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A facelift (rhytidectomy) is a plastic surgery operation that lifts and repositions sagging tissue of the lower face and neck through surgical incisions, addressing moderate to severe laxity. It is a true operation—performed under anesthesia, with recovery measured in weeks—and sits in a different tier of intervention from non-invasive tightening treatments such as radiofrequency or focused ultrasound devices.
A facelift is usually discussed when the signs of aging go beyond surface texture: jowls forming along the jawline, sagging cheeks, deepening folds around the mouth, and loose skin or banding in the neck. These changes reflect the descent of skin and the deeper supporting tissue, which is why they respond poorly to creams and often only modestly to energy-based devices.
The operation physically repositions tissue and removes excess skin, which is what makes it effective for genuine laxity. It does not, however, change the quality of the skin surface—fine lines, sun damage, and pigmentation need other categories of treatment—and it does not stop aging. Mild, early laxity is more often a conversation about non-invasive tightening, which stimulates collagen with heat for a more modest effect; a facelift is for changes that have gone past that point.
Most mainstream techniques work on the SMAS (superficial musculoaponeurotic system), a layer of connective tissue and muscle beneath the skin. By tightening or repositioning this deeper support layer—rather than pulling on skin alone—modern facelifts aim for a more natural and longer-lasting result and avoid an over-stretched look. Incisions typically run around the ear and may extend into the hairline; the operation is usually done under general anesthesia or sedation and takes several hours.
Preparation starts well before the operating room: a medical history review, adjustment of medications that affect bleeding as directed by the surgeon, and stopping smoking in advance because it impairs healing. On waking, the face is usually bandaged, small drainage tubes may be placed, and tightness, swelling, bruising, and numbness are expected. The improvement emerges gradually as swelling settles over the following weeks, and the contour continues to refine over several months.
The typical candidate is an adult in good general health with clear sagging of the lower face or neck—descended tissue that non-surgical devices can no longer meaningfully address—and realistic expectations about looking refreshed rather than different. A worthwhile consultation should cover which technique the surgeon recommends and why, where incisions and scars will sit, whether a neck lift or other procedures would be combined, the anesthesia plan, how much time to plan away from work, and how long results can reasonably be expected to hold as aging continues.
A facelift is not appropriate for everyone. Uncontrolled medical conditions, bleeding or clotting disorders, and an inability to stop smoking raise surgical risk, particularly for wound healing. People whose main concern is skin texture or pigmentation are usually better served by other categories of treatment. The decision must be made through an in-person consultation with a licensed, qualified plastic surgeon, with full disclosure of medical history, medications, and supplements.
Swelling, bruising, a feeling of tightness, and numbness around the ears and cheeks are expected in the early weeks. Sutures are typically removed within the first couple of weeks, and many people plan roughly two weeks or more away from work and social commitments. Residual swelling and altered sensation can persist for months, and scars around the ears usually fade gradually over many months rather than disappearing quickly.
The most frequent early complication is a hematoma—a collection of blood under the skin that causes sudden, often one-sided swelling and pain and needs prompt surgical attention. Other uncommon complications include infection, delayed wound healing or skin loss (markedly more likely in smokers), noticeable or thickened scars, hair loss near the incisions, and asymmetry. Injury to branches of the facial nerve is infrequent and any resulting weakness is often temporary, but permanent weakness is possible; anesthesia itself also carries its own risks.
Contact the surgical team promptly if there is rapidly increasing swelling or pain on one side, fever, discharge from the incisions, darkening or color change of the skin, or new facial weakness. A facelift should only be decided on—and performed—by a licensed plastic surgeon after an in-person assessment. This guide is general information, not a diagnosis or a substitute for medical advice.