Facelift

What is lifted. A facelift works on the cheeks, the folds from nose to mouth and the jawline; a neck lift works below it, on loose skin, the vertical bands and the fat under the chin. They meet at the jaw, which is why one without the other can leave a visible step between them, and why the two are often planned as a single operation.

It is the layer of muscle and fibrous tissue between the skin and the deeper structures of the face, and it is what carries the weight. A facelift that lifts the SMAS moves the tissue that has descended; one that pulls only the skin puts the tension in the wrong layer. That distinction is why the word appears on every page about this operation, including this one.

They follow the border of the ear: up in front of it, around the earlobe and back into the hairline behind. Where the neck is part of the plan there may be a small incision under the chin as well. The lines are placed where the skin changes — at a hairline, in the fold in front of the ear — because that is where an incision is least conspicuous, not because it disappears.

One is surgery and the other is not. A liquid facelift is filler placed to restore volume where it has been lost; it adds, and it moves nothing. A facelift repositions tissue that has descended and removes the skin left over. They answer different complaints — a hollow cheek is not a heavy jawline — and a surgeon will say which of the two your face is asking for.

Age is not what the decision is made on. What is looked at is what the tissue is doing: how much has descended, whether the skin springs back, how much volume has gone and where the jawline sits now. Two people born in the same year can need different operations, or one of them none at all. If the answer is that surgery is not what your face needs yet, that is an answer a surgeon should be willing to give.

They are often discussed together, because a facelift works on the lower two thirds of the face and leaves the eyes and the forehead where they were. Eyelid surgery and a brow lift address the upper third. Whether they are done in one operation is your surgeon’s decision, taken on what is being lifted and on your own health rather than on convenience.

In an accredited Istanbul hospital with its own anaesthesia team, under general anaesthetic. The surgeon who examined your face is the one who performs the operation — you are given their name, and you can read about them on the surgeons’ pages. Everything said to you is said through an interpreter, and the hospital appears in your written plan before you book anything.

A photograph of yourself from ten or fifteen years ago is more use than one of somebody else — it shows where your own tissue used to sit. Bring a list of what you take, including anything affecting blood pressure or clotting, a note of previous facial surgery, fillers or thread lifts and roughly when, and be straight about smoking. How you scar is worth mentioning too.