§01 Face · Cosmetic surgery
Rhytidectomy · Face and neck lift · SMAS facelift
A facelift is an operation that repositions the deeper soft tissues of the lower face and removes surplus skin to reduce jowls and sagging, and a neck lift does the same for loose skin, fat and muscle bands in the neck, either on its own or as part of the same operation.
The surgeon who would operate decides whether it is right for you and takes your consent personally. Vertex Medic helps you understand it first, then coordinates the consultation and the practical side.
Free to ask · No obligation · Never a clinical assessment
Vertex Medic is a booking, marketing, administration and coordination platform. It is not a clinic and does not employ surgeons. Your surgeon, an independent registered clinician working from registered premises, decides whether a procedure is suitable, takes your consent and carries it out. Vertex helps you understand your options, arranges the consultation and keeps the practical side in one place.
§02 What it is
A facelift, known medically as a rhytidectomy, is an operation to lift and reposition the soft tissues of the lower face and to remove surplus skin. It is aimed at the changes that come with age, sun exposure or significant weight loss: jowls along the jawline, deepening folds between the nose and the corners of the mouth, and loose skin below the cheeks. A neck lift addresses the neck itself, tightening the platysma muscle, removing or redistributing fat under the chin and trimming loose skin. The two are often carried out together as a face and neck lift, which is the combination the NHS describes and prices.
Modern techniques work on a layer beneath the skin called the SMAS (superficial musculoaponeurotic system), which continues into the neck as the platysma muscle. The surgeon either stitches this layer into a higher position or cuts and repositions it, then redrapes the skin and removes the excess. According to BAAPS, the more the deeper tissues are moved, the greater and more durable the change tends to be, but also the longer the recovery and the higher the risk profile. Which approach is proposed depends on the surgeon's assessment of the individual's skin elasticity, bone structure, fat distribution and neck anatomy.
It is elective surgery, usually carried out under general anaesthetic with an overnight stay, and it is rarely available on the NHS. It does not stop ageing, and no surgeon can guarantee a particular result: BAAPS explains that the long-term outcome depends on how the individual's tissues heal and form internal scar, which cannot be controlled. Vertex Medic is not a clinic; it coordinates. The independent surgeon assesses suitability, chooses the technique, operates and provides follow-up; this page exists only to help visitors understand the procedure and the questions worth asking.
Vertex Medic does not assess suitability. This section exists so you can decide whether a consultation is worth your time; the surgeon decides the rest.
§03 Options
The surgeon recommends a technique after examining you. This is what the choice tends to affect, so the conversation makes sense when you have it.
An older approach that lifts and trims the skin without repositioning the deeper SMAS layer. BAAPS notes that the skin stretches under tension, so the result tends to be less durable than techniques that work on the deeper tissues.
Often considered for: Rarely used on its own now; sometimes discussed for very limited skin laxity.
The surgeon tightens the SMAS layer either by folding it with stitches (plication) or by removing a strip and sewing the edges together (SMASectomy), then redrapes and trims the skin. This is the common basis of most facelifts described by BAAPS.
Often considered for: Moderate jowling and loss of jawline definition where the skin still has some elasticity.
The SMAS layer is lifted as a flap and repositioned as a unit with the skin, rather than being folded or trimmed. BAAPS describes this as more invasive, with generally larger and more durable change but a longer recovery and a higher risk profile.
Often considered for: More advanced sagging of the cheeks, jowls and neck; the surgeon judges whether the extra dissection is warranted.
A more limited operation using shorter incisions and suspension stitches placed in the SMAS to lift the tissues. The NHS prices a mini facelift at the lower end of the range. Recovery is usually shorter but the degree of correction is smaller.
Often considered for: Early jowling in people with good skin elasticity and little neck laxity.
Focuses on the neck: the platysma muscle is tightened, either by sewing the two edges together in the midline or by pulling it backwards and securing it, and excess fat is reduced by liposuction or direct removal. A small incision under the chin is often used alongside incisions around the ears.
Often considered for: Neck bands, loose neck skin or fullness under the chin with relatively little change in the face.
The face and neck are treated in one operation, lifting the SMAS and platysma as a continuous sheet and trimming skin in both areas. This is the combination the NHS describes and usually takes longer than a facelift alone.
Often considered for: Ageing changes affecting both the lower face and the neck, which BAAPS notes commonly occur together.
A facelift may be combined with fat grafting to restore volume, eyelid surgery (blepharoplasty), a brow lift, or skin resurfacing such as a chemical peel or laser. BAAPS notes that fine wrinkles and sun damage respond to resurfacing rather than lifting.
Often considered for: People whose concerns include the eyes, brow or skin surface as well as sagging; the surgeon advises on sequencing and safety.
§04 Consultation and decision
From the first consultation, every clinical decision is your surgeon's. Vertex Medic arranges the meeting and keeps the paperwork; it is not in the room.
Meeting the surgeon who would actually operate. GMC guidance states that the doctor carrying out a cosmetic intervention must discuss it and seek consent personally and must not delegate this.
A discussion of why the person wants surgery, what they hope to change and what they would consider a successful result, so the surgeon can say whether that is realistic.
A full medical history, including all medications and herbal remedies, smoking or nicotine use, diabetes, weight and body mass index, previous facial surgery and any bleeding or clotting problems.
Examination of the face and neck: skin elasticity, bone structure, position of the facial fat, jowls, neck bands and any existing asymmetry. Photographs are usually taken for the medical record, with separate written consent for any other use.
An explanation of the options, including the technique the surgeon proposes and why, alternatives such as fat grafting, thread lifts or energy-based skin tightening, and the option of no treatment.
A frank account of the risks and complications, the incision and scar pattern, the expected recovery and how durable the result is likely to be for this person.
A written breakdown of costs covering the surgeon, the consultant anaesthetist and the hospital, what follow-up is included, and what a revision or the treatment of a complication would cost.
Written information to take away, then a period to reflect. The Royal College of Surgeons advises at least two weeks between consultation and surgery, with consent taken in two stages by the operating surgeon.
Confirmation that the person can change their mind at any point, and a discussion of whether the GP should be contacted. The surgeon may suggest deferring surgery or seeking psychological support where that is appropriate.
§05 What generally happens
Every timing here is typical, not promised. Your surgeon and anaesthetist give you the plan that applies to you.
Before admission the surgeon's instructions typically include stopping smoking and all nicotine products at least six weeks beforehand, avoiding aspirin and anti-inflammatory tablets for two weeks, having any hair colouring done in advance, and showering in the 24 hours before surgery.
On the day the surgeon marks the face and neck, confirms consent, and the anaesthetist discusses the anaesthetic. A facelift is usually done under general anaesthetic, occasionally under local anaesthetic with sedation.
Incisions are made in front of the ear, running up into the temple hairline and around behind the earlobe into the crease behind the ear and the lower scalp. For neck work a small incision may be made under the chin.
The skin is lifted and the SMAS layer beneath it is tightened, either with stitches or by cutting and repositioning it. In the neck the platysma is tightened and excess fat is reduced by liposuction or direct removal.
Surplus skin is trimmed to fit the original incision and the wounds are closed with stitches. Fat may be redistributed or grafted to restore volume where the surgeon has planned this.
Small drains are sometimes placed for the first night to reduce the risk of blood collecting under the skin, and the face is dressed with a supportive bandage.
The operation usually takes 2 to 3 hours according to the NHS, longer for a combined face and neck lift or when other procedures are added, and most people stay in hospital overnight.
§06 Recovery
The scale is stretched in the early weeks so the first days can be read. Every timing is typical, not promised; your surgeon gives you the plan that applies to you.
Day 1 to 12 months on a logarithmic scale: the first fortnight takes up half the line because that is where the questions are.
First 48 hoursDays 1 to 2
The face is bandaged and feels tight, swollen and numb, with bruising developing around the cheeks, ears and neck. Pain is usually controlled with prescribed tablets. Any drains are removed before discharge. The NHS advises not showering and keeping bandages dry for the first two days. Sudden one-sided swelling, severe pain or difficulty breathing needs immediate contact with the surgical team, as a blood collection in the neck can press on the airway.
Week 1Days 3 to 7
Swelling tends to peak in the first few days and then begins to settle. Bandages are replaced by lighter dressings and the first review takes place. Sleeping propped up and walking gently are usually encouraged. The NHS notes that a low mood is common in this period as the face looks worse before it looks better. Driving is not resumed until the surgeon agrees.
Weeks 2 to 4Days 7 to 28
Stitches are removed between 7 and 14 days. Bruising is usually visible for at least two weeks and the NHS advises 2 to 4 weeks off work. Strenuous activity, saunas and massages are avoided for at least two weeks. Numbness of the cheeks and around the ears is expected and hair colouring is delayed while the scars are fresh.
Around 6 weeksWeeks 4 to 6
According to the NHS, stiffness usually settles by about six weeks and most people have returned to normal activities and exercise. Scars are still pink and may feel firm. Some tightness when opening the mouth wide or turning the head can persist, which BAAPS says usually resolves over a few months.
3 to 6 monthsMonths 3 to 6
Residual swelling continues to fade and the contours of the jawline and neck settle. Scars begin to soften and pale. BAAPS notes that occasional shooting pains in the face and neck are part of nerve regrowth and can continue for up to a year. Small areas of firmness or unevenness often improve in this period.
6 to 12 monthsMonths 6 to 12
The NHS states that the full result is generally visible at 6 to 9 months. Scars continue to mature. Some early slackening of the skin is expected as it adapts to its new tension. This is usually the point at which the surgeon and patient assess the outcome and discuss whether any revision is warranted.
12 months and beyondYear 1 onwards
Numbness usually resolves by 12 to 18 months according to BAAPS, although small patches can be longer lasting. Scars reach their final appearance. Ageing continues from the new starting point, and the durability of the lift depends on the individual's tissue quality and how the internal scar tissue has held the repositioned layers.
§07 Scarring
Scars run in front of the ear, often tucked partly along the edge of the ear cartilage, up into the temple hairline, and around the earlobe into the crease behind the ear and the lower scalp. A neck lift may add a short scar in the crease under the chin.
According to the NHS, scars fade over several weeks to months but can be thick and obvious, and hair loss around the scars, a raised hairline or altered sideburns can occur. BAAPS adds that scars can become raised (hypertrophic) or, more rarely, keloid, may differ between sides, and that the extent of scarring is variable and cannot be predicted.
In men, beard-bearing skin can be moved closer to the ear. Careful placement and closure by the surgeon reduce visibility but do not remove the scars.
dashed: where an incision typically runs
§08 Risks and trade-offs
The list below separates the risks of any surgery from the ones specific to this procedure. No likelihoods are given here: your surgeon should explain how likely each one is for you, and how it would be treated if it happened.
§09 Questions to ask
Tick them as you go. The list stays on this device and goes nowhere else.
§10 Choosing a surgeon
Vertex Medic lists the checks. The registers are the source of truth, and they are free to search.
Check the surgeon on the GMC register (gmc-uk.org) and confirm they hold a licence to practise. Look for entry on the specialist register, normally in plastic surgery, or in another relevant surgical specialty such as ENT or oral and maxillofacial surgery. The RCS notes that a doctor in the private sector only needs GMC registration to offer cosmetic surgery, so specialist registration is a choice the patient has to check for.
Open the GMC registerCheck whether the surgeon holds Royal College of Surgeons of England cosmetic surgery certification for the relevant area of the face, using the RCS list of certified surgeons, which gives GMC numbers and the procedures covered.
Open the GMC registerAsk whether the surgeon is a full member of BAAPS or BAPRAS, both of which restrict membership to surgeons on the specialist register and publish member lists.
Open the BAAPS directoryConfirm that the hospital or clinic is registered with the Care Quality Commission in England, or with Healthcare Improvement Scotland, Healthcare Inspectorate Wales or the Regulation and Quality Improvement Authority in Northern Ireland, and read its latest inspection report.
Find a service on the CQC registerAsk to see details of the surgeon's professional indemnity insurance covering facelift and neck lift surgery in the UK; the RCS says patients are entitled to ask.
Open the RCS cosmetic surgery pageswhat counts as a revision, what it costs, over what period it applies, and what happens to hospital and anaesthetist fees.
Ask who provides aftercare, including out-of-hours cover, and obtain the name and contact details of a doctor who can deal with problems after the procedure before surgery takes place.
Expect a cooling-off period. GMC guidance requires the operating doctor to give patients the time and information they need to reflect and to tell them they can change their mind at any point; the RCS standards add that consent should be a two-stage process with at least two weeks between stages. A provider that presses for a quick decision or offers time-limited discounts is not following that guidance.
Open the GMC registerSources: GMC: Guidance for doctors who offer cosmetic interventions (2016) · Royal College of Surgeons: cosmetic surgery · CQC: choosing cosmetic surgery · CAP Code, section 12: medicines, medical devices, health-related products and beauty products. Vertex Medic follows the same rules on this site.
§11 What moves the price
Your chosen provider gives you a written, itemised quote after your consultation. This is what usually changes the number, and what the quote should say.
To about £10,000
From a few thousand pounds for a mini facelift to about £10,000 for a face and neck lift, plus the cost of consultations and follow-up care, as stated by the NHS
Source: NHS, Facelift (cosmetic procedures). NHS page last reviewed 22 September 2023; next review due 22 September 2026. Checked 5 September 2026.
Prices vary by surgeon, hospital, complexity and location, and the NHS figure is an indication rather than a quote. Vertex Medic does not set or quote treatment prices; any figure is provided by the independent surgeon or hospital after a consultation.
§12 Common questions
There is no fixed figure. BAAPS explains that the result depends on how the tissues heal and form internal scar, on skin quality and on how the face continues to age, and describes the outcome as varying from person to person and not predictable. Some slackening of the skin is expected even in the early months, and ageing continues afterwards. Your surgeon can give a view based on your own tissues and the technique proposed.
A facelift lifts the loose skin and deeper tissues of the face below the eyes, chiefly the cheeks and jawline; anything above the eyes is a brow lift. A neck lift tightens the platysma muscle and the skin of the neck, sometimes with fat removal under the chin, and may use a small extra incision beneath the chin. Many people have both at the same time because the lower face and neck age together, and the surgeon advises which combination fits the individual.
BAAPS states that it should not be obvious that someone has had a facelift. Because the deeper tissues are moved, facial shape does change, and BAAPS warns that some people feel they no longer look quite like themselves. Telling the surgeon what you would consider a successful result, and looking at before-and-after photographs of patients they personally treated, helps align expectations before consent.
There is no set age. BAAPS notes that most people having facelifts are in their 40s to 60s but that the operation can be done successfully for people in their 70s or 80s. What matters more is general health, skin elasticity, bone structure and the absence of factors that raise risk, such as smoking, a high body mass index or poorly controlled diabetes, all of which the surgeon assesses.
BAAPS lists several: fat grafting or fillers to restore volume, barbed thread lifts that give a temporary lift, liposuction for mild fat excess in the neck, and energy-based skin tightening using laser or radiofrequency. These address different problems and none repositions the deeper tissues in the way surgery does. Not having any treatment is also an option, and the consent process should acknowledge it.
The NHS advises allowing 2 to 4 weeks off work, with bruising usually visible for at least two weeks and stitches removed at 7 to 14 days. Strenuous activity, saunas and massages should be avoided for about two weeks, and driving only resumed once the surgeon agrees. People with physically demanding or public-facing jobs often plan for the longer end of that range.
Very rarely. The Royal College of Surgeons states that cosmetic surgery is seldom available through the NHS unless there is an overriding physical or psychological reason, and its consultation checklist warns that the NHS is unlikely to help after private surgery unless a serious complication needs emergency treatment. Facelifts are almost always self-funded, so the arrangements for treating complications should be agreed in writing beforehand.
Yes, considerably. The BAAPS consent document advises stopping smoking, nicotine vapes, patches and gum six weeks before surgery and not restarting, because nicotine reduces blood flow to the lifted skin and raises the risk of skin loss, poor healing and worse scars. The BAAPS leaflet specifically mentions the skin flaps behind the ear losing their blood supply. Surgeons may decline to operate on people who continue to use nicotine.
§13 Also considered
Ordinary editorial navigation: nothing here is inferred from anything you have told us.
Written by the Vertex Medic editorial team from published UK guidance, checked 5 September 2026. This page is general information, not medical advice. Your surgeon will assess you personally, and no surgeon can guarantee a particular result.
§14 When you are ready
Tell the Vertex Medic booking concierge what you are considering. A real person calls you back within one working day, explains what happens next, and arranges a consultation with an independent surgeon if you want one. No deposit, no deadline.
Free to ask · No obligation · Never a clinical assessment
Vertex Medic coordinates your care and remains your point of contact. Your treatment is carried out by the surgeon and registered healthcare provider named above, who are responsible for your clinical care. These details are confirmed to you in writing before you book.