Facial Plastic Surgery

Medically reviewed by Dr. Bouraoui Kotti, Specialist Plastic Surgeon, MD, PhD

You may notice heavier eyelids, a lower brow position, flatter cheeks, jowls, loose skin around the neck, or a change in the shape or proportion of your nose. Each of these concerns can come from a different part of the facial anatomy, so the right treatment depends on what has changed, your skin quality, your overall health, and the result you want to achieve.

The main types of facial plastic surgery include facelift surgery, neck lift, brow lift, eyelid surgery, midface lift, facial fat grafting, rhinoplasty, and facial contouring procedures.

At Seline Clinic in Jumeirah, Dubai, facial surgery begins with a whole-face assessment. The aim is to understand how the brows, eyelids, cheeks, jawline, neck and facial proportions relate to one another before deciding which procedure is appropriate.

What Does Facial Plastic Surgery Actually Treat?

Facial plastic surgery covers procedures that reshape, restore or rejuvenate structures of the face and neck. Some procedures are performed for cosmetic reasons. Others have reconstructive aims, or combine functional and aesthetic goals.

Ageing affects the face at several levels. Skin gradually loses elasticity, facial fat changes in position and volume, and deeper supporting tissues can descend. Around the lower face this can appear as jowls or a softer jawline. Around the eyes, the visible change can come from eyelid skin, fat, brow position, or more than one of these factors.

Surgery is used to address structural change. A facelift can reposition descended tissue and remove excess skin, while concerns such as pigmentation, sun-related change and fine surface lines are treated through a different skin-focused approach.

A Quick Guide to the Main Procedures

Main concern

Procedure that may be considered

Jowls or lower-face laxity

Facelift

Loose neck skin or visible neck bands

Neck lift

Heavy or descended brows

Brow lift

Excess upper-eyelid skin

Upper blepharoplasty

Under-eye bags or lower-eyelid fullness

Lower blepharoplasty

Descended or flatter cheeks

Midface lift

Facial volume loss

Facial fat grafting

Nose shape or proportion

Rhinoplasty

Chin imbalance

Genioplasty or chin augmentation

This table is a starting point. The same visible concern can have more than one anatomical cause, which is why an examination is needed before a procedure is recommended.

Facelift Surgery: When the Lower Face Has Changed

A facelift is mainly used to treat structural ageing in the lower face. Patients commonly consider surgery when the jawline has lost definition, jowls have developed, or the skin and deeper tissues have started to descend.

Modern facelift surgery addresses the supporting tissues beneath the skin as well as the skin itself. One of the key layers is the superficial musculoaponeurotic system, or SMAS, which is involved in many established facelift techniques.

The surgical approach is chosen according to the anatomy and the degree of tissue descent:

SMAS facelift: repositions and tightens the deeper supporting layer beneath the skin.

Deep plane facelift: mobilises deeper facial tissues so they can be repositioned with less reliance on skin tension.

Limited-incision or mini facelift: a smaller operation for patients with earlier lower-face laxity. Techniques can include approaches such as the MACS lift or S-lift.

Endoscopic techniques: use smaller incisions and camera assistance in appropriate facial areas.

Technique selection depends on the pattern and extent of ageing. Early jowling with good skin quality presents a different surgical problem from advanced lower-face and neck laxity.

Who Usually Considers a Facelift?

Most facelift candidates have visible tissue descent in the cheeks, jawline or lower face and are medically suitable for elective surgery. Smoking, medications, supplements, previous surgery and existing medical conditions all form part of the assessment because they can influence bleeding, healing and anaesthesia.

Age by itself is a poor shortcut. Tissue quality, anatomy and the pattern of ageing usually tell the surgeon more than the number on a passport.

What the Operation and Recovery Can Involve

Facelift surgery can be performed under general anaesthesia or intravenous sedation, depending on the operative plan, patient factors, surgeon preference and facility protocol. Incisions are commonly positioned around the ear and within or close to the hairline, following natural boundaries wherever possible.

Swelling and bruising are most noticeable early in recovery. Some patients have a temporary drain or compression dressing, and sutures can be removed in stages. For many facelift patients, the visible recovery is measured in weeks, while deeper healing continues beyond that point.

Residual swelling settles gradually, and the face continues to refine for several months before the result can be properly assessed.

What a Facelift Can and Cannot Do

A facelift can improve jowls, lower-face laxity and jawline definition. Repositioning descended tissue can also soften some facial folds.

Fine surface lines, uneven pigmentation and sun-related skin changes can remain after surgery and can require separate treatment.

Facelift scars are permanent, although they are positioned within the hairline and around natural ear contours where possible. Haematoma is one of the recognised early complications after facelift surgery. Nerve injury is uncommon but possible. Other risks include infection, wound-healing problems, fluid collection, asymmetry and complications related to anaesthesia or blood clots.

What People Mean by a 'Full Facelift'

The phrase "full facelift" is commonly used to describe a broader surgical plan involving several areas of the face and neck rather than one single standardised operation.

For one patient, this can mean an extended facelift with a neck lift. For another, the plan can also include blepharoplasty, a brow lift or facial fat grafting. The combination is chosen according to the areas that contribute to the overall facial appearance.

Combined surgery involves a longer operation and a more involved recovery. Several areas can be treated in one procedure when this is appropriate, while other patients are better served by a staged plan.

Midface Lift: When the Cheek Is Part of the Problem

The midface can be easy to overlook because the concern is often noticed somewhere else. A patient may focus on deeper smile lines or a hollow beneath the eyes when part of the change is actually coming from the position of the cheek.

As cheek tissue descends, the upper cheek can look flatter and the transition between the lower eyelid and cheek becomes less smooth. A midface lift repositions this tissue and restores support to the area.

Suitability depends on cheek position, tissue descent, skin quality and facial anatomy more than on a specific age.

The operation can be performed through an endoscopic or more traditional approach. It can also be combined with lower blepharoplasty when the lower eyelid and cheek need to be treated as one aesthetic unit. Recovery varies considerably. Bruising and swelling settle first, while the final contour can take months to mature.

Brow Lift: Is the Brow Really the Cause?

Heavy upper eyelids are a good example of why diagnosis matters. For some patients, excess eyelid skin is the main issue. For others, the brow itself has descended. Both can contribute at the same time.

A brow lift repositions descended brows and can create a more open appearance in the upper face. It can also soften some forehead creases. Dynamic expression lines are influenced by muscle activity and can require separate treatment.

Common surgical approaches include:

Endoscopic brow lift: uses small scalp incisions and camera assistance.

Temporal brow lift: focuses mainly on the outer brow.

Coronal or open brow lift: a more extensive traditional approach that can be considered in appropriate cases.

Thread lifting is a non-surgical treatment with a different mechanism, degree of correction and expected duration from surgical brow lifting.

Swelling and bruising are common during early recovery. Patients need a period of social recovery, and strenuous activity is restricted until healing has progressed sufficiently.

Blepharoplasty: Upper Eyelids, Lower Eyelids, or Both?

Blepharoplasty is eyelid surgery and can involve the upper eyelids, lower eyelids, or both, depending on the concern being treated.

Upper blepharoplasty removes or reshapes excess tissue through an incision placed in the natural eyelid crease. Lower blepharoplasty addresses under-eye bags and related contour concerns. In some lower-eyelid cases, the surgeon can use a transconjunctival approach through the inside of the eyelid, avoiding an external skin incision.

When the upper and lower eyelids are treated in one operation, this is called combined upper and lower blepharoplasty.

Bruising, swelling, dryness and temporary irritation are common early effects. The appearance improves as swelling settles, although subtle swelling can take longer to resolve.

Rhinoplasty: Reshaping the Nose in Balance With the Face

Rhinoplasty changes the shape, size or proportions of the nose. Some patients have a feature they have wanted to change for years. Others consider surgery after an injury or because the nose feels out of balance with the rest of the face.

The operation can address the bridge, tip, nostrils, width, projection or overall nasal shape. Cosmetic rhinoplasty can also be planned alongside functional nasal surgery when breathing concerns are present.

Good rhinoplasty planning considers the nose in relation to the rest of the face. The surgeon looks at the chin, forehead, lips, facial width, skin thickness and overall profile. Even a relatively small nasal change can make a noticeable difference to facial balance.

Swelling is expected after rhinoplasty and is most noticeable in the early stages. Much of it settles gradually, while the nose can continue to refine for many months before the final shape is fully appreciated.

Neck Lift and Jawline Contouring

The neck can show a different pattern of ageing from the face. Some patients develop loose skin, while others are more concerned about platysmal bands, fullness beneath the chin, or loss of jawline definition.

A neck lift can tighten loose skin and address platysmal bands. When submental fat is also present, the surgical plan can include liposuction or another contouring technique.

Liposuction works best when there is localised fat and the skin has enough elasticity to retract. In a neck with substantial skin laxity, removing fat alone may not provide enough correction.

Other Facial Contouring Procedures

Facial plastic surgery also includes procedures that focus primarily on proportion and contour rather than ageing changes.

Buccal fat removal: reduces fullness in the lower cheek. Careful patient selection matters because facial volume naturally decreases with age.

Chin surgery: can involve genioplasty or an implant to improve balance between the chin, nose and jawline.

Otoplasty: changes the position or shape of prominent ears.

Surgical Facelift vs Non-Surgical Facial Rejuvenation

Surgical and non-surgical treatments work in different ways.

Surgery physically repositions descended tissue and can remove excess skin. Non-surgical treatments have different roles. Fillers can restore volume in specific areas, while botulinum toxin alters muscle activity. Skin boosters and biostimulators target skin quality or collagen-related change. Energy-based treatments can help with mild laxity, and thread lifts create a more limited and temporary mechanical effect.

Treatment choice should match the anatomical problem. Mild laxity can respond to non-surgical treatment. Established tissue descent generally requires surgery when meaningful structural repositioning is the goal.

How a Surgeon Decides Which Procedure Fits

Patients sometimes arrive with the name of an operation already in mind. Examination can point to a different plan because the visible concern does not always come from the area the patient expects.

A softer jawline can result from jowling, neck laxity, submental fat, a small chin, or a combination of these factors. Heavy upper eyelids can come from eyelid skin, brow descent, or both. A hollow beneath the eye can relate to the eyelid, cheek position, volume loss, or several of these changes together.

The consultation therefore looks at the face as a whole. Skin elasticity and facial volume matter, as do tissue descent, bone structure and medical history. Smoking, medications, weight stability and the amount of recovery time available also influence planning.

The operation should follow the anatomy, not the trend.

Risks and Safety Considerations

Every operation carries risk, including elective surgery performed after careful planning. The exact risks depend on the procedure. Facial surgery can involve bruising, swelling, numbness, bleeding, haematoma, infection, delayed wound healing, asymmetry, scarring, temporary or rarely lasting changes in sensation or muscle movement, and complications related to anaesthesia.

Smoking and nicotine exposure can interfere with healing. Blood-thinning medication and certain supplements can increase bleeding risk, so these factors need to be discussed before surgery.

Choosing a properly licensed facility, working with a qualified plastic surgeon, and following pre-operative and post-operative instructions are important parts of reducing risk.