16 Things I Wish I Knew Before Getting a Facelift
- Last updated: 3 months ago
A facelift is one of the most popular and highest-rated treatments onsite, with a RealSelf Worth It Rating in the mid-90s. This surgical solution to lifting sagging skin and reducing wrinkles is also the most effective procedure to consider when non-surgical treatments aren't cutting it anymore.
As with all surgical options, many people have questions about facelifts and what to expect. Here are 16 tips from RealSelf doctors and community members that you might find helpful when considering a facelift.
1. Find the right doctor.
A facelift is important surgery, so take time to find the right doctor. Read reviews and consult with multiple plastic surgeons to address all your concerns. Investigate your potential doctor's qualifications to ensure that they have ample experience. Look for board certifications, ASAPS membership, and that he/she has completed a fellowship in plastic surgery.
“Find out who the other surgeons go to for their facelifts,” says community member yogajan in a RealSelf review. “If you spend more time with a ‘closer’ than you do with the surgeon, run. They work on commission and try to sell you more surgery than you may need. Fancy addresses are just geography and have nothing to do with the results you get. Also, you are paying for those high rents. Go for the best surgeon, not the best address. Go online and check out the programs for plastic surgery meetings and see who is invited by their peers to lecture. It may give you some idea who is respected professionally; though not a guarantee, but something most of us have not considered.”
2. What to ask during your facelift consultation.
It’s important to have realistic expectations about what you will look like after a facelift. Talk to the doctor about what you can realistically expect. Look at before and after photos to see what the doctor’s work looks like, and, if possible, talk to the doctor’s other patients.
“When interviewing the doctor's patients, focus in on the stitch sites,” says community member David22 in a RealSelf review. “If there are visible scars after eight months, most likely the doctor did not take the time to do the best job. Remember you are not his patient just to make him money, you have elected to do this for results which should last for awhile.”
3. There are different types of facelifts.
Facelifts come in a few different forms, and each doctor may mean something slightly different when they use these terms. But in general, there are three terms doctors commonly use to refer to surgical facelifts:
- A comprehensive facelift lifts and tightens the upper face, lower face, and neck. Incisions will usually be placed in front, within, and behind the ear.
- A mini lift or lower facelift addresses only the bottom third of the face. It uses shorter incisions and less skin removal than a full facelift. Often performed under local anesthesia, it is a quicker and less invasive procedure, but the results may not last as long.
- A cheek lift or midface lift addresses the signs of aging around the cheekbones. There will be minimal incisions.
There are many other terms for types of facelifts, but doctors recommend that you choose a well-qualified surgeon first. “Don't get too hung up on the type of lift,” says Dr. Darrick Antell, a New York plastic surgeon, in a RealSelf Q&A. “You're paying your surgeon to apply their expertise to you in order for the surgeon to pick the best technique for you.”
Two other procedures are sometimes offered as alternatives. Many doctors offer a liquid facelift, a non-surgical alternative using injectable fillers to give the face a fuller, more youthful look. A thread lift is another alternative, in which non-absorbable stitches are left in the face.
4. Prepare for your facelift.
Your plastic surgeon will provide you with pre-op instructions, including a list of medications to avoid or stop taking. Certain medications and supplements can thin the blood, and could cause increased bleeding during surgery. Arrange for someone to drive you home after the surgery and for someone to stay with you for at least the first 24 to 48 hours after. Many people find that consuming a low-salt diet before the surgery keeps swelling to a minimum.
See also: Top 10 facelift tips.
5. Have the right items for recovery.
Stock your kitchen with healthy foods, including soft foods that are easy to eat with minimum chewing. If your doctor has given you prescriptions for medicines you’ll need after surgery, fill those ahead of time.
Community member Angellady65 also recommends the following items in a RealSelf review:
- Button-up pajamas. Avoid clothing that goes over your head.
- Handheld mirror to hold behind your head and look into your bathroom mirror, so can see where to apply the ointments and peroxide behind your ears and neck.
- Hairpins to hold your hair out of the way so you can see to apply ointments and peroxide.
- Peroxide, Q-tips and baby shampoo. The peroxide keeps away infection and helps the healing process, apply using a Q-tip around the ears and chin areas.
- Witch hazel for areas where the sutures are in the hair, as peroxide will bleach out your hair.
- Hot water bag to put ice in.
- Dove, or super gentle, soap for washing your face after the first week. Skin will be dry at first and this will help since you can’t use harsh soaps or lotions.
See also: 10 supplies for your facelift recovery.
6. Some hair loss or thinning is possible.
After surgery, you will have to wait at least a day before washing your hair and at least six weeks before you can have your hair cut and colored. A facelift can cause temporary hair loss around the incisions. There is also sometimes overall thinning of the hair near the temples. Plastic surgeons plan the location of incisions to minimize impact to your hair. Talk with your doctor about what to expect.
“Do something drastic with your hairstyle beforehand,” says Angellady65 in a RealSelf review. “Everyone seems to think it's my haircut that makes me look different. I had a guy come up to me again just last night and tell me that my new style makes me look 10 years younger. I wanted to smack my husband when he started snickering!”
Related Q&A: Hair loss after brow, face, and neck lift.
7. Take ample time for recovery.
You will need someone to drive you home after surgery and someone to stay with you for the first 24 to 48 hours, but RealSelf community members recommend rallying more help. Your doctor will advise you about physical activity, but typically you should not lift anything heavier than a gallon of milk for the first week. You will also need someone to drive you to post-op appointments.
“Don’t plan to go back to work too soon,” says Dr. Parker A. Velargo, a New Orleans facial plastic surgeon, in a RealSelf video. “You need at least a couple of weeks before most of your swelling and bruising are gone.”
“Don’t try going through this alone,” says community member Angellady65 in a RealSelf review. “Have a close friend or nurse stay with you the first week at least. My husband took off two days...that was not enough! You will need their help, if only to help take care of the incision areas. You won’t want to and shouldn’t do much the first week. Let someone pamper you.”
8. You might be shocked by your post-op appearance.
There may be a lot of swelling and bruising immediately after surgery. Some people are shocked by their appearance, especially since they may be so swollen that their eyes look slanted and their face looks lumpy. That will likely continue for at least a week.
“The surgery itself went smoothly, and I was out of it for much of that day,” says community member trekker in a RealSelf review. “I awoke to the pain from hell and when I felt my face it was all puffed up. I could hardly feel a person under there! When I looked in the mirror for the first time I was also bruised everywhere (and I mean EVERYWHERE). I didn’t look in the mirror much after that!”
Related video: Dr. Marie Montag explains facelift recovery.
9. These things help swelling.
After a facelift, there are a few things you can do to reduce swelling. Elevate your face as much as possible. That means sleeping in a recliner or propped up on pillows. Ice the swollen areas, avoid blood-thinning medications, and ask your doctor about how Arnica montana might help.
“Swelling of your face is a weird thing,” says community member truckin 916 in a comment on a RealSelf review. “First off, swelling falls down your face, so your neck will be the last to relax. Swelling also tends to go from one side of your face to the other. Wait it out. I have had several procedures over the years and know that if a doctor tells you, 'wait two weeks and you can go back out in public,' you can at least double that time.”
10. Healing after a facelift takes time.
“There are many factors that influence facelift recovery time,” says Dr. Brock Ridenour, a St. Louis facial plastic surgeon, in a RealSelf Q&A. “Among them are the patient's age, health status, nutritional habits, tobacco and alcohol use, the skill of the surgeon, and the quality of post-operative care.”
RealSelf community members also advise being patient with the process.
“I have been told by my surgeon that it takes up to one full year to be completely healed from a facelift and for things to settle in,” says community member Redmond852 in a RealSelf review. “The hardest part about any of these procedures is being patient and giving oneself time. We all want it to go faster, but everyone heals at their own rate. So, be patient and you will be thrilled with the end result.”
Related Q&A: How long before complete facelift/necklift recovery?
11. The pain level will be different for everyone.
You may have quite a bit of pain after your facelift, or very little. “Patients usually do not have pain, but more of a ‘tight’ sensation that relaxes somewhat over the coming months,” says Dr. Anand Patel, a Brookfield, Wisc., plastic surgeon, in a RealSelf Q&A.
“After surgery the doctor gave me drugs that really knocked me out, and I remember little about coming home or settling into bed,” says community member Boston9280 in a RealSelf review. “The next few days were a trip. I have read that facelifts are ‘almost completely painless.’ That you only need Tylenol. NO NO NO. I was in pain. Not excruciating, but enough that I used my pain meds to sleep through much of it for the next few days. My face really swelled up, and I looked like an egg! But a young egg. Yes, it was evident immediately that my jaw was tight and my cheekbones restored, thanks to a temporal lift with the face lift.”
12. Ask about options for anesthesia and sedation.
Some facelifts are done under general anesthesia and others with local. Doctors say both are safe when performed by a board-certified anesthesiologist. The choice of anesthesia depends on the procedure, your surgeon’s preference, and your tolerance for pain. Doctors note that it can be difficult for a patient to lie still for a comprehensive facelift, which can take three hours or more.
Surgeons who use local anesthetic often combine it with sedation, either something you take by mouth, like Valium, or through an IV. “The beauty of IV sedation is that during the procedure you are unaware of anything going on and cannot hear anything, yet you are still breathing on your own,” says Dr. Sam Naficy, a Seattle facial plastic surgeon, in a RealSelf Q&A.
13. Take it easy when returning to daily life.
Most people are ready to go back to work in a week to 10 days, but it depends on what you do and how you feel about your appearance.
“I allow patients to drive after four days if they are off pain meds,” says Dr. David Mobley, a Sarasota, Fla., plastic surgeon, in a RealSelf Q&A. “Before this, some mild neck stiffness may make driving safely more difficult since you may not turn your head as far to look for cars. Recovery from a facelift involves bruising (usually down low along the neck) and swelling, which increases some each day for the first four days after surgery. On the fifth day after surgery this begins to improve rapidly, and usually by the seventh or eighth day makeup can be applied. Patients often tell me with a scarf and some sunglasses they can run quick errands.”
People often use a turtleneck or scarf to cover neck swelling and bruising, and hairstyles or a hat to cover incisions around the ears. Men sometimes grow a beard.
“After the surgery, I won't lie, it hurt,” says community member Signwench in a RealSelf review. “But nothing I couldn't handle. I was back at my office in less than one week. I work for myself and could take it easy. I wouldn't suggest going back that soon for most folks.”
14. Take photos to track results.
RealSelf community members recommend taking photos of yourself to track your progress. You may be pleasantly surprised.
“When I went into the O.R. there was a picture on the wall of a lady,” says community member FL721 in a comment on a RealSelf review. “I wondered who that old, tired-looking lady was. When I went for my first follow-up appointment, the picture was in my file. I asked who it was, and the doctor said it was me! I had no idea I looked that old. I honestly didn't know I looked that bad until I saw the pictures he took in February. My surgery looks good—I look maybe seven years younger—but not half as tired as I looked in February.”
15. Lumps, bumps, and side effects.
Although many people are happy with their facelift results, not everyone gets the outcome they desired. Small lumps or bumps after a facelift are most likely temporary and may go away on their own. Or they could also be small blood clots in the tissue, the effects of swelling, or ridges from fat removal.
“I had lumps along my cheek and was very concerned,” says community member Dee in a RealSelf review. “They are completely gone now. They went away in about four months. I was completely healed in six months. The numbness is also gone with the exception of under my chin. It's not completely numb, just a slightly different feeling. It's been about 10 months since my procedure, and I am very pleased. No regrets! It's just hard to be patient while healing. Hang in there!”
Related Q&As: Lumps that persist after facelift and neck lift.
16. What’s the best age to get a facelift?
Sometimes people wonder when is the best age to get a facelift. Should they get a facelift earlier, to prevent sagging from getting worse, or wait until they’re older?
“There is no specific age as to when patients should have their first facelift,” says Dr. William Portuese, a Seattle facial plastic surgeon, in a RealSelf Q&A. "The goal of a facelift is to tighten up the jowls, remove the fat in the neck both above and below the platysma muscle, tightening the muscle cords in the neck, and facial skin laxity is also tightened.
"Some patients have earlier signs of aging, say in their late 40s, while other patients remain rather tight into their early 60s. It really depends on when the aging process begins to show and when the patient is emotionally and physically ready for a facelift. Patients can undergo a facelift in their 70s, however the skin tone is somewhat loose and will not last as long.”
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