Facelift (Rhytidectomy)

Facelift surgery, also known as a rhytidectomy, is a cosmetic surgery procedure designed to address significant signs of ageing changes seen in both the face and neck region.

RELATED: Facelift Surgery FAQs – Q&As about Rhytidectomy

To gain a better understanding of what facelift surgery can achieve, it is important to gain an appreciation of what is involved in the ageing process of the face and neck. With the ageing process, the skin will lose between 20-80% of hydration and volume as time progresses. This loss of volume is primarily related to reduced synthesis of the structural components of skin which include both collagen and elastin but also glycosaminoglycans (GAGs), which are found in the dermal layer of the skin. This loss of structural support leads to the commonly seen end result of skin laxity. Skin laxity is also accompanied by loss of adhesion with the deeper-lying muscles and soft tissues. This leads to loss of tissue tightness. The skin, therefore, sags, resulting in jowl formation and loss of a well-defined jawline. The extra skin and underlying soft tissue sag downwards, leading to the loss of the sharply defined cervicomental angle between the neck and chin. Ageing changes in the midface region lead to volume loss in the cheeks and bone loss from the facial skeleton. The resulting hollowed-out appearance becomes more evident with age. The younger face possesses features consistent with a youthful inverted triangle. With age, this triangle flips over as the face gains more volume in its lower part due to the sagging of the soft tissues under the influence of gravity and the loss of volume from the midface.

Facelift Expected Results

The expected results of a facelift procedure can vary depending on the individual patient but generally include the following:

1. Improved Facial Contours: A facelift can improve the contours of the face, giving it a more youthful and refreshed appearance. The procedure can lift and reposition the cheeks and jowls, which can help to smooth out wrinkles and fine lines.
2. Tightened Skin: A facelift can remove excess skin and tighten the remaining skin, which can help to improve the appearance of the face and neck. This can help to reduce the appearance of wrinkles and fine lines and can also help to improve the definition of the jawline and neck.
3. Reduced Sagging: A facelift can address sagging skin in the mid-face, jawline, and neck. This can help to reduce the appearance of jowls and a “turkey neck” and can also help to improve the overall shape of the face and neck.
4. Long-lasting Results: The results of a facelift can last for several years, depending on the individual’s age, skin condition and overall health. The procedure can provide a long-term solution for addressing the signs of ageing.

It’s important to note that the facelift procedure is not a one-size-fits-all solution, and the results can vary depending on the individual patient’s needs and the surgeon’s technique. Additionally, it’s also important to remember that a facelift is a surgical procedure, and as such, it involves certain risks and complications. It is important to have realistic expectations and to discuss them with the surgeon before deciding to undergo the procedure.

A facelift, also known as rhytidectomy, is a cosmetic surgery procedure that aims to improve the appearance of the face by tightening and repositioning the skin and underlying tissue. The procedure can address wrinkles, sagging skin, and loss of definition in the mid-face, jawline, and neck. Here are some of the benefits of a facelift procedure:

• Improved Appearance of Wrinkles and Fine Lines: A facelift can smooth out wrinkles and fine lines on the face, particularly those around the mouth, nose, and eyes.
• Tightened and Firmer Skin: The procedure can help to tighten and firm the skin on the face, giving it a more youthful appearance.
• Enhanced Definition of the Jawline and Neck: A facelift can also help to enhance the definition of the jawline and neck, giving the face a more balanced and proportionate look.
• Long-lasting Results: Facelift results can be long-lasting, especially when compared to non-surgical options such as injectable fillers or Botox. The effects of a facelift can last for several years, depending on the patient’s age, lifestyle, and overall health.
• Increased Self-confidence: Many patients report an increase in self-confidence after a facelift, as they feel more attractive and youthful.
• Customizable to suit individual needs: Facelift procedures can be customized to suit individual needs and can be combined with other procedures to provide a comprehensive, well-rounded result.

It’s important to note that facelift surgery is not a one-size-fits-all solution, and the best results are achieved when performed by a qualified and experienced plastic surgeon. Also, the facelift procedure is major surgery, and it carries certain risks and recovery time. Patients should be well informed about the risks, recovery and expected results before undergoing any procedure.

It’s also important to have realistic expectations and understand that a facelift can’t stop the ageing process, but it can help to reverse some of the signs of ageing.

Facelift before and after:

While a facelift can provide significant improvement on its own, it can also be combined with other procedures to enhance the overall results. Some of the most common procedures that can be combined with a facelift include:

• Eyelid Surgery (Blepharoplasty): This procedure can address wrinkles, puffiness, and sagging skin around the eyes. It can also remove excess fat and skin from the upper and lower eyelids to improve the appearance of the eyes.
• Brow Lift (Forehead Lift): This procedure can address wrinkles and sagging skin on the forehead and can also reposition the eyebrows to a more youthful position.
• Neck Lift: This procedure can address wrinkles, sagging skin, and excess fat in the neck area. It can also be used to tighten the muscles in the neck and improve the appearance of the jawline.
• Chin & Neck Liposuction: This procedure can be used to remove excess fat in the face and neck area. It can also be used to contour the face and improve the appearance of the jawline.
• Rhinoplasty (Nose Job): This procedure can be used to reshape the nose and improve its overall appearance. It can also be used to address breathing problems caused by structural abnormalities in the nose.
• Otoplasty (Ear Surgery): This procedure can be used to reshape the ears and make them less prominent.
• Fat Grafting: This procedure can be used to add volume to the face, particularly to the cheeks, lips, and temples.

Combining these procedures can help to provide a more comprehensive, well-rounded result. However, it’s important to note that each patient is unique and should consult with a qualified and experienced plastic surgeon to determine the best course of treatment based on their individual needs and goals.

It’s also important to note that some procedures may have more downtime and recovery time. Combining procedures can increase risks and also recovery time. The patient should be well informed about the risks, recovery and expected results before undergoing any procedure.

Whether or not you are a good candidate for facelift surgery depends on a number of factors, including your overall health, skin type, and desired results.

Some of the factors that may make you a suitable candidate for facelift surgery include the following:

• Age: Facelift surgery is typically recommended for patients over the age of 40, as this is when the signs of ageing typically become more pronounced.
• Skin Type: Patients with good skin elasticity and minimal sun damage are generally considered to be the best candidates for facelift surgery.
• Desired Results: If you have realistic expectations of what facelift surgery can achieve and understand that it can’t stop the ageing process, but it can help to reverse some of the signs of ageing.
• Overall Health: Patients who are in good overall health and have no underlying medical conditions that could complicate the surgery or recovery process are generally considered to be the best candidates for facelift surgery.

Some factors that may make you less suitable for facelift surgery include:

• Smoking: Smoking can impede healing and increase the risk of complications, so it’s best to quit smoking for at least six weeks before and after the surgery.
• Excessive weight: Being overweight can make the procedure more challenging, and it’s best to be at a stable weight before considering the surgery.
• Active skin conditions: Patients with active skin conditions such as rosacea, eczema, or psoriasis may not be suitable for the surgery.

It’s important to consult with a qualified and experienced plastic surgeon to determine if facelift surgery is right for you. The surgeon will examine your skin and underlying tissue, evaluate your overall health, and discuss your desired results with you. They will also inform you of the risks, recovery time, and expected results of the procedure.

It’s also important to remember that facelift surgery is a major procedure, and it’s important to make an informed decision. It’s best to have realistic expectations and understand that the surgery can’t stop the ageing process, but it can help to reverse some of the signs of ageing.

Facelifts are not just for women

Men and women both experience the effects of the facial ageing process, and both can benefit from facelift surgery. Demand for facelift surgery in men in the UK has increased by over 25% over the last twenty years, while demand for female procedures has remained relatively static. About 10% of all facelift procedures are performed in men and this is a growing percentage year on year.

The ideal candidates for a facelift procedure are men and women with a face and neck that are starting to look older but with elastic skin and a very well-defined bone structure. Even though most facelift patients are around 40 to 60, a facelift can be successfully performed in patients between 70 and 80, subject to satisfactory medical clearance for the surgical procedure.

Some questions to ask at your facelift consultation

• Am I an ideal candidate for facelift surgery?
• Is it possible to attain results in line with my expectations?
• What can I do to achieve ideal results following the facelift procedure?
• Do you have before and after photos of patients who have undergone similar facelift procedures?
• What can I expect in the recovery period after a facelift?
• What scars are created from facelift surgery, and where will they be located?
• Will I experience pain after facelift surgery?
• How soon can I return to work after a facelift?

Yes, men can have a facelift. A facelift, also known as rhytidectomy, is a cosmetic surgery procedure that aims to improve the appearance of the face by tightening and repositioning the skin and underlying tissue. The procedure can address wrinkles, sagging skin, and loss of definition in the mid-face, jawline, and neck. It can be performed on both men and women.

The facelift procedure for men is often referred to as a “male facelift” or “brotox”, and it is tailored to address the unique concerns of men’s ageing faces. Men typically have thicker skin and more prominent facial features than women, so the procedure may differ slightly.

The procedure for men may involve a more aggressive approach to remove excess skin and reposition the remaining skin and underlying tissue. The incision may be made in the hairline to minimise the visibility of scars. The procedure may also involve liposuction to remove excess fat in the neck and jawline area to enhance the contours of the face.

Men who are good candidates for facelift surgery are typically those who are in good overall health, have realistic expectations and understand that the surgery can’t stop the ageing process, but it can help to reverse some of the signs of ageing. Men who smoke or have excessive weight may not be suitable for the surgery as this can impede healing and increase the risk of complications.

The recovery time for a facelift can vary, but most men can expect to return to work and normal activities within two to three weeks. It’s important to follow the post-operative instructions provided by the surgeon to ensure a smooth recovery.

It’s important to note that facelift surgery is a major procedure, and it’s important to make an informed decision. It’s important to consult with a qualified and experienced plastic surgeon to determine if facelift surgery is right for you. The surgeon will examine your skin and underlying tissue, evaluate your overall health, and discuss your desired results with you. They will also inform you of the risks, recovery time, and expected results of the procedure.

It’s also important to remember that facelift surgery is not a one-size-fits-all solution, and the best results are achieved when performed by a qualified and experienced plastic surgeon who is familiar with the unique concerns of men’s ageing faces.

Cutaneous facelift – not performed at Centre for Surgery

The cutaneous lift is also known as a skin-only facelift. The cutaneous lift does not address the underlying muscle or SMAS layer. Like with all facelifts, the skin is gently separated and secured in a new lifted position before trimming any excess skin off. Cutaneous facelifts are generally considered to have a lower risk of complications and are often performed under a local anaesthetic. Many surgeons may recommend this option for older patients who may suffer from various medical co-morbidities that may place them at high risk of complications during general anaesthesia. There are several significant shortcomings associated with cutaneous lifts – only skin laxity can be corrected, and the results are not particularly long-lasting. Scars are more obvious, with more risk of skin rippling from superficial suture placement. The scarring is more evident in skin-only facelifts as the tension is held entirely on the skin layer. With continued ageing, the skin layer which is being placed under considerable stretch may actually lose more collagen and elastin compared with other methods of facelift surgery. The cutaneous lift is not generally recommended at Centre for Surgery as there are much better options available.

SMAS Facelift

Plication is a term that means a state of being folded or forming folds in something. Unlike a cutaneous lift, the SMAS facelift involves tightening the skin and underlying deeper tissues, including the SMAS layer. In conjunction with the SMAS, the platysma layer in the neck is also tightened to restore youthful contours in the lower face and neck. After reconstructing the deeper tissues using precise suture placement, the skin layer is lifted, tightened, and excess skin removed. In SMAS facelifts, the incision does not have as much tension placed upon it as a cutaneous lift. The resulting scars have optimal scar aesthetics as a result. SMAS facelifts have more robust results and last much longer than skin-only facelifts. SMAS facelifts, when performed by an expert facelift surgeon at Centre for Surgery can last for ten years or more.

Deep Plane Facelift

A deep plane facelift is the most invasive and major type of facelift surgery. It is a more advanced version of the traditional facelift. Deep plane facelifts have more powerful rejuvenating effects – they can correct deeper nasolabial folds as the plane of dissection is actually beneath the SMAS layer on top of the facial muscles. The deep plane of dissection results in even less tension on the skin compared with a SMAS facelift. Deep-plane facelifts are often ideal for those with thicker skin and heavy faces. Male facelifts are often deep-plane facelifts.

A deep plane facelift requires a surgeon who is very experienced in facial plastic surgery and regularly performs facelifts of this type. The deep plane facelift takes considerably longer to perform as the dissection is extremely precise and meticulous. There is a higher risk of complications, including nerve injury, which can be permanent in nature. Many facial plastic surgeons and well-informed patients will more commonly opt for a less invasive facelift option to minimise the risk of complications as much as possible.

Composite facelift

The composite facelift builds upon the SMAS plication facelift in several ways. It is regarded as a composite technique as it brings together two key aspects of addressing gravitational changes to restore youthfulness to the face. A composite facelift is still a two-layered technique like a SMAS lift, but the key difference lies in the additional vertical upward vector that a composite facelift can achieve. A composite facelift addresses all the traditional areas of a SMAS facelift, such as the jowl area, cheeks and neck but also includes rejuvenation of the periocular region.

The composite facelift has both horizontal and vertical components. The downtime after a composite facelift is slightly longer compared with a SMAS facelift with a longer duration of postoperative swelling. There is also a slight increase in the risk of postoperative complications.

Mid Facelift

The midface is the term used to describe the area of the face, which comprises the nose, eyes and corners of the mouth. With ageing and loss of skin laxity, these areas undergo sagging and downward descent under the influence of gravity. In some cases, patients may develop localised skin laxity of the eyes, cheeks and mouth without significant ageing of other parts of the face, such as the neck or jawline. In these cases, a mid-facelift could address these ageing changes effectively without the invasiveness and risks of a full facelift. Compared with a full facelift, the results of a mid-facelift are commonly seen as subtle in nature without the longevity of a full facelift. It is rare for our surgeons to perform a mid-facelift on their own. A mid-facelift is commonly combined with other complementary procedures, including eyelid surgery (both upper and lower blepharoplasty), brow lift and fat grafting to the face.

Mini Facelift

A mini facelift is a less invasive form of a traditional facelift. Mini facelifts are often very suitable for patients with mild degrees of ageing and facial descent in the lower third of the face. The most common age range for a mini facelift is patients in their 30s to early 50s who may not need a more extensive full facelift but may still benefit from the improvement of the facial contours, particularly the jowls and more defined jawline. Mini facelifts have experienced a surge in popularity recently and may go by several catchy names and are often promoted as being able to be performed under a local anaesthetic with minimal downtime. Unlike a traditional facelift which involves incisions being made both in front of and behind the ears, a mini facelift or short-scar facelift often has incisions primarily in front of the ears without the extension into the posterior hairline. A mini facelift may not be as effective for ageing changes affecting the neck and the lower face. It is important to understand what the mini facelift will address for your face. Your surgeon can advise you on what the mini facelift can address at your consultation.

Here is a general overview of the steps involved in a facelift procedure:

1. Anaesthesia: The patient will be given either general anaesthesia or local anaesthesia with sedation.
2. Incision: The surgeon will make incisions in the hairline at the temples, extending around the ear and ending in the lower scalp.
3. Deep Plane Technique: The surgeon will use a deep-plane technique to lift and reposition the deeper layers of the face, including the cheeks and jowls, to create a more youthful appearance.
4. SMAS (Superficial Musculoaponeurotic System) and/or platysma muscle tightening: The surgeon will then lift the SMAS layer and/or platysma muscle which will help to further improve the contours of the face and neck.
5. Excess skin removal: The surgeon will remove any excess skin and trim it to the appropriate size.
6. Closure: The incisions will be closed with sutures, skin adhesives, or surgical tape.
7. Recovery: After the procedure, the patient will experience some swelling, bruising, and pain, which can be managed with medication. The patient will need to avoid strenuous activity for about 2-4 weeks and should avoid sun exposure for several months.
8. Final result: The final result of the facelift procedure will not be immediately visible, as it can take several weeks for the swelling and bruising to subside. The final result will be visible around 2-3 months after the procedure.

It’s important to note that every facelift procedure is different, and the steps may vary depending on the individual patient’s needs and the surgeon’s technique.

Every patient has completely different facial anatomy and characteristics, facial ageing patterns and objectives for surgery.

The traditional facelift generally consists of incisions made both in front of and behind the ears. The incision behind the ears extends to the hairline. The surgeon would place the incisions strategically to look as inconspicuous as possible to blend in with the natural skin folds and contours. After a skin incision, the skin is gently lifted or undermined to separate the skin from the underlying soft tissue and muscle layer in the previously marked areas by the surgeon. After the soft tissue undermining component, the facelift surgeon surgically tightens the area in its new lifted position with sutures and finally trims any excess redundant tissue.

Locations of Facelift incisions

In facelift surgery, the positioning of the skin incisions is vital for avoiding the impression that you have just had surgery. The vast majority of patients prefer a natural and rejuvenated look without features of visible incisions or scars. The expert facelift surgeon takes great care to place incisions in areas that are as well concealed as possible. The skin incisions are best placed in the natural folds both in front of and behind the ear, with the incision extending to the hairline where a neck lift is required. The position of the ear and hairline should be preserved and remain in the same position after surgery. The standard method for a facelift is to gently lift the deeper tissues to reduce tension on the skin layer, which reduces the risk of skin stretching. This means a more cosmetically acceptable scar is possible. Patients are often concerned about the risk of possible hair loss from the incision. To reduce this risk, the surgeon will perform a bevelled incision technique to facilitate proper hair growth. This is very important as it means patients are not restricted to wearing certain hairstyles to hide the incisions due to their visibility. Not all surgeons take this level of care and attention in scar cosmesis. All our surgeons are skilled in placing their incisions along the borders of the ear and behind the tragus of the ear. The incisions are much better concealed than placing incisions in front of the ear, which looks more visible. The incision behind the tragus is closed in such a way as to minimise distortion of this structure. It is important to have a truly artistic eye for facelift surgery. Patient satisfaction is much higher when the results are natural, restoring youthful vitality without the telltale signs of having had a surgical procedure.

Recovery after facelift surgery is an important aspect of the process and can vary depending on the individual patient. Here is a general overview of what to expect during the recovery process:

1. Swelling and Bruising: Swelling and bruising are common after a facelift procedure and can last for several weeks. The swelling will typically peak in the first 2-3 days and then gradually subside.
2. Pain and Discomfort: Pain and discomfort are also common after a facelift procedure, but they can usually be managed with medication. Your surgeon will provide you with a pain management plan that you should follow.
3. Stitches and Bandages: The incisions will be closed with sutures, skin adhesives, or surgical tape. The bandages will be removed within a few days of the surgery, and the stitches will be removed within a week or two.
4. Rest and Relaxation: It is important to get plenty of rest and avoid strenuous activity for at least 2-4 weeks after the surgery. This will help to minimize swelling and promote healing.
5. Follow-up Visits: You will have several follow-up visits with your surgeon to monitor your progress and address any concerns. Your surgeon will provide you with detailed instructions on how to care for your incisions and monitor your recovery.
6. Final Result: The final result of the facelift procedure will not be immediately visible, as it can take several weeks for the swelling and bruising to subside. The final result will be visible around 2-3 months after the procedure.

It’s important to note that every patient’s recovery is different and the recovery time can vary depending on the individual’s overall health, the type of facelift procedure, and the patient’s adherence to post-operative care instructions.

With any cosmetic surgery procedure, there is always the potential for complications, whether minor or major in nature. At Centre for Surgery, our facelift surgeons take extra precautions to keep the risk of complications at as low a level as possible. Despite this, it is still very important to know the range of potential complications that could occur with facelift surgery.

Potential risks of facelift surgery

• Anaesthetic risks
• Postoperative haematoma – a haematoma is a collection of organised blood clots beneath the skin. A haematoma after facelift surgery is one of the most common complications after facelift surgery and usually arises early, often within 24 hours after surgery. If a haematoma is suspected, your surgeon will assess you urgently to decide the best course of action. Most haematomas can be removed with a simple needle and syringe in the clinic. Some haematomas will require surgical removal under local anaesthetic.
• Surgical site infection (SSI) – SSIs are always a potential risk after any surgical procedure. Bacteria can enter wounds through small entry points leading to a localised infection. Clinical features of infection include redness, swelling, heat and pain in the affected area. SSIs need treatment with a course of antibiotics.
• Nerve injury – during the undermining of the skin flap, the nerves of the face could be injured, leading to numbness, tingling or weakness of the affected facial muscles. Most nerve injuries are temporary in nature and often settle after a few months. A minority of nerve injuries are permanent in nature.
• Scarring and hair loss – Scars from facelift surgery are hidden in the natural hairline and skin folds. In some people, hypertrophic scarring can develop. Thickened scars can lead to either temporary or permanent hair loss in the region of the incision lines. Injection of steroids and or hair transplantation can address this issue effectively.
• Skin necrosis – skin necrosis refers to the death of the skin flap due to an insufficient blood supply to the area. Skin necrosis is a rare complication of facelift surgery, but the risk increases in patients who smoke.

Many potential complications of facelift surgery can be effectively managed with meticulous postoperative care. Our postoperative support programme was described as outstanding by the CQC. At your consultation, it is important to understand all the potential risks and complications of facelift surgery. Please take care to follow all of the surgeon’s pre- and post-operative instructions to maximise the chances of successful healing.

Pixie Ear Deformity

The importance of making precise incisions for facelift surgery cannot be emphasised enough when it comes to preventing an unnatural look on the earlobe, also known as a pixie ear deformity. The pixie ear deformity develops as a result of inaccurate correction of the earlobe after the re-draping of the facial skin. Often earlobe distortion develops from excessive traction being placed on the earlobe. The stretched earlobe extends downwards and is a tell-tale sign of recent facelift surgery. It is commonly associated with older methods of performing facelift surgery, with much of the tension being placed on the skin rather than the deeper soft tissue layers. Our skilled plastic surgeons avoid this unnatural appearance with modern techniques for performing facelift surgery.

There are several factors that will determine the overall cost of the facelift procedure, and the final quotation will be given after your face-to-face consultation with your specialist plastic surgeon.

Our aftercare programme was recently described as ‘outstanding’ by our regulator, the Care Quality Commission. 

Our postoperative support team call all our patients during the first two weeks. The proactive nature of our postoperative support gives every patient the best opportunity for a smooth postoperative recovery free of complications. In many cases, if complications were to occur, their impact would be markedly lessened by early detection, prompt clinical assessment and correct treatment. When a patient expresses concern to our team over the phone, we often call patients on the same day for assessment with one of our expert nursing team. Even if there is no significant issue, the careful explanation and calm reassurance provided by our team can help to alleviate any worries you may have experienced.

1. Over 15 years of experience with all types of facelift surgery – short scar mini facelift, full scar facelift, neck lift and combined procedures (facelift with eyelid surgery or facial fat grafting).
2. We regularly receive patients from overseas at our London facial plastic surgery specialist centre.
3. Our surgeons are UK-trained NHS consultant plastic surgeons.

Trust a facial plastic surgeon.

A facial plastic surgeon is trained to undertake aesthetic surgical procedures in the facial region. They are dedicated sub-specialists. Compared with general plastic surgeons, facial plastic surgeons are inherently better trained to perform delicate facial procedures such as a full facelift and neck lift. The extra years of surgical training by facial specialists focused on the facial region results in an exceptionally high degree of skill.

Our surgeons are full members of:

What is included in my facelift treatment package?

• As many preoperative consultations with your surgeon as you like to make sure the procedure is right for you
• Enhanced same-day discharge with the added benefits of recovering in your own home
• 24/7 clinical support from your surgeon for the first 48 hours and our expert postoperative support team
• Your very own dedicated patient coordinator
• In-depth preoperative medical assessment to make sure you are fully fit for the rhinoplasty procedure
• Exceptionally high standards of postoperative care are described as ‘outstanding’ by the CQC, with regular telephone and face-to-face checks by our expert postoperative support team.

RealSelf Top Doctors

RealSelf’s top doctor status is awarded to less than 10% of the RealSelf doctor community.  This status is earned by achieving consistently high patient satisfaction (from RealSelf reviews), getting excellent feedback on expert answers to patient questions, and investing significant time in Q&A and other doctor activities. RealSelf’s top doctors are rated among the best surgeons in the United Kingdom.