Facelift (Rhytidectomy)
Filters are great,
but great skin is better.
Average Stay
2 weeks
Duration of Hospital Stay
1 day
Duration of Operation
2-4 hours
Type of Anesthesia
General Anesthesia
Recovery Time
2 weeks
What is a facelift?
Facelift surgery (aka a rhytidectomy) is a facial rejuvenation procedure that can create transformative results. It’s the most effective way to address significant sagging and smooth deep wrinkles and folds, with results that last a decade or more.
A facelift is the singular cornerstone for facial rejuvenation.
The technique can be customized for each patient's anatomy and aesthetic goals, but the procedure usually involves lifting tissues, tightening the underlying muscles, removing excess skin, and re-draping the remaining skin, to give your face and neck a more youthful appearance.
What is the best age for a facelift?
The optimal age range for facelift surgery is usually from your late 40s into your 60s, but it's possible to have the procedure well into your 80s.
The ideal patient should have visible aging of the face—descent of the cheeks, jowls and marionette lines, face and neck laxity, and banding in the neck—and the desire to do something about it.
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.
How does a facelift work?
There are two primary methods of full facelift surgery: an SMAS lift and a deep plane facelift.
The SMAS, which stands for superficial musculoaponeurotic system, is a sheet of firm facial tissue, or fascia, covering the muscle layer of the face. Every modern facelift addresses the SMAS in some way.
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 skin thickness and quality, the angles of your neck, your bone structure, and your desired results.
Regardless of the facelift technique used, surgeons make discreet incisions either inside the ear (tragal incision) or in front of the ear (pre-tragal incision), following the natural crease by your earlobe.
During a SMAS lift, the skin is lifted off the SMAS and muscle layer, which is tightened before the skin is redraped onto deeper tissues and any excess or loose skin is removed.
With a deep plane facelift, the skin and SMAS are lifted and tightened together, as one composite unit. Proponents of the deep plane say the results are more natural-looking and longer-lasting, but observational 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. 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.
A short-scar or mini facelift involves making a limited incision, primarily in front of the ear and into temporal hair tuft. (With a traditional facelift, the incision also extends along the hairline and behind the ear.) The short-scar facelift is typically done in younger patients who have early aging and modest sagging of skin.
A facelift is usually done under either general anesthesia or local anesthesia with IV sedation.
Once you’re unconscious or sedated, your face will be injected with a mix of lidocaine, epinephrine, and tranexamic acid, to numb the area and minimize bruising.
For a SMAS lift, our surgeon will make incisions in front of and behind the ears. They’ll separate the skin and fatty tissue from the SMAS before lifting the muscles, securing them with sutures, and redraping the skin. Then they’ll trim away any excess skin and close the facelift incisions with tiny stitches.
With most modern facelifts, the muscular substructure of the face is lifted upward, the muscular structure of the neck is pulled sideways, and the skin is gently redraped on top, almost like smoothing a bedsheet. This differs drastically from skin-only lifts of the past, which left patients looking overly pulled, tight, and windswept.
With a deep plane lift, the surgeon creates a composition flap that includes skin, fat, and SMAS, which are lifted and repositioned as one unit. The muscular structure of the neck is also lifted and supported. Tension-bearing sutures are placed in the SMAS layer.
What’s the difference between a full facelift and a lower facelift?
While a traditional full facelift addresses sagging in the cheek (mid-face), jowl, and neck, a lower facelift focuses primarily on the jawline and neck.
The incision locations are similar, but a lower facelift may tighten only the platysma, or neck muscles, rather than the entire SMAS layer. A lower facelift can be good for younger patients with early aging of the lower face.
How long does a facelift take?
Facelift surgery typically takes anywhere from 2 to 4 hours, depending on the skill of your surgeon and the technique they use.
You’ll need additional time in the recovery room as the anesthesia wears off and the nurses ensure that you’re doing well.
What happens during facelift recovery?
After surgery, you’ll be discharged to go home, with bandages on your face and head and possible a drainage tube. You’ll be very groggy, so make sure you have a trusted friend, partner, or family member take you home and stick around for the first night, to monitor how you’re feeling.
You’ll be on a soft-foods 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 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.
As you begin to heal, you may experience itchiness, swelling, and some tightness, which is completely normal and subsides within the first few weeks.
Facelift recovery time depends a lot on how your body heals, but this is a typical timeline.
Day 2: The day after surgery, you’ll have a follow-up appointment. Our surgeon will remove the surgical dressing and evaluate your facelift incisions as well as any bruising or swelling. They’ll also remove any drains that had been placed to prevent fluid buildup. You’ll be sent home in fresh bandages or no bandages at all, depending on how you’re healing. You can bathe the day after your surgery, but if you still have bandages on, avoid getting your head wet.
Day 3–4: Bruising and swelling are at their max at this point. Take only your prescribed pain medication for the first few days of recovery, not aspirin or other over-the-counter painkillers. Day 3–5: You’ll have another follow-up appointment within five days, and any remaining bandages will be removed. Our doctor may give you a removable elastic strap to wear for support. You’ll care for the facelift incisions by cleaning them with saline and applying a thick ointment, such as Vaseline or Aquaphor. You can wash your hair with warm water, using baby shampoo. Gently let the water run through your hair, to remove any dried blood, surgical soap, and normal residue, and don’t disturb the staples or sutures. Avoid letting shower water hit your face. Pat your face dry and let your hair air-dry (blow-dryers can be too hot). You’ll also want to skip makeup and your regular skin-care regimen until your surgeon gives you the green light.
Day 7: Stitches and sutures are removed around this point. You’ll be allowed to do light housework or other activities, if you feel well enough. Some patients choose to return to work at this time, but many wait for most of the swelling to go down (around the two-week mark). Don’t bend over; lift anything heavy; or bump your head, face, or neck—this can cause bleeding.
Week 2: You can resume sleeping on your side, but don’t sleep on your stomach until our doctor says it’s safe to do so.
Month 1: Typically, after 30 days, you should be back to your regular routine. Avoid elevating your heart rate for four weeks—skip the cardio and weight lifting, though walking is okay.
Month 3–4: During the first three or four months after surgery, stay out of the sun and apply sunscreen with a high SPF.
You may notice very minor swelling, bruising, tightness, and even numbness for up to a year, but it’s rarely noticed by others.