Common Risks and Complications of Facelift Surgery

Facelift surgery is widely performed and generally safe when done by an experienced surgeon. However, like all surgical procedures, it carries potential risks and complications. Understanding these risks helps patients make informed decisions and prepare properly for surgery and recovery.

Most complications are temporary or manageable, especially when surgery is performed using modern techniques and proper aftercare.

General Surgical Risks

These risks are not unique to facelift surgery but apply to most surgical procedures.

Bleeding and Hematoma

• Accumulation of blood under the skin
• Usually occurs within the first 24–48 hours
• May require drainage if significant

This is one of the most common early facelift complications.

Infection

• Rare due to good blood supply to the face
• Risk increases without proper wound care
• Usually treatable with antibiotics

Strict hygiene and post-operative care significantly reduce this risk.

Adverse Reaction to Anesthesia

• Nausea, dizziness, or allergic reactions
• Serious reactions are uncommon
• Pre-operative evaluation helps minimize risk

Facelift-Specific Risks and Complications

Swelling and Bruising

• Expected after surgery
• Most swelling subsides within 2–4 weeks
• Residual swelling can last several months

This is part of normal healing rather than a true complication.

Nerve Injury

• Temporary numbness or weakness may occur
• Facial nerve irritation can cause asymmetry during recovery
• Permanent nerve damage is rare

Most nerve-related symptoms resolve over time as swelling decreases.

Scarring

• Incisions are usually hidden along the hairline or behind the ears
• Scars may appear firm or red initially
• Scar quality improves over several months

Poor scarring risk increases with smoking or poor wound healing.

Skin Necrosis (Skin Loss)

• Rare but more likely in smokers
• Caused by reduced blood supply to the skin
• May require additional treatment

Smoking cessation before and after surgery is critical.

Hair Loss Around Incisions

• Temporary hair thinning near incision sites can occur
• Hair usually regrows within a few months
• Permanent hair loss is uncommon

Asymmetry

• Mild facial asymmetry is normal
• Swelling can exaggerate asymmetry early on
• Persistent asymmetry may require revision

Long-Term or Less Common Complications

Unsatisfactory Aesthetic Results

• Results may not match expectations
• Over-tightening or under-correction is possible
• Revision surgery may be needed in some cases

Clear communication and realistic expectations reduce this risk.

Prolonged Swelling or Firmness

• Some areas may remain firm longer
• Usually resolves with time and massage

Fat Necrosis or Lumpiness

• Small firm nodules under the skin
• Often temporary
• More common when combined with fat grafting

Factors That Increase Facelift Risks

Certain factors raise the likelihood of complications:

• Smoking or nicotine use
• Poor circulation or diabetes
• Blood-thinning medications
• Previous facial surgeries
• Aggressive surgical techniques

A thorough medical evaluation helps identify and reduce these risks.

How to Minimize Facelift Complications

Patients can reduce risks by:

• Choosing an experienced, board-certified surgeon
• Following pre- and post-operative instructions closely
• Stopping smoking well before surgery
• Avoiding blood-thinning supplements unless approved
• Attending all follow-up appointments

Proper planning is as important as the surgery itself.

When to Contact Your Surgeon

Seek medical attention if you experience:

• Rapid swelling or severe pain
• Sudden facial weakness
• Signs of infection (fever, redness, discharge)
• Worsening asymmetry after initial recovery

Early intervention prevents minor issues from becoming serious problems.

Key Takeaway

Facelift surgery is generally safe, but understanding the common risks and complications allows for realistic expectations and safer outcomes. Most complications are temporary and manageable when surgery is performed carefully and followed by proper aftercare.

Being informed, prepared, and selective about surgical expertise plays a major role in achieving a successful facelift result.