Facelift Methods
As we age, the collagen and elasticity of the skin decrease, and the fat tissue and supporting structures of the face shift downwards. Genetics, sun exposure, smoking and rapid changes in weight also affect this process. The result is sagging and wrinkles in the face and neck.
Treatments aimed at lifting the face or making it look fresher are divided into surgical and non-surgical. These methods do not solve the same problem: the method that can remove excess skin and reposition sagging tissues is facelift surgery. Non-surgical treatments have a limited and temporary effect on problems such as wrinkles, volume loss or skin quality. The doctor decides at the examination which method is suitable. Results vary from person to person.
It is not possible to lift the face with exercise or creams. Regular skin care, sun protection and not smoking help to slow down skin ageing.
Surgical Facelift Methods
In facelift surgery, the tissues beneath the skin are repositioned and excess skin is removed. The technique used is chosen according to where the sagging is and how marked it is. For detailed information you can read our facelift page.
Classic facelift
It is performed for marked sagging in the middle and lower parts of the face and in the neck. The incisions start in the hair-bearing skin of the temple, follow the natural fold in front of the ear and extend behind the ear into the hair-bearing scalp.
Mini facelift
It is performed for mild and moderate sagging, on a more limited area and with shorter incisions. For the differences from a classic facelift, you can read our article Differences Between a Mini Facelift and a Facelift.
Mid-face lift
It is aimed at the downward shift of the cheekbone area and cheeks, the hollow between the lower eyelid and the cheek, and the deepening of the lines running from the side of the nose to the corner of the mouth. The location of the incision depends on the technique chosen by the doctor.
Lower face and neck lift
It is performed for sagging along the jawline, loosening of the neck skin and fat under the chin; if needed, the neck muscles are also tightened. For details you can read our article Neck Lift Surgery: Procedure, Recovery and Risks.
Eyelid surgery and a brow lift are not part of a facelift; if needed, they can be performed as separate procedures during the same operation.
Non-Surgical Treatments
Non-surgical treatments do not remove excess skin and do not replace facelift surgery when sagging is marked. Their effects are temporary; they need to be repeated at intervals. The doctor decides which treatment is suitable and whether several should be combined. These treatments also have side effects and should be performed by a doctor.
Botulinum toxin
It is used for expression lines on the forehead, between the eyebrows and around the eyes. By temporarily relaxing the muscles it softens these lines; it does not correct sagging. Its effect is temporary.
Fillers
Fillers, mostly containing hyaluronic acid, are injected into areas where volume has been lost. Their effect is temporary. A rare but serious risk is the filler blocking a blood vessel; for this reason the treatment should be performed by a doctor.
Thread lift
With absorbable threads placed under the skin, the tissues are suspended upwards. It has a temporary effect on mild sagging. It is not performed during pregnancy, in bleeding disorders or in uncontrolled chronic illness. For detailed information you can read our thread lift page.
HIFU
High-intensity focused ultrasound (HIFU) uses sound waves to heat the tissues beneath the skin and stimulate collagen production. It may provide limited tightening in mild laxity; it does not remove sagging skin. For detailed information you can read our HIFU page.
Treatments for skin quality
Treatments such as mesotherapy, PRP, in which plasma obtained from the person's own blood is applied, salmon DNA, radiofrequency microneedling, laser and chemical peels aim to improve the hydration, tone and texture of the skin. They are usually performed in several sessions. They can support skin quality, but they do not correct sagging.
Who Is Facelift Surgery Suitable For?
It is considered for people with marked sagging of the face and neck whose general health is suitable for surgery and anaesthesia, who do not smoke or can stop before surgery, and who have realistic expectations. There is no specific age limit; what matters is the degree of sagging. Before surgery, blood-thinning medicines need to be stopped as advised by the doctor.
Surgery and Recovery
- The operation is usually performed under general anaesthesia; its length depends on the techniques and additional procedures performed.
- Swelling and bruising are expected after surgery; they decrease within a few weeks. To help the swelling go down, the head is kept raised in the first days.
- A return to daily life and to work that does not require physical effort is usually possible within a week. For strenuous exercise and sport, the doctor's approval should be awaited.
- During recovery, the skin is protected from the sun; wound care is done as advised by the doctor.
- Temporary numbness may occur in the face.
The effect of facelift surgery can last for many years, but the operation does not stop ageing. Sagging can develop again as the years pass.
Risks
The risks of facelift surgery include a collection of blood under the skin (haematoma), bleeding, infection, a prominent scar, reduced sensation, hair loss around the incision and injury to the facial nerves; nerve injury can cause temporary or permanent weakness of facial movements. Because the incisions are placed in natural folds and the hair-bearing scalp, the scar usually fades over time, but it is permanent. If rapidly increasing swelling, pain or bleeding that does not stop is noticed on one side of the face, the doctor should be contacted immediately. The risks should be discussed in detail with the doctor before surgery.
Author: Op. Dr. Yücel Sarıaltın