and the one that may mean going back to theatre within the first few hours —, infection, healing problems, hair loss around the incision, asymmetry and changes in sensation in the skin of the face and the ears, which are usually temporary.
There is also a risk of injury to a branch of the facial nerve, which can produce weakness in a particular expression. It is uncommon and in most cases recovers with time, but it can be permanent. It is the risk most worth understanding before signing the consent.
Smoking and uncontrolled high blood pressure are, by some distance, the two factors that raise these risks most in this particular operation. That is why either can be a reason to postpone the date.
A facelift repositions tissues: it does not stop ageing, it does not change the quality of the skin and it is not permanent. The face goes on ageing from the next day, though starting from a different point. These risks are reduced by a sound indication, complete pre-operative tests, a licensed surgical facility and serious follow-up. They are not eliminated, and the ones that apply to your case are set down in writing in the informed consent you sign before surgery.
The information on this page is for guidance and does not replace an in-person medical consultation. Medical practice is an obligation of means, not of result.
What people ask most about facelifts
The studies and clinical experience point to a benefit that holds for years, often around a decade, but it is not a figure that can be promised: it depends on genetics, on skin care, on sun, on tobacco and on weight changes.
What can be said precisely is that ageing carries on. A facelift does not freeze the face at the moment of surgery; it takes it back to an earlier point, and from there the clock runs on just as before.
That look almost always comes from two things: tightening the skin instead of repositioning the deep layer, and pulling horizontally instead of following the natural vector. The technique used here works on the SMAS precisely to avoid it.
That said, no surgeon can guarantee an exact result: your anatomy, the thickness of your skin and the way you heal all take part in the final outcome.
They follow the natural creases in front of the ear, go around the lobe and continue behind it into the hairline. When the neck is worked on, a small incision may be added under the chin.
Over time they usually become hard to notice, and your hair covers them during the first few months. How they develop depends on your skin type: in skin prone to hypertrophic scars the behaviour is less predictable, and that is assessed in the consultation.
It depends on how much tissue has dropped. With early drop, non-surgical treatments can give a real improvement and are a reasonable alternative. Once the tissue has fallen markedly, they do not reach: they improve little, and for a short time.
In the consultation you will be told honestly which of the two situations you are in, even if that means recommending something that is not surgery.
There is no right age: there is an anatomical moment. What decides is how much the tissue has dropped and what state the skin is in, and that varies a great deal between people of the same age.
It is true that having surgery while the drop is moderate tends to give more natural results and easier recoveries than waiting for advanced deterioration.
Yes, and it often is: blepharoplasty, fat grafting or skin treatment are frequently combined with a facelift, because the face ages through several mechanisms at once.
Whether to do it all in one session or spread it out depends on the total time under anaesthesia and on your state of health. Safety comes before the convenience of a single recovery.
We do not publish prices, because the cost depends on the extent of the lift, on whether it is combined with other procedures, on the time in theatre and on the surgical facility: any figure on its own would end up being wrong for your case.
After the consultation you receive a written quote, itemising what is and is not included, and how long it is valid for.
Question not answered here? There are more answers in the frequently asked questions.
