A facelift is normally performed under general anaesthetic, with an overnight stay in hospital. In certain circumstances (one-stitch facelift, mini-facelift or R-facelift), it may be possible to carry out the procedure under local anaesthetic and intravenous sedation (not fully asleep, but slightly drowsy).
Depending on the type, the facelift incisions can be made above the hair line, at the temple and continue in the natural skin crease, just in front of the ear, to skirt under the earlobe and behind it, in the crease behind and off into the back of the scalp. A less extensive incision is made in the R-facelift, mini and one-stitch facelift.
Occasionally further skin incisions are necessary, for example, under the chin, if neck skin needs tightening or the fat here needs thinning-out using liposuction. Deep facial and neck tissues under the skin include structures like the platysma muscle (neck) and the more fibrous layer in the face, called the S.M.A.S. Tightening these structures with deep stitches, adds to the overall facelift effect and how long its lasts.
Drains are usually placed under the skin, in both sides of the face, before the skin is stitched back. In the R-facelift no drains are needed. A bandage is placed around the face and neck to support the lifted skin, minimise bruising and swelling. The dressing is removed the next day and the drains, if used, taken out. Surface tapes to the incision lines stay on for 5-7 days and the skin stitches, if needed, are removed at 7 days. In the R-facelift, all the stitches are usually dissolving.
