Facelift (Rhytidectomy) | Cleveland Clinic Cosmetic & Plastic Surgery

Overview

Patients seeking facelift surgery often complain that people constantly bring up that they look sad or tired. They may also complain of jowls — excess skin or fat in the neck. A facelift procedure addresses all these areas and has the most significant effect on the facial aging process.

Modern facelift surgery doesn’t just remove extra skin but also repositions the soft tissue of your face by tightening muscle and, often, adding fat. Fat grafting has become a common addition to current facelift treatment.

Facelifts are commonly performed in patients ranging from their 40s to their 80s. There are a wide variety of facelift options, depending on the degree of facial aging and patient concerns. Some people require neck treatment only, others desire correction of the cheek area only and some desire a more complete approach.

A patient may desire to have additional procedures performed at the same time as the facelift, including eyelid, eyebrow (forehead) or chin surgery. Others prefer to have the facelift alone.

Why choose us?

When considering a facelift (rhytidectomy), always look for a surgeon with significant experience performing the procedure. Seek referrals from friends and family or advice from your primary care provider.

You should be comfortable with your surgeon. Ask them how many procedures they’ve performed and ask to see before-and-after photos of your surgeon’s patients. Additionally, make sure to ask about their credentials and training.

Learn more about Cleveland Clinic Cosmetic & Plastic Surgery Center.

Before & After Photos

This is a woman in her mid-sixties who wished to rejuvenation her lower face and improve contour of her neck and jawline. She is shown before lower facelift (left) and over 1 year after (right).
This is a woman in her mid-sixties who wished to rejuvenation her lower face and improve contour of her neck and jawline. She is shown before lower facelift (left) and over 1 year after (right).
This is a 60-year-old woman who desired improvement in her lower face and neck. She underwent a lower facelift along with a chin implant, upper eyelid surgery, and peels around the eyes and mouth. She is shown before surgery (left) and nearly 10 months after surgery (right).
This is a 60-year-old woman who desired improvement in her lower face and neck. She underwent a lower facelift along with a chin implant, upper eyelid surgery, and peels around the eyes and mouth. She is shown before surgery (left) and nearly 10 months after surgery (right).
This is a woman in her mid-sixties who wished to rejuvenate her face and neck area. She is shown before lower facelift (left) and 9 months after surgery (right). She also had a browlift, upper eyelid surgery, and peel around her mouth at the same time.
This is a woman in her mid-sixties who wished to rejuvenate her face and neck area. She is shown before lower facelift (left) and 9 months after surgery (right). She also had a browlift, upper eyelid surgery, and peel around her mouth at the same time.
This is a 46 year old female 9 months post op facelift and fat injections of the face.
This is a 46 year old female 9 months post op facelift and fat injections of the face.
This is a 68 year old female 10 months post op facelift, perioral phenol croton oil peel and fat grafting to the face. She is also 3 months post op direct excision marionette lines.
This is a 68 year old female 10 months post op facelift, perioral phenol croton oil peel and fat grafting to the face. She is also 3 months post op direct excision marionette lines.
This is a 74 year old female who underwent a facelift, phenol croton oil peel around the mouth and lower eyelid area, and fat injections to the cheeks. She is 1 year and 8 months post surgery.
This is a 74 year old female who underwent a facelift, phenol croton oil peel around the mouth and lower eyelid area, and fat injections to the cheeks. She is 1 year and 8 months post surgery.
This is a 57 year old female who underwent facelift, phenol croton oil peel to lower eyelids and upper lid blepharoplasty. She is 1 year post op.
This is a 57 year old female who underwent facelift, phenol croton oil peel to lower eyelids and upper lid blepharoplasty. She is 1 year post op.

How To Prepare

Am I a candidate for a facelift (rhytidectomy)?

As mentioned above, a facelift addresses a tired or sad look, as well as a wide variety of areas in your face and neck, including:

Loose skin or wrinkles in your cheeks.
Jowls or marionette (“puppet”) lines.
The deep creases running from your nose to the corner of your mouth.
Loose neck skin or a “double chin” (“turkey gobbler”).

Are you interested in a minimally invasive facelift procedure?

There are a wide variety of options for those interested in facelift surgery, from more minor, less invasive procedures to operations for greater degrees of aging, including:

Neck-only procedures addressing skin, fat (double chin) and muscle excess.
Short scar facelifts (which limit incisions to the front of your ear), such as a minimal access cranial suspension (MACS) lift.
Procedures which tighten skin and muscle in your face and neck, such as a SMAS (superficial musculoaponeurotic system) lift, a deep plane lift or a high SMAS lift.

Candidates for facelift surgery should be in good health. People who actively smoke are at a greater risk of healing problems than people who’ve never smoked or people who’ve quit. Details of your smoking history should be discussed with your cosmetic surgeon.

How do I prepare for a facelift?

Preparing for your facelift procedure at Cleveland Clinic Cosmetic & Plastic Surgery Center will include a discussion with your cosmetic surgeon about your health, desires and lifestyle. As part of the consultation, they’ll evaluate your general health status and any preexisting health conditions or risk factors you may have.

To ensure the best results from your facelift procedure, be prepared to discuss:

Why you want the surgery, your expectations and desired outcome.
Medical conditions, drug allergies and medical treatments.
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
Previous surgeries.

Your cosmetic surgeon will also:

Discuss the options available to you for facelift and other facial rejuvenation procedures.
Examine and measure your face.
Take photographs for your medical record.
Discuss your facelift procedure options and recommend a course of treatment.
Discuss likely outcomes of a facelift and any risks or potential complications.

Learn more about what to expect and access consultation information.

What To Expect

How is a facelift performed?

There are a wide variety of facelift procedures offered at Cleveland Clinic Cosmetic & Plastic Surgery Center. Each procedure is highly individualized for a patient’s specific needs.

Facelift techniques can be simple, minimally invasive approaches completed through incisions under your chin (isolated neck lift), in front of your ear (short scar) or both in front of and behind your ear. These incisions allow your surgeon to address loose skin in your cheek and the neck. Most modern facelift techniques address not only the skin, but also tighten the underlying soft tissue (SMAS).

Are there different types of facelift procedures?

There have been many advancements in facelift techniques throughout the last decade, with each yielding more natural-looking results, minimal scarring and a shorter recovery. With so many options, the best way to determine which facelift technique is best for you is through a full consultation from a cosmetic surgeon at Cleveland Clinic Cosmetic & Plastic Surgery Center.

Facelift techniques offered at Cleveland Clinic Cosmetic & Plastic Surgery Center include:

Anterior-only neck lift

This procedure is designed for those who are most concerned with their necks or for people with a double chin or mild to moderate extra skin in their necks. This operation was developed as an extension of liposuction and is limited to an incision under the chin. No incisions are made in front of or behind the ear. Change is more noticeable in the side view or profile.

Short scar facelift

An alternative to traditional facelifts is the short scar facelift, which is also called the S-Lift, MACS Lift or minimal incision facelift. This is a good option for someone who has minimal facial aging or is looking for a more minimally invasive facelift. This procedure limits the length of the incision behind the ear.

A common incision used in a short scar facelift is an S-shaped incision (S-lift) at the temple or in front of the ear and not extending behind the ear. The MACS technique uses an incision that stops at the ear lobe. Short scar facelifts are best for younger people with mild to moderate aging.

Deep plane facelift

Most modern facelift operations address your SMAS (layer under the skin), as well as your skin. The idea is that tension is placed on the deeper layer and not on your skin, leading to a longer-lasting result. The deep plane, the high SMAS and the extended SMAS are all variations of this technique.

In these operations, the skin is dissected for a short distance, and the SMAS or deeper layer is then dissected. Tension is placed on this layer, tightening the skin on your cheek, nasolabial folds (the lines from your nose to the corner of your mouth), and your neck muscle for a longer-lasting result.

Mid-face lift

A mid-face lift (or cheek lift) focuses on addressing the eyelid, eyebrow and upper cheek area only. It addresses the hollows below your lower eyelids and the sagging cheek but not the jowl or neck area. A surgeon generally performs this procedure through a lower eyelid incision rather than an incision in front of your ear.

Is a facelift safe?

Possible risks of facelift surgery include:

Unfavorable scarring.
Bleeding (hematoma).
Infection.
Poor wound healing.
Anesthesia risks.
Correctable hair loss at the incisions.
Facial nerve injury with weakness.
Facial asymmetry.
Skin loss.
Numbness or other changes in skin sensation.
Fluid accumulation.
Pain, which may persist.
Skin contour irregularities.
Skin discoloration, sensitivity or swelling.
Deep vein thrombosis, cardiac (heart) and pulmonary (lungs) complications (rare).
Possibility of revisional surgery.

Here are important steps you can take to minimize risks:

Manage your blood pressure before, during and after surgery. There’s clear evidence that high blood pressure after surgery increases the risk of bleeding (known as hematoma).
Avoid blood thinners, including aspirin, other anti-inflammatory drugs and multivitamins.
Stop smoking (although many surgeons tell patients to stop smoking at least one month prior to surgery, the longer the interval between stopping smoking and surgery, the less the risk of healing complications). Ask a healthcare provider for resources to help you quit.

Results

What results can I expect?

Post-surgery bruising and swelling lasting two to three weeks is typical after facelift surgery. You may also experience tightness, numbness and swelling for several weeks. Results from your facelift will be long-lasting, but it may take several months for minor swelling to fully subside. You can help maintain a rejuvenated, youthful appearance by protecting your skin from the sun and maintaining a healthy lifestyle. Follow-up consultations with your cosmetic surgeon will help ensure desired facelift results.

What is involved in recovery?

When your facelift procedure is complete, you may have a bandage around your face to minimize swelling and bruising. A thin tube may be inserted to drain any excess blood or fluid that may collect under the skin, which is removed the day after surgery.

Even though most people experience very little pain, your cosmetic surgeon will prescribe pain medication. Some degree of swelling and bruising is unavoidable, and you may be instructed to use cold compresses to minimize swelling. If you have a bandage on your face, it’ll be removed within one to two days.

You’ll be instructed to keep your head elevated when lying down, to avoid as much activity as possible and to report any discomfort to your cosmetic surgeon. All sutures are usually removed within five to 10 days after surgery. In general, you’ll be recommended to avoid vigorous activity.

Facelift procedures are often performed in outpatient care (meaning you’ll go home the same day) or with a one-night stay at Cleveland Clinic Cosmetic & Plastic Surgery Center. If you complete your facelift as an outpatient, make sure you bring someone to drive you to and from surgery and to stay with you for at least the first night after surgery.

Recovery from traditional facelift procedures may be lengthier than a minimally invasive facelift. However, most people return to work and ordinary activities within two to three weeks. Your Cleveland Clinic Cosmetic & Plastic Surgery Center cosmetic surgeon will advise the best recovery plan for you.

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