Facelift surgery (rhytidectomy) typically involves removing excess skin through an incision made along the border where the ear meets the cheek. During the surgery, not only the upper skin but also the underlying muscle tissue (SMAS) is repositioned.
A proper facelift surgery shapes all layers of the skin in three dimensions.
Pulling one’s cheeks towards their ears in front of a mirror until the mouth shape is not distorted will give us an idea of the effect of the operation.
Excess skin in the chin area (jowl and neck) can be removed with this surgery.
Facial rejuvenation, the goal of this surgery, is also known as facelift aesthetics. Depending on the individual’s condition, it can make you look 10-15 years younger.
Suitability for Surgery
If changes in the following facial areas are bothersome, you may be suitable for this surgery:
- Drooping eyebrows
- Sagging eyelids
- Drooping of the cheek skin
- Deepening lines at the corners of the mouth (nasolabial folds)
- Sagging below the jawline (sagging of the bulldog and pre-jawline areas)
- Double chin (submental fat)
- Sagging or excess skin in the neck
Types of Facelift Surgery
Your expectations for the surgery may vary depending on the sagging in your face. Basically, there are 4 types of facelift surgery in Turkey. They can be categorized based on the extent of their effect as follows:
Other surgeries that can be combined with facelift surgery:
- Lower Facelift (Double Chin and Neck Lift)
- Brow Lift
- Eyelid Surgery (Upper and Lower Eyelids)
- Upper Blepharoplasty
- Fox eye surgery
- Chin augmentation or reshaping
- Lip Lift
- Forehead Reduction Surgery
- Facial stem cell injection
Endoscopic Facelift
In endoscopic facelift surgery, the incision is made within the hair-bearing skin. Thus, there is no visible scar.
Small incisions are made within the hair-bearing skin around the cheekbones to reposition them upwards.
Endoscopic facelift surgery area and impact direction A small incision is made from the hair-bearing skin area (temporal region) to enter the subcutaneous tissue. With the help of a camera, the subcutaneous tissue and fatty tissue are repositioned by placing stitches.
- Brow lift
- Removing bags under the upper and lower eyelids
These are including this surgery commonly preferred for this procedure.
Mid-Facelift
A treatment aimed at eliminating wrinkles and signs of aging in the middle area of the face, not sides.
It encompasses interventions made in the middle area of the face, which can be described as around the eyes and nose.
This surgery can be performed with an incision made either from under the lower eyelid (on surface) or from within the eyelid itself (no visible scar). This choice varies depending on the patient’s condition.
For example, if there is excess skin under the lower eyelid, an incision can be made along the lash line to remove this skin. If there is no excess skin in the lower eyelid area and the goal is to address wrinkles formed from the corners of the mouth towards the nose, then this procedure can also be done with an incision made from within the eyelid.
Mini Facelift
A mini facelift surgery involves removing excess skin and stitching in the mouth, cheek, and jaw areas with an incision made at the level of the ear.
The incision area and the effect of the mini facelift surgery The length of the incision made in this surgery is about 3-4 cm. Targeted areas include:
- Wrinkles formed under the eyes and on the cheeks
- Wrinkles around the mouth area
Deep Plane Facelift (Face and Neck lift)
Deep plane facelift, also referred to as full facelift or classic facelift surgery, encompasses the entire face, jaw, (double) chin and neck areas.
In a deep plane facelift surgery, the incision starts at the border of the ear, similar to the mini facelift. The incision wraps behind the ear, extending to the hairline at the back of the head, and then continues downward for an additional 3-4 cm as needed. With this additional incision, sagging in the jaw and chin areas can be addressed in addition to the sagging around the cheeks and mouth targeted in the mini facelift surgery.
Areas addressed in a total facelift include:
- Sagging skin in the cheek area
- Deepening lines around the mouth (nasolabial folds)
- Sagging below the jawline (Bulldog and Pre-jawline sagging)
- Sagging in the neck area
Surgeries Combined with Facelift Surgery
We will briefly touch on the other surgeries most commonly performed in conjunction with facelift surgery in this section.
Brow Lift: This surgery is performed with an incision hidden in the hair-bearing area of our temporal region. Skin is removed to the extent desired for lifting the brow, and the incision is closed. Since the incision in this surgery is within the hair-bearing skin, there is no visible scar.
Eyelid Surgery (Upper and Lower Eyelids): You can get rid of the aged appearance due to drooping and fat accumulation in the eyelids. A fresher appearance can be achieved by removing skin with an incision made in the upper eyelid skin.
Chin Augmentation Surgery: Chin augmentation surgery can be performed to lengthen the face or achieve a more prominent chin profile. This surgery can also be performed along with procedures such as fat injection to create a sharper jawline.
Lip Lift: Drooping of the upper lip can be repositioned to appear fuller with an incision made under the nose (similar to the incision made in nose surgery).
Forehead Narrowing Surgery: This surgery is performed by making an incision just at the end of the hair-bearing skin for individuals with a wide forehead.
Buccal Fat Removal: It is the process of removing fat in the cheeks through liposuction. The goal of the operation is to achieve more prominent cheekbones.
Facial Stem Cell Injection: It is a treatment that enhances the overall quality of our skin. It involves enriching the facial area with stem cells by injecting fat tissue taken from the abdomen. The treatment leads to faster wound healing.
Facelift Surgery Steps
You can find “How is facelift surgery performed?” in this section. Although there are many combinations, the basic steps are as follows:
- Drawings are made for the planned areas with the patient before the surgery.
- If chin augmentation is included, an incision of 1-1.5 cm is made under the chin, and liposuction is performed to remove the fat.
- Again in the chin area, the two basic muscles located under the chin are lifted upwards by stitching them together.
- An incision starting from the ear area border is made. This incision, for mini facelifts, extends 3-4 cm from the ear-cheek line, up to behind the ear for total facelifts, and up to the hairline in neck lifts.
- The excised skin is lifted, and fat tissue is shaped below, while nerves and muscles are preserved and stitched at the same time to prevent future loosening of the skin.
- Excess skin is gathered in the incision area around the ear and marked with exact addresses before cutting. This ensures a fully symmetrical and smooth fusion of the skin when stitched.
- Excess skin is removed, and all layers of the skin are stitched with different types of sutures (fibers, muscles, fat tissue, and upper skin).
- A drain is attached, and the surgery is completed.
Surgical Process
- By looking at the patient’s youth photographs, the direction of deformation of the face is determined for surgical planning. Planning is done accordingly.
- A photograph is taken before surgery and during the surgery process for reference.
- You can have this surgery under local anesthesia, as well as under general anesthesia or sedation.
- The surgery will last between 2-4 hours.
- A light bandage is applied after the surgery.
- You may need to stay in the hospital for 1 day after surgery or you may be discharged on the same day depending on the situation.
Postoperative Period
- There may be some swelling and pain in the face. Bruising may also occur to a lesser extent. These conditions decrease after the first week.
- You will need to come to the clinic the day after the surgery. Dressings and drains are removed.
- A corset is worn instead of a loose bandage on the second day.
- You can shower after the third day.
- Since your stitches will be absorbable, they will fall out on their own.
- You can return to work and apply makeup after 1 week.
- You can walk and do light exercise after 2 weeks.
- You can do body-to-body sports such as basketball after 4 weeks.
Facelift Before and After (Frontal View)
Facelift Before and After (Side View)
Dr Cengizhan Ekizceli’s Review about Facelift
Frequently Asked Questions
Is there a risk of facial paralysis?
Facial nerves extend from the chin to the cheeks in five branches. It’s important for the surgeon to preserve these nerves during the operation. Temporary numbness in the muscles and nerves can occur after the operation, leading to asymmetry in facial movements. However, these conditions are expected to improve over time.
What is the recovery process like?
Only skin layers are incised and stitched in a facelift operation, with no vital organs affected by human metabolism. Therefore, the recovery process is approximately two weeks. Swelling and bruising may occur in the first three days but gradually decrease over time.
Post-operative recovery:
- 50% recovery in the first 2 weeks
- 80% recovery after 4 weeks
- 100% recovery may take up to 6 months, depending on the operation’s scope and method.
How long does the effect last?
Depending on the method and scope of the operation, the longevity can vary. Depending on the individual’s personal condition and lifestyle, the effects can last up to 10-15 years.
Can the longevity of a facelift be increased?
Yes, by maintaining a healthy lifestyle, avoiding smoking and alcohol, managing stress, and protecting the skin from the sun, the longevity of a facelift can be extended to 15+ years.
How much tightening can be done?
The amount of tightening depends on the individual’s skin elasticity. The tightening can be done until the mouth shape changes when pushing from the cheeks with your hand.
At what ages can it be done?
Typically, it’s performed on individuals aged 40 and above, depending on the elasticity of the skin. However, it can be performed after the age of 20 depending on rapid weight fluctuations or certain metabolic conditions.
What causes sagging in the face?
The primary cause is genetic factors. Skin elasticity decreases due to external factors such as gravity, resulting in wrinkles.
Factors causing wrinkles on the face:
- Exposure to sunlight without protection
- Smoking
- Rapid weight gain or loss
- Decrease in collagen as we age
These conditions can cause sagging of the skin.
How can wrinkles on the face be prevented?
We can make facial expressions through the muscles in our face. Excessive use of facial expressions can cause wrinkles. Botulinum toxin application can be done to prevent these. Thus, wrinkles will be less as the muscles responsible for facial expressions will work less.
It is very important to protect the skin from the sun to prevent aging.
What is non-surgical facelift?
- Cosmetic tapes
- Fillers and botox (Liquid Facelift)
- Ultrasonic treatments (ThermiSmooth Face)
- Laser applications
- Platelet-rich plasma (PRP) and Stemcell treatments (Vampire Facelift)
Those are expressed as non-surgical facelift procedures. The effects of these treatments are more limited and shorter-term (6 months to 1-2 years) solutions.
Will there be a scar?
The incision area can be seen between the ear and the cheek. However, since this area is a boundary/transition area, it will not be seen as clearly as a normal incision. The incision remaining in the hairy skin area is almost invisible because it is already covered with hair.