Cervico-Facial Ritidectomy, or more commonly referred to as "Facelift", is the most complete approach in the treatment of deep face wrinkles and sagging that accompany aging. Surgery involves removing excess skin, strengthening the deeper tissues of the face (fascia and muscle) and repositioning the skin on the face and neck. The main objectives are the correction of ptosis or skin fall in the middle third of the face, marionette lines, double chin. Every year, thousands of people undergo this intervention with very satisfactory results.

Facelift, the surgery that ends with sagging and wrinkles of the face

Common Questions


When doing a Facelift

We can think of a Cervico-Facial Ritidectomy in the following situations:

  • If your face does not reflect the joviality of your spirit and your energy level
  • If facial aging and excess skin are becoming a "burden" in your personal, professional or social life;
  • If signs of facial aging are evident but the skin still has some elasticity;
  • If one day found that time, gravity, sun exposure and some hereditary factors have achieved a transformation that does not please and with which it is not identified.

Will I be a good candidate for the Facelift?

The following topics are the main and most common reasons that make a potential patient a candidate for Cervical Facial Rhytidectomy:

  • Skin fall on face, jaw line, chin;
  • Deep wrinkles that extend from each side of the nose to the mouth (nasolabial grooves);
  • Marked wrinkles that extend from the corners of the mouth to the chin (marionette lines);
  • Facial volume (face fat) that "fell" or moved from site;
  • Flaccidity and loss of muscle tone in the lower third of the face and neck;
  • Double chin, which results from sagging and excess skin and fat deposited on the chin and jaw line;
  • Wrinkles and sagging neck.

How is Facelift performed?

Most "Facelift" techniques are directed to the lower regions of the face, such as the mandibular line, double chin, and cheek drop. In a Facelift, the middle region of the face or even the uppermost region (commonly called the "forehead") can be approached. In some situations, the deeper tissues of the face (muscle-aponeurotic layer) have to be repositioned or tightened to restore a more youthful, firm contour. Removing volume (fat) or increasing the volume (fat or fillers) may be necessary to achieve the best results.

What will my scars look like?

The scars have become as camouflaged as possible, and are generally located in this way:

  • Desde o couro cabeludo, passando pelo contorno natural da orelha e depois caminhando por detrás da orelha em direção à parte posterior do pescoço.
  • Nas regiões onde existe cabelo, as cicatrizes ficam escondidas para dentro da linha de implantação capilar.

No “Facelift” tradicional as cicatrizes percorrem todo o trajeto já descrito, desde o couro cabeludo (nas têmporas), passando pelo contorno natural da orelha até à parede posterior do pescoço.

No mini “Facelift” as cicatrizes normalmente estarão localizadas ao longo do couro cabeludo (nas têmporas) continuam no contorno natural da orelha, ficando limitadas à parte da frente da orelha.

No “Lift cervical” isolado, ou seja, o “Lift” do pescoço, as cicatrizes partem desde o lóbulo da orelha e continuam por detrás da mesma até à face posterior do pescoço.

Em todas estas variantes cirúrgicas, estão englobadas as cicatrizes em torno das pálpebras e na linha do queixo. Nem sempre as pálpebras são abordadas num “Facelift”, mas o mais frequente é que o sejam.
A incisão no rebordo inferior do queixo permite trabalhar a camada muscular nesta região, melhorando o contorno.

As cicatrizes de um “Facelift” devem ser bem posicionadas para que se tornem imperceptíveis e se confundam com as pregas naturais da pele.

A boa evolução do processo cicatricial depende de vários factores: técnica cirúrgica, ausência de tensão sobre as cicatrizes, ausência de infecção, estado nutricional da paciente, do controlo das patologias associadas, da ausência de tabagismo ativo no período que precede e que sucede a cirurgia, e de tendências genéticas.

Há risco de cicatrização anómala (cicatrizes hipertróficas e quelóides) sempre que a pele é cortada, contudo há formas de prevenir e minimizar o desenvolvimento destes problemas (ponto 5). Tudo será posto em prática na fase adequada do período de recuperação.

What can I do to help healing?

The cicatricial process occurs according to well defined and known steps, however, there are a number of factors and characteristics that can interfere with healing. This way it is important that you do not smoke as tobacco interferes with healing. If you are a smoker, you should stop at least 6 weeks before the intervention and for 4 to 6 weeks after the intervention. Other important care is the treatment of scars, after fully epithelialized, with silicone (gel and / or plaque) associated with compressive massage on the scar.

The accomplishment of manual lymphatic drainage by experienced professionals and aimed at the postoperative follow-up of this type of intervention is another essential aspect for a better result.

What precautions should I take in the preoperative period?

The preoperative period deserves special attention. There are some precautions or precautions to take.

Preoperative exams should be performed. Above all, it should be a preparation period in which you will be closely monitored by your Physician and your team. Be calm and do not hesitate if you need any clarification.

Dr. Ana Silva Guerra will provide you with the appropriate preoperative instructions and will answer any questions or concerns. First, your History and Clinical Background will be addressed.

Assessing your face and diagnosing major problems is essential as well.

What will the postoperative look like?

The postoperative period is a period of doubt and anxiety that requires close monitoring by the Surgeon and his team. If all the main reasons for doubts and concerns are previously addressed and clarified the postoperative becomes much easier and serene.

In the case of a re-intervention, is surgery more costly? Is there special care?

In case you have already undergone a procedure similar to this one with another medical team, it is important to provide Dr. Ana Silva Guerra and her team with all data regarding the procedure that was performed (medical reports, previous photos). A surgical review of a "Facelift" is not necessarily more painful. Surgery is however of another complexity. As it has already been an intervened region, the scar fibrosis of the already manipulated tissues can condition an increased risk of hemorrhage, seroma or cicatricial retraction (the tissues become less elastic or complacent).

A re-intervention is an excellent time to make corrections, or to detail some aspect that has been neglected, so you must forward to Dr. Ana Silva Guerra your concerns, so that it can be duly clarified.

Sometimes it is not possible to meet the expectations of the patient for several reasons that do not depend on the surgical intervention.

Any surgical intervention involves risks and may be associated with complications. What can happen in a cervico-facial rhytidectomy?

Fortunately, complications resulting from a "Facelift" are infrequent and the degree of satisfaction is usually very high. This surgery remains the gold standard of facial rejuvenation and usually takes place without major problems.


Any surgery should be preceded by a thorough study. It is important to inform Dr. Ana Silva Guerra of your medical history. You must inform Dr. Ana Silva Guerra of any interventions you have made as well as any previous follow-up that has already been done and clinical attitudes that have been taken.


Ask your questions.