Choosing a surgeon for a facelift is a decision that shapes both appearance and wellbeing for years to come. Patients in Waterfall, Midrand, and the broader northern Johannesburg area often travel to accredited day hospitals in the region for their procedure, where they can be cared for by a qualified plastic surgeon working within a registered theatre and recovery environment. This page explains what a facelift involves, the techniques most commonly used, how candidacy is assessed, what recovery looks like, and the practical steps involved in booking a consultation with Dr Deon at Life Fourways Hospital.
Facelift surgery, also called rhytidectomy, is performed to lift and reposition the soft tissues of the lower face and neck, remove excess skin, and redefine the jawline. Modern techniques focus on repositioning the deeper SMAS (superficial musculo-aponeurotic system) layer rather than simply pulling the skin tight, which gives a more natural result that lasts longer and avoids the “wind-tunnel” look associated with older skin-only lifts.
Who is a good candidate for a facelift?
Most patients who present for facelift surgery are in their late forties to early seventies and have noticed laxity along the jawline, deepening nasolabial folds, marionette lines, or loose skin and banding in the neck. Good candidates are non-smokers (or willing to stop at least four weeks before and after surgery), are in reasonable general health with no uncontrolled medical conditions, and have realistic expectations about what surgery can and cannot achieve. A facelift improves structure and contour; it does not change skin quality, pigmentation, or fine surface lines, and those concerns are often best addressed with adjunct treatments such as skin resurfacing, peels, or medical-grade skincare.
During the consultation, Dr Deon takes a full medical history, examines facial proportions and skin quality, photographs the face from standardised angles, and discusses which combination of procedures will produce a balanced, refreshed result. For some patients, a facelift alone is sufficient. For others, a neck lift, blepharoplasty, brow lift, fat grafting, or a non-surgical treatment such as dermal filler or anti-wrinkle injections may be recommended alongside the surgery to address the face as a whole.
Facelift techniques offered
Different patterns of facial ageing call for different techniques. The choice depends on the degree of laxity, the thickness of the skin, the position of the hairline, and the patient’s anatomy. The three most commonly performed variations at the practice are summarised below.
| Technique | Best suited to | Typical incision | Recovery |
|---|---|---|---|
| Mini facelift (short-scar) | Younger patients (late 40s to mid 50s) with early jowling and mild neck laxity | Limited incision around the front of the ear | 10 to 14 days before social activities |
| SMAS facelift (standard) | Moderate facial ageing, defined jowls, laxity along the jawline | Incision from the temple, around the ear, into the hairline behind the ear | 2 to 3 weeks before social activities |
| Deep plane facelift | More advanced ageing, marked midface descent, significant neck laxity | Similar to SMAS but with deeper release of facial ligaments | 2 to 4 weeks before social activities |
Thread lifts are sometimes marketed as a non-surgical alternative to a facelift. They have a role for carefully selected younger patients with very mild laxity, but the results are temporary (typically 12 to 24 months) and do not match the structural change of a surgical lift. Dr Deon will discuss during consultation whether a thread lift is appropriate, or whether a surgical approach will give better long-term value.
What the procedure involves
A facelift is performed under general anaesthetic at an accredited day hospital or in-hospital theatre. The procedure takes between three and five hours, depending on the technique and whether adjunct procedures (such as blepharoplasty or fat grafting) are performed at the same time. Patients go home the same day in most cases, although some prefer an overnight stay.
The surgery involves making incisions in natural creases around the ear and into the hairline, lifting the skin, repositioning and tightening the SMAS layer, removing excess skin, and closing the incisions with fine sutures. A small thin drain may be placed on each side and is usually removed the next day. A head dressing is applied and worn for 24 to 48 hours.
Recovery and downtime
Recovery Time Depends On The Type Of Facelift. Most Patients Experience Swelling And Bruising For One To Two Weeks, With Gradual Return To Daily Activities. Dr Deon Provides Clear Post-Operative Instructions To Support A Smooth Recovery.
As a general guide, patients can expect the following timeline. Days one to three are usually the most uncomfortable, with swelling and a tight, heavy feeling across the cheeks and neck; pain is well controlled with prescribed medication. By the end of week one, the dressing and any drains are removed and most bruising can be covered with makeup. By week two, many patients feel comfortable enough to return to light office-based work. Strenuous exercise, heavy lifting, and contact sports should be avoided for at least four to six weeks.
Scars are placed in natural creases around the ear and within the hairline, and they mature over 12 to 18 months. Sun protection on the scars for the first year is essential to prevent hyperpigmentation.
Risks and complications
Facelift surgery is performed routinely and is considered safe when carried out by a qualified plastic surgeon in an accredited facility. That said, all surgical procedures carry some risk, and patients should be fully informed before consenting.
| Risk | Approximate rate in published series | Notes |
|---|---|---|
| Hematoma (collection of blood under the skin) | Around 1 to 3% | Most common complication; small ones resolve, larger ones may need drainage |
| Infection | Less than 1% | Treated with antibiotics; rare in facelift surgery |
| Nerve injury (temporary or, very rarely, permanent) | Temporary weakness in around 1 to 2%; permanent injury is rare | Usually affects the lower facial nerve supplying the corner of the mouth |
| Poor scarring or widened scar | Variable | More common in smokers and patients with a history of keloid scarring |
| Skin necrosis (most often behind the ear) | Rare, higher in smokers | Reasons to stop smoking before and after surgery |
| Asymmetry or contour irregularity | Variable | Often minor and correctable; revision surgery is uncommon |
Smoking dramatically increases the risk of skin necrosis and poor healing, and patients who smoke will be asked to stop at least four weeks before and after surgery. Uncontrolled high blood pressure also increases the risk of hematoma, so any history of hypertension should be well managed before the procedure.
How to choose a facelift surgeon in the Waterfall area
Waterfall falls within the broader Midrand and northern Johannesburg catchment, and patients are not limited to surgeons physically located in their suburb. What matters is that the surgeon is appropriately qualified and that the facility is accredited. In South Africa, patients can verify a surgeon’s registration on the Health Professions Council of South Africa (HPCSA) register and can confirm specialist plastic and reconstructive surgeon status through the Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa (APRASSA).
A good consultation should include a full facial analysis, a discussion of the various technique options, a clear explanation of the risks and the recovery, before-and-after photographs of previous patients with similar anatomy, and a transparent, all-inclusive quote. Patients should feel comfortable asking how many facelifts the surgeon performs each year, where the surgery will be done, who will administer the anaesthetic, and what the policy is on revision surgery.
Cost of a facelift
The cost of a facelift varies depending on the technique, the surgeon, the anaesthetist, the facility, and whether adjunct procedures are performed at the same time. A surgeon’s fee typically reflects training, experience, and the complexity of the case rather than the geographic suburb in which the surgery is performed. Patients should expect a fully itemised quote that separates the surgical fee, the anaesthetic fee, the facility fee, implants or garments if used, and any follow-up visits.
Medical aid schemes in South Africa generally do not cover cosmetic facelift surgery. Where a functional component is present (for example, redundant skin impairing vision or causing skin breakdown), partial cover may apply; this is assessed on a case-by-case basis and pre-authorisation is required.
Booking a consultation
Patients in Waterfall and surrounding areas can begin the process with an online consultation and photo review, which allows Dr Deon to assess the face remotely, suggest which procedures are most likely to address the concern, and give a provisional cost range before an in-person visit. The practice is based at Suite B22, Life Fourways Hospital, and can be reached on 011 875 1694.
Frequently asked questions
What happens during the consultation?
The consultation includes a full medical history, a facial analysis with standardised photographs, a discussion of which technique is best suited to the anatomy and the desired result, an explanation of the risks and the recovery timeline, and a detailed quote. Patients are welcome to bring a partner or family member, and there is no obligation to proceed.
How long is the recovery?
Most patients take 10 to 14 days off work for a mini or standard facelift, and 14 to 21 days for a deep plane or combination procedure. Bruising is usually gone by the second week; residual swelling can take several weeks to settle fully.
Are the results permanent?
A facelift sets the clock back, but it does not stop ageing. Most patients continue to look refreshed for 8 to 12 years, after which a smaller revision procedure or non-surgical treatment can be considered. Good skin care, sun protection, and a healthy lifestyle all help to maintain the result.
Is the procedure painful?
Facelift surgery is not generally described as painful. Most patients describe a feeling of tightness, heaviness, and mild discomfort rather than sharp pain. This is well controlled with prescribed analgesics in the first week, after which most patients manage with over-the-counter medication.
Will the scars be visible?
Incisions are placed in the natural creases around the ear and within the hairline. Once fully matured (12 to 18 months) they are usually very difficult to see, even on close inspection.
Can a facelift be combined with other procedures?
Yes. Common combinations include blepharoplasty (eyelid surgery), brow lift, neck lift, fat grafting to the cheeks or temples, and skin resurfacing. Combining procedures is often more cost-effective than staging them, although it does extend the operating time and the recovery.
What anaesthetic is used?
Facelift surgery is performed under general anaesthetic administered by a qualified anaesthetist in an accredited facility.
Where is the surgery performed?
Dr Deon operates at accredited facilities in the greater Johannesburg area. The practice is based at Life Fourways Hospital, Suite B22.
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- Top Rated Facelift Surgeon in North Riding
- How to Find the Best Plastic Surgeon for a Facelift | 8 Key Questions
This content is for general information and does not constitute medical advice. Individual results, recovery timelines, and risks vary. Always consult a qualified, HPCSA-registered plastic surgeon for advice specific to your situation. Surgical procedures carry risks, and informed consent should be obtained directly from the treating surgeon.
