Facelift

What is a facelift?

A facelift (rhytidectomy) addresses sagging skin, jowls, loss of jawline definition, and neck bands that develop with age. The goal is to restore a more refreshed, youthful appearance while preserving natural facial expression — without producing an artificial or "pulled" look.

Modern facelift techniques go beyond skin tightening — the underlying SMAS layer and neck structures are repositioned for longer-lasting, natural results. The most advanced approach, the deep plane facelift, repositions skin and SMAS as a single composite unit, producing the most natural results currently achievable in facial rejuvenation surgery.

Who is a candidate?

Candidates typically have visible jowling, deepened nasolabial folds, neck laxity, loss of facial oval definition, or have found non-surgical treatments insufficient. Most patients are between 45 and 70 years old, but biological age and tissue quality matter more than chronological age.

Ideal candidates are non-smokers (or willing to stop smoking 4-6 weeks before surgery), in good general health, with realistic expectations. International patients traveling to Istanbul for facelift surgery undergo a thorough preoperative evaluation, including video consultation before travel.

Types of facelifts

Mini facelift (short-scar): Suitable for patients aged 35-50 with mild-to-moderate sagging. Shorter incision, limited SMAS work, faster recovery.

Classic SMAS facelift: The Superficial Musculoaponeurotic System (SMAS) layer is repositioned independently from the skin. A standard approach for moderate sagging.

Deep plane facelift — the technique Dr. Erdal prefers in the majority of his cases: Dissection is performed beneath the SMAS layer, repositioning skin, SMAS, retaining ligaments and deep facial fat compartments as a single composite block. Considered the gold standard in modern facelift surgery, this technique delivers more natural results, longer-lasting outcomes, and minimal "pulled" appearance. Dr. Erdal routinely performs deep plane facelift for suitable patients in Istanbul.

Neck lift (necklift): A short submental incision allows tightening of the platysma muscle and contouring of submental fat. Most deep plane facelift patients receive a combined neck lift to ensure unified rejuvenation of the lower face, jawline and neck.

Deep Plane Facelift — why it is the preferred technique

In Dr. Ayhan Işık Erdal's facelift practice, the deep plane technique is preferred for the majority of suitable candidates. This preference reflects both the anatomical advantages of the technique and long-term patient satisfaction observed in clinical experience.

Anatomical foundation: Facial sagging is not just a skin-level problem. Skin, SMAS, retaining ligaments, and deep fat compartments all descend together under gravity. In classic SMAS techniques, skin and SMAS are addressed as separate layers and pulled independently, which can lead to skin and underlying structures being repositioned in different vectors — and produce a tight, unnatural appearance. Deep plane technique moves the dissection beneath the SMAS, allowing skin, SMAS and fat compartments to be repositioned as a single composite block.

Clinical advantages:

1) More natural results: Because skin and underlying structures move together, natural mimicry, smile lines and expression are preserved. The "pulled" or "windswept" appearance is virtually eliminated.

2) Effective midface rejuvenation: Areas where classic SMAS is limited — such as the cheek-midface, nasolabial fold, malar volume, and lid-cheek junction — show significant improvement with deep plane technique.

3) Longer-lasting results: Because skin-SMAS continuity is preserved, the tendency to "drop back" over time is reduced. International literature reports deep plane results lasting 12-15 years.

4) Minimal skin tension: Because tension is borne by the SMAS rather than the skin, scar quality is improved and the risk of skin necrosis is reduced.

5) Unified neck integration: Most deep plane cases include platysmaplasty (neck muscle repair), so lower face, jawline definition, and neck are addressed as a single unit. Jawline definition improves significantly.

Technical demands: Deep plane facelift requires dissection in close proximity to facial nerve branches (especially the frontal and marginal mandibular branches). It is technically demanding and requires advanced training and experience. Dr. Erdal performs this technique routinely as a result of fellowship training abroad and many years of clinical experience.

Who is a candidate for deep plane? Patients with moderate-to-advanced facial sagging, prominent nasolabial folds and jowls, who want natural results and are in good general health are typically candidates for deep plane technique. Younger patients with very mild sagging may benefit from a mini facelift instead, while complex revision cases may require individualized modifications.

Combined procedures: Deep plane facelift is frequently combined in a single session with neck lift (cervicoplasty + platysmaplasty), eyelid surgery (upper/lower blepharoplasty), brow lift, lip lift, and fat grafting. These combinations achieve comprehensive facial rejuvenation in one operation.

Incisions and scarring

Facelift incisions begin in front of the ear, curve around the ear, and extend into the hairline or behind the ear. Scars are largely concealed in natural contours and fade significantly over 6-12 months. Modern technique favors retro-tragal incisions and pre-trichial planning to preserve hairlines and avoid altering the patient's hairstyle.

Deep plane facelift uses the same incision placement as classic SMAS — the difference lies in the dissection plane beneath the incision. There is no scar disadvantage; in fact, scar quality is often better with deep plane because skin-level tension is reduced.

Preoperative preparation

Smoking must be stopped at least 4-6 weeks before surgery. Smoking severely impairs facial skin perfusion and dramatically increases the risk of skin necrosis. Even passive smoke exposure should be minimized.

Blood-thinning medications (aspirin, ibuprofen, NSAIDs, vitamin E, fish oil, ginkgo) are stopped 10 days before surgery. Hypertension must be controlled before and after surgery — uncontrolled blood pressure significantly increases hematoma risk in the first 48 hours postoperatively.

Standard preoperative tests are performed: complete blood count, biochemistry, coagulation, ECG. International patients can complete part of their workup at home and the remainder upon arrival in Istanbul.

The surgery

Facelift is performed under general anesthesia in an accredited hospital. Operative time depends on technique and combined procedures, averaging 4-6 hours. Combined cases (face + neck + eyelids) may extend to 7 hours. Hospital stay is typically 1 night, occasionally 2.

A compression dressing is applied to the face postoperatively to control swelling and reduce hematoma risk. Drains may be placed and removed in 1-2 days. An elastic facial compression garment is then worn at night for 1-2 weeks.

Recovery timeline

First week: Significant swelling and bruising around the face. Pain is generally mild-to-moderate and well-controlled with analgesics. Limit chewing and facial movements. Sleep with the head elevated.

Weeks 2-3: Swelling decreases substantially, bruising fades. Social recovery — return to public-facing activities — is appropriate. Light makeup can conceal residual marks. Hair washing can begin in the first week.

Weeks 4-6: Light exercise (walking, stationary cycling) can resume. Vigorous exercise, weight training, and saunas are introduced after 6 weeks.

Months 3-6: Most healing is complete. Skin softness and natural movement settle during this period. Scars may appear pink — this is normal.

1 year: Final result. Scars become fine white lines. Surgical results last 8-15 years; aging continues, but from a significantly rejuvenated baseline.

Risks and complications

Facelift is a safe procedure in experienced hands but carries potential risks:

Early-period risks: Hematoma (2-8% — the most common), infection (under 1%), seroma, temporary skin sensory changes, transient facial nerve weakness (usually resolves within weeks to months).

Late-period risks: Scar quality issues, asymmetry, persistent nerve weakness (rare, under 1%), hairline changes, skin necrosis (especially in smokers).

Aesthetic risks: Result that differs from expectations, "pulled" appearance (minimized with modern technique, particularly with deep plane), minor asymmetry.

Facelift in Istanbul — Assoc. Prof. Dr. Ayhan Işık Erdal's practice

Dr. Ayhan Işık Erdal's private clinic is located in central Istanbul, in the Nisantasi district — Istanbul's premier neighborhood for plastic surgery, luxury retail and medical excellence. Address: Teşvikiye Cad. No:9/12, Istanbul. The clinic is easily accessible from major Istanbul hotels and from Istanbul Airport (IST) and Sabiha Gökçen Airport (SAW).

Istanbul has become a leading destination for facelift surgery worldwide, attracting patients from Europe, North America, the Middle East, and Asia. International patients choose Istanbul for the combination of board-certified plastic surgeons, modern accredited hospitals, competitive pricing compared to Western Europe and the US, and the cultural-tourism appeal of the city itself.

Dr. Erdal's practice in Istanbul is structured to provide international patients with seamless coordination: video consultation prior to travel, transfer between airport and hotel, English-speaking medical team, accommodation arrangements at partner hotels near the clinic, and full postoperative follow-up. The hospital partners are accredited facilities in central Istanbul with international anesthesia standards and dedicated postoperative care.

For deep plane facelift, Istanbul offers a unique combination: a surgeon experienced in this advanced technique with international training (Memorial Sloan Kettering, Ghent University Hospital), accredited operating facilities, and structured medical tourism support. Patients typically stay in Istanbul for 10-14 days following surgery. WhatsApp consultations are available at +90 544 850 72 32 for international inquiries.

Frequently Asked Questions