A facelift does not stretch skin. It repositions the layer underneath — the one that actually holds the face up. That distinction is the whole reason the result lasts years rather than months.
Please note: A medical consultation is a chargeable service under the German physicians’ fee schedule (GOÄ). Online bookings are binding; the practice team will explain the expected consultation fee when arranging your appointment.
Medically reviewed by Dr. med. Juliane C. Finke and Dr. med. Stephan Frantzen · Board-certified plastic surgeons · Last reviewed:
A facelift is an operation that lifts and re-secures not only the skin but the fibrous and muscular layer beneath it — the superficial musculoaponeurotic system, or SMAS. This layer carries the weight of the face; the skin only covers it.
Picture a mattress with a fitted sheet. If the mattress sags, pulling the sheet tighter makes it look better for a while, but the sheet stretches back and the mattress still sags. That is a pure skin lift: quick, cheap, and visibly gone within a year or two — often with the tell-tale over-tightened look that people rightly dislike.
Lifting the SMAS moves the weight-bearing layer back where it belongs and fixes it there. The skin is then re-draped over it without tension. That is why the result lasts, and it is also why it looks natural: the skin is not what is holding anything up.
Which regions are treated is decided by the finding, not by the name. In practice these are the parts that can be lifted alone or in combination:
A smaller, targeted lift often achieves more than a large one done reluctantly. We will say when one region alone will do — a mini lift of an hour is a real option, not a consolation prize.
Depending on the extent, the operation is performed under twilight sedation or general anaesthetic and takes between one and four hours. The incision runs in front of the ear, around the earlobe and into the hairline behind — placed along natural borders so the scar hides where the skin already changes.
The skin is lifted, the SMAS layer is repositioned and secured with sutures, excess skin is removed without tension, and the incisions are closed. Small drains are common and come out after a day.
You stay one to three nights at the MEOCLINIC. The head dressing comes off the following morning, and most patients are surprised that the discomfort is more tightness than pain.
We examine which regions should be tightened and discuss openly what can be achieved. Sometimes other techniques are better suited to a radiant overall result – such as fat grafting or eyelid surgery. If the specialist advises against it, he or she says so.
Depending on its extent, the operation takes up to four hours; smaller facelifts are possible in around an hour. It is usually performed under sedation or general anaesthetic, with the incision hidden behind the hairline.
After the operation you are first cared for as an inpatient at the MEOCLINIC – expect a stay of one to three days. Depending on the extent, a padded dressing is applied for one to two days.
Regular check-ups take place at the practice. For questions outside consultation hours you receive an emergency number on which you can always reach your surgeon. Follow-up checks are recommended after 1, 3, 6 and 12 months.
Honest timeline, because this is where expectations go wrong:
We see you at one, three, six and twelve months. Those appointments are part of the treatment, not extras.
Eight to twelve years is the usual figure for a properly performed SMAS lift, and many patients get more. What it does not do is stop ageing: your face continues to change from the new starting point, just as it would have from the old one.
What shortens it: smoking, marked weight fluctuation, unprotected sun. What extends it: none of those, plus small maintenance measures — a little volume or a thread lift a few years later — rather than waiting for a second operation.
Common and temporary: swelling, bruising, tightness, numbness of the skin in front of the ear that can last several months.
Less common: haematoma requiring drainage — the most frequent early complication and the reason for the overnight stay; wound healing problems, greatly more likely in smokers; widened or visible scarring; temporary hair loss around the incision in the temple.
Rare: injury to a branch of the facial nerve, causing weakness of part of the face. In the great majority of reported cases this is temporary. It is the risk patients ask about most, and we go through it properly rather than glossing over it.
| How long | 1–4 hours in theatre, depending on extent |
|---|---|
| Anaesthetic | Twilight sedation or general anaesthetic |
| Stay | 1–3 nights as an inpatient |
| Back to work | About 4 days for desk work; 2–4 weeks to feel fully yourself |
| Scar | In front of the ear, around the earlobe and into the hairline behind |
| Follow-up | Reviews at 1, 3, 6 and 12 months, included |
| Lasts | Typically 8–12 years |
| Where | Consultation and aftercare at our practice in Berlin-Prenzlauer Berg, the operation as an inpatient at the MEOCLINIC, Friedrichstraße 71 (private hospital in Quartier 206) |
| Paid by | Private fee or private insurance benefit |
What does a facelift cost? There is no flat rate. Time in theatre, technique, anaesthetic and the extent of the procedure differ from person to person. You get a binding quote at the end of your consultation — in writing, with nothing hidden. And the consultation itself? Medical advice is a treatment in its own right and is invoiced under the German scale of medical fees (GOÄ) — including when you decide against a procedure afterwards. We tell you what to expect when the appointment is made.
Will insurance pay? As a rule, no: purely aesthetic procedures are paid privately. German statutory insurers only contribute where a medical indication is recognised; private insurers and international policies decide case by case. We will tell you honestly whether you have any prospect of cover.
These points apply generally. What applies in your case – with existing conditions or regular medication – we go through at your pre-operative consultation. That conversation is what counts.
A facelift is the largest step, and it is not always the first one. We look first at whether something smaller would do the job – and we will say so if none of these procedures fits your finding.
Board-certified plastic surgeon (plastic &
aesthetic surgery), Fellow of EBOPRAS
Board-certified plastic surgeon and
board-certified general surgeon
Dr. Juliane C. Finke and Dr. Stephan Frantzen are full members of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) and the German Society of Senology (DGS). Dr. Finke is also a Fellow of EBOPRAS and passed the European board examination in 2010; Dr. Frantzen operates on a voluntary basis for INTERPLAST in South America. The jameda seals lead to the independent physician profiles with patient reviews of Dr. Finke and Dr. Frantzen.
Medically reviewed by Dr. Juliane C. Finke and Dr. Stephan Frantzen
No — and if that is what you want, we are the wrong practice. A properly executed SMAS lift puts your own tissue back where it used to be. The comment patients report most often is that people ask whether they have been on holiday.
There is no right age. What matters is the finding: enough descent for a lift to have something to reposition, and skin with enough quality to re-drape. Most patients are between 45 and 65, but we have operated outside that range in both directions.
A lift limited to one region, usually the lower face and jawline, through a shorter incision. It takes about an hour, the recovery is quicker, and for the right finding it is genuinely enough. For a face that has descended broadly, it is not — and we will say so.
In the crease in front of the ear, around the earlobe, and up into the hairline behind. Those are all borders where the skin naturally changes, which is why the scar becomes hard to find once it has faded.
Yes, and it is a common combination — the eye region is often what makes a face look tired even after the lower face has been lifted. One anaesthetic, one recovery.
From about day three, gently and with lukewarm water. No hairdryer on hot, no colouring for four weeks.
If the neck is included, yes — and it is often the region patients are happiest about. Where the platysma muscle bands have separated, they are brought back together in the same operation.
Walking straight away, gentle cardio after two to three weeks, and anything that raises blood pressure sharply — heavy lifting, hot yoga, sauna — after four to six weeks.
Consultation and aftercare at our practice in Berlin-Prenzlauer Berg. The operation is performed as an inpatient at the MEOCLINIC, Friedrichstraße 71 — the private hospital in Quartier 206.
Book a personal consultation. We show you what a lift can reposition — and what it cannot, so nothing about the result surprises you afterwards.
Related treatments: Thread lift · FaceTite · Eyelid surgery · Facial treatments
Medically reviewed by Dr. Juliane C. Finke, board-certified plastic surgeon (plastic and aesthetic surgery), and Dr. Stephan Frantzen, board-certified plastic surgeon and board-certified general surgeon.
Last medically reviewed:
The content of this page is for general information and does not replace medical advice. A binding assessment is only possible after a personal examination.
Independent information: The German Society of Plastic, Reconstructive and Aesthetic Surgeons provides patient information on choosing a specialist, consent, limitations and possible complications. The German Medical Association explains the GOÄ fee schedule. These German-language sources supplement, but do not replace, an individual medical examination.
