Performed by Specialist Plastic Surgeon Dr Qadir Khan (FRACS)
As we age, natural changes in the skin may lead to a loss of elasticity, contributing to visible lines, rhytids, and laxity in areas such as the chin and jawline. Several factors, including genetics, environmental conditions, skin quality, stress and the normal ageing process, may affect your skin over time.
Rhytidectomy, or facelifting, removes excess fat, as well as tightens loose skin and facial muscles. Facelift surgery is one option for addressing visible signs of ageing, while non-surgical treatments may offer temporary improvements. Face surgery involves realigning tissues, removing excess fat, and correcting lost volume. In some cases, a facelift may also include eyelid surgery, neck lift surgery, and fat grafting.
This content has been medically reviewed by Dr Khan, MBBS, MRCS (Edin), FRACS (Plast)
Your first step to having a facelift is to schedule an appointment with Dr Khan at West Coast Plastic Surgery. Get your GP to send us a referral to apply for a Medicare rebate for your consultation (special conditions apply from Medicare). You can also contact us by phone at 0862303041 or by fax at 0862303042 for facelift surgery. Alternatively, you can send an email to admin@wcps.au. You will be contacted by a team member to book your appointment, and you can ask any questions you may have about facial lifting or cosmetic surgery.
It is normal to experience some swelling, bruising, irritation, or discomfort during the healing process, which may be managed with medications, cold compresses, and elevating the head. Dr Khan will provide you with specific instructions following your procedure.
Recovery time varies for each individual, but your wound may begin healing within 7-14 days. The time it takes to return to work will depend on your specific job and recovery. Full healing may take several additional weeks.
Fat grafting results may be visible initially, with final results developing as swelling subsides over time. Your incision lines will continue to fade over several months to a year, depending on individual healing.
While the procedure may change the appearance of facial features, you will continue to age naturally after surgery. Regular sun protection and moisturisation can support healthy skin.
Dr Khan will discuss whether fat grafting is an appropriate addition to your facelift based on your needs and preferences.
After your first consultation with Dr Khan, a treatment plan tailored to your individual needs will be developed. You will be provided with the cost for the recommended procedure.
Our highly qualified practitioners bring extensive expertise in cosmetic medicine and skin rejuvenation, delivering safe, effective treatments tailored to your individual needs.
We utilise the latest medical-grade equipment and proven treatment modalities to address multiple skin concerns with precision and effectiveness.
Every patient receives a thorough consultation and customised treatment plan based on your specific concerns, skin type, and aesthetic goals.
We prioritise subtle, natural-looking outcomes that refresh and rejuvenate your features without appearing overdone or artificial.
We provide honest communication about treatment options, expected outcomes, and costs so you can make informed decisions with confidence.
We provide thorough aftercare guidance, follow-up appointments, and ongoing support to ensure you achieve the best possible outcomes.
A facelift, known medically as rhytidectomy, is surgery that repositions the sagging soft tissue of the lower face and neck and removes the excess skin that results. It addresses the jawline, jowls, the folds running from nose to mouth and, where a neck lift is included, loose skin and banding under the chin. A facelift does not treat the forehead, the eyelids or the quality of the skin surface, so it is often combined with a brow lift, eyelid surgery or fat transfer to the face. It repositions tissue rather than simply pulling skin tight, which is what separates a modern facelift from the over-tightened results of decades past. At West Coast Plastic Surgery in West Perth, facelift surgery is performed by Specialist Plastic Surgeon Dr Qadir Khan (FRACS, MED0001546567).
Incisions are made in front of the ear, following the natural contours around the tragus, then around the earlobe and back into the hairline behind the ear, with an extension into the temporal hairline where needed. The skin is lifted off the deeper layer, and the surgeon then works on the SMAS, the fibrous layer that carries the facial muscles, tightening or repositioning it upward and backward so the deeper tissue holds the lift. The skin is redraped without tension, excess is trimmed, and the incisions are closed in layers. A neck lift, if included, uses a small incision under the chin to tighten the platysma muscle. Drains are sometimes placed overnight. Tension on the SMAS rather than the skin is what produces a natural result.
SMAS stands for superficial musculoaponeurotic system, the fibrous sheet lying beneath the skin and fat that carries the muscles of facial expression. A SMAS facelift lifts this layer as well as the skin, rather than tightening skin alone, which is what allows the result to look natural and hold for years instead of months. The layer can be folded and stitched, known as plication, or partially cut and repositioned, known as SMAS imbrication or SMASectomy. A high SMAS variation extends the dissection higher over the cheekbone to lift the midface more effectively. SMAS techniques are the standard against which other facelifts are compared, and they suit most patients with moderate lower face and jawline laxity.
A deep plane facelift dissects beneath the SMAS layer rather than above it, releasing the retaining ligaments that tether the cheek to the underlying bone, then lifts the skin and SMAS together as one composite unit. Because the ligaments are released, it can reposition the midface and the folds from nose to mouth more effectively than techniques that work above the SMAS, and because the skin is not separated from the layer beneath it, tension is spread through deeper tissue. It takes longer, requires dissection close to the facial nerve branches, and demands specific training. Whether it is objectively better remains debated among surgeons, and comparative evidence is limited. The right technique depends on your anatomy and on the surgeon’s experience with it.
A mini facelift, sometimes marketed as an S-lift or short scar facelift, uses shorter incisions confined largely to the front of the ear and performs a more limited lift of the SMAS layer. It targets early jowling and mild laxity along the jawline in younger patients, typically in their forties to mid fifties, and offers a shorter operation and a faster recovery. Its limitations are the important part: it does very little for the neck, it cannot address significant midface descent, and the result does not last as long as a full facelift. Patients who need more and choose a mini facelift are usually the ones disappointed at six months. Dr Khan will tell you if your anatomy needs the larger operation.
A ponytail facelift is a marketing name rather than a distinct surgical technique. It describes a lift using a vertical, upward vector with incisions concealed entirely within the hairline at the temple and behind the ear, so that no scar shows when the hair is pulled back into a ponytail. It is often performed with endoscopic assistance and suits younger patients with good skin elasticity and early midface descent rather than established jowls or neck laxity. The trade-offs are real: hairline incisions can shift the hairline or cause localised hair thinning, and because the approach avoids the area around the ear it does little for a sagging neck. Dr Khan will explain which vector and incision pattern suits your anatomy.
None of these is a facelift, and the shared use of the word causes a great deal of confusion. A liquid facelift uses dermal fillers to restore volume, which can soften folds and hollows but cannot remove excess skin or reposition descended tissue. A thread lift uses barbed sutures to pull tissue upward, giving a modest change that typically fades within twelve to eighteen months. HIFU, radiofrequency and similar energy devices tighten skin slightly and temporarily. Names such as 9D facelift, one-stitch facelift and lunchtime facelift are branding for bundled non-surgical treatments rather than recognised operations. These options can suit patients with early changes, but they do not substitute for surgery once skin is genuinely lax.
There is no single best technique, and any clinic promoting one for every patient is selling rather than assessing. The right operation depends on where your ageing has actually occurred, on the quality and elasticity of your skin, on how much volume you have lost, and on how much recovery time you can commit to. Someone with early jawline softening and good skin needs something different from someone with established jowls and a lax neck. Deep plane techniques are the current focus of attention, but a well-executed SMAS facelift produces excellent results in appropriately selected patients. A surgeon should recommend the technique after examining you, not name one before. Dr Khan will explain why a particular approach suits your face.
Jowls are among the changes a facelift addresses most reliably, because they are caused by descent of the cheek fat pad past the jawline, and repositioning that tissue upward and backward restores a defined jaw. A sagging neck is different: a facelift alone improves the neck only partially, and lasting correction usually requires a neck lift performed at the same time, using a small incision beneath the chin to tighten the platysma muscle and address fat above and below it. A separate lateral incision is made in the hairline which is the extension of a facelift incision, following the ear into the posterior neck hairline. Patients who still have jowls after surgery have typically had a technique that lifted skin without adequately repositioning the deeper layer. Fillers and energy devices do not correct established jowls. Dr Khan will assess whether your neck needs treating alongside the face.
A well-performed SMAS or deep plane facelift generally holds a clear improvement for around ten to fifteen years, and patients typically continue to look younger than they otherwise would even after that, because the deeper layer has been repositioned. A mini facelift is shorter lived, commonly quoted at around five years, since less is done and less is released. A ponytail facelift sits somewhere between the two depending on how much lifting was performed. Non-surgical alternatives are measured in months: a thread lift around twelve to eighteen months, fillers six to eighteen months. No facelift stops aging, and skin quality, sun exposure, smoking and weight fluctuation all influence how long the result holds.
There is no ideal age, and the useful question is whether your anatomy has changed enough to justify surgery rather than what year you were born. Most facelift patients are between their late forties and their seventies, with the largest group in their fifties and sixties. Operating earlier, while skin elasticity is still good, tends to produce a smoother recovery and a subtler result, which is part of why smaller lifts appeal to patients in their forties. Operating later is entirely reasonable and remains safe where general health allows, though heavier tissue and less elastic skin change what is achievable. General health, blood pressure control and not smoking matter far more than age. Dr Khan will assess suitability on your examination findings.
A good candidate has visible laxity of the lower face, jawline or neck, retains reasonable skin elasticity, is in good general health with well-controlled blood pressure, and holds realistic expectations about what surgery changes. Smoking is the single most important factor, because nicotine constricts the small vessels supplying the lifted skin and substantially raises the risk of skin loss and wound breakdown; most surgeons require you to stop for several weeks before and after surgery. A stable weight matters, since later weight loss creates new laxity. A facelift does not improve skin texture, pigmentation, fine lines or volume loss, which need other treatments. Dr Khan will tell you directly if a facelift is not the right procedure for your concerns.
A full facelift with a neck lift usually takes around four to six hours, while a mini facelift is shorter, often two to three hours, and combining a facelift with eyelid surgery or fat grafting extends theatre time further. Most facelifts in Australia are performed under general anaesthesia with a specialist anaesthetist, although some surgeons use sedation combined with local anaesthetic for smaller lifts. You should allow the full day at the hospital once admission, preparation and recovery are included. Many patients stay one night, particularly where drains are used, so that blood pressure can be monitored and any early bleeding detected. You will need someone to take you home and stay with you afterwards.
Incisions run in the crease in front of the ear, follow the natural contour of the tragus, curve under and around the earlobe, then continue behind the ear into the hairline, with a temporal extension where required. Placed this way, mature scars are difficult to see at conversational distance. They are pink and firm for the first few months and continue to fade for 12 to 18 months. Pixie ear deformity describes an earlobe pulled downward and stretched, losing its natural free edge, and it happens when closure places tension on the skin around the lobe rather than on the deeper SMAS layer. It is a technique-related complication rather than an inevitable one, and correcting it requires revision surgery.
Facelift surgery is well established but carries specific risks worth understanding before consenting. Haematoma, a collection of blood beneath the lifted skin, is the most common complication, usually appearing within the first 24 hours and may need a return to theatre; it is more frequent in men and in patients with poorly controlled blood pressure. Facial nerve injury causes weakness in part of the face, is usually temporary, and is permanent only rarely. Skin flap necrosis is uncommon but far more likely in smokers. Other risks include infection, numbness of the cheek and ear that can take months to resolve, hair loss along the incisions, asymmetry, poor scarring, pixie ear deformity, blood clots and the possibility of revision surgery. Dr Khan discusses the risks relevant to your circumstances.
Most patients find a facelift less painful than they expect, describing tightness, pressure and a heavy or numb sensation across the cheeks and neck rather than sharp pain. The face has an excellent blood supply and heals quickly, and the numbness that follows surgery masks a good deal of what would otherwise be sore. Discomfort peaks over the first two to three days and is managed with prescribed pain relief, with most patients on simple analgesia within a few days. Tightness under the chin is often the most persistent complaint and eases over several weeks. Severe or one-sided pain, particularly with rapid swelling in the first 24 hours, may indicate a haematoma and should be reported immediately.
Most patients take two to three weeks off work and are socially presentable, with makeup, at around two to three weeks. Dressings and any drains are removed in the first day or two, and sutures come out in stages between roughly day five and day fourteen. Bruising is at its worst around days three to five and largely resolves by two to three weeks, though it can track down the neck and chest before it fades. Driving usually resumes at one to two weeks, once you are off prescription pain medication and can turn your head comfortably. Keeping your head elevated, avoiding bending and straining, and keeping blood pressure controlled all matter in the first fortnight.
Swelling peaks around days two to four, settles substantially over the first three to four weeks, and then continues to resolve slowly, with residual swelling and firmness taking three to six months to disappear entirely. Mild asymmetry during this period is normal, since the two sides rarely settle at the same rate. Numbness across the cheeks, in front of and around the ears, and under the chin is expected because small sensory nerves are inevitably divided, and it typically resolves over three to six months, occasionally taking up to a year. Odd sensations such as tingling, itching or a crawling feeling as the nerves recover are normal. Judge your result at six months rather than earlier.
Sleep on your back with your head elevated on two or three pillows or a wedge for the first two to four weeks, since elevation reduces swelling and keeps pressure off the healing incisions around the ears. Side sleeping generally resumes at around four weeks and stomach sleeping later. Most patients can shower and gently wash their hair with a mild shampoo from around 48 hours to a week after surgery, following the instructions given, using lukewarm water and patting the incision lines dry rather than rubbing. Hair colouring, bleaching and chemical treatments are usually delayed for at least four to six weeks, because the chemicals can irritate healing incisions. Dr Khan’s instructions for your surgery take precedence.
Gentle walking is encouraged from the first day or two to support circulation. Beyond that, restrictions after a facelift are stricter than they are for body surgery, because anything that raises blood pressure raises the risk of bleeding beneath the lifted skin. Light activity resumes over the first two weeks, moderate cardio at around three to four weeks, and strength training, heavy lifting, bending forward and anything involving straining generally wait until six weeks. High-impact activity, hot yoga, saunas and spas wait until cleared. Protecting the healing scars from sun exposure matters throughout, since ultraviolet light darkens them permanently. Dr Khan will confirm the timeline that applies to your surgery.
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