A facelift is a cosmetic procedure that changes a person's appearance. Facelifts aim to reduce lines, wrinkles and other visible signs of ageing. Your face may be less lined and possibly appear more youthful after the operation. However, a facelift doesn't stop the ageing process.

What is a facelift?

A facelift is a surgical procedure to lift and tighten the face and neck tissues. Facelifts also reduce sagging skin on a person's face. The operation might also involve:

• tightening of facial muscles
• removing or redistributing fat from the neck, jowls and face
• taking fat from other parts of the body, such as the abdomen, and putting it in areas like the cheeks.

A facelift is also known as a meloplasty or rhytidectomy.

A facelift can be combined with other procedures like a brow lift, eyelid surgery or a nose reconstruction.

A facelift is a surgery, however there are non-surgical options such as fillers, dermabrasion, and thread lifting.

If you are thinking about a facelift

If you are considering a facelift, you should be physically healthy. You should not have any medical conditions that might make it harder to heal after surgery. You also need to have stopped smoking.

The most important thing is to have realistic expectations. A facelift usually lasts 5 to 12 years, then might need to be repeated. Repeat procedures may lead to further scarring.

A facelift can make you look younger temporarily, but it can't stop the ageing process. It can reduce sagging, creases and fatty deposits in areas such as:

• the mid-face
• jowls
• chin
• under your lower eyelids
• along the nose

A facelift won't:

• remove deep frown lines on your forehead
• remove wrinkles around your mouth
• change your eyelids
• raise sagging eyebrows

Ageing is a normal, natural process. You don't need to appear young to be respected, develop relationships, or get a job. Not everyone wants or needs a facelift, and there are alternatives to achieve a more youthful appearance for those that do.

You should be aware that the government and medical profession have concerns about facelifts. The Medical Board of Australia has issued guidelines to doctors to ensure that:

• Anyone having any major cosmetic surgery (involving cutting beneath the skin), including a facelift, meets with the surgeon before scheduling any surgery. They also need to wait through a compulsory cooling off period before the surgery can take place.
• The treating doctor is satisfied that the person considering cosmetic surgery is in good psychological health. If the doctor is unsure about this, and how it may affect the person's suitability for a facelift, they need to refer them for an independent psychological assessment.

A facelift might boost your self-esteem, however it will not treat psychological conditions such as depression and body dysmorphic disorder. Speak to your doctor if you need support.

Healthdirect has more information about cosmetic surgery in general.

How do I choose a surgeon?

If you are considering a surgical facelift, it is important to choose a surgeon you feel comfortable with. Your surgeon should speak to you honestly about the benefits and risks of any surgery.

The Australian Health Practitioner Regulation Agency (AHPRA) has a register of medical practitioners. You can check this register to ensure your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS). You can also check if the surgeon has had any serious disciplinary action taken against them.

Some people consider having cosmetic surgery overseas, but there can be many problems with this.

What questions should I ask before surgery?

There are many things to consider before agreeing to any operation. Questions you might ask the surgeon include:

• What are the risks of this operation for a person in my state of health?
• How many facelifts have you performed?
• How often is a second procedure required?
• Is this the best option for me?
• Can you show me before and after photographs of other patients?
• How long is my recovery likely to take?
• What is the cost?

You can also use the Question Builder tool to create your question list for the appointment. Prepare your list, then print or email it so you remember what you want to ask.

How to prepare for a facelift

Your surgeon will need your full medical history and will discuss your expectations. Take notice of any pre-surgery instructions.

You might be asked to:

• stop taking certain medicines, including those containing aspirin, around 2 weeks before surgery
• quit smoking

What happens during a facelift procedure?

The type of facelift procedure you have will depend on what you have agreed with your surgeon. You will be given a local or general anaesthetic.

Full or traditional facelift: The surgeon is likely to make an incision (cut) that follows your hairline from the temples, around the ears and down to the lower scalp. If needed, a small incision may also be made under your chin to give access to the neck.

The surgeon will then raise the skin away from the face and reposition the underlying muscle and tissue. They might remove or redistribute facial and neck fat.

Sometimes fat is collected by liposuction from elsewhere in the body, such as the abdomen. This may be used to plump up the cheeks or other parts of the face.

The surgeon repositions the skin over the face and neck. They will also trim any excess skin. They sew, staple, or tape the incisions closed and apply a dressing. Sometimes a small thin drainage tube is placed under the skin to remove excess blood or fluid.

Mini or limited incision facelift: This operation is a minor variation of the full facelift, with shorter cuts around the hairline. Additional cuts may be made in the lower eyelids or under the upper lip.

Neck lift: This operation focuses on removing fat and sagging skin in the neck area. The incisions are usually done around the ears and under the chin.

What should I expect after a facelift?

Some facelifts are a day procedure. However, your procedure might require a short stay in hospital, so it is best to prepare a bag. The day after surgery, the doctor is likely to remove any drainage tubes and put fresh dressing on the wounds. You will need to return to have the stitches taken out, usually after a week.

You are likely to have pain, bruising and swelling around the site of the operation. Your doctor may prescribe pain relief medication. Sleep with your head elevated to reduce the swelling.

Contact your doctor if you have:

• heavy bleeding from the wounds
• increased redness around the incisions
• a temperature higher than 38°C
• excessive swelling around the surgery site
• lower leg swelling
• difficultly breathing
• pain not controlled by prescribed pain relief medication

What are the risks of a facelift?

Like any surgery, a facelift procedure comes with risks. You should discuss the risks in detail with your surgeon. You should also discuss the risks of anaesthetic with your anaesthetist.

While most operations go smoothly, the risks of facelift surgery include:

• heavy bleeding
• infection that might require antibiotic treatment
• blood clots and deep vein thrombosis
• need for a skin graft
• abnormal, unsightly scarring
• numbness or changes of sensation
• persistent pain
• prolonged swelling
• skin discolouration
• hair loss around the scars (usually temporary but it may be permanent)
• deformed ear lobe
• an unbalanced looking face
• damage to the facial nerve, which can make the face look lopsided (in about 1 in 100 patients)

You may need a revision of the operation to correct complications.

Non-surgical facelift options

You may want to consider a non-surgical facelift. Some facial rejuvenation procedures include:

• Peeling: Chemical peel treatments that refine the surface of the skin. These can improve blemishes and wrinkles.
• Dermabrasion: Mechanical treatment that smooths the skin.
• Fillers: Cosmetic injections that can reduce wrinkles, scars, fine lines, and provide volume.
• Thread Lift: Also known as suture lifting or a PDO thread face lift, this is a less invasive facelift procedure. Threads are inserted under the skin to tighten facial muscles and improve the appearance of sagging skin.

How much will a facelift cost?

The cost of a facelift varies from patient to patient. It also depends on the:

• surgeon's fees
• anaesthetist's fees
• clinic or hospital fees
• cost of medication, dressings, and support garments
• medical tests needed

Your surgeon and anaesthetist must provide you with information in writing about the cost of a facelift. This should include:

• the total cost
• details of deposits and required payment dates
• payments for follow-up care
• possible further costs for additional revision surgery or treatment

Medicare doesn't cover the cost of cosmetic surgery and generally private health insurance doesn't either. However, some of the cost might be covered if the facelift is done as part of a reconstructive procedure to correct deformities or treat traumatic injuries.

Where can I get more information on facelifts?

If you are considering a facelift, you should first discuss it with your doctor. More information is also available on the Australasian Foundation for Plastic Surgery website, and in our guide to cosmetic surgery.