What are the risks involved with a facelift?

Erik A. Hoy, MD
Plastic Surgery
The most common complications seen with a facelift are hematoma (postoperative bleeding), seroma (collection of fluid), infection, sloughing of skin, and unattractive scarring of the incisions. These risks can be minimized to some extent, but they are inherent to the procedure. As part of the process of informed consent, you should discuss these relative risks and other the possible complications along with the benefits of the procedure.
Stuart A. Linder, MD
Plastic Surgery
The risks involved in a face lift should be discussed prior to the operation. The most common risks include: hematoma (bleeding), infection (cellulitis-skin infection), seroma (fluid collection), skin slough (necrosis), fat atrophy, and scarring (peri-auricular and posteriorly into the hairline).
Sarmela Sunder, MD
Facial Plastic Surgery (ENT)
Although a facelift is generally a very safe procedure, the following are some potential risks of facelift surgery that a patient needs to be aware of:
  • hematoma -- excessive bleeding can create a collection of blood under the skin flap which needs to be drained in a timely manner
  • seroma -- collection of fluid within the wound
  • infection -- treated with antibiotics and close observation
  • sloughing of skin -- rare, but a more significant risk among smokers, patients with suboptimal nutritional status, patients with certain medical conditions
  • reaction to anesthesia
  • nerve weakness -- rare and usually temporary
  • numbness around the dissection area -- usually temporary
  • poor scarring -- although there is always a scar where an incision is made, the visibility of the scar can be made less obvious with careful wound handling and specific closure techniques
  • hair loss along incisions placed in hairline -- this can be minimized with appropriate technique
Arthur W. Perry, MD
Plastic Surgery
A multitude of potential complications can occur with face-lifts. Infection and bleeding can take place. Because the open area under the lifted skin is so large, a great deal of blood can collect. In fact, this hematoma can get big enough to destroy the skin.

Hematomas usually occur in the first twenty-four hours following surgery, but have been reported for up to three weeks. When they are diagnosed, the patient returns to the operating room as rapidly as possible. Some plastic surgeons think that drains, or tubes under the skin, can decrease hematomas, but others do not believe in them. A new technique sprays the tissue with human glue, fibrin. It doesn't decrease the chance of a hematoma, however, and the increased cost and the theoretical chance of contracting an infectious disease from a human product are the downsides. Hematomas are more likely in men than in women. Hypertension is a major cause of this problem and must be carefully controlled before, during, and after surgery.

Scars will, of course, result from this procedure. The quality of the scar depends on the skill of the surgeon and the genes of the patient. Certain spots are notorious for bad scarring. One is the span behind the ear, extending into the hairline. We try to not use sutures in the skin in this area, relying on deep stitches and Dermabond instead. Sutures leave unattractive, usually white, cross-marks.
Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

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Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

The public’s recent exuberance toward cosmetic surgery has spurred an unprecedented demand for appearance-changing procedures. But how can an average consumer discern the hype from solid truth? ...
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All surgeries come with some risk. In this video, plastic surgeon Anthony Youn, MD, describes possible complications of facelifts.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.