Risks of face lift

General anaesthetic

A deep plane facelift is usually performed under general anaesthesia, which can occasionally cause an adverse reaction.

If you have had problems with anaesthesia in the past, please tell us, as other arrangements may be possible.

Deep vein thrombosis (DVT)

Deep vein thrombosis, a blood clot in the leg veins, is a risk whenever the body is immobile for long periods, for example under general anaesthesia.

Compression stockings, calf pumps and, sometimes, medication reduce the risk. Simple leg stretches, ankle movements and drinking plenty of fluids after surgery also help.

Please tell us before surgery about any personal or family history of blood clots, as extra tests or precautions may be needed.

Long journeys also increase the risk. Avoid long-haul flights for at least four, and ideally six, weeks after surgery.

Blood loss, pain and discomfort

Some bleeding and bruising are expected after a facelift. Keeping blood pressure well controlled is one of the most important ways to reduce them. Ultrasonic instruments, used for a large part of the operation, help to control bleeding precisely.

Occasionally blood collects under the skin (a haematoma) in the first hours after surgery and needs to be removed. This is one of the reasons for staying in hospital on the first night.

Pain after a facelift is usually moderate and settles quickly, with some discomfort for a little longer while the swelling goes down.

Infection

The risk of infection is reduced in several ways, which are discussed with you before surgery.

In our practice, dressings are used for the first night only. You are encouraged to wash your hair the next day, and ideally every day for the first week to 10 days. The simplest way is to apply shampoo and rinse it off, so that the water also runs over the incisions. Gentle washing keeps the wounds clean and helps them heal.

Serious infection after a facelift is rare, but it can damage the skin and cause scarring. Contact your surgeon straight away if you notice increasing redness, pain, swelling or a raised temperature.

Asymmetry and scarring

No face is exactly the same on both sides, and surgery cannot remove this completely. 3D planning helps to improve symmetry, and small differences can sometimes be refined with fillers once the swelling has settled.

The position and length of the scars are discussed before surgery. In most people the scars are hard to see, but they need to be considered carefully when deciding on surgery.

Scars are more likely to stretch when the skin is under tension. In a deep plane facelift the deeper layer carries the lift, so the skin is closed without tension. The scars behind the ears can occasionally thicken; if you notice this, tell your surgeon promptly, as early treatment gives a better result.

Sensory changes and facial nerve injury

A facelift involves the skin, fat and muscle layer of the face, which contain nerves that may take time to recover. Injury to the branches of the facial nerve that move the face is reported in around 1% of facelifts in the medical literature, including both temporary and permanent injury. Temporary weakness usually recovers within a few weeks. Permanent injury is rare; if it happens, treatment such as botulinum toxin on the other side can improve the balance of the face.

Numbness, tingling or increased sensitivity are common at first, and usually settle as the swelling goes down.

Occasionally a change in sensation is permanent, most often over the cheeks or under the chin. Light touch can still be felt, but it feels slightly different from before.