Facelift Meloplasty

Overview

A facelift is an operation that lifts and tightens loose skin and the deeper tissues of the face and neck. Doctors also call it a meloplasty or a rhytidectomy — meloplasty comes from words meaning 'cheek' and 'reshaping'. It softens sagging along the cheeks, jawline and neck so the face looks fresher and more rested. It is cosmetic (elective) surgery, which means you choose to have it — it is not done to treat an illness. A facelift does not stop ageing, and it does not change who you are. It turns the clock back a few years in specific areas, then you carry on ageing as normal. It also does not fix skin surface problems such as sun spots, fine lines or uneven colour — other treatments are used for those.

Facelifts are among the most common facial cosmetic operations worldwide, and more men are choosing them than in the past. How common they are varies a lot between countries and communities, so it can help to ask your surgeon how often they personally do the operation.

Most people who have a facelift are in their 40s to 70s. Women have them more often, but growing numbers of men do too. The best results tend to come in people who are in good general health, do not smoke, whose sagging is mostly from loose tissue rather than heavily sun-damaged skin, and who have realistic expectations about what surgery can and cannot do.

Symptoms

Common symptoms

• This is not an illness, so there are no medical 'symptoms'. Instead, people usually notice visible changes linked to facial ageing.
• Skin on the cheeks and jawline starts to sag, blurring the clear line between the face and the neck.
• Soft pouches called jowls form along the jaw.
• The lines running from the nose to the corners of the mouth (nasolabial folds) look deeper.
• Loose skin and loose muscle bands in the neck create a heavy or drooping look, sometimes called a 'turkey neck'.
• The cheeks look flatter or sit lower than they used to, because fat pads under the skin slip downwards with time.
• These changes are normal. They are not a sign of disease and do not need treatment unless they bother you.

Causes

Main causes

• Ageing: the body makes less collagen and elastin — the fibres that keep skin firm and springy — so skin loosens.
• Gravity and time: fat pads in the cheeks slowly slip downwards.
• Years of sun exposure, which breaks down the skin's supporting fibres.
• Smoking, which reduces blood flow to the skin and speeds up ageing.
• Genetics: how and when your face changes is strongly inherited.
• Weight loss or big changes in weight, which can leave looser skin.
• Natural loss of facial fat and bone volume with age.

Risk factors

• Smoking — it raises the risk of wound problems and poor skin healing.
• Uncontrolled diabetes or other conditions that affect healing.
• High blood pressure.
• Medicines that thin the blood. Never stop a prescribed medicine on your own — speak to the person who prescribes it.
• A history of unusual scarring (such as keloids) or a bleeding disorder.
• Being very overweight, or having recently lost a large amount of weight.
• Being pushed into surgery by someone else, or having expectations that surgery cannot realistically meet.
• Body dysmorphic disorder (being intensely distressed about a flaw others barely see). It is worth raising with your doctor, because surgery often does not help this and can make distress worse.

When to see a doctor

See a doctor urgently if:

• Any of the emergency or same-day warning signs listed above, especially after surgery.
• A wound that is opening, leaking pus, or becoming increasingly red and painful.
• Sudden swelling on one side of the face or neck, or new facial weakness.
• Fever after surgery.
• Feeling very low, panicky or unable to cope after the operation.

Book a routine appointment if:

• You are thinking about a facelift and want honest information about options, risks and costs.
• You want to talk through whether your general health makes surgery safe, and review your medicines.
• You are bothered by sagging but are not sure whether surgery, a non-surgical treatment or simply waiting is right for you.
• You have questions about recovery time, scarring or how long results might last.

Diagnosis

There is no test that 'diagnoses' a need for a facelift. Instead, you have a consultation with a properly qualified surgeon — usually a plastic or facial plastic surgeon. They will ask what bothers you and what you hope to look like, take your medical history, check your blood pressure and look closely at your skin, facial shape and neck. They will also explain which operation would suit you, what it can and cannot do, the risks, the recovery, and the cost. Some surgeons take a short cooling-off period before booking surgery, which is a good sign.

Tests that may be done

• A full medical history and review of all your medicines, including anything you buy over the counter.
• A physical examination of your face, neck and skin quality.
• Clinical photographs, taken before and after surgery for your record.
• Routine blood tests, and sometimes a heart tracing (ECG), if your health or age makes this sensible.
• A conversation about your mental wellbeing and expectations — this is a normal and important part of assessment.
• Sometimes a referral to another specialist, such as a cardiologist, if you have a health condition that needs checking first.

What to expect at your appointment

A first consultation usually takes 30 to 60 minutes. You should feel able to ask anything: how many of these operations your surgeon does, what their complication rates are, what happens if something goes wrong, and who will look after you afterwards. Take notes or bring someone with you. Do not feel pressured to book on the day, and do not pay large sums upfront without written information. Be very cautious about cheap deals, prize draws or high-pressure sales.

Treatment

Options range from skin care and non-surgical treatments, which improve skin quality but do not lift sagging tissue, through to surgery. Surgical choices include a full facelift (which lifts deeper layers as well as skin), a smaller 'mini' facelift, a mid-face lift, and a neck lift — often combined. Some people also have fat transfer or eyelid surgery at the same time. Surgery is usually done under a general anaesthetic or heavy sedation, takes several hours, and often means an overnight stay or a day-case procedure with a responsible adult taking you home.

Self-care at home

• Stop smoking well before surgery and stay off it afterwards — this is one of the single biggest things you can do to help healing.
• Follow your surgical team's instructions on wound care, dressings and when stitches or clips come out.
• Sleep with your head raised on extra pillows for the first week or two to reduce swelling.
• Use cold packs as advised, wrapped in a cloth, never directly on the skin.
• Avoid strenuous exercise, heavy lifting, bending right over and saunas or hot tubs for the time your surgeon advises.
• Keep out of the sun and use a high-factor sunscreen on healing scars for at least a year.
• Do not use harsh skin products, exfoliants or hair dye near the scars until you are told it is safe.
• Attend every follow-up appointment, even if everything feels fine.

Medical treatments

Non-surgical options can improve skin tone and texture but will not lift loose tissue. They include good skin care, sun protection, creams that may soften fine lines, chemical peels, microneedling, laser or light treatments, and skin-tightening treatments using heat or ultrasound. After surgery, your team will give you medicine for pain and to help prevent infection, plus advice on caring for the wound. Always take medicines exactly as your own team instructs, and check with a pharmacist before taking any new medicine, supplement or herbal product around the time of surgery.

When is surgery considered?

Surgery may be worth considering if loose sagging in the cheeks, jawline or neck bothers you, you are in good general health, you have a clear idea of what surgery can and cannot do, and you are choosing it for yourself rather than for someone else. It is usually better to wait if you smoke, if your weight is changing a lot, if you are recently bereaved or going through a hard time, or if you are hoping surgery will fix something that is not really about your face.

Living with this condition

The first few days are the hardest: swelling, bruising, tightness and some soreness are expected. Most people feel comfortable enough to go out with sunglasses and a scarf after about a week to ten days, and many return to desk work after two to three weeks, depending on the operation and their job. Swelling settles over several weeks, and the final shape often takes three to six months to appear. Numbness and odd sensations usually improve gradually over weeks to months.

Lifestyle tips

• Plan time off in advance and arrange help at home for the first week.
• Line up someone to drive you home and stay with you for the first night.
• Avoid alcohol for the first couple of weeks — it increases swelling and bruising.
• Ease back into exercise gradually, following your surgeon's timeline.
• Be gentle with your face and hair, and avoid tight hats or headbands over the scars.
• Keep a simple photo diary if it helps you see progress — swelling can make it hard to judge day to day.

Diet and exercise

Eat normally and keep well hydrated in the first weeks; a balanced diet with enough protein supports healing. Gentle walking from the first few days helps circulation and reduces the risk of clots. Wait for your surgeon's go-ahead before returning to running, gym classes, swimming or contact sports — usually around four to six weeks. Protect healing skin from the sun whenever you are outdoors.

Mental health and emotional wellbeing

It is very common to feel emotional after cosmetic surgery. Some people feel a low mood or a wobble in confidence at around two to three weeks, when swelling is still there and the result is not yet visible. This usually lifts as healing continues. If you feel persistently low, anxious, or distressed about how you look, please talk to your surgical team or your family doctor — this is a normal thing to ask for help with. If you ever have thoughts of harming yourself, contact your local emergency number or a local crisis line straight away.

Prevention

You cannot prevent your face from ageing, and a facelift does not stop the process. You can, however, slow some of the visible changes and lower the risks of surgery. Protecting your skin from the sun, not smoking, keeping a steady weight, and managing conditions such as high blood pressure all help. If you do decide on surgery, the best 'prevention' is a thorough consultation with a properly qualified surgeon and honest, careful preparation.

Screening programmes

There is no screening programme for facial ageing. What does matter is general health screening — for example blood pressure checks and, where relevant, diabetes testing — before any planned operation. Your surgical team will arrange what you need.

Complications

If left untreated

• Nothing bad happens. A facelift is a choice, and there is no medical harm in not having one — your face simply carries on ageing as it would have.
• If a complication after surgery is left untreated, problems can worsen: a collection of blood under the skin (haematoma) can stretch the skin, an infection can spread, and a healing wound can break down.
• Numbness or weakness caused by bruising around a facial nerve often improves on its own, but lasting changes are possible and should be checked early.

Long-term outlook

Most people who have a facelift are pleased with the result, particularly when they chose a well-qualified surgeon and had realistic expectations. Results commonly last several years, though no operation freezes time. Bruising, swelling and tightness improve steadily, and the scar usually fades to a fine line over many months. Serious complications are uncommon but real, and they are much easier to deal with when reported early — so stay in touch with your surgical team and speak up about any worry, however small.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.