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Facelift surgeryPublished by BUPA's health information team, healthinfo@bupa.com, December 2007. This factsheet is for people who are considering having a facelift operation. This is an operation to lift up the facial skin and tissues and/or the underlying muscle, to make the face tighter and smoother. There are different types of facelift operation available and only the most common are discussed here. Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.
About facelift surgeryAs you age, your facial muscles slacken and your skin becomes less elastic, creating folds and lines. A facelift operation can give you a more alert and youthful appearance by reducing saggy skin and wrinkles. Facelifts may be done on your whole face (a full facelift) or just on your brow area, lower face, or neck only. The effects of a facelift last for about seven to 10 years. The best results are achieved if you maintain a stable body weight, have skin with good levels of elasticity, and have a strong bone structure. In older people, or people who spend a lot of time in the sun, the results don't last as long. What are the alternatives?Other treatments may be used either as alternatives, or in combination with a facelift.
Getting adviceIt's important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or give advice about how to choose which hospital to be treated in. Before opting for a facelift, discuss with your surgeon what you are hoping to gain from the operation and the results you can realistically expect. A facelift will not affect the fine lines around the lips for example. Preparing for your operationYour surgeon will explain how to prepare for your operation. For example, if you smoke you may be asked to quit, as smoking increases your risk of getting a chest or wound infection and slows your recovery. A facelift typically requires a two night stay in hospital and is usually done under general anaesthesia. This means you will be asleep during the procedure. Typically you must not eat or drink for about six hours before a general anaesthetic. However some anaesthetists allow occasional sips of water until two hours beforehand. At the hospital your nurse will explain how you will be cared for during your stay. Your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine. Your surgeon will usually visit you to discuss the operation and ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead. Your surgeon will examine your face and may take photographs so that the results of surgery can be compared with your original appearance. Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. About the operationThe operation takes around three to four hours. There are several different facelift techniques. Your surgeon will explain the options available to you. Traditional faceliftYour surgeon will make a surgical cut right around your hairline, past the front of your ears. Cuts may also be made under your chin if you want to lift a sagging jawline. Your skin is carefully separated from the underlying facial muscles. Excess fat is removed and the muscles are tightened. The skin is lifted up, pulled back and any excess trimmed off. The skin is then stitched back to the line where the cut was initially made. Afterwards, your face is tightly wrapped in bandages. Depending on the exact procedure carried out, these may run under your chin, around your ears and/or over your head. They are usually taken off after a day or two. Fine plastic tubes may be left in the wounds for up to 48 hours afterwards. These allow blood and fluids to drain into a bag. Minimal-access cranial suspension (MACS)Surgical cuts (shorter than for a traditional facelift) are made in your temple and in front of your ears. Excess fat is removed and the muscles are tightened using permanent stitches. Keyhole surgeryYour surgeon will make several tiny cuts into your skin. Special operating instruments and an endoscope (a small, flexible tube with a light and a camera lens at the end) are passed through the cuts. Your surgeon will do the operation by looking at pictures sent by the camera lens to a TV screen. Both MACS and keyhole surgery have the advantages of smaller scars and usually a shorter recovery time. What to expect afterwardsYou will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours. Your nurse will give you some advice about caring for your healing wounds and a date for a follow-up appointment before you go home. Dissolvable stitches will disappear on their own in seven to ten days. Non-dissolvable stitches are removed a week after surgery. Recovering from a faceliftIf you need them, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice. You will have some swelling. Applying a cold compress, such as ice or a bag of frozen peas (both wrapped in a towel) can help to reduce the swelling and bruising. You should not apply ice directly to your skin as it can give you an ice "burn". Most people can return to work after about three weeks. To help promote your recovery, it's important that you:
What are the risks?Facelift surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure. Side-effectsThese are the unwanted, but mostly temporary effects of a successful procedure, for example feeling sick as a result of the general anaesthetic. Side-effects of facelift surgery include:
ComplicationsThis is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, infection, or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Antibiotics may be needed to help prevent infection. Specific complications of a facelift are uncommon, but can include:
There is a risk your earlobes may hang at an irregular angle making your ears appear uneven. Further corrective surgery may be needed. It's possible that you may not be completely satisfied with your appearance after the operation. The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by cosmetic surgeon Anthony Attwood, MB BS, FRCS (Ed.) and by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: December 2007. Expected review date: December 2009.
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