dr. jugenburg

Facelift Complications

When it's your face, you only want the best.

A Facelift, like any surgical procedure, can have associated complications.  The best treatment of these complications is prevention:  Finding the best qualified Plastic Surgeon.

However, no Surgeon is perfect, and no Surgeon can guarantee a problem free Facelift.  Should a complication arise, a skilled Plastic Surgeon is trained and experienced to manage such situations.

On this page, you can read about things to watch out for, and how they are treated.

Facelift Before and After Photo Gallery

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cosmetic surgeon for facelift

What Happens If You Develop Complications After A Facelift?

No surgeon is perfect, no procedure is fool proof.  That is why every facelift consultation should also include a discussion of potential complications and their treatments.

The best treatment for any complications is prevention:

  1. choosing an experienced Plastic Surgeon which experience in Facelift procedures
  2. getting proper medical screening before surgery to ensure you are healthy and suitable for a facelift
  3. following all pre- and post- surgery instructions which we provide you before your surgery

If a complication does occur, it is important that you let us know right away.  Any complication, when caught early, is easily treated.  If allowed to go on for a long period of time, even the simplest problem can become serious.

So what are possible complications of a facelift?

  1. Bleeding (most common)
  2. Skin necrosis
  3. Infection
  4. Nerve Injury
  5. Abnormal scars

Bleeding after a Facelift

Bleeding is the most common complication after a facelift surgery.  In the published literature, the average risk of bleeding after a facelift is 3%   (8% for patients who have high blood pressure or men).

Having a little bit of blood oozing from your wounds is normal and expected.  A serious bleeding is when you notice significant swelling under the skin to a point that your skin protrudes.  If that happens, please let us know immediately.

The most common cause of bleeding is uncontrolled blood pressure.  For that reason, we treat your blood pressure before, during and after the facelift.  Prior to the surgery, we will give you medication to lower your blood pressure, and continue to keep it low during the time of the surgery.  Following your facelift, we will provide you with more medication for blood pressure, if needed.  We also prefer that you stay at our Hotel facility overnight, stay relaxed and comfortable to avoid raising you blood pressure.

Prior to surgery, you should avoid all of the following, to lower the risk of bleeding:

  1. Aspirin, Ibuprofen, Advil, Plavix, Coumadin, Warfarin (or any other blood thinner)
  2. Vitamin E
  3. Fish Oils / Omega 3s
  4. Glucosamine / nutritional supplements
  5. any homeopathic medications
  6. any herbal medications / supplements /herbal tea
  7. high fish diet
  8. alcohol

All of the above should be discontinued at least 2-3 weeks before surgery.


facelift photo gallery

Skin Necrosis

Skin necrosis happens when the blood supply to the skin is compromised and some parts of the skin then lack proper oxygen and nutrient supply.  The rate of this complication is 1% in sub-SMAS procedures, and 3.6% in skin-only facelifts.

Causes of skin necrosis

  1. smoking (you must stop smoking >2 weeks before a facelift)
  2. very thin skin elevation
  3. excessive tension on the skin
  4. bleeding under the skin
  5. excessively tight compression garment after the surgery
  6. pre-existing vascular disease

The treatment of this complication is with wound care.  The area affect is allowed to heal on its own and requires additional surgery in only very rare cases.


Infection is a very rare complication after a facelift because the face is very well vascularized.  There is no scientific evidence to support pre-treating patients with antibiotics to prevent an infection from taking place.  If one does develop an infection, the treatment depends on the type of bacteria isolated.  Infections around the ear may be related to a species Pseudomonas aeruginosa, which is naturally found in the ear canal.  These are treated with antibiotics, and sometimes require drainage of any collection that may be found.

Signs of an infection include the following:  Your skin is red, hot, especially tender and there may be some pus visible.

If you think you may have an infection after a facelift, send us a photo of the area of concern before becoming overly concerned, as very often little bit of redness is normal and does not represent an infection.

Facelift Toronto
Facelift Toronto

You can click the above before and after images to enter our Facelift Photo Gallery

Nerve Injury

The incidence of a permanent facial nerve injury is less than 1 percent, although transient nerve dysfunction for the first few hours after a facelift are common due to the lingering effects of the local anesthetic used during the surgery.

Prolonged nerve dysfunction can be due to traction, use of the cautery (to stop bleeding), sutures, or nerve transection.  In most of these situations, there is a spontaneous recovery which can take place at any time between 2 weeks and 4 months.

There is not much to do in this situation, aside from waiting for the facial nerve to regain its function.  While waiting, use of an injection such as BOTOX to temporarily relax the other side of the face is used to create symmetry.

If a surgeon notices a branch of the facial nerve has been cut during the surgery, that requires surgical repair to reapproximate the cut edges to allow them to heal.  The healing can take 3-6 months, which is the time it takes the nerve to regrow and re-innervate facial muscles.

Abnormal scars

Abnormal scars are scars that are placed incorrectly, that are obvious and one that my be hypertrophic or keloid.

Improper scar placement can lead to obvious scars, distortion of the ear, and un-natural shifting of the hairline.  Excessive tension can cause scar widening, loss of hair, loss of pigmentation, and the development of hypertrophic scars.

If you do develop any abnormal scar, you will need to wait at least 6 months to allow for them to heal before a scar revision can be performed.

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Can you fix my problem?

The best way to determine if your problem requires correction is to meet with Dr. Jugenburg. You will have an opportunity to discuss your goals and expectations about the surgery with the doctor, and ask any relevant questions you may have.

During your initial consultation, Dr. Jugenburg will:

  • Review your medical history and any medications you are taking
  • Discuss the procedure and any related procedures
  • Provide recommendations based on your needs and goals
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Facelift Surgery FAQs

  • Anyone who has loose and lax facial and neck skin can benefit from this procedure. There is no particular age restriction for a facelift.

  • There are many different types, including deep plane surgery, S-lift or “mini lift” surgery, SMAS facelift, or “traditional facelift,” mid-facelift and others. Each has its own recovery times and is usually decided by the surgeon.

  • It is more important for you to find the right surgeon than for you to try and decide with technique is “best.” Look at the results of facelifts done by a surgeon, regardless of the technique used. If you like the results, you’re on the road to finding the results you are looking for.

  • A facelift takes anywhere from 2 – 2.5 hours; if additional procedures are added at the same time, such as eyelid surgery, the procedure will take anywhere from 3 – 3.5 hours.

  • The length of time it takes for a procedure depends on the type of the technique used (some techniques take much longer than others) and on the surgeon’s comfort with the procedure.  Many surgeons still perform the older deep plane technique.  In this procedure the facial nerve can be exposed and therefore it is crucial that a slow and meticulous technique is used to avoid injuring the facial nerve.   In contrast, Dr. Jugenburg’s technique does not expose the facial nerve and therefore the step which requires careful and slow dissection is not required.  The benefit is not only a lower risk of nerve injury, but a much shorter operative time (and thus lower risk of overall complications)

  • A “mini” facelift is most effective in younger patients needing only a small amount of correction. A traditional facelift addresses the neck, jowls and mid-face.

  • Most often, a facelift is combined with eyelid surgery to correct drooping upper eyelids and puffy bags below the eyes. A brow lift is also often employed to smooth wrinkles on the forehead.

  • You should stop smoking at least two weeks prior to surgery, as smoking can seriously impede the healing process. Avoid aspirin and aspirin products in the weeks leading up to your surgery. In addition, Dr. Jugenburg will review your medications with you during your initial consultation, and may recommend stopping certain medications before your surgery.

  • Incisions are usually concealed in areas of the skin where creases naturally occur. Facelift incisions heal well and often go undetected after only a few months.

  • Most patients can return to work in 1 to 2 weeks. Any type of physical activity that will raise your blood pressure should be avoided for about 3 weeks.

  • Losing a few pounds won’t make that much of a difference. If you plan to lose a large amount of weight, greater than 30 pounds, for example, then you should wait until you lose the weight and your weight is stabilized.

  • How long a facelift lasts depends on many factors. If you live a healthy lifestyle you can expect the results to last a long time, but gravity and aging will play a role in how long the appearance lasts.  A facelift doesn't stop facial aging.  You will continue to age, but from a new starting point.

  • As with all cosmetic surgeries, there are some risks involved. These risks include bleeding, infection, swelling, scar irregularities and blood clots, but they are rare. Our operating suite is state-of-the-art, and we do everything we can to minimize the risks associated with surgery. Most importantly, Dr. Jugenburg and his team have various protocols in place to prevent complications from occurring.


Smoking is one of the worst things you could do before a facelift, and that is a reason why some surgeons will refuse to operate on smokers.  A smoker has skin necrosis risk that is 12 times higher than a non-smoker.

Smoking cause blood vessels to constrict, limiting the oxygen delivery to the skin.  This in effect suffocates the skin.  Skin can die, wound healing is delayed, and incisions can break open.

You should abstain from smoking 4 weeks before surgery and 4 weeks after surgery to minimize smoking-related complications