Three reasons patients delay a facelift, and what to ask about each

RNWOOD Plastic Surgery in Seoul names three reasons that held back patients who delayed surgery: 1) believing that a deep plane facelift would be too painful, 2) repeating minimally invasive and temporary procedures multiple times when clear sagging symptoms are already visible, and 3) fear of scarring and visible incision lines. None of them can be answered with a promise, but each factor should be discussed carefully before patients make a decision.

"It will be too painful"

Ask about the method of anesthesia and the protocol in place to monitor your condition. At RNWOOD, a deep plane facelift and neck lift along with fat grafting takes about four to five hours and is generally performed under IV sedation. RNWOOD's in-house anesthesiologist remains present throughout the entire procedure, continuously monitoring each patient's condition. Before surgery, an electrocardiogram, chest X-ray and blood test are required as pre-operative tests, and blood pressure, heart rate and oxygen saturation are monitored during the operation.

More importantly, Dr. Ryu utilizes the preservation and composite techniques to minimize unnecessary dissection and skin trauma to ensure a swift and painless recovery.

Unfortunately, what cannot be promised is a recovery without discomfort. Pain, swelling, bruising, tightness and numbness can persist during the postoperative care period, and recovery speed differs between individuals. However, with intensive care provided at RNWOOD Plastic Surgery, including daily evaluations by Dr. Ryu along with the Hyperbaric Oxygen Therapy and Healite LED Light Therapy services available, you can rest assured that the discomfort will eventually and swiftly subside.

"I'll keep doing threads and HIFU instead"

Ask what is contributing to your areas of concern. If there are signs of soft-tissue sagging or a structural change, Dr. Min-Hee Ryu does not present repeated laser or lifting procedures as a replacement for surgery, but rather suggests an effective lifting surgery instead.

Undergoing thread lifting, HIFU and fillers multiple times while clear sagging was present increases adhesion and scar tissue, and previous procedures of this kind can affect the condition of the tissue if surgery is planned later, which is why a medical history including previous cosmetic procedures along with their year and month is requested.

"I'm afraid of the scars"

Ask where the incisions are placed for the recommended surgeries and to see patient before-and-after photos for reference. Dr. Ryu's deep plane facelift involves an incision along the front of the ear and around the earlobe, which extends behind the ear for the neck lift.

Although scar quality is one of the risk factors for a lifting surgery, Dr. Ryu's deep plane facelift releases the retaining ligaments for a differentiated result without skin tension, which leads to a nearly invisible scar with the incision line becoming faint over time. The associated risks are listed in full at the end.

What helps when deciding?

Clear answers to specific questions. Who operates? At RNWOOD, Dr. Ryu is the sole operating surgeon throughout lifting procedures. How many facelifts a day? One surgery per day to ensure patient safety. Who follows up? Dr. Ryu evaluates his patients' recovery progress daily during their stay in Korea, and through a WhatsApp group chat after their departure. When does the surgeon advise against surgery? When sagging is not significant and the skin still has enough elasticity, or when the change hoped for is something a facelift cannot easily improve.

Is there a right time?

Age alone is not used as the deciding factor. The actual degree of sagging, skin elasticity, the structure of the face and previous procedures matter more. After a recent facelift, a revision is generally assessed only after at least six months.

Frequently asked questions

Q1) Is a deep plane facelift too painful?

A1) The procedure is mostly performed under IV sedation, and RNWOOD's in-house anesthesiologist remains present throughout the entire procedure. More importantly, Dr. Ryu utilizes the preservation and composite techniques to minimize unnecessary dissection and skin trauma to ensure a swift and painless recovery. Pain, swelling and tightness can continue during recovery, and recovery differs between individuals.

Q2) Can I keep having threads and HIFU instead of surgery?

A2) To address visible sagging symptoms, repeated procedures are not presented as an effective replacement for surgery.

Q3) Where is the face and neck lift incision?

A3) Along the front of the ear for the facelift, extending behind the ear for the neck lift.

Q4) Will I have visible scars?

A4) Although scar quality is a listed risk, Dr. Ryu minimizes skin tension for a nearly invisible scar as it heals and fades over time.

Q5) Does waiting longer make surgery harder?

A5) Repeated temporary procedures during clear sagging can increase adhesion and scar tissue, which can affect the tissue if surgery is planned later.

About the Author

Dr. Min-Hee Ryu is the Medical Director and Founder of RNWOOD Plastic Surgery in Seoul and a plastic surgery specialist certified in Korea (2008). He has been Faculty of the Mendelson Advanced Facial Anatomy Course (MAFAC) since 2016, an Editorial Board Member of the Aesthetic Plastic Surgery Journal since 2019, and an Educational Council Member of the International Society of Aesthetic Plastic Surgery (ISAPS) since 2024.

Deep Plane Facelift — Deep plane facelift involves extensive dissection beneath facial tissues. Risks include anesthesia reactions, bleeding, hematoma, infection, seroma, delayed healing, wound separation, persistent pain, and visible scars. Swelling, bruising, tightness, and numbness can last for months, and hair loss or distortion of the hairline or ear position can occur. Poor blood supply can cause skin loss or tissue death. Nerve injury can cause temporary or permanent weakness, an altered smile, or numbness, and injury to the parotid gland or salivary duct can cause salivary leakage. A postoperative hematoma can require urgent drainage or another operation. General risks include thrombosis or embolism, and a complication can require emergency treatment or additional surgery. No result, symmetry, scar quality, or duration can be guaranteed, and sagging can recur. Necklift — Neck lift can require extensive dissection beneath neck tissues. Risks include anesthesia reactions, bleeding, hematoma, infection, seroma, delayed healing, wound separation, persistent pain, and visible scars, as well as prolonged swelling, tightness, numbness, contour irregularity, and asymmetry. Nerve injury can cause temporary or permanent weakness, including lower-lip weakness, or altered sensation, and injury to the parotid gland or salivary duct can cause salivary leakage. A large neck hematoma can obstruct the airway and require immediate emergency treatment. Platysmal bands can remain or return. General risks include thrombosis or embolism, and a complication can require emergency treatment or additional surgery. No result, symmetry, scar quality, or duration can be guaranteed, and revision surgery can become necessary.