Facelift (Rhytidectomy) at Highgate Hospital

What happens during a facelift operation?

A facelift is usually performed under general anaesthetic and usually takes two to three hours. The surgical technique will depend on what area is being lifted.

SMAS facelift - Your surgeon will make an incision on both sides of your face in the hairline around your ears. They will cut under the deeper layer of tough tissue (superficial musculo-aponeurotic system or SMAS layer), lifting and tightening it. Your surgeon will then tighten the skin towards your ears and remove any excess skin.

MACS facelift - The MACS (Minimal Access Cranial Suspension) face lift involves a smaller incision eliminating any scarring behind the ear. Your surgeon will tighten the SMAS layer with special suspension stitches to avoid cutting underneath it. MACS face lift involves less surgery but the results may not last as long as an SMAS facelift.

Mid-facelift - A mid facelift addresses the area below your lower eyelids over the cheekbone. Your surgeon will make small cuts along your hairline and either inside your mouth or in your lower eyelid. They will use special surgical instruments and stitches to lift the cheeks.

• Once you have recovered from the anaesthetic, you will be encouraged to sit up in bed
• Sitting upright will help to reduce some of the swelling
• Your face is likely to feel tight and tender around the ears
• However, there should not be any severe pain and this will be controlled with simple analgesia
• You may feel drowsy following surgery
• Expect to wake up and doze off for the remainder of the day
• You may have a bandage around your head and under your chin after surgery
• We will remove it the day after your surgery
• Small, thin tubes (drains) may be temporarily inserted in the wounds
• You are likely to stay in hospital overnight
• You may be given a support garment to wear after your bandages are removed. 

What happens during a mini facelift?

A mini facelift is usually performed under general anaesthetic and usually takes between 1 and 2 hours. Your surgeon will numb the area in front or just behind your ears. They will make a few small incisions in front or behind your ears and (depending on the extent of lift needed) along your hairline. They will extend and tighten the skin where needed. Your wounds will be closed using very fine stitches.

Going home after a facelift

• You may experience swelling and bruising following your face lift
• You may feel tightness when opening your mouth
• Your surgeon may ask you to sleep upright for the first few days to keep swelling under control
• Stitches can be removed after 10 to 14 days
• Be sure and discuss your return to work with your surgeon
• At around four weeks you will be feeling more like your “normal” self
• However the full effect of a facelift may not be visible for 6 to 9 months after the procedure.

Guide to stages of recovery from facelift surgery

Days 1 - 4

• Swelling is at its worst days 2 and 3 after surgery
• Sleep upright in bed supported by pillows. Icepacks will be soothing
• Wear any support garment as instructed
• Take things easy for now.

5 - 14 days

• Gradually increase your activity but nothing too strenuous
• Light housework and gentle walks are fine
• Stitches around the ear will be removed.

2 weeks

• Any remaining staples will be removed
• You can think About returning to work after two weeks
• Continue to Wear support garment at night.

4 weeks

• All the visible swelling and bruising should have gone by now
• Should be able to remove any support garment
• Restart any exercise you do.

6 - 9 months

• Scars will soften and fade
• Final result can begin to be judged.

Specific complications of a facelift may include:

• Loss of skin or hair
• Developing a collection of blood under the skin
• Developing pale or dark areas on your face
• Damage to the facial nerve
• Cosmetic problems.