- Average Treatment Cost
- Procedure Time
- 2-4 hours
- Local with sedation or general
- Recovery Time
- Up to 2 weeks
- Duration of Results
What you should know
What Is A Facelift?
Facelifts surgically reposition sagging muscles, fat and tissue along with re-draping skin and reduction of excess skin of the face, jawline and neck to produce a more youthful appearance.
A facelift is facial rejuvenation surgery that goes beyond just tightening skin. While there are a variety of facelift procedures, it usually extends below the skin to address the superficial musculoaponeurotic system (SMAS) by repositioning underlying facial muscles and removing any excess skin. A truly complete and comprehensive facelift with the most natural outcome will reduce, redistribute, and in some cases, add micro-fat, to the face in areas where there is deficient volume.
The modern facelift has moved away from using skin tension to contour the face. As a face ages, there are changes to how fat is distributed, specifically the fat in the lower part of the face. The result a face that looks longer and squarer in shape—young faces tend to be tapered or angular. Thus, the most important aspect of a facelift is to improve facial shape while limiting signs that a surgical procedure has been performed.
Every plastic surgeon and facial plastic surgeon has their own variation on a facelift. All facelift procedures share a common goal: to restore natural curvatures to the features while maintaining an appropriate amount of volume in the right places.
Today’s surgeons typically perform facelifts either individually or in combination with other common facial rejuvenation procedures like eyelifts, browlifts, lip or chin augmentation, necklifts and so on.
Here, a menu of the types of surgical facelift procedures that board-certified plastic and facial plastic surgeons perform:
- Traditional or Full Facelift
- Mini-Facelift or Limited-Incision Facelift
Studies show that patients get the best results with a combination of facial rejuvenation surgery that both lifts and repositions skin and underlying sagging tissue combined with the use of injectables and fillers to restore lost volume and natural fat.
A term for Minimal Access Cranial Suspension Lift, MACS-Lifts elevate sagging facial features through a short, minimal incision by suspending them from above. The scar is positioned in front of the ear, instead of behind, which many surgeons say is easier to hide in the hairline. It is less-invasive than a traditional facelift and the final result can be seen in four to six weeks, or sooner.
You may be a candidate for a MACS-Lift if you have mild-to-moderate loss of elasticity and muscle tone in your face and neck. Those with jowls and deep nasolabial folds, you may also benefit. Some people opt for the MACD-Lift if they feel as though they look tired or sad, even when they’re not.
If you are in your 50s or 60s and have a traditional (full) facelift, your face will age more slowly, from the point of where it has been reset, and you’ll look at least 10 years younger.
The traditional facelift (a rhytidectomy) is considered the only comprehensive way to address multiple signs of aging—from the forehead to the neck, and all areas in between—thus providing the most permanent results of any of the many facelift procedure types available today.
With a full facelift, surgeons can exert the best control of redistributing fat, repositioning muscle and accurately treating excess skin.
The full lift is well-suited to you if you have:
- Excess or sagging facial skin
- Deep facial creases
- Redistributed facial fat pockets
- Or if you look tired, sad and angry even when well-rested
Those with excess skin around the chin, neck and jowls benefit the most from a necklift with contouring of the fat. In most cases, this procedure is performed with a facelift. If your skin is excessively saggy, or if there is a loss of muscle tone, a traditional facelift (which has been modified and improved so that the skin is not just pulled and lifted) can include a cheek and necklift, and takes care of sagging and lack of volume by tightening up the muscle. It also gets rid of any fatty deposits and brings the underlying tissue back to a more youthful position, while getting rid of excess skin.
How a facelift is performed
Full facelift incisions begin at the temples and continue along the natural curve of the ear, under and behind the ear, and then back into the nape of the neck within the hair.
To create a natural, longer-lasting look, surgeons developed the SMAS—or submuscular aponeurotic system—technique that is still in widespread use. The surgeon peels back the skin and tightens the deeper layers of tissue and muscle below the skin. Excess skin is removed and wrinkles smoothed out.
Expect the initial recovery from a full facelift to take two weeks. It can take a few months for all the swelling and bruising to go down, and up to six months for the scars to fade.
If your aging concerns are confined to the midface area, a limited-incision facelift (or mini-facelift) procedure may provide the results you’re looking for with minimal scarring.
As the name implies, the mini-facelift is suited to those who have a limited amount of excess or sagging skin, and fewer concerns with a droopy brow, lower eyelid and in general, sagging in the midface, jawline and neck.
Limited-incision facelifts using short-scar and endoscopic facelift techniques reposition the underlying facial tissues to a more youthful contour.
In your 40s, if you have a mini-facelift, the rate at which the lower part of your face ages may be lessened.
It’s becoming more common for women in their 40s to have small facelift procedures—known as mini-lifts or short-scar lifts—to correct initial signs of aging and give better definition. “These procedures are different than a traditional facelift. They’re less invasive and small incisions can be hidden more easily, but may not produce a good cosmetic result in patients with greater tissue laxity and will not last as long as a traditional facelift.
Like a traditional facelift, during a mini-facelift, the underlying muscles are tightened, which provides a youthful boost to the brows and cheeks. A mini-lift keeps you looking younger longer.
Some considerations about mini-facelifts:
They target signs of aging in a particular area of the face. These procedures are called “limited” because they use abbreviated facelift incisions that give your surgeon access to limited areas of muscle, fat and excess skin.
They are appropriate for younger people who are starting to exhibit signs of droopy jowls, or people who have already had a lift, but once again are showing some signs of sagging.
Incisions are generally placed at the temples and in the hairline to give the surgeon access to the underlying tissues.
They are generally performed in one to four hours, usually with local anesthesia and/or sedation.
The results can make you look five to 10 years younger, but overall your face will continue to age naturally.
As with any surgical procedure, they carry the risk of nerve damage, infection, irregular scarring and complications related to anesthesia.
Some doctors are even trademarking specific techniques, which are essentially marketing techniques. It’s important to ask about surgical details such as incision placement of the targeted area and whether or not an endoscope is used in conjunction with the lift.
Mid-facelift is a term used to describe a limited-incision facelift that targets the middle portion of the face. It can be achieved through incisions of 1 to 2 centimeters in length with the use of endoscopic technology. Endoscopes are cameras that allow surgeons to view and reach distant anatomies through very small incisions. Using an endoscope in surgery requires very specific surgical training.
For a mid-facelift, many surgeons favor endoscopic methods. The endoscope allows them to reach deeper or more contained pockets of fat they otherwise could not. Because you will lose some elevation with the first year, many surgeons tend to overcorrect a bit, which is why you may look a little tight in the first few weeks after a mid-facelift.
Endoscopic lifts include the assistance of a surgical periscope inserted through limited incisions to address lifting underlying facial tissues. Only limited amounts and areas of excess skin can be improved using an endoscope.
Limited endoscopic facelifts generally erase three to eight years from your face. After an endoscopic lift you will continue to age naturally and the procedure can be repeated in the future. You may also opt for a full lift in the future.
“The limited-incision facelift helps to elevate the cheeks and smooth nasolabial folds, as well as gives the jaw line a better look,” says Ellicott City, MD, plastic surgeon Daniel Markmann, MD.
The endoscopic lift is named so because of the special instrument called an endoscope that is used to extend the surgeon’s reach and field of vision beneath the skin’s surface.
At some point in time, lines and wrinkles trouble us all, which is where the liquid lift can help. A quick fix that literally plumps up lines and erases wrinkles, the liquid lift or injectable facelift has become a mainstay facial rejuvenator. The liquid facelift is a nonsurgical way to take years off your appearance.
Strategically placing a variety of fillers can help to turn back the clock. To restore volume or to provide definition, your plastic surgeon or dermatologist can inject fillers along the cheekbone, under the eyes and around them, in the temples, lips and midface. While there are a variety of injectables available, different ones produce varying effects. Not all of them last the same amount of time.
In a liquid facelift, many of the injectables used are used off-label but there are several options that are considered safe and effective. For temporary correction, hyaluronic acid fillers like Restylane and Juvéderm are usually used, as well as collagen stimulators such as Radiesse and Sculptra Aesthetic.
A liquid lift can fill lines and wrinkles, increase facial volume and contour or add definition to facial features. However, liquid lifts are not used for eliminating excess skin or tightening skin. While a liquid lift offers a substantial change, it doesn’t offer the same results as surgery. And, results are measured in months, not years.
A liquid facelift may delay a facelift
Injectables can’t prevent you from possibly needing a facelift down the road, but they can potentially delay it.
Botox, Dysport and Xeomin, in particular, can prevent dynamic wrinkles—those associated with muscle movement—from forming. Even though injectable fillers are often used in conjunction with a facelift, they are not a replacement or substitute for surgery.
If you have severe signs of aging, like extreme skin laxity, then a traditional facelift is most likely a better alternative.
Although a liquid facelift may produce temporary results, keep in mind that they aren’t long-term. You will need to repeat the procedure for the best outcome.
Who Should Consider A Facelift
Not everyone is suited to having a facelift. If you are considering one, many factors come into play that will help you determine whether it is right for you.
If you are under age 40, you probably don’t have enough age-related signs to warrant a full facelift or even a mini-facelift. Facelifts are typically performed on people between the ages of 40 and 60. You may be a good candidate in your 50s, 60s, 70s, and 80s, if you are in good overall health and cleared for the procedure by your physician.
Sun Damage or Wrinkles
Facelifts are not usually indicated to treat fine lines or wrinkles of the face. They address fixing deeper wrinkling and other age-related damage to the face from too much sun exposure, like deep lines around the mouth and a loss of definition around the jaw line stet. Loose neck skin can also be treated with a necklift or combined with a facelift. Ask your doctor about your concerns to see if you are a good candidate.
The best candidates for facelift procedures have realistic expectations. You need to be fully aware of what surgery can and cannot do for you, as it is not a magic pill. Look at before and after pictures with your surgeon and fully discuss your goals with your doctor before you opt for surgery.
Your individual issues and concerns are factors in determining which lift is right for you, and a consultation with a board-certified plastic surgeon is the best way to decide whether you are a candidate for a facial rejuvenation option. A facelift may not solve all the problems of aging—age spots and surface texture changes—but a variety of techniques can make you look as young as you feel.
Who Should Not Consider A Facelift
Some patients have existing medical conditions that pose some medical risk to having a facelift procedure performed.
For instance, those with uncontrolled high blood pressure should not have this treatment. People who have blood-clotting conditions have a higher risk of complications. Medical risks associated with these two conditions often outweigh the benefit of facelift surgery, which is an elective procedure.
If you tend to form excessive scars, this may not be the right plastic surgery for your needs.
Find a skilled surgeon who will take the time to answer your questions. If you and your surgeon both feel like you are a good candidate for the procedure, then move forward.
What to Expect With a Facelift
The type of facelift you and your doctor choose will depend on the severity of skin laxity and other signs of aging you need to address. Recuperation time for facial plastic surgery will vary depending on your individual procedure combined with your individual medical profile.
Traditional Facelift: If you have a full or traditional facelift, expect at least 10 to 14 days recovery time before returning to work. Swelling, bruising or stiffness can last up to four weeks. A facelift offers a permanent advantage in that you’ll always look seven to 10 years younger than if you hadn’t had it done. Results depend upon your general health, genetics, skin elasticity, quality of the skin and environment.
Sun exposure, smoking and significant weight gain and loss also can affect your facelift’s longevity. In many cases, a facelift is a one-time procedure, although that can vary depending on your age at the time of your first lift, genetics and your individual signs of aging.
Mini- or Limited-Incision Facelift: Recovery takes one to three weeks. You can expect results to last about five to 10 years. The more elastic your skin is, the longer the results will last.
Mid-Facelift: You will probably be swollen and bruised for four to 10 days. Results can last five to 10 years.
Post-Treatment Care: Facelift
Facelift hospital stays average about three days.
Some ideas to help your post-facelift recovery:
Arnica: Also called leopard's bane, this herbal supplement reportedly helps reduce post-surgical swelling and bruising. There is no hard data proving it works, but some patients and doctors swear by it. In controlled doses, arnica is not harmful, but when taken inappropriately, it can cause serious intestinal distress.
Vitamin K: Primarily an essential blood-clotting agent, vitamin K is recommended as a topical by some plastic surgeons to reduce redness, swelling and broken capillaries following facelift surgery. It is also considered a calming agent for serious burns and has been suggested to improve scar formation. Whether or not vitamin K makes a difference has yet to be scientifically proven.
Lymphatic drainage: Some plastic surgeons believe in the benefits of gentle rhythmic massage to stimulate the body's lymphatic system. The system is responsible for regulating the immune system and defending against infectious diseases and conditions such as cancer. It also transports nutrients to cells and eliminates metabolic waste and excess fluids from the body. There is no clinical data that shows the effect of lymphatic massage as essential to healing.
Compression: Some plastic surgeons use drains, while others use a compression garment on the head and neck for a few days after facelift surgery. Clearly in the case of a necklift where deeply sagging jowls have been corrected, compression following surgery is helpful to control swelling and to support the newly sculpted skin and tissue.
Inside Tips: Facelift
- Do not put ice or cold on your face unless specifically instructed by your doctor. After a facelift, for example, putting anything too cold or too hot on the skin can cause serious injury.
- If you’ve ever wondered what you’d look like after facial surgery, lie flat on a bed while holding a mirror over your face, which will mimic the results of a facelift.