Face · Facelift

How to Prepare for a Facelift: Medicines, Smoking, Blood Pressure and Surgery Day

The outcome of a facelift is not decided in the operating theatre alone. Many of the factors that raise the risk of the most common complications, such as haematoma, can be dealt with before surgery: medicines, smoking and poorly controlled blood pressure.1

This guide walks through preparation in order, from the weeks before surgery to the final days and the practical arrangements that make the first days of recovery easier. Instructions vary between patients, so always follow the list your surgeon gives you.

Key points

  • About 3 weeks before: blood thinners, aspirin, ibuprofen, some herbal supplements and hormone therapy are often stopped around this time, on your surgeon’s instructions.1
  • Smoking: markedly increases the risk of poor healing, haematoma and skin loss; your surgeon will tell you how long to stop.1,2
  • Long-term conditions: poorly controlled diabetes or blood pressure raises the risk of poor healing, haematoma and heart complications.1
  • Surgery day: usually no food after midnight; if you go home the same day, arrange a lift and someone to stay the first night.1
  • Do not rush: be sure of your reasons; results cannot be guaranteed.3

First step: a detailed consultation

Preparation begins with a consultation in which the surgeon reviews your medical history, every medicine and supplement you take, your facial structure and your goals.1 The NHS advises not rushing the decision, being sure of your reasons and understanding that results cannot be guaranteed.3 The extent of surgery, scar positions, type of anaesthesia, recovery timeline and any additional procedures should all be clear after this conversation.

Bringing a list of long-term conditions, regular medicines and previous facial treatments (fillers, threads and so on) makes planning easier. How earlier treatments change planning is covered in facelift after fillers or threads.

Medicines and herbal supplements

Medicines and supplements that increase bleeding raise the risk of haematoma, the most common facelift complication. Examples given by Mayo Clinic include warfarin, clopidogrel, aspirin, ibuprofen, ginseng, Ginkgo biloba and fish oil; surgeons often ask for these to be stopped about three weeks before surgery.1 Hormone replacement therapy raises the risk of blood clots and is usually stopped around the same time.1

Important: never stop a blood thinner prescribed for your heart, blood vessels or a clot on your own. That decision is made with the doctor who prescribed it, and sometimes stopping is not appropriate.

Smoking and nicotine

Smoking markedly increases the risk of poor wound healing, haematoma and skin loss.1 A classic 1984 study attributed a significant share of skin sloughs after facelift to cigarette smoking.2 Your surgeon will tell you how long before surgery to stop, and that period also covers recovery. Ask the same question about other nicotine products.

Long-term conditions and weight

  • Diabetes and high blood pressure: if poorly controlled, the risk of poor healing, haematoma and heart complications rises.1 Readings should be stable before surgery.
  • Bleeding or clotting disorders: can make surgery impossible and must be mentioned in advance.1
  • Weight fluctuations: frequent changes affect facial shape and skin and can reduce long-term satisfaction with the result.1 If you plan to lose weight, it makes sense to consider surgery once your weight is stable.

Preparation timeline

WhenWhat to do
Weeks beforeConsultation, surgical plan, any tests needed; stop smoking1
About 3 weeks beforeStop blood-thinning medicines and supplements and hormone therapy, as instructed1
Final weekPlan time off (usually 2 to 4 weeks), prepare your home, get front-fastening clothes3,1
The night beforeUsually no food after midnight; water and approved medicines are usually allowed1
Morning of surgeryWash face and hair with antibacterial soap as directed1

Arrangements to make in advance

If you go home the same day, arrange for someone to drive you and to stay with you for at least the first night.1 Most people stay one night in hospital.3 In the first days you will be asked to rest with your head raised, use cool packs and avoid pressure on the wounds; clothes that fasten at the front, rather than going over your head, make this easier.1 You should not drive for a number of days.3 Time off work is usually 2 to 4 weeks, and bruising is visible for at least two weeks.3

What happens in the following weeks is explained in facelift recovery week by week, and the operation itself in what happens during a facelift.

Frequently asked questions

How long before a facelift should I stop aspirin?

Surgeons often ask for blood-thinning medicines and supplements to be stopped about three weeks before. Never stop medicines prescribed for your heart or blood vessels on your own.1

I smoke. Can I have a facelift?

Smoking markedly increases the risk of poor healing, haematoma and skin loss; you will be asked to stop before and after surgery.1,2

Should I lose weight before a facelift?

Frequent weight changes can affect satisfaction with the result, so a period when your weight is stable is preferred.1

What can I eat on surgery day?

Usually nothing after midnight; water and approved medicines are usually allowed. Follow the instructions you are given.1

How much time off should I take?

Usually 2 to 4 weeks. Bruising is visible for at least two weeks.3

Can I be alone after surgery?

If you go home the same day, an adult should stay with you for at least the first night.1

Questions to ask your surgeon

  • Which medicines and supplements should I stop, and when can I restart them?
  • How long before and after surgery should I stop smoking?
  • Which tests do I need before surgery?
  • Will I stay in hospital the first night?
  • When can I go back to work and exercise?

Let us plan your facelift preparation together

A list of every medicine and supplement you take, your long-term conditions and your preferred dates makes preparation much easier.

Sources

  1. Mayo Clinic. Face-lift.
  2. Rees TD, Liverett DM, Guy CL. The effect of cigarette smoking on skin-flap survival in the face lift patient. Plast Reconstr Surg, 1984.
  3. NHS. Facelift.

This article is general information, not a personal diagnosis or treatment recommendation. Seek prompt medical care for urgent symptoms.

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