This article has been medically reviewed for accuracy by Atlanta, GA facial plastic surgeon Dr. Elizabeth Whitaker, MD, FACS on June 7, 2022.
With a 92% Worth It Rating, facelift surgery is one of the most popular—and commonly performed—cosmetic procedures. “It’s done to provide facial rejuvenation and improve signs of aging in the face and neck,” explains Dr. Samuel Lin, a board-certified plastic surgeon in Boston, and it’s the most effective procedure to consider when nonsurgical treatments simply aren’t cutting it anymore. But we’ve all seen what can happen when a facelift goes wrong, so it’s natural to have a lot of questions, if you’re considering one.
Here, we’ve rounded up 10 key things to know about facelifts, according to top plastic surgeons and RealSelf members who’ve had the procedure.
1. Find the right doctor and ask the right questions
A facelift is a major surgery, so it’s crucial you take the 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. You want to look for board certification, American Society for Aesthetic Plastic Surgery (ASAPS) membership, and whether they have completed a fellowship in plastic surgery. “Many providers may offer facelifts, but plastic surgeons who are certified by the American Board of Plastic Surgery (ABPS) are equipped to perform this procedure, given their extensive training in this procedure,” says Dr. Lin.
Go into your consultations with realistic expectations about what you will look like after a facelift. 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. “There is no ‘best age’ to have a facelift, but one of the most important questions to ask your surgeon is whether you are a good candidate for this surgery. Other questions you may consider asking include where the procedure will be performed, what type of anesthesia will be used, what surgical technique is recommended for you, and what the typical recovery period is,” recommends Dr. Lin.
2. Familiarize yourself with the different types of facelifts
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. 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 are minimal incisions.
“Each of these facelift variations addresses a different area and severity, which will be addressed during your consultation with a plastic surgeon,” Dr. Lin explains.
Additionally, many doctors offer liquid facelifts (a nonsurgical alternative that uses injectable fillers to give the face a fuller, more youthful look) and thread lifts, for those who aren’t facelift candidates or aren’t ready to undergo surgery quite yet.
3. Know your anesthesia and sedation options
“On the day of your facelift surgery, you may undergo general anesthesia, local anesthesia, or intravenous sedation, depending on the type of facelift surgery your doctor recommends,” Dr. Lin says. Both general and local anesthesia are safe when performed by a board-certified anesthesiologist, and the choice 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.
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.
“In addition to the cessation of these agents, it is important to prepare your home for recovery so you are able to relax during the process,” Dr. Lin says. Stock your kitchen with healthy foods, including soft foods that are easy to eat with minimal chewing. If your doctor has given you prescriptions for medicines you’ll need after surgery, fill those ahead of time.
A RealSelf member who had a facelift recommends having the following items on hand during recovery:
- Button-up pajamas: you want to avoid clothing that goes over your head
- Handheld mirror, to hold behind your head and look into your bathroom mirror so you can see where to apply the ointments and peroxide behind your ears and neck
- Hairpins, to keep your hair out of the way
- Peroxide, which keeps infection away and helps the healing process; apply it around the ears and chin area with a Q-tip
- 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 soap (or any other super gentle option), for washing your face after the first week
5. Set aside 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 members recommend rallying more help. “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.”
As for the pain level, experiences vary greatly. But Dr. Lin says it’s “usually mild and improves over the first few days.” After the first few days, you will likely switch from prescription pain medications to over-the-counter pain medications, like Tylenol. “However, it is important to avoid blood-thinning medications, such as NSAIDs [aspirin, Aleve, ibuprofen, etc],” notes Dr. Lin.
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.
There may be a lot of swelling and bruising immediately after surgery; some RealSelf members describe being shocked by how swollen and squinty their eyes looked and by seeing uneven lumps on their face. Know that this is normal and to be expected as well as temporary: “Most patients typically recover from a facelift over the course of one to three weeks,” says Dr. Lin.
6. Many factors affect the healing process
A patient’s age, health status, nutritional habits, and tobacco and alcohol use; the skill of the surgeon; and the quality of post-operative care all play a role in recovery speed. “Following your surgery, there are several steps you may take to ensure adequate healing and recovery,” Dr. Lin advises. “First, maintaining a position with your head elevated will help minimize postoperative swelling. You may also apply ice packs, to reduce swelling and help alleviate pain in the surgical area. Refraining from strenuous activity, using proper skin products on the face/surgical site, and avoiding smoking are all critical, to ensure proper recovery.”
“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 one community member 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.”
7. 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. “Temporary or permanent hair loss at the incision sites is rare and dependent on the type of facelift as well as the location of the incisions,” Dr. Lin notes, but it is possible. There is also sometimes overall thinning of the hair near the temples. Plastic surgeons plan the location of incisions to minimize the impact to your hair. Talk with your doctor about what to expect.
9. Take photos to track your results
RealSelf community members recommend taking photos of yourself to track your progress. You may be pleasantly surprised. “When I went into the OR, there was a picture on the wall of a lady,” writes a RealSelf member. “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.”
10. Be patient with the final outcome
Although many people are happy with their facelift results, not everyone gets the outcome they desired. “Side effects and complications after facelift surgery are rare but may include facial nerve injury weakness, fluid collection, infection of the surgical site, numbness or sensation changes of the skin, scarring, and skin discoloration,” Dr. Lin notes.
Small lumps or bumps also may appear after a facelift but are most likely temporary and may go away on their own. 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,” writes a RealSelf reviewer. “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!”
