The facelift procedure

The facelift surgery procedure is divided into three steps. These include what happens before, during and after a facelifting. On this page the two first steps are discussed.

All about facelift surgery (face lift)

Planning a facelift

Facelifts are highly individual. Before reaching a decision you will need to book a consultation with a plastic surgeon. During your first visit your surgeon will examine your face, your skin and your underlying structure. Thereafter you will discuss your aims of the surgery, which method is suitable and what the surgeon things can be achieved as well as the risks involved.

Face lift surgery procedureThe surgeon will also examine your general health in order to make sure there are no medical conditions that can influence your safety, such as high blood pressure, metabolic diseases, heart troubles, blood clotting or tendencies for extensive scarring. Make sure to tell your surgeon about all medicines and other supplements you are taking.

Pain relieving tablets that contain Acetylsalicylic acid or vitamin E should, due to their anticoagulant effect, be completely avoided for two whole weeks before and after surgery. Also food containing garlic should be avoided since this also can increase bleeding.

You will also be provided with instructions about how you are to take care of your hygiene in order to minimise the risk of infection in conjunction with your facelift. This includes a so called, preoperative wash which involves taking a double shower twice and washing your body and hair with Decutan or Hebiscrub, the day before your facelift. These are available at the pharmacy. The night before your facelift you will need to sleep with clean bed linen and on the day of surgery you will be required to perform a third double shower before going to the clinic.

Be aware that you surgeon will severely dissuade you from smoking in connection with this type of surgery.

Face lift preparations

If you, after your consultation decide to undergo surgery, you will receive a booking and then specific instructions about how you are to prepare yourself for your face lift surgery. These include information about what to eat and drink, rules regarding smoking, the usage of vitamins, medications and other supplements.You will also receive instructions about how you are to shower and wash before the procedure. Follow these carefully in order to minimise the risk of infections and other complications.

Face lift restrictionsIf you smoke it is necessary to refrain from doing so for at least four weeks before and after your facelift. This is because smoking impairs blood circulation of the skin which has an effect on the healing process and increases the risk of complications.

If you have short hair it can be a good idea to let it grow slightly prior to the facelift so that the scars are covered while healing.

Whether you stay at the clinic over night or leave the same day it will be necessary for someone to collect you once you are done and assist you for a few days afterwards.

You can read more on the page about surgery preperations ».

Facelift surgery procedure

A facelift is performed under general anaesthetic or in combination with a local anaesthetic. The surgery depending on the method, takes between 2-4 hours. Sometimes other procedures are performed at the same time and then it takes longer. Some surgeons choose to divide the procedure/procedures into two sessions.

Each surgeon performs the procedure in their own way. Some prefer to do one half of the face first then do the other, while others prefer to change between the two face halves. The exact position of the incisions and in what order the stages are performed depends on method choice, your unique prerequisites and the surgeons preferences.

Face lift - The surgery procedureYou will arrive to the clinic the same day your facelift is to be performed. It is therefore important that you have followed the detailed preoperative instructions and restrictions that the clinic gave you before arriving to the clinic.

Once you have arrived you will signed into you patient room. Thereafter you will meet the cosmetic surgeon who will draw the exact incisions, plan your surgery and photograph you. Once the plastic surgeon is done with the preparations you will be transferred to the operating theatre where the anaesthetist will take care of you before the procedure begins.

1. Incision placement

Facelift incision placementWith a face lift an incision is made slightly above the hairline by the temples and along a natural line in front of the ear, continuing back around it and into the hairline down towards the back of the neck.

The incision is made in such a way that it will be hidden by hair or natural creases as much as possible. Sometimes the surgeon places an incision under the chin in order to be able to tighten the neck.

2. Stretching the tissue

Once the incisions have been made the surgeon loosens the skin with underlying fat from the fascia/muscle (SMAS). Thereafter fatty tissue is either removed or relocated, weakened muscles and fascia are stretched and trimmed, whereby the tissue is fixed into new positions with sutures (stitches). The neck muscle is also stretched and when needed the chin, neck and sometimes the back of the neck is liposuctioned.

Face lift - Stretching the tissueWhen the underlying tissue of the face has been stretched and fixed into the new positions the surgeon stretches the skin upwards and backwards and removes the excess skin. The incisions are then closed up with sutures or metal clips.

In some cases a small draining tube is inserted into the skin behind the eye in order to drain blood that sometimes collects there.

When the procedure is finished a traditional head bandage or cooling mask is applied in order to reduce bruising and swelling.

Middle face lift surgery procedure

A middle facelift (sometimes called a cheek lift) implies restoring sunken tissue in the middle face and the nasolabial creases around the nose. The surgeon can access this tissue in various ways.

Some surgeons use endoscopic technique (keyhole surgery). In these cases small short incisions are placed inside the mouth and in the hairline by the temples. By using special tools and video camera one then loosens the skin and fatty tissue from the underlying tissue.

The surgeon can also create access to the tissue in the middle face by placing two 3-5 cm long incisions in the hair above the temples. Here one also loosens the skin and fatty tissue from the underlying tissue.

Once the surgeon has access to the area of treatment, fatty tissue, weakened muscles and connective tissue is stretched and fixed into its new position using sutures.

Thereafter, the incisions are closed with sutures or metal clips.

When the procedure is finished a traditional head bandage or cooling mask is applied in order to reduce bruising and swelling.

Several variations for middle facelifts

Note that middle facelifts can be performed with several variations, depending on where the surgeon gains access to the area of treatment. Sometimes a limited variation of the facelift incision is used; a middle face lift using this method is called an S-lift since the incision has the shape of an S.

Some surgeons consider the S-lift method the most suitable for a middle facelift since this provides the opportunity to remove excess skin which is a limitation of the other two methods.

Once the surgery is finished, the incisions are closed and a bandage is applied and the patient is moved to their room for monitored recovery.

« Facelift techniques and options | Post facelift surgery »

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