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There used to be a lot of stigma around plastic surgery—celebrities and common folk alike kept it hush-hush when they had work done. Nowadays, though, people are much more open and comfortable talking about having surgical cosmetic procedures. The American Society of Plastic Surgeons reported a 22% increase in cosmetic surgery procedures from 2000 to 2020, and facelifts are the 3rd most common of the bunch (ASPS, 2021). Read on to learn more about facelifts, types, and what to expect.
What is a facelift?
A facelift, also called a rhytidectomy, is a procedure in plastic surgery that can reduce wrinkles and other signs of aging in the face and neck regions.
While there are many contributors to skin aging, such as genetics and sun exposure, most of them work in the same ways and form these characteristics of aging skin with which we’re all too familiar.
Under the top layer of skin, known as the epidermis, is the dermis, the layer of your skin containing collagen and elastin fibers. These elements form scaffolding that gives your skin that plump, voluminous look we associate with youth and health. As we age, these fibers break down, and external factors such as sun damage speed up that process (Shanbhag, 2019).
The top layer, too, is affected by the aging process. We naturally produce hyaluronic acid, which helps keep our skin hydrated by attracting and holding onto water molecules. Over time, the production of hyaluronic acid decreases, leading to dry skin. Dry skin can accentuate the look of fine lines and wrinkles—so facial rejuvenation may involve going after different aspects of aging skin.
What is a facelift used for?
Wrinkles aren’t the only concerns addressed during cosmetic surgery. A facelift may include some elements of reconstructive surgery and overall aims to lessen the look of multiple signs of aging, including (Pérez, 2021):
- Skin sagging due to the natural loss of elastin and collagen as we age
- Double chin or “turkey neck” caused by fat and loose skin around the chin
- Displacement of fat (like under the eyes), resulting in a loss of volume and tone
- Jowls developing around the cheeks and/or jawline
- Deepening of folds, especially between the corners of the nose and mouth
How does a facelift work?
During a facelift, the surgeon removes excess skin to reduce the look of wrinkles. The different types of facelifts all focus on helping you reclaim tighter-looking skin, which tends to get wrinkled and sag as we age. The gist of the surgery is similar to making your bed—by pulling and moving skin and muscle, your wrinkles smooth out, and your face looks younger.
During this procedure, your surgeon lifts the skin of your face while tightening the underlying tissue and muscles. Fat may be redistributed or injected to create a plumper, more youthful appearance; excess fat can be removed or trimmed. The surgeon then redrapes the skin, cuts the extra, and repairs the incisions.
But while facelifts can address the visible signs of facial aging to give you a more youthful appearance, they cannot slow down the aging process.
Types of facelifts
Surgical techniques are constantly evolving, and terms are often confused and misused in marketing. The best way to learn about the different facelift options is to talk to a board-certified plastic surgeon. Some of the types of facelifts you may come across in your research include:
A full facelift uses a traditional facelift incision, starting at the hairline by the temple, extending to the temple on the other side of your head. Some plastic surgeons will use a deep plane facelift technique during this procedure to effectively lift both skin and muscle to give you a more youthful look. A full facelift may not fully address brow, eyelid or neck sagging—so you may need to combine it with other procedures (Raggio, 2021).
How to reverse aging: 9 ways to reduce premature skin aging
This name can be misleading. The “mini-lift” refers to a smaller incision than the full facelift—this incision is only in front of the ears. It is still an invasive procedure that moves and lifts facial tissues. Some people use this term to refer to a facelift that only works on part of the face (i.e., a mid-face lift that focuses on the center third of your face) (Pérez, 2021). It is more accurate to name the facelift based on which parts of the face it is addressing rather than “mini.”
If you have significant loose, saggy neck skin (or “turkey neck”), you may benefit from a neck lift or platysmaplasty. It can be done alone or in combination with other surgical techniques (Alexander, 2021).
A “liquid” facelift is not a surgical procedure. Instead, your provider injects dermal fillers (e.g., Restylane, Juvederm, Sculptra, Radiesse, etc.) to plump up your face and smooth out your fine lines and wrinkles. These injectable fillers may contain hyaluronic acid or other compounds to restore facial volume. Neuromodulators, like Botox, can also help lift certain parts of your face by weakening specific muscles (Shah, 2018).
Who’s a good candidate for a facelift?
First and foremost, a range of less invasive options can improve wrinkles and perhaps even quell your desire for a facelift. But if you’re looking for additional help, consulting with a cosmetic surgeon can be a great way to explore the various options and address your specific concerns. Options such as fillers and Botox can be effective at eliminating fine lines in the short term until you’re ready to dive into more invasive procedures.
If your surgeon agrees that a facelift is the proper next step, they’ll look to see if you’re a good candidate. Good candidates for this procedure are generally healthy and don’t have any medical conditions, nutritional deficiencies, or other issues that might slow wound healing.
Studies show that smoking impairs wound healing. Scientists have many theories as to why this happens. It may be due to the chemicals in cigarette smoke, increased inflammation noted with smoking, decreased blood flow and oxygen supply to tissues, or a combination of mechanisms.
Some surgeons will not perform elective (non-essential) surgery on people who smoke because of the effects of cigarettes on wound healing (Lassig, 2018).
Last, but certainly not least, your surgeon will make sure that you have realistic expectations for the procedure’s outcome. As mentioned, facelifts cannot slow or reverse the aging process, and some people find that one approach is not enough to reach their desired results.
How can fasting help fight aging?
How long does a facelift last?
While facelift results are permanent, as you continue to age, the structures in your face will continue to become laxer, resulting in further sagging and drooping. There are a range of treatments (like chemical peels, lasers, etc.) that can diminish the appearance of these progressive changes. After a certain point, some people may find that additional surgeries are required to maintain their new, more youthful appearance.
In addition, different surgical procedures in the head/neck region can further improve facelift results, and many of these can be done simultaneously with your facelift surgery. Some examples include neck lifts (platysmaplasty), eyelid surgery (blepharoplasty) done on the upper or lower eyelids, and brow lifts (also called forehead lifts).
Recovery after a facelift
It’s worth noting that it takes some time to fully see the results of a facelift. Right after surgery, you may notice bruising, swelling, numbness, and soreness in the area of the procedure—these are expected side effects of surgery. For the most part, it’s generally possible to go out in public and return to some of your usual activities within 10–14 days. However, it may take weeks to months for your face to feel normal again.
Risks of facelifts
Facelifts are invasive and come with possible complications similar to other low-risk surgical procedures that use general anesthesia. Anesthesia comes with risks and is not suggested for certain groups of people. The most common risks are bleeding, infection, problems with wound healing, blood clots, and cardiac events. But there may also be pain, scarring, prolonged swelling, or bruising at the incision sites. In some cases, there may also be hair loss at incision sites (Pérez, 2021).
Your recovery time may vary based on your medical history and how well you follow post-surgical instructions from your plastic surgeon. In some cases, you may get pain medication to help with some of the side effects of the surgery, such as incision site pain, swelling, and bruising.
Cost of facelifts
According to the 2020 statistics from the American Society of Plastic Surgeons, a facelift costs around $8000 on average. This price does not include anesthesia fees, surgery center charges, or other costs related to the procedure. If you are considering a facelift, make sure to discuss the total cost with your surgeon. Most insurance companies do not cover cosmetic procedures like facelifts (ASPS, 2021).
- Alexander, L. & Patel, B. C. (2021). Platysmaplasty facelift. [Updated Sep 10, 2021]. In: StatPearls [Internet]. Retrieved on Oct 20, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK563291/
- American Society of Plastic Surgeons (ASPS). (2021). 2020 Plastic Surgery Statistics Report. Retrieved from https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf
- Lassig, A., Bechtold, J. E., Lindgren, B. R., Pisansky, A., Itabiyi, A., Yueh, B., et al. (2018). Tobacco exposure and wound healing in head and neck surgical wounds. The Laryngoscope, 128(3), 618–625. doi: 10.1002/lary.26813. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015653/
- Pérez, P. & Hohman, M. H. (2021). Mid face facelift. [Updated Aug 26, 2021]. In: StatPearls [Internet]. Retrieved on Oct 20, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK563237/
- Raggio, B. S. & Patel, B. C. (2021). Deep plane facelift. [Updated Jul 25. 2021]. In: StatPearls [Internet]. Retrieved on Oct 20, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK545277/
- Shah, A. R., & Kennedy, P. M. (2018). The aging face. The Medical clinics of North America, 102(6), 1041–1054. doi: 10.1016/j.mcna.2018.06.006. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30342607/
- Shanbhag, S., Nayak, A., Narayan, R., & Nayak, U. Y. (2019). Anti-aging and Sunscreens: Paradigm Shift in Cosmetics. Advanced Pharmaceutical Bulletin, 9(3), 348–359. doi: 10.15171/apb.2019.042. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773941/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.