Is a Facelift Safe? The Risks and How Each Is Reduced
Updated: 13 hours ago
Medical editor: Dr. Semih Yıldız, plastic, reconstructive and aesthetic surgeon (FEBOPRAS) · Last updated: October 2026
For healthy people who prepare well, a facelift is a well-established operation, and serious complications are uncommon. The most frequent early problem is bleeding under the skin (haematoma), nerve weakness is usually temporary, and the strongest risk factors you can influence are smoking and high blood pressure. Most risks are lowered by careful selection, technique and aftercare.
The risks listed on our facelift in Istanbul page are bleeding or haematoma, infection or delayed wound healing, visible scars or hair loss, numbness, asymmetry, facial nerve weakness and the need for revision. Below, each is explained with what makes it more likely and what is done to reduce it, so that you can weigh them calmly.
Safety starts weeks before the operation
Many facelift risks are shaped long before the day of surgery, by the health of the person having it:
Blood pressure: uncontrolled high blood pressure is one of the strongest medical risk factors for haematoma, so it is checked and, if needed, treated before surgery goes ahead.
Nicotine: cigarettes, vapes, patches and gum all reduce blood flow to the lifted skin. Stopping for at least 4 weeks before and after surgery is part of the preparation, not an optional extra.
Medicines and supplements: blood thinners, aspirin, ibuprofen, fish oil and some herbal products, such as ginkgo or garlic tablets, can increase bleeding and may need to be paused. Prescribed blood thinners are only adjusted together with the doctor who prescribed them.
Previous treatments: fillers, threads and earlier facial surgery change the tissues and are taken into account when the technique is chosen.
General health: pre-operative tests check your fitness for general anaesthesia, and conditions such as diabetes or heart disease need to be stable.
Age on its own is not a barrier. A fit person in their seventies may be a safer candidate than a younger smoker with untreated high blood pressure.
Bleeding and haematoma
A haematoma is a collection of blood under the lifted skin. It is the most common early complication of a facelift and usually appears within the first 24 hours as swelling and pressure on one side. It is more common in men, whose beard-bearing skin has a richer blood supply, and in people with raised blood pressure.
Prevention runs through the whole process: blood pressure controlled before and after surgery, bleeding-promoting medicines paused, careful control of bleeding before the skin is closed, a supportive dressing and a calm first night under monitoring in hospital. Good control of pain and nausea matters too, because pain, vomiting and straining push blood pressure up. A small collection may only need draining at a check-up; a larger one is treated promptly in the operating theatre, and when that happens early, the final result is usually not affected.
Nerves: feeling and movement
Numbness of the cheeks and around the ears is an expected effect rather than a complication. Small sensory nerves are divided when the skin is lifted, and feeling returns over weeks to months. The nerve that supplies the earlobe (great auricular nerve) runs close to the incision behind the ear, and lasting numbness of part of the ear is uncommon.
The facial nerve, which moves the muscles of expression, runs beneath the deeper layers. Its branches to the forehead and to the corner of the lower lip are the ones most likely to show weakness, for example a brow that lifts less or a smile that looks uneven. Such weakness usually comes from stretching or swelling around the nerve and recovers over weeks to months; permanent weakness is rare. Precise knowledge of facial anatomy, and a plane of dissection chosen to suit your face, are what protect these branches.
Skin healing and infection
Once lifted, the skin is fed by vessels from the areas that were not lifted. Behind the ear, where it is thinnest and furthest from that supply, it is most vulnerable, and nicotine or excess tension can cause slow healing or a small area of skin loss. Such areas usually heal with dressings over a few weeks, but they can leave a wider scar that may be revised later.
Infection is uncommon in the face, which has a rich blood supply. Spreading redness, warmth, fever or discharge are treated with antibiotics and, if needed, drainage. Closing the skin without tension and staying completely off nicotine are the two strongest protections for healing.
Anaesthesia and blood clots
A facelift is performed under general anaesthesia in hospital and usually takes 3–5 hours. Your tests, medicines and history are reviewed before surgery, and you are monitored in hospital for two nights afterwards. Every procedure added to the facelift lengthens the anaesthetic, which is one reason combinations are decided after assessment and kept within sensible limits.
Long operations and long periods of sitting raise the risk of a clot in the leg veins (deep vein thrombosis). Standard measures include compression of the legs during and after surgery, walking from the first evening, enough fluids and a flight home that follows the wound check rather than coming a day or two after surgery. Oestrogen-containing hormone treatment and a previous clot increase the risk and should be mentioned at assessment.
Scars, hair, earlobes and asymmetry
Visible scars and hair loss around the incisions are listed risks. They are reduced by placing the incisions along the natural lines of the ear and hairline, protecting the hair follicles and closing the skin without tension, which also keeps the earlobe in its natural shape. Hair shedding near the incisions is usually temporary.
No face is exactly symmetrical before surgery, and swelling is often uneven in the first weeks, so small differences are judged only once the result has settled at 6–12 months. A pulled or windswept look is avoided by lifting the deeper layers and re-draping the skin rather than stretching it. Rarer problems include a collection of fluid from the salivary gland in front of the ear (parotid gland), which usually settles with compression and time, and small contour irregularities that soften as the swelling resolves. If a revision is needed, such as a scar correction or a tuck of residual neck skin, it is planned once the result has settled.
What you can do to lower your risk
Several of the strongest protections are in your hands:
Stop all nicotine at least 4 weeks before surgery and stay off it for at least 4 weeks afterwards.
Have your blood pressure checked in the weeks before travelling, and keep taking any prescribed blood pressure medicine.
Send a complete list of medicines and supplements, and of previous fillers, threads and facial surgery.
Keep the first days calm: head raised, no straining, bending or lifting.
Stay about 10 days, so that stitch removal and the wound check happen before you fly.
Report sudden swelling on one side, fever, darkening skin, new facial weakness, calf pain or breathlessness without delay.
Dr. Semih Yıldız reviews your medical history, medicines and previous treatments before the technique is agreed, and what the operation can and cannot do, together with the alternatives, is discussed with you before you give informed consent. The full list of risks and the recovery timeline are on our facelift page.
Frequently asked questions
Is a facelift riskier for men?
Men have a higher rate of haematoma after a facelift, mainly because the beard area has a richer blood supply and blood pressure plays a large part. Careful blood pressure control before and after surgery, pausing medicines that promote bleeding and a calm first night reduce this risk. Otherwise the risks are broadly similar, although the incisions need extra planning around the beard.
Is there an upper age limit for a facelift?
There is no fixed age limit. What matters is general health: blood pressure, heart and lung function, diabetes, medicines and fitness for general anaesthesia, which the pre-operative tests and the anaesthetic assessment check. A healthy person in their seventies can be a suitable candidate, while a younger person with uncontrolled blood pressure may need treatment before surgery.
Is a deep plane facelift riskier for the facial nerve?
Not necessarily. Working beneath the SMAS brings the surgeon closer to the branches of the facial nerve, so it calls for precise anatomical knowledge, but nerve weakness is a listed risk of every facelift technique and is usually temporary. The technique should be chosen to suit your anatomy rather than to avoid or seek a particular plane.
If you would like your health history and risk factors reviewed before you decide, you can send your photos and medical details for a free online assessment.
This article provides general information and does not replace a medical consultation. Results vary from person to person.
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