Facelift: what it can and cannot change

A facelift (rhytidectomy) repositions the deeper layers of the face and neck that have loosened with time, and removes the skin that is left over. It is an operation about sagging and slackness, not about skin quality, volume or colour.

What it can change — and what it cannot

It can improve a heavy jawline, deep folds running from the nose to the corners of the mouth, loose skin under the chin and a slack neck.

It cannot change the texture or thickness of your skin, remove fine lines around the lips or eyes, treat sun damage or pigmentation, or stop ageing. Those need different treatments, and some of them are not surgery at all. A facelift also does not make you look like someone else; it makes the same face look rested.

If your main concern is hollow cheeks or thin lips, a facelift is the wrong operation — tightening a face that has lost volume can make it look more drawn, not younger.

Assessment and planning

The consultation looks at skin elasticity, the position of the deeper tissue layer, the neck angle, bone structure and your general health. Smoking, uncontrolled blood pressure, diabetes and blood thinners all affect wound healing and are discussed before a date is offered.

We will tell you honestly if the result you are describing cannot be achieved by this operation, or if a smaller procedure would serve you better.

The operation

Incisions follow the hairline and the natural creases in front of and behind the ear, so that scars fall in shadow. The deeper layer is lifted and fixed, then the skin is redraped without tension — tension is what produces a pulled, artificial look. The operation usually takes three to five hours under general anaesthesia, with one night in hospital.

Recovery, honestly

• First week: swelling and bruising are at their worst around days two to four. Dressings and sutures are removed during this week. Sleeping with the head raised helps.
• Weeks 2–4: most people are presentable in public at around two to three weeks, with make-up. Numbness in front of the ears is normal and improves slowly.
• Months 2–6: swelling continues to settle; scars go through a pink phase before fading.
• At one year: the result is settled and the scars are usually pale.

A facelift does not stop time. It sets the clock back; the face continues to age from the new starting point.

Risks

Every operation carries risk. For a facelift these include bleeding under the skin (haematoma) in the first hours, temporary numbness, slow healing at the scars — considerably more likely in smokers — infection, asymmetry, hair thinning near the incisions, and, rarely, weakness of a facial nerve branch that is usually temporary but can be permanent. Anaesthesia carries its own risks, which the anaesthetist explains separately.

Questions worth asking your surgeon

• Which layer will be lifted, and why is that the right choice for my face?
• Where exactly will the scars be, and how will they look at one year?
• Do I need anything else — eyelids, volume, skin treatment — to get the result I am describing?
• What is your plan if I develop a haematoma or heal slowly?
• If I travel from abroad: how long must I stay, when can I fly, and who follows me up afterwards?

Facelift surgery at Medinova is performed within our Plastic, Reconstructive and Aesthetic Surgery department by Surgeon Dr. Deniz Güneş.