Facelift
An operation on the deeper layers The surgeon lifts and repositions the tissue under the skin, then removes the skin that is now spare. Often done with a neck lift.
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Dermapedia / CompareProcedures
Facelift vs Botox
Botox softens lines made by muscle movement. It relaxes the muscles that crease your forehead and the skin between your brows. A facelift repositions sagging tissue and removes loose skin. It is surgery, under anaesthetic, with a real recovery. These are not two versions of the same thing, and if your complaint is jowls or a loose neck, no injectable fixes it.
At a glance
| The difference | Facelift | Botox |
|---|---|---|
| What it is | An operation on the deeper layers | An injection into a muscle |
| What is involved on the day | Anaesthetic and a few hours | A short appointment |
| Downtime | Two weeks before you feel presentable | None to speak of |
| Cost | One large one-off cost | A smaller cost, several times a year |
Botox
Side by side
The differences that matter
What it is
Facelift
An operation on the deeper layers
The surgeon lifts and repositions the tissue under the skin, then removes the skin that is now spare. Often done with a neck lift.
Botox
An injection into a muscle
A few small injections into the muscles that fold your skin. It takes about ten minutes and you walk out.
What problem it fixes
Facelift
Skin and tissue that have dropped
Jowls, a heavy jawline, loose skin on the neck, deep folds from the nose to the mouth.
Botox
Lines made by movement
Frown lines, forehead lines and crow's feet. The lines that appear when you make an expression.
What it will not do
Facelift
It does not stop lines forming
Surgery repositions tissue. The muscles keep working, so a frown line will still crease afterwards.
Botox
It does not lift anything
Toxin has no effect on loose skin. It cannot raise a jowl, tighten a neck or remove spare skin.
Conditions treated
Botox
Hyperhidrosis
A grid of small injections that block the nerve signal reaching the sweat glands in that patch of skin. It starts working within a few days to a week and lasts several months before it needs repeating. Underarm injections are well tolerated; palms and soles hurt more and are usually done with numbing, and palm injections can cause temporary weakness of grip. It is an approved medical treatment for severe underarm sweating, not a cosmetic one, and insurance often covers it once antiperspirants have been tried and documented.
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Rosacea
Very small amounts injected into the surface of the skin, not the muscle, to reduce flushing and background redness. Early studies are encouraging and dermatologists do use it for stubborn flushing. It is off-label for rosacea, it is not usually covered, and it wears off in a few months.
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Wrinkles and Fine Lines
The reliable treatment for lines caused by movement — frown lines, forehead lines and crow's feet. It relaxes the muscle that folds the crease, so the line softens over about two weeks and returns as the effect wears off at three to four months. It does nothing for lines that are already there at rest, and nothing for sagging.
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What is involved on the day
Facelift
Anaesthetic and a few hours
A hospital or surgical suite, a general or heavy sedation anaesthetic, and someone to take you home.
Botox
A short appointment
Numbing cream if you want it. Most people go back to work straight after.
How long until you see it
Facelift
Weeks, then months to settle
The shape is there once the swelling drops. The final result takes around three months.
Botox
A few days to start
Full effect at about two weeks.
How long it lasts
Facelift
Around a decade
Ranges roughly from seven to fifteen years depending on the technique and your skin. It does not stop ageing, it sets you back.
Botox
Around three to four months
Then it wears off and you repeat it.
Downtime
Facelift
Two weeks before you feel presentable
Bruising and swelling are heavy at first and settle over the first fortnight. Most people take two to three weeks before they want to be seen.
Botox
None to speak of
Small red dots for an hour and the occasional bruise.
The downside
Facelift
It is surgery
Scars, though they are placed in front of and behind the ear. A recovery. A real risk profile that you discuss with a surgeon, and a result you cannot undo.
Botox
It is temporary and it can sit wrong
A heavy brow or an uneven lift happens, and there is no reversal. You wait about three months for it to fade.
Cost
Facelift
One large one-off cost
Priced as surgery. The quote should include the surgeon, the anaesthetist and the facility, so ask for all three.
Botox
A smaller cost, several times a year
Priced per unit or per area. Work out the yearly total, not the visit price.
The at-home or drugstore version
Facelift
None
Face tape, gua sha and facial exercises move nothing. Sagging is a structural change under the skin, and nothing you do at the surface repositions it.
Botox
Creams, and they are a different thing
"Botox in a jar" creams use peptides such as argireline. The cream sits on the surface. The muscle folding your skin is several millimetres down and no cream reaches it.
Who each suits
Facelift
- Best for — Jowls, a loose neck, skin that has clearly descended.
- The mindset — You accept surgery and a recovery for a change that lasts years.
Botox
- Best for — Lines that show when you frown, raise your brows or smile.
- The mindset — You want something small, reversible by waiting, and repeatable.
What people usually actually want
Botox
Botox is the right first step if your concern is the upper face. Forehead, brows, crow's feet. It is low commitment, and if you hate it, it fades.
Before you book
More photographs
Botox
Common questions
Questions Patients Ask
Can Botox replace a facelift?
No. Botox relaxes the muscles that crease your skin when you move. It cannot lift or remove loose skin. If your concern is jowls or a loose neck, no injectable will fix it.
Which one should I do first?
If your lines only show when you frown or raise your brows, start with Botox. If your face looks changed even when it is completely still, a surgical consultation will tell you more, whether or not you go ahead.
Does Botox help jowls?
Not meaningfully. A small amount of toxin along the jaw and neck can soften the pull of certain muscles, but jowls are loose tissue that has dropped, and relaxing a muscle does not lift it back.
Do people have Botox after a facelift?
Often, yes. A facelift changes the shape of the lower face and neck; it does not stop the forehead creasing. The two treat different things, so they are commonly used together.
How much cheaper is Botox?
Far cheaper per visit, but you repeat it three or four times a year for as long as you want the effect. A facelift is one large cost that holds for around a decade. Compare the yearly figure, not the visit price.
How long is facelift recovery?
Bruising and swelling settle over about two weeks. Most people want two to three weeks before being seen socially, and the result finishes settling around three months.