Medical review: Dr. Walter Zamarian Jr. – plastic surgeon in Londrina, Brazil, CRM-PR 17.388, RQE 15.688, full member of the Brazilian Society of Plastic Surgery (SBCP) and member of the American Society of Plastic Surgeons (ASPS). Last reviewed on May 22, 2026.
Dr. Zamarian has 20+ years of medical experience and 8,000+ surgeries performed, with focused work in Deep Plane facelift, neck lift, blepharoplasty, facial fat grafting and revision facial surgery.
Deep Plane facelift risks are real. Careful patient selection, blood pressure control, anatomy-based technique, sterile surgery and structured follow-up reduce risk, but they do not eliminate it.
A Deep Plane facelift works in deeper facial planes to reposition selected facial and neck tissues. That technical depth is exactly why risk discussion matters: the operation involves skin, blood vessels, nerves, deeper soft tissues, anesthesia and healing biology.
Quick answer
A Deep Plane facelift can be appropriate for selected patients, but it is still surgery. The most important risks to understand are hematoma, bleeding, nerve injury, numbness, infection, delayed healing, skin suffering, scarring, hairline change, asymmetry, anesthesia reaction, DVT, pulmonary embolism and the possibility of revision surgery.
The safest consultation does not say that one technique has no risk. It explains which risks apply to the patient, which factors can be optimized, and which warning signs require urgent contact after surgery.
Hematoma and bleeding
Hematoma is a collection of blood beneath the skin and is one of the key early facelift risks. It can happen in the first hours after surgery and may require urgent evaluation or drainage. Blood pressure spikes, coughing, vomiting, straining, blood-thinning medicines and individual bleeding tendency can increase risk.
Risk reduction includes careful hemostasis, blood pressure control, medication review, nausea control, avoiding straining and close early follow-up. Patients should report sudden swelling, severe one-sided pain, tightness, rapid bruising or uncontrolled bleeding immediately.
Nerve injury, numbness and sensation changes
Facelift surgery can affect sensory nerves and, less commonly, facial nerve branches that move facial muscles. Temporary numbness, tingling or tightness can occur during healing. Facial weakness, asymmetry or movement changes require prompt evaluation.
Anatomy-based dissection and experience help reduce nerve risk, but no surgical plan can make nerve injury impossible. This is why the consultation should include a direct discussion of temporary and persistent nerve-related symptoms.
Skin, scars and hairline risks
Skin suffering or skin loss is uncommon but serious. Smoking, nicotine, poor blood flow, uncontrolled diabetes, high tension on the skin and certain medical conditions can increase risk. Nicotine avoidance is therefore a safety requirement, not a cosmetic preference.
Scarring, widened scars, hairline change, temporary hair shedding or visible incision concerns can occur. Incision planning, low-tension closure and follow-up help, but scar behavior also depends on biology and healing.
Infection, seroma and delayed healing
Infection after facelift surgery is not common, but it can occur. Redness that spreads, worsening pain, fever, foul drainage, skin breakdown or feeling systemically unwell should trigger contact with the surgical team.
Fluid collections such as seroma, saliva-related collections near the parotid region, delayed healing and wound separation are also possible. These issues are usually manageable when identified early, which is why follow-up is part of the operation, not an optional add-on.
Anesthesia, DVT and systemic risks
Facelift surgery also carries systemic risks: anesthesia reaction, heart or blood pressure events, deep vein thrombosis and pulmonary embolism. These risks are influenced by age, medical history, medications, mobility, smoking, hormone therapy, clotting history and procedure length.
Patients should seek urgent care for shortness of breath, chest pain, fainting, irregular heartbeat, one-sided calf swelling or severe weakness. These symptoms are not normal recovery symptoms.
Auersvald hemostatic net and drains
The Auersvald hemostatic net is a technique that uses a network of sutures to reduce dead space and support bleeding/fluid control in selected facelift approaches. In Dr. Zamarian’s practice, it is part of the risk-reduction strategy for many Deep Plane cases.
That does not mean risk disappears. Drain use, dressing strategy and follow-up depend on the surgical plan, tissue behavior, bleeding control and patient-specific risk. The responsible question is not whether a technique sounds modern, but how the surgeon monitors and responds if swelling, bleeding or fluid collection occurs.
Who has higher risk?
Risk can be higher in patients who smoke or use nicotine, have uncontrolled hypertension, use blood-thinning medicines, have clotting problems, poorly controlled diabetes, significant weight fluctuation, previous facial surgery, fragile skin, poor nutrition or limited ability to follow postoperative instructions.
Some risk factors can be optimized before surgery. Others may make surgery unsafe or suggest delaying the procedure. A careful surgeon should be willing to say no or wait when the medical risk is not acceptable.
Questions to ask during consultation
- What risks are most relevant to my health, anatomy and surgical plan?
- How do you monitor and treat hematoma, bleeding or fluid collection?
- How do you protect facial nerve branches and sensory nerves?
- What happens if I develop sudden swelling, fever, drainage or facial weakness?
- Where will surgery be performed, and what anesthesia support is present?
- How long should I stay nearby before travelling home?
Related procedures and planning
Some patients considering facelift also need focused evaluation of the neck, eyelids or previous surgery. Related pages include regenerative Deep Plane facelift, neck lift, blepharoplasty and secondary facelift.
International patients can start with an online consultation to review photographs, health history, medications, smoking/nicotine exposure and whether in-person evaluation in Londrina is appropriate.
Frequently asked questions
Is Deep Plane facelift risk-free?
No. Deep Plane facelift is a surgical procedure with real risks. Technique and experience can reduce risk, but they do not eliminate it.
What is the most urgent early warning sign?
Sudden one-sided swelling, severe pain, tightness or rapid bruising can suggest hematoma and should be reported immediately. Shortness of breath or chest pain requires urgent medical care.
Does the hemostatic net mean drains are never needed?
No. The hemostatic net can help reduce dead space and support fluid control, but drain use depends on the surgical plan, tissue behavior and risk profile.
Can facial nerve injury happen?
Yes. Facial nerve irritation or injury is a known facelift risk. It may be temporary or persistent, and it should be discussed before surgery along with the surgeon’s prevention and follow-up strategy.
When should facelift surgery be delayed?
Surgery should be delayed when blood pressure, nicotine use, diabetes, clotting risk, medication safety, infection, nutrition or postoperative support is not adequately controlled.
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Dr. Walter Zamarian Jr.
Plastic surgeon in Londrina, Brazil (CRM-PR 17.388 | RQE 15.688), full member of SBCP and ASPS. He has worked in plastic surgery for more than 20 years, with a focus on individualized planning, patient safety, Deep Plane facelift, structural rhinoplasty, and female intimate surgery.
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