Facelift Surgery

What is a facelift?

A facelift, or rhytidectomy, repositions and tightens the deeper structures of the face and removes excess skin, addressing loss of definition in the lower face and jawline. Modern facelift surgery works on the underlying tissue layer — the SMAS — rather than simply pulling skin tight, which is what produces a natural result rather than an operated appearance.

Facial ageing is not only a matter of skin. Beneath the skin, fat pads descend and deflate, ligaments that support the face weaken, and bone volume is gradually lost. Skin loses elasticity on top of all this. A facelift addresses descent and laxity; it does not address skin texture, pigmentation or fine lines, which are treated separately.

Patients commonly consider a facelift for:

• Loss of firmness in the mid-face and reduced cheek definition
• Deepening folds between the nose and mouth
• Jowls forming along the jawline
• Loss of a defined jawline and neck contour
• Facial appearance that no longer reflects how they feel

Am I a suitable candidate?

There is no correct age for a facelift. Suitability depends on the degree of laxity, your skin quality and your general health rather than a number.

Generally, candidates are:

• Experiencing changes in the lower face, jawline or neck that concern them
• In good general health, with well-controlled medical conditions — particularly blood pressure, as poorly controlled hypertension increases bleeding risk
• Non-smokers, or willing to stop well before and after surgery — smoking substantially increases the risk of skin loss in facelift surgery specifically
• Of reasonable skin elasticity
• Realistic in expectations, understanding that surgery repositions tissue rather than making someone look like a different person

Referral requirement. All patients require a referral from a GP or another specialist before their first consultation. If it is deemed that your surgery is cosmetic in nature and you do not qualify for a Medicare (MBS) item number, a referral is still required, in line with Australian requirements introduced in July 2023.

Psychological screening and cooling-off. Where surgery is cosmetic, Dr. Anavekar screens all patients for body dysmorphic disorder (BDD) as part of the assessment. A second consultation is required before any decision to proceed, and a minimum seven-day cooling-off period applies after that second consultation and before surgery can be booked, as required under AHPRA guidelines.

Facelift techniques

SMAS facelift

The SMAS is a layer of fibrous tissue and muscle beneath the skin. Tightening and repositioning this layer, rather than the skin alone, supports the result over the longer term and avoids the tight, pulled appearance associated with older skin-only techniques. This is the foundation of modern facelift surgery.

Deep plane facelift

The dissection is carried beneath the SMAS, releasing the ligaments that tether the face. This allows the mid-face and cheek to be repositioned vertically as a single unit. It is technically more demanding and is suited to patients with significant mid-face descent.

Mini facelift / short scar

A shorter incision addressing early jowling and mild laxity, with a more limited dissection. Recovery is shorter, but so is the extent of correction — it is not a substitute for a full facelift where laxity is significant.

Facelift with neck lift

The lower face and neck age together, and a facelift is very commonly combined with a neck lift to address platysmal banding and submental fullness. Treating the face without the neck can produce an unbalanced result.

Adjunctive procedures

Fat grafting is often combined to restore lost volume in the cheeks and temples, since repositioning tissue alone does not replace volume that has deflated. Eyelid surgery, brow lift and skin resurfacing may also be discussed depending on your concerns.

What is involved

Before surgery

Before surgery, you’ll have more than one consultation, where your facial anatomy is assessed, photographs taken, and incision placement explained — facelift incisions are designed to sit within the hairline and the natural contours around the ear, where they settle inconspicuously.

A seven-day cooling-off period applies after your second consultation and before any booking for cosmetic surgery. Blood pressure is reviewed and optimised where necessary. You must cease smoking, and pause medications or supplements that can increase bleeding risk.

On the day

Surgery is usually performed under general anaesthetic administered by a specialist anaesthetist, in an accredited private hospital. The length of your operation depends on the technique used and whether a neck lift or other procedures are combined. Most patients stay overnight.

Incisions are made in the agreed position, the SMAS layer is repositioned and secured, excess skin is removed without tension, and the incisions are closed in layers. Drains are sometimes used, and a supportive dressing applied.

After surgery

Your face will be swollen and bruised, and this is more pronounced than most patients anticipate. Sleeping with the head elevated is important. Pain after facelift is usually less than expected — tightness and numbness are the dominant sensations.

Your recovery

Recovery varies between individuals. The following is a general guide only.

Sleeping elevated for the first two weeks, avoiding vigorous activity, and protecting scars from sun exposure all materially affect the result.

Potential benefits

A facelift may:

• Improve firmness and definition in the mid-face, jawline and neck
• Restore definition to the jawline
• Soften deep folds between the nose and mouth
• Reposition descended cheek and mid-face tissue
• Produce a rested, less tired appearance

Outcomes vary between individuals and cannot be guaranteed. A facelift does not stop ageing — it repositions tissue at a point in time, and ageing continues from there. It does not improve skin texture, pigmentation, sun damage or fine lines, which require separate treatment.

Costs

The total cost includes the surgeon's fee, the anaesthetist's fee, hospital fees and follow-up care, and varies considerably with the technique used and whether a neck lift, eyelid surgery or fat grafting are combined.

Facelift surgery performed for cosmetic reasons does not attract a Medicare rebate, and private health insurance does not generally contribute. Where facial surgery is performed for reconstructive reasons — following trauma, cancer surgery or facial palsy — a Medicare item number may apply.

You will receive a written quote setting out all costs before committing to surgery, as part of the informed financial consent process. For questions about fees, contact the practice on 03 9075 0005.

Why Evolve

Dr. Namrata Anavekar is a Fellow of the Royal Australasian College of Surgeons and a specialist plastic and reconstructive surgeon. She graduated with honours from Monash University and completed the Australian Plastic Surgery Training Program, with rotations through St Vincent's Hospital, The Royal Children's Hospital, The Alfred and The Austin, followed by an international fellowship in Switzerland and France.

Dr. Anavekar is a board member of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and has authored multiple research publications. She holds several public and private hospital appointments, and is a professional member of ASAPS, the Australian Society of Plastic Surgeons (ASPS), the Royal Australasian College of Surgeons (RACS), the Australian Medical Association (AMA), and the International Society of Aesthetic Plastic Surgery (ISAPS).

Dr. Anavekar is part a relatively small group of experienced female specialist plastic surgeons in Melbourne, and consults from Bulleen and Sunbury locations.

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