Most expanding hematomas appear in the first 12 hours, often after office hours. Drains, when used, come out after one to two days.[1][2]
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Recovery and risks
Among patients who came back to the same surgeon after a SMAS flap facelift, the second operation came about 12 years after the first on average. About 1 in 5 of them came back within 5 years, most often for loss of skin
Recovery
Most expanding hematomas appear in the first 12 hours, often after office hours. Drains, when used, come out after one to two days.[1][2]
In one surgeon's patients, swelling and bruising were graded as none by day 8, the average day of return to social life.[1]
Return to work averaged two weeks after a short-scar lift. Recovery took about four weeks after both deep-plane and SMAS plication lifts.[1][2]
Lymph drainage had mostly recovered by three months. Red marks from a hemostatic net cleared in 2 to 3 months.[1][2]
Lymph drainage returned to its pre-surgery pattern after six months. Most facial nerve weakness had recovered fully within six months without surgery.[1][2]
Lower face and neck measurements were still changing at twelve months. The result is judged at 6 to 12 months, and the scar at a year or more.[1][2][3]
Risks
In a US registry, about 1 in 55 facelift patients needed an emergency visit, a hospital stay or a second operation within 30 days. The rate rose when other operations were added.[1]
Bleeding under the skin is the most common serious complication, about 1 in 90 facelifts in the same registry. Men had about four times the risk.[1]
Any weakness of a facial muscle followed about 1 in 150 facelifts in pooled data. Permanent weakness followed about 1 in 2,000. About 7 in 10 injuries recover fully within six months without surgery.[1][2]
Loss of an area of skin followed about 1 in 1,000 deep-plane lifts in pooled data. Skin loss was linked to smoking after surgery.[1][2]
Infection followed about 1 in 300 facelifts in a US registry.[1]
Injury to the great auricular nerve, which gives feeling to the earlobe, is the most frequent nerve injury after a facelift, at 6%.[1]
A raised scar formed in about 3 in 100 patients after deep-plane lifts. A pixie ear, the earlobe pulled down onto the cheek, appeared in about 1 in 20 earlobe repairs in a review.[1][2]
How long results last
Among patients who came back to the same surgeon after a SMAS flap facelift, the second operation came about 12 years after the first on average. About 1 in 5 of them came back within 5 years, most often for loss of skin elasticity. Reviews of secondary facelifts put the interval at 9 to 12 years. Nearly all patients rated their result very good or better at one year, and about two in three did at about 12 years. No randomized study has measured how long a facelift lasts.[1][2][3]