Aesthetic surgery
Facelift
It lifts what has descended. It does not change the quality of your skin, and understanding that difference is what separates a satisfied patient from a disappointed one.
What this treatment involves
A facelift — rhytidectomy — addresses the descent of the deeper structures of the lower face and neck. Incisions run in front of and behind the ear, often into the hairline. Through them the surgeon lifts the SMAS, the fibrous layer that carries the fat and muscle of the cheek and jaw, repositions it upwards and backwards, and then removes the skin that is left over.
That sequence matters. An operation that pulls only the skin puts tension on the one layer that cannot hold it, which is what produced the wind-tunnel look of older techniques and why the result did not last. Modern technique moves the layer underneath and lets the skin drape over it without tension.
The extent varies. A neck lift addresses the neck alone; a mini or short-scar lift treats early jawline descent through shorter incisions; a full facelift treats the lower face and neck together. Which one applies is a matter of what has actually descended, and that is an examination finding.
Who may be suitable
Generally considered for people with visible descent of the cheek, jawline or neck, whose skin still has some elasticity, who are in good general health and at a stable weight.
Smoking is the single most important factor. Nicotine constricts the small vessels that supply the lifted skin flap, and smokers have a substantially higher rate of skin loss along the incision — a complication that scars badly and is slow to correct. Surgeons generally require stopping several weeks before and after.
Significant weight change after surgery will alter the result, so it is worth reaching a stable weight first. Uncontrolled blood pressure raises the risk of bleeding under the flap and is usually treated before an operation is scheduled.
What a facelift does not treat: skin texture, sun damage, pigmentation, fine lines around the mouth, or hollowing from volume loss. Someone whose main complaint is any of those is being offered the wrong procedure, and should hear so at the consultation rather than after it.
Why patients choose it
The change is to position — a defined jawline, a reduced jowl, a cleaner angle between the chin and the neck. Because the deeper layer is repositioned and secured, the result is structural rather than superficial.
No non-surgical treatment repositions descended tissue. Energy devices tighten skin modestly and filler adds volume; neither lifts the SMAS. A patient who has reached the limit of what those achieve is the patient for whom this operation exists.
The result is long-lasting but not permanent. Surgery does not stop ageing: the tissue continues to descend from the new position, and most patients are described as looking like themselves some years earlier, continuing to age from that point.
How treatment works
Consultation and examination
Day 1
The surgeon examines which structures have descended and how much skin elasticity remains, and distinguishes descent from volume loss and from skin quality — because they need different treatments and only one of them is surgery.
Planning and discussion
Day 1–2
The extent of the lift, the position of the incisions and the expected scars are discussed with photographs. Scar position is a decision you should understand before the day of surgery, not after.
Pre-operative tests
Day 2
Blood tests, ECG and anaesthetic review as indicated. Blood pressure is checked and treated if raised, since it is the main modifiable risk for bleeding after the operation.
Surgery
Day 3
Performed under general anaesthetic, generally taking three to six hours depending on the extent and whether a neck lift or eyelid surgery is combined with it.
First night
Day 3–4
One night in hospital is usual. The first twenty-four hours are when a haematoma is most likely, which is the reason for observation rather than same-day discharge.
Review and sutures
Day 5–10
Dressings changed, drains removed if used, and sutures taken out in stages. The team confirms when it is safe to fly.
Settling
3–12 months
Swelling resolves, numbness recovers and scars fade over this period. The result should be assessed at a year, not before.
What happens in Istanbul
Facial surgery requires a stay of seven to ten days. Consultation, examination and pre-operative tests take the first day or two, followed by surgery and, depending on the procedure, one night in hospital or a same-day discharge. You then remain in Istanbul for review and for removal of sutures before flying. Departure is confirmed by the surgical team rather than by your booking — flying too soon after surgery raises the risk of swelling and blood clots.
Recovery
Swelling and bruising are marked for the first ten to fourteen days, and asymmetric swelling in that period is normal rather than a sign of an uneven result. A dressing is worn initially, and sutures come out in stages over one to two weeks.
Sleeping propped up and avoiding anything that raises blood pressure — bending, lifting, straining — matters most in the first week, when the risk of bleeding under the flap is highest.
Most people are presentable at three to four weeks with makeup, and back to normal activity at four to six. The result is not finished then. Tightness across the cheek and numbness in front of and behind the ear are expected and resolve over months; the numbness in particular can take six months or more. Scars are pink and firm at three months and continue to fade for a year or longer. Judging the outcome before twelve months is judging something still settling.
Risks and considerations
General anaesthetic carries its own risks. Specific to facelift surgery: haematoma — a collection of blood under the skin flap — is the most common early complication, occurs most often in the first twenty-four hours, and usually requires a return to theatre to evacuate it. It is more frequent in men and in patients with raised blood pressure.
Injury to a branch of the facial nerve can cause weakness of the muscles of expression. It is usually temporary, resolving over weeks to months, but permanent weakness is a recognised possibility. Injury to the greater auricular nerve causes numbness of the ear, which may be permanent.
Skin loss along the incision, most often behind the ear and strongly associated with smoking, leaves a scar that may need revision. Scars can widen, thicken, or in some people form keloid. The hairline can be distorted and hair lost around the incision.
Asymmetry is possible — the two sides of a face are never identical to begin with, and they do not heal identically. Some patients are dissatisfied with the degree of change, in either direction. Revision surgery is possible but harder than the first operation.
This information is general and educational. Whether a procedure is appropriate for you can only be determined by a qualified medical professional after an individual assessment, including your medical history and an examination.
Common questions
How long does a facelift last?
There is no single figure, and any clinic quoting one precisely is guessing. The repositioning is durable, but ageing continues from the new starting point, so how long the change remains visible depends on your skin quality, your genetics, sun exposure, smoking and weight stability. What is accurate to say is that the tissue does not simply fall back to where it was: it continues to descend gradually from where it was placed.
Could threads or energy devices achieve the same thing?
No. Threads and energy-based devices act on the skin and produce a modest, temporary tightening; they do not reposition the SMAS layer, which is what a facelift does. They can be a reasonable choice for someone with early changes who does not want surgery, but presenting them as an equivalent to a facelift is inaccurate. The honest comparison is that they are a different, smaller intervention — not a non-surgical version of the same one.
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