Facelift
A facelift is a surgical procedure that addresses sagging and pronounced signs of aging, primarily in the lower face, along the jawline (jowls), and—when necessary—the neck. Unlike non-surgical treatments, it offers significant tissue lifting and a more defined, youthful contour, aiming for a natural, “rested” look without altering one’s features. The appropriate technique (such as deep plane, short-scar/MACS, or a combined neck lift) is selected on an individual basis following a clinical assessment, depending on the degree of skin laxity and skin quality.
What is a facelift and what does it improve?
A facelift is one of the most renowned aesthetic procedures performed by plastic surgeons to visibly improve signs of aging on the face and neck.
It is worth noting that, to date, no non-surgical treatment can achieve results as spectacular as a facelift performed by an experienced plastic surgeon.
In particular, facelift improves the following:
The relaxation in the face
deep wrinkles under the lower eyelids
deep wrinkles, on the bridge of nose, extending from the corners of the mouth
fat atrophy
the loss of skin tone on the lower face, which looks like a hanging jawline
loose skin and excess fat under the chin and the jawline, which may give the appearance of “double chin”, even to a person with normal weight.
The loss of youthful contour on the face can take place due to various factors including heredity, gravity, environmental conditions and stress. Several times, the best result can be achieved by combining surgical procedures, such as browlift and blepharoplasty.
What the facelift does NOT fix
- A facelift does not “erase” all fine surface wrinkles (e.g., around the mouth) if they are primarily due to skin quality.
- It does not replace treatments such as Botox or laser therapy when the issue is mainly dynamic wrinkles or skin texture.
- Its goal is lifting and contour restoration, not altering one’s features.
What is the main difference between a facelift and non-surgical treatments?
While non-invasive treatments can improve skin texture and fine lines or provide a “refresh,” a rhytidectomy (facelift) targets tissue laxity and supports deeper layers to achieve a more substantial restoration of facial contours.
Who is a good candidate for a facelift?
Candidates for a facelift are the following:
people with obvious sagging skin of the face
people without medical conditions which delay recovery
people with realistic expectations
What to expect at your first appointment:
At your first appointment, you will discuss:
- what exactly is your concern in the appearance of the face, and if facelift is the appropriate treatment for you.
- your past medical history, if you are on any medication, vitamins or other herbal supplements, if you have any allergies or any other operations in the past
- if you smoke (if the answer is yes, how many cigarettes per day).
Afterwards, Dr. Karmiris:
- will evaluate your general health condition and any other risk factors
- will examine you and will take all the detailed measurements from you face, excess or sagging skin, and he will evaluate your skin quality
- will take preoperative photographs
- will discuss with you all the possible surgical options, depending on your case
- will discuss with you all the possible results of the surgical procedure and any risks or potential complications, as described in the international literature and finally
- will discuss with you about the anaesthetic plan.
What we evaluate in order to select the right technique
- degree of lower face and jawline (jowl) sagging
- neck condition / “double chin”
- skin quality (elasticity/thickness)
- nasolabial folds & “marionette lines”
- realistic expectations and recovery time
Plastic Surgeon Dr. Karmiris emphasizes detailed preoperative planning to ensure the chosen facelift technique is truly tailored to your facial anatomy and needs. The goal is a natural, harmonious result featuring a defined contour and a refreshed, rested appearance.
When do we consider combined procedures (brow lift, blepharoplasty, neck lift)?
In many cases, the most natural and comprehensive result is achieved when facial aging is addressed holistically (e.g., the upper face, eyelids, and neck). The final choice is tailored to the individual, depending on the degree of skin laxity, skin quality, and the desired aesthetic outcome.
Preoperative assessment primarily includes blood tests, a chest X-ray, and an electrocardiogram, as well as specialized tests depending on the specific case.
You will also need to stop smoking before the surgery and in the immediate postoperative period, and avoid taking aspirin and anti-inflammatory drugs, as these increase the risk of bleeding.
Preparation prior to a facelift is crucial for safety and smooth healing. You will receive personalized instructions regarding medications and supplements, as well as guidance on when it is safe to resume exercise and daily activities.
There are several types of facelifts, depending on the desired outcome and the specific area of the face or neck requiring correction. This means that a patient might need a traditional facelift, a limited-incision facelift [such as a short-scar or Minimal Access Cranial Suspension (MACS) lift], or a neck lift to achieve the desired result.
Which technique suits which problem?
- Deep Plane facelift: when more comprehensive correction of facial and/or neck sagging is required
- Short scar / MACS: when smaller incisions are desired and the laxity or neck issues are more limited
- Neck lift: when the neck and the “double chin” are the main issue
In a traditional facelift, the incision begins at the hairline in the temporal region, continues around the ear, and ends at the back of the scalp. Subsequently, the local fatty tissue is redistributed, while the deeper facial layers (such as the SMAS and underlying muscles) are lifted and tightened to achieve the desired result.
In the final stage, the skin of the area is redraped and the excess skin is removed. A second incision under the chin may be necessary to further improve the neck.
Modern techniques—such as the short-scar and MACS procedures—offer an alternative to the traditional facelift; they utilize smaller incisions in the temporal region or around the ear, yielding results comparable to the traditional method without requiring extensive incisions. However, it should be noted that these techniques provide limited access to the neck and nasolabial folds.
Dr. Karmiris will explain the entire procedure to you in detail and discuss the appropriate technique for your specific case to ensure an excellent result.
If there is significant neck laxity or excess skin and fat beneath the chin, addressing the neck area can be crucial for achieving a defined contour. A combined facelift and neck lift is designed to ensure a seamless transition between the face and neck, avoiding any unnatural tightness.
Immediately after surgery, you will have gauze or dressings over the incisions, which will be gradually reduced. If drains are used, they will be removed within one or two days at the latest, while the sutures are removed after a week.
In most cases, patients return home the following day. Mr. Karmiris will provide you with specific instructions on how to care for your incisions in the immediate postoperative period, which medications to take, and when you will be seen again.
Recovery time – what to expect week by week
- 1st week: swelling/bruising, suture removal where applicable, light activity
- 2nd-3rd week: significant fading of bruises, easier social reintegration
- 6th-12th week: gradual “maturation” of the result, improvement in sensation/swelling (depending on the individual)
In general, a facelift is a safe procedure performed with great success. However, like any surgery, it carries certain risks and potential complications that every patient should be informed about and fully understand before undergoing the operation.
The most significant potential complications are:
- Bleeding or hematoma formation (occurring in approximately 1% of cases)
- Wound infection
- Poor healing of incisions
- Injury to local nerves
- Localized hair loss (alopecia) where incisions are located within the hairline
- Reduced sensation (hypoesthesia) in the incision area, which may be temporary or permanent (occurring in 5–10% of cases)
- General risks associated with anesthesia, such as deep vein thrombosis and cardiac or pulmonary complications.
Selecting the right technique, preoperative preparation, smoking cessation, and strict adherence to postoperative instructions significantly reduce the risk of complications.
If you are concerned about sagging skin on your face or neck and wish to explore what a facelift can offer, you can schedule a consultation with Dr. Karmiris. During the visit, you will discuss the options best suited to your specific case, the expected results, and a realistic recovery timeline.
Frequently Asked Questions
What is a facelift and what does it correct?
A facelift is a surgical procedure that primarily addresses sagging in the lower face, jowls, and the loss of youthful facial contours. If necessary, it can also be combined with neck rejuvenation.
What is the difference between a facelift and a mini-facelift?
A mini-facelift is typically performed for milder sagging and covers a more limited area. A classic or traditional facelift is more comprehensive and is used when the sagging is more pronounced and/or affects multiple areas.
What is the difference between a deep-plane facelift and a short-scar or MACS lift?
The deep plane facelift involves a larger incision and allows for more extensive correction. Short-scar or MACS techniques utilize smaller incisions and can yield comparable results in selected cases, but they typically offer more limited access to the neck and nasolabial folds.
Does a facelift correct wrinkles around the mouth or very fine wrinkles?
A facelift primarily targets tissue laxity and lifting, rather than fine surface wrinkles. Supplementary treatments may be required for textural wrinkles or fine lines (depending on the case).
When does a facelift need to be combined with a neck lift?
When there is significant skin laxity or excess fat in the neck or under the chin (e.g., a “double chin”), treating the neck area can be crucial for achieving a defined face and neck contour.
Can a facelift be combined with blepharoplasty or a brow lift?
Yes, this combination is often chosen when there are indications in other areas of the face as well (upper eyelids/brows). The decision is personalized and depends on the overall aesthetic goal and the recovery time.
Is rhytidoplasty painful?
The discomfort is entirely manageable and gradually subsides. Detailed instructions and medication—where necessary—will be provided to ensure a comfortable recovery.
How long does recovery take after a facelift?
Swelling and bruising occur during the first few days or weeks but gradually subside. Many patients return to light activities relatively soon, while the final result continues to take shape over the following months.
When are the stitches removed, and what happens with the drains?
Where drains are used, they are usually removed within 1–2 days. Sutures are often removed after about a week, depending on the surgical plan.
When can I return to work and social obligations?
This depends on the type of procedure, its extent, and the body’s rate of recovery. Typically, the condition improves noticeably after the first 1–2 weeks, and you will receive personalized instructions.
Where are the incisions located, and how visible are the scars?
The incisions are strategically placed along the hairline and around the ear so that they lie within natural facial creases. With proper care and time, the scars become inconspicuous.
How long do the results of a facelift last?
A facelift reduces sagging but does not stop the natural aging process. The longevity of the results is influenced by factors such as skin quality, heredity, lifestyle, and post-operative care.
Does smoking affect a facelift?
Yes. Smoking can negatively affect healing and increase the risk of complications. Quitting before surgery and immediately after is recommended, in accordance with your doctor’s instructions.
Are there non-surgical alternatives for mild sagging?
For mild skin laxity, non-invasive or minimally invasive options may be recommended; however, these do not replicate the results of a surgical facelift when laxity is significant. The choice is made following a clinical assessment.
Do you feel you need a Facelift?
Contact our practice to book your personal assessment appointment.
