What is a facelift?

A facelift is a surgical procedure to lift and tighten your face and neck tissues. Facelifts also reduce sagging skin on your face. The operation might also involve:

• tightening of your facial muscles
• removing or redistributing fat from your neck, jowls and face
• taking fat from other parts of your body, such as the abdomen, and putting it in areas like the cheeks

A facelift is also known as a meloplasty or rhytidectomy.

A facelift can be combined with other procedures like a brow lift, eyelid surgery or a nose reconstruction.

A facelift is a surgery, however there are non-surgical options such as fillers, dermabrasion, and thread lifting.

If you are thinking about a facelift

If you are considering a facelift, you should be physically healthy. You shouldn't have any medical conditions that might make it harder to heal after surgery. You also need to have stopped smoking.

The most important thing is to have realistic expectations. A facelift usually lasts 5 to 12 years, then might need to be repeated. Repeat procedures may lead to further scarring.

A facelift can make you look younger temporarily, but it can't stop the ageing process. It can reduce sagging, creases and fatty deposits in areas such as:

• the mid-face
• jowls
• chin
• under your lower eyelids
• along your nose

A facelift won't:

• remove deep frown lines on your forehead
• remove wrinkles around your mouth
• change your eyelids
• raise sagging eyebrows

Wrinkles are lines or creases on your skin which appear as a natural part of ageing on sun-exposed areas of your body.

Ageing is a normal, natural process. You don't need to appear young to be respected, develop relationships, or get a job.

Not everyone wants or needs a facelift. There are alternatives to achieve a more youthful appearance for those that do.

You should be aware that the government and medical profession have concerns about facelifts. The Medical Board of Australia has issued guidelines to doctors to ensure that:

• Anyone having any major cosmetic surgery (involving cutting beneath the skin), including a facelift, meets with the surgeon 2 times before scheduling any surgery. At least one of the meetings must be in-person. They should not be asked to sign a consent form at the first appointment. They also need to wait through a compulsory cooling off period before the surgery can take place.
• The treating doctor is satisfied that the person considering cosmetic surgery is in good psychological health. If the doctor is unsure about this, and how it may affect the person's suitability for a facelift, they need to refer them for an independent psychological assessment.

A facelift might boost your self-esteem, however it will not treat psychological conditions such as depression and body dysmorphic disorder. Speak to your doctor if you need support.

How do I choose a surgeon?

If you are considering a surgical facelift, it's important to choose a surgeon you feel comfortable with. Your surgeon should speak to you honestly about the benefits and risks of any surgery.

The Australian Health Practitioner Regulation Agency (AHPRA) has a register of medical practitioners. You can check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also see if the surgeon has had any serious disciplinary action taken against them.

Some people consider having cosmetic surgery overseas, but there can be many problems with this.

What questions should I ask before surgery?

There are many things to consider before agreeing to any operation. Questions you might ask the surgeon include:

• How many facelifts have you performed?
• What are the risks of this operation for a person in my state of health?
• How often is a second procedure required?
• Is this the best option for me?
• How long is my recovery likely to take?
• What is the cost?
• Will the surgery be performed in an accredited facility?

You can also ask to see before and after photographs of other patients.

How to prepare for a facelift

Your surgeon will need your full medical history and will discuss your expectations. Take notice of any pre-surgery instructions.

You might be asked to:

• stop taking certain medicines, including those containing aspirin, around 2 weeks before surgery
• quit smoking

What happens during a facelift procedure?

The type of facelift procedure you have will depend on what you have agreed with your surgeon. You will be given a local or general anaesthetic.

Full or traditional facelift: the surgeon is likely to make an incision (cut) that follows your hairline from the temples, around the ears and down to the lower scalp. If needed, a small incision may also be made under your chin to give access to your neck.

The surgeon will then raise the skin away from your face and reposition the underlying muscle and tissue. They might remove or redistribute your facial and neck fat.

Sometimes fat is collected by liposuction from elsewhere in the body, such as the abdomen (tummy). This may be used to plump up your cheeks or other parts of the face.

The surgeon repositions the skin over your face and neck. They will also trim any excess skin. They sew, staple, or tape the incisions closed and apply a dressing. Sometimes a small thin drainage tube is placed under the skin to remove excess blood or fluid.

Mini or limited incision facelift: this operation is a minor variation of the full facelift, with shorter cuts around your hairline. Additional cuts may be made in your lower eyelids or under your upper lip.

Neck lift: this operation focuses on removing fat and sagging skin in your neck area. The incisions are usually done around your ears and under your chin.

What should I expect after a facelift?

Some facelifts are done as day procedures. However, your procedure might require a short stay in hospital, so it's best to prepare a bag.

The day after surgery, your doctor is likely to remove any drainage tubes and put fresh dressing on your wounds. You will need to return to have the stitches taken out, after about a week.

You are likely to have pain, bruising and swelling around the site of the operation. Your doctor may prescribe pain relief medication. Sleep with your head elevated to reduce the swelling.

Contact your doctor if you have:

• heavy bleeding from the wounds
• increased redness around the incisions (cuts)
• a temperature higher than 38°C
• excessive swelling around the surgery site
• lower leg swelling
• difficulty breathing
• pain not controlled by prescribed pain relief medicines

What are the risks of a facelift?

Like any surgery, a facelift procedure comes with risks. You should discuss the risks in detail with your surgeon. You should also discuss the risks of the anaesthetic with your anaesthetist.

After a face lift, common side effects are:

• a swollen or numb face
• a stiff feeling in your face and mouth
• bruising
• pain
• low mood
• scars which should fade, but will not completely disappear
• a raised hairline
• reduced hair growth at the temples (sides of your forehead)

While most operations go smoothly, the risks of facelift surgery include:

• nerve injury and loss of feeling or movement in your face
• uneven facial features
• problems healing
• excessive bleeding
• developing a blood clot in a vein
• infection
• an allergic reaction to the anaesthetic

You may need more surgery to correct any complications.

Non-surgical facelift options

You may want to consider a non-surgical facelift. Some facial rejuvenation procedures include:

• Peeling: chemical peel treatments refine the surface of your skin. These can improve blemishes and wrinkles.
• Dermabrasion: mechanical treatment that smooths your skin.
• Fillers: cosmetic injections that can reduce wrinkles, scars, fine lines, and provide volume.

How much will a facelift cost?

The cost of a facelift varies from patient to patient. It also depends on:

• your surgeon's fees
• your anaesthetist's fees
• your clinic or hospital fees
• the cost of medicines, dressings, and support garments
• any medical tests needed

Your surgeon and anaesthetist must provide you with information in writing about the cost of a facelift. This should include:

• the total cost
• details of deposits and required payment dates
• payments for follow-up care
• any further costs if you need additional surgery or treatment

Medicare doesn't cover the cost of cosmetic surgery and generally private health insurance doesn't either.

However, some of the cost might be covered if the facelift is done as part of a reconstructive procedure, such as to treat traumatic injuries.

Resources and support

If you are considering a facelift, you should first discuss it with your doctor. More information is also available on the Australasian Foundation for Plastic Surgery website, and in our guide to cosmetic surgery.

If you want to know more about chilblains, or to get advice on what to do next, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week.