A face-lift (rhytidectomy) is a cosmetic surgical procedure to create a younger appearance in your face. The procedure can reduce the sagging or folds of skin on the cheeks and jawline and other changes in the shape of your face that occur with age.
During a face-lift, a flap of skin on each side of the face is pulled back, and tissues below the skin are surgically altered to return the contour of the face to a more youthful shape. Before the flap is sutured closed, excess skin is removed.
A neck lift (platysmaplasty) is often done as part of a face-lift to reduce fat deposits and sagging skin on the neck.
A face-lift won’t decrease fine creases or wrinkles in your skin or damage from sun exposure. Other cosmetic procedures can address the appearance or quality of the skin itself.
A face-lift surgery can cause complications. Some can be managed with appropriate care, medication or surgical correction. Long-term or permanent complications, while rare, can cause significant changes in appearance. The risks include:
- Hematoma. A collection of blood (hematoma) under the skin that causes swelling and pressure is the most common complication of face-lift surgery. Hematoma formation, which usually occurs with 24 hours of surgery, is treated promptly with surgery to prevent damage to skin and other tissues.
- Scarring. Incision scars from a face-lift are permanent but typically concealed by the hairline and natural contours of the face and ear. Rarely, incisions can result in raised, red scars. Injections of a corticosteroid medication or other treatments might be used to improve the appearance of scars.
- Nerve injury. Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. Temporary paralysis of a select muscle, resulting in an uneven facial appearance or expression, or temporary loss of sensation can last a few months to a year. Surgical interventions may offer some improvement.
- Hair loss. You might experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be addressed with surgery to transplant skin with hair follicles.
- Skin loss. Rarely, a face-lift can interrupt the blood supply to your facial tissues. This can result in skin loss (sloughing). Sloughing is treated with medications, appropriate wound care and, if necessary, a procedure to minimize scarring.
In general, a face-lift involves elevating the skin and tightening the underlying tissues and muscles. Fat in the face and neck may be sculpted, removed or redistributed. Facial skin is then re-draped over the newly repositioned contours of the face, excess skin is removed, and the wound is stitched or taped closed.
The incisions for the procedure depend on the techniques that will be used and the patient’s preferences. Options include:
- A traditional face-lift incision starts at your temples in the hairline, continues down and around the front of your ears and ends behind your ears in your lower scalp. An incision might be made under your chin to improve the appearance of your neck.
- A limited incision is a shorter incision that begins in your hairline just above your ear, wraps around the front of your ear, but does not extend all the way into the lower scalp.
- Neck lift incision starts in front of your earlobe and continues around your ear into your lower scalp. A small incision also is made under your chin.
A face-lift generally takes two to four hours but might take longer if other cosmetic procedures are done at the same time.
After a face-lift, you may experience:
- Mild to moderate pain
- Drainage from the incisions