What is a facelift in cosmetic surgery?

At its inception, the facelift was primarily designed to counteract the effects of ageing by correcting excess skin. First introduced by Eugen Höllander in 1901, the classic or traditional facelift—‘lift’, meaning ‘to raise’ in English—involves tightening and pulling the skin.

There are different types of lifts such as the facelift, which includes aesthetic surgical procedures aimed at rejuvenating the face. They address sagging and excess skin in the facial and neck regions. The arm lift is also an aesthetic surgical procedure. It aims toremove excess skin and fat from the arms, thus limiting the ‘batwing’ effect. On the same principle, the thigh lift is intended to remove excess fat and skin from the thighs to refine the silhouette. The breast lift is an aesthetic surgical procedure designed to rejuvenate and reshape the breasts by lifting them. The abdominoplasty is an aesthetic surgical procedure dedicated to removing excess fat in the abdominal area and to recontouring sagging skin in this region. In the case of diastasis, it also provides repair of the abdominal wall. The body lift targets excess fat and skin throughout the central torso. It thus tightens sagging skin in this area while lifting the buttocks.

There is no specific age at which to undergo a facelift, as this procedure primarily depends on the condition of the skin and individual requirements. While those between 40 and 60 years of age are the most commonly affected, other factors such as genetics, lifestyle or particular events (weight loss, pregnancy) may justify undergoing a facelift earlier. In younger individuals, less invasive solutions may suffice. Hence, it is the overall evaluation of skin laxity that guides the decision, rather than age alone.

Before the operation, the cosmetic surgeon will typically schedule dedicated consultations to plan the procedure. A visit to the anaesthetist must also take place no later than 48 hours before the operation. Similarly, a series of examinations will be required such as blood tests, an X-ray, etc. The facelift is performed under local anaesthesia, or even general anaesthesia in the operating theatre, and lasts from one to four hours depending on the technique chosen.

There are various lift procedures, each designed for a specific area of the body or face, intended to correct skin laxity, enhance contours, and restore a firmer, more toned appearance.

A one-night hospital stay is often necessary, followed by at least two weeks of recovery. The outcome of the facelift is typically apparent three months after surgery.. Upon returning home, pain management is fundamental. It centres on several points, notably, the intake of analgesics, adherence to guidance on positioning or activity restrictions, rest, and avoidance of self-medication.

A facelift does not provide definitive results, as the natural ageing process continues after the procedure. On average, the effects of a facelift last between 10 and 15 years, but this duration varies depending on the technique used, the area treated, the patient’s lifestyle and genetics. A study of 42 patients showed that theinterval between a first and a second facelift ranges from 1 to 34 years, with most repeat procedures occurring between 10 and 20 years. Tissue laxity can gradually reappear, especially around the neck, jowls and eyelids. To prolong the effects of the facelift, an appropriate skincare regimen, a healthy lifestyle, a balanced diet and regular physical activity are essential. Thus, although a facelift delivers long-lasting results, it does not halt ageing and may require a further procedure in the long term.

The surgeon is required to inform the patient of the risks and dangers associated with cosmetic surgery, including anaesthetic risks in the event of incorrect prescription by the anaesthetist. In this context, contraindications to a facelift concern individuals suffering from cardiac rhythm disorders or those for whom sedation is not recommended. Likewise, tobacco use is prohibited in the weeks leading up to the operation. Furthermore, infectious risks resulting from inadequate preparation by the professional cannot be ruled out, necessitating mandatory post-operative monitoring of the patient. Depending on the type of cosmetic procedure and the suturing techniques employed by the practitioner, the risk of scarring must also be anticipated. Indeed, scars are inevitable and will be more or less visible or discreet.

Significant complications remain rare, particularly in the case of a bodylift. Nevertheless, the following signs may occur in some patients, such as a delay in healing, often associated with smoking, a haematoma, oedema or bruising, an infection, healing disorders or asymmetrical scarring.

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• BONNEFON A. Cervicofacial lift, a minimally invasive, efficient and long-lasting procedure. Annals of Aesthetic Plastic Surgery (2011).

• LE LOUARN C. Specific considerations in rhytidectomy, including the mid-face lift, in cases of facial palsy. Annals of Aesthetic Plastic Surgery (2015).

• ROHRICH R.J. et al. Safety and Adjuncts in Facelifting. Plastic and Reconstructive Surgery (2019).

• Sung Gun B. et al. An Approach to Selecting Face-Lift Techniques for Different Facial TypesAn Analysis of 1,000 Asian Patients Over a Nine-Year Period Annals of Plastic Surgery (2024).