A facelift consultation is much more than a simple discussion about surgery. It's a comprehensive assessment where your surgeon evaluates your facial anatomy, understands your concerns, and develops a personalised surgical plan. Understanding what happens during this appointment helps you prepare effectively and get the most from your time with your surgeon.
The Initial Assessment
Your consultation begins with a detailed discussion about what brings you to consider facial rejuvenation. Your surgeon will want to understand your specific concerns, whether that's sagging jowls, loose neck skin, descended cheeks, or overall facial aging. Being specific about what bothers you helps guide the examination and surgical planning.
During the physical examination, your surgeon assesses multiple aspects of your facial anatomy:
- Skin quality and laxity - How much excess skin is present and its overall condition
- Fat pad position - Whether the malar (cheek) and jowl fat pads have descended
- Muscle tone - The condition of the underlying SMAS layer
- Facial asymmetry - Natural differences between the two sides of your face
- Neck contour - Excess fat, skin laxity, and platysmal banding
- Brow position - Whether the eyebrows have dropped, particularly at the outer edges
Your Medical History Matters
A thorough medical history is essential for safe surgical planning. You'll be asked about:
Previous Facial Treatments
Any previous procedures significantly affect surgical planning. Thread lifts can create internal scarring and tethering that changes the surgical approach. Fat transfers may have resulted in overfilling or asymmetry. Fillers in certain areas affect tissue planes. Your surgeon needs complete information to plan accordingly.
Medications
Certain medications require special consideration. Weight loss medications like Mounjaro must be stopped approximately two weeks before surgery because they delay gastric emptying, which affects anaesthesia safety. If you've had fat transfers to your face while taking these medications, the transferred fat will continue to shrink as you lose weight.
Smoking and Nicotine
Smoking and nicotine use significantly increase surgical risks, including infection, wound breakdown, skin necrosis, and the need for revision surgery. While surgery can proceed with nicotine users, the risks must be clearly understood and accepted.
Understanding the Surgical Technique
Your surgeon will explain the specific techniques recommended for your anatomy. A comprehensive facelift typically involves:
Incision Placement
The incision runs in front of the ear, extends into the temple area at the junction of the hairline and skin, continues behind the ear, and across towards the back of the hairline and neck. This positioning allows access to all the tissues that need repositioning while keeping scars well-concealed.
Deep Plane Technique
Going underneath the SMAS muscle layer allows for more comprehensive tissue repositioning. This isn't just about removing excess skin - it's about elevating and suspending the descended fat pads and tightening the underlying muscle structure. The malar fat pads and jowl fat pads are mobilised and sutured upwards to the immobile SMAS layer, providing lasting lift and support.
Neck Work
The neck is typically addressed as part of the facelift through the same incisions. In some cases, an additional incision in the submental area (under the chin) may be recommended, but this depends on individual anatomy.
Complementary Procedures
During your consultation, your surgeon may discuss additional procedures that could enhance your results:
Brow Lift
If the tail of your eyebrows has dropped, a temporal (lateral) brow lift can be performed through an extension of the facelift incision. For significant frown lines between the eyebrows caused by strong muscles, Botox is often more appropriate than surgical intervention, as addressing the inner brow surgically requires a more extensive operation.
Eyelid Surgery
Blepharoplasty addresses excess skin and fat in the upper or lower eyelids. This may be recommended immediately or as a secondary procedure once facelift swelling has settled and the true eyelid appearance can be assessed.
Lip Lift
If the distance between your nose and upper lip is long (the philtrum), a lip lift can create better facial proportions. This involves removing a small amount of skin just beneath the nose.
Risks and Complications Discussed
A responsible consultation includes honest discussion of potential risks:
- Bleeding and haematoma - Blood collection under the skin that may require drainage
- Infection - Particularly important to discuss if you have implants or a history of infections
- Nerve injury - Temporary or rarely permanent numbness or weakness
- Asymmetry - Some natural asymmetry exists pre-operatively and complete symmetry is not achievable
- Scarring - While well-concealed, scars are permanent
- Skin necrosis - Small patches of skin death, more common in smokers
- Revision surgery - The possibility of needing additional procedures
Impact on Existing Features
Your consultation should address how surgery will affect existing features. For example, if you have tattoos near the incision lines, skin removal will affect their appearance. Earlobes may be repositioned. Previous scars may be incorporated or relocated. Understanding these changes beforehand prevents surprises.
Anaesthesia Options
Facelift surgery can be performed under deep intravenous sedation or general anaesthetic. Your surgeon will discuss which option is most appropriate based on the extent of surgery planned, your medical history, and personal preferences. Some patients experience anxiety or react to the adrenaline in local anaesthetic, making sedation or general anaesthesia preferable for a smooth procedure.
Recovery Expectations
Your consultation should set realistic expectations for recovery:
- Immediate post-op - You'll have a head bandage and visible stitches in the neck and cheek areas
- First two weeks - Significant bruising and swelling; most people take this time off work
- Weeks 2-4 - Bruising fades, swelling improves, stitches removed
- Months 1-3 - Continued settling and refinement of results
Questions to Ask Your Surgeon
Come prepared with questions. Consider asking:
- How many facelifts do you perform annually?
- What technique do you recommend for my specific concerns?
- Can I see before and after photos of similar patients?
- What are the most common complications you see?
- How do you handle revision surgery if needed?
- What is your protocol for post-operative care?
- How long before I can return to normal activities?
Key Takeaway
A facelift consultation is a two-way conversation. Your surgeon needs to understand your goals and concerns, while you need to understand the proposed approach, realistic outcomes, and potential risks. Take your time, ask questions, and ensure you feel confident in both the plan and your surgeon before proceeding.
Frequently Asked Questions
A thorough facelift consultation typically takes 30-45 minutes. This allows time for detailed assessment, discussion of your goals, explanation of surgical techniques, and answering all your questions.
Be open about your medical history, any previous facial procedures (fillers, threads, fat transfers), medications including weight loss drugs like Mounjaro, smoking history, and your specific concerns. Honesty helps your surgeon plan the safest, most effective approach.
A deep plane facelift involves going underneath the SMAS muscle layer to release and reposition facial tissues. This technique addresses not just skin laxity but also the underlying muscle and fat pad descent, providing more natural and longer-lasting results.
This depends on your individual concerns. Common complementary procedures include brow lifts, eyelid surgery (blepharoplasty), neck lifts, and lip lifts. Your surgeon will discuss which combinations would best achieve your goals.
Medications like Mounjaro must be stopped about two weeks before surgery as they delay gastric emptying. Additionally, if you've had fat transfers and are losing weight, the transferred fat will shrink, which affects surgical planning.
Your surgeon will discuss risks including infection, bleeding, nerve injury, asymmetry, scarring, skin necrosis, and the potential need for revision surgery. Smoking and nicotine use increase these risks significantly.
Yes. Previous thread lifts can cause internal scarring and tethering. Fat transfers may have created asymmetry or overfilling. Fillers in certain areas can affect tissue planes. Your surgeon needs to know your complete treatment history to plan accordingly.
Facelifts can be performed under deep intravenous sedation or general anaesthetic. The choice depends on the extent of surgery, patient preference, and medical factors. Both options are discussed during your consultation.