Facelift surgery (aka a rhytidectomy) is a facial rejuvenation procedure that can create transformative results. It’s the most effective way to address signs of facial aging, including significant sagging and deep wrinkles and nasolabial folds, with results that last a decade or more.
“A facelift is the singular cornerstone for facial rejuvenation,” says Dr. Stephen Prendiville, a facial plastic surgeon in Fort Myers, Florida.Â
All facelift procedures involve lifting soft tissue, repositioning and tightening the underlying muscles, removing excess skin, removing fat deposits in the neck, and re-draping the remaining skin, to give your face and neck a more youthful appearance.Â
Despite a hefty price tag and up to two weeks or more of downtime, it’s one of the more popular plastic surgery procedures.Â
There’s great debate among plastic surgeons about which facelift technique delivers the most long-lasting, natural-looking result. What’s most important is that a surgeon customizes their approach for each patient's specific anatomy and aesthetic goals.
See New York City-based facial plastic surgeon Dr. Dilip Madnani answer top questions from a RealSelf member who's considering getting a facelift.
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See real RealSelf members decide whether or not they want to go through with facelift surgery.
The cost of a facelift can vary widely, depending on the extent of your procedure as well as your surgeon’s level of training, experience, practice location, and the specifics of your surgery. While RealSelf members have reported facelift costs as high as $30,000, some Instagram-famous NYC surgeons reportedly charge as much as $150,000.
Related: Facelift Costs: What Exactly Are You Paying For?
This is an elective cosmetic procedure that's not covered by insurance, but most surgeons accept third-party financing options like CareCredit.
As you're choosing your facial plastic surgeon, look for facelift pictures that show carefully hidden, thin scars, natural-looking ears and sideburns, cheeks that look lifted without being pulled, facial symmetry, a crisp jawline, and a smooth transition to the neck. Most importantly, the patient should look significantly younger while still looking like themselves.
The pictures in our facelift photo gallery were shared by the surgeon who performed the procedure, with the patient's consent.
The optimal age range for facelift surgery is usually from your 40s into your 60s, but if you’re healthy and have obvious laxity, it's possible to have the procedure in your 30s or well into your 80s.
“The ideal patient should have visible aging of the face—descent of the cheeks, [prominent] jowls and marionette lines, face and neck laxity, and banding in the neck—and the desire to do something about it,” Dr. Prendiville says.Â
Good candidates are also nonsmokers in generally good physical and mental health, with no serious underlying medical conditions. Your surgeon will ask about your medical history during a consultation. Here's how to tell whether you're a good candidate.
There are two primary techniques for full facelift surgery: a SMAS lift and a deep plane facelift.
Both methods reposition the deep tissues of the face, primarily the SMAS (superficial musculoaponeurotic system), which is a sheet of firm facial tissue (fascia) covering the muscle layer of the face. The platysma muscle of the neck is also resuspended during most facelifts.
While facelifts of old stretched and resized the skin only (often giving a windswept look), all modern procedures, both SMAS and deep plane, address both the skin and the SMAS.Â
The type of facelift your surgeon performs will come down to their preference—the technique they’re trained in and feel most confident delivering—as well as your needs, anatomy (your skin thickness and quality, the fullness of your face, the angles of your neck, your bone structure), and your desired results.Â
Regardless of which approach your surgeon favors:
All SMAS facelifts involve lifting up the skin and manipulating the SMAS to restore the contours of the face. During the procedure:Â
Under the SMAS umbrella, there are various kinds of facelift techniques, two of the more popular being the SMAS imbrication and the SMASectomy. Surgeons commonly put their own spin on these textbook procedures, extending the degree of dissection, mobilizing the SMAS to a lesser or greater extent, or adjusting the direction of lift (aka the vector).Â
Learn more about SMAS facelifts
With a deep plane facelift:Â
Proponents of the deep plane technique say the results are more natural-looking and longer-lasting, but certain studies have found no major differences between the two techniques in patients under 70 years old, even when comparing the results over a 10-year period.Â
When someone has thick facial skin and a very full face, a deep plane lift may provide better support. In the spirit of customizing the procedure to the patient, “many surgeons will vary their facelift technique depending on anatomic considerations, such as the width and shape of the face, the patient’s skin thickness, and the distribution of subcutaneous fat,” says Dr. Ridenour.Â
Learn more about deep plane facelifts
A short-scar or mini facelift involves making a limited incision, primarily in front of the ear and into temporal hair tuft, explains Dr. Ridenour. “The short-scar facelift is typically done in younger patients who have modest sagging of skin,” he says.
One type of mini lift is a lower facelift, which focuses primarily on the jawline and neck, explains Dr. Ridenour. “A lower facelift may tighten only the platysma, or neck muscles, rather than the entire SMAS layer, and can be good for younger patients with early aging of the lower face.”
While mini lifts vary in scope and intent, outcomes tend to be less dramatic and less durable than those of traditional facelifts.
RealSelf Tip: “Ponytail facelift” is a marketing term with no standard medical definition, but it typically refers to a limited endoscopic lift. “The most common elements of a ponytail lift are the elevation of the midface, cheek structures, and jowls using small incisions” hidden in the hairline, explains San Francisco plastic surgeon Dr. Carolyn Chang. “Often, an endoscope is employed and suture suspension [is used] to achieve the results” (though some surgeons may skip the camera). Since a ponytail lift doesn’t allow for skin removal, it’s most appropriate for younger patients with early signs of aging.
Most full facelifts include a neck lift. The surgeon elevates the skin off the neck’s platysma muscle (an extension of the facial SMAS layer) and tightens that muscle.
The platysma can usually be accessed through the same facelift incision sites around the ears, but sometimes an incision under the chin is necessary—especially in the case of severe skin laxity and platysmal banding (when the muscle is seen as two vertical bands that run the length of the neck, from jawline to collarbone).
Platysmal banding can be corrected by cutting and suturing the muscle through a small incision under the chin.Â
Through this same incision, any excess fat above the platysma muscle can be removed with liposuction, while the deep fat underneath the platysma muscle must be surgically removed. This typically includes a platysmaplasty for more dramatic contouring, according to Dr. Portuese.
Related: Lower Facelift vs. Neck Lift: What’s the Difference?
You’ll be through the worst of facelift recovery after 7–10 days and looking pretty presentable by 2 weeks post-op.Â
That said, the first week can be rough—you’ll be swollen, stiff, and sore—especially if you’ve tacked on additional procedures like laser resurfacing, rhinoplasty, facial fat grafting, and/or eyelid surgery, all of which can dramatically compound puffiness and discomfort.
Following facelift surgery, you’ll be on a soft-food diet for the first few days, drinking only from glasses or cups (the sucking motion of straws can be painful), so stock up on smoothies, bland soups, and easy-to-chew foods that are high in protein.
You’ll also want a firm cushion that can elevate your head while you rest, since regular pillows can put pressure on your ears.Â
“As you begin to heal, you may experience itchiness, swelling, and some tightness, which is completely normal and subsides within the first few weeks,” says Jupiter, Florida, plastic surgeon Dr. Jason Cooper.
Facelift recovery time depends a lot on how your body heals, but this is a typical day-by-day timeline.
You may notice very minor swelling, bruising, tightness, and even numbness for up to a year, but it’s rarely noticed by others.
RealSelf Tip: Dr. Prendiville tells his patients to eat well so they can heal well. That means a diet high in protein and also avoiding fish oil, alcohol, ginkgo biloba, vitamin E, and other blood thinners (which can prolong bruising).
You'll be under anesthesia during the surgery itself, so you won't feel any discomfort.Â
Once the anesthesia wears off, it's recommended that you stay ahead of any pain you may feel for the first two to four days with prescribed pain medication.Â
Everyone experiences pain differently, but you can expect to feel swollen, bruised, and tender for the first two weeks of recovery, with the worst swelling between 48 and 72 hours after surgery, says Dr. Prendiville.Â
Avoid bending over or doing any heavy lifting for two weeks, to help prevent excessive swelling.
You can use cold compresses (crushed ice in a bag, a soft ice pack, or even a frozen washcloth) to help reduce swelling and bruising, and ease the discomfort. Gently apply the compress to your face, 20 minutes on, 20 minutes off, during the first 48 hours.
Facelift surgery has a complication rate of 1.8%, according to a 2015 study. There is a lack of data on general facelift complications, because as the authors note, “A plethora of accepted techniques exist for facelift surgery, as well as significant individual surgeon variation, leading to inconclusive data on outcomes.” This analysis doesn’t focus on any one specific style of facelift or the outcomes of one particular surgeon; it looks at 11,300 facelifts performed between 2008 and 2013, and the complications that arose in this group of patients. Â
Facial nerve injury is possible, but the chance is extremely low, and it’s typically not permanent. “Facial nerve palsy and facial muscle weakness following a facelift are almost always temporary, with full recovery by three to six months [afterward],” says Tampa, Florida, plastic surgeon Dr. Jaime Perez.
A 2019 analysis of complication rates between different types of facelifts found “that all rhytidectomy approaches have a comparable and safe complication profile.” The authors conclude that “the choice of rhytidectomy technique should primarily be made on the basis of the quality of the result rather than the presumed complication rate.”
You should have a more lifted, youthful appearance for 10 years or more.
While you're effectively turning back the clock, the natural aging process will still continue and signs of aging will continue to accrue.Â
Consistent skin care—a gentle cleanser and moisturizer, a vitamin C serum, a nightly retinoid—can help extend your results by safeguarding skin health and elasticity.Â
Additionally, “wearing sunblock, [practicing] good nutrition, getting enough sleep, and trying to minimize stress are wonderful ways to keep your skin and the results of your facelift looking their best,” says Raleigh, North Carolina, plastic surgeon Dr. Michael Law.
These less invasive alternatives to a facelift can’t deliver results on par with a surgical lift, but they may be good options for those who aren’t ready for surgery.
Before deciding on a facelift procedure, schedule a “facial rejuvenation” consultation with a board-certified facial plastic surgeon. Your doctor can discuss both surgical and nonsurgical options to address your aging skin.
Updated May 9, 2023