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The future of the facelift

More men, younger patients and people who lost weight on GLP-1 drugs now ask for facelifts. Surgeons are moving toward deeper release, hidden incisions and work under the neck muscle, and research has not yet shown which of these methods works best.

Dr. T. Gerald O'Daniel, whose work is cited here, is a featured surgeon and a client of the publisher; see the disclosure.

The people asking for facelifts are changing, and so is the operation. Much of the newest surgical work comes from single surgeons reporting their own patients, and facelift studies rarely use validated measures of satisfaction or appearance (Hornick 2026). How today's methods began is told in The papers that changed the facelift.

Who has facelifts now

Why people come. In 2025 members of the American Society of Plastic Surgeons (ASPS) named restoration after life changes such as pregnancy, aging and weight loss as the main reason patients sought plastic surgery. ASPS president Bob Basu: "Today's patients are increasingly seeking authentic restoration rather than transformation." (ASPS 2026). In the UK, Nora Nugent, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), linked the rise in facelifts to growing awareness that surgery can give a natural, lasting result without the constant upkeep of fillers (Guardian 2025, men).

Younger patients. Members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) expect the average age of facelift patients to keep falling, though most facelifts are still done in patients 56 and older (AAFPRS 2026, trends). Basu told Fortune: "25 years ago, the people who would get face lifts are basically a 60-plus crowd. That's not the case anymore." (Fortune 2026). The BBC and The Guardian reported in 2025 on people in their late 20s and 30s having facelifts (BBC 2025; Guardian 2025, young women).

Age at the first lift may affect how long it lasts. Patients who returned to the same surgeon for a second facelift did so about eleven years after the first, and those who were younger at the first lift came back later (Levin 2026; Mandelbaum 2026). See Facelift by age.

Older patients. Cosmetic procedures grew fastest among patients 66 and older in 2025 (ASPS 2026). In one surgeon's screened practice, complications did not rise with age, including past 75 (Vishwanath 2026, age). Second facelifts are more common than they were (Stein 2024); see Secondary and revision facelift.

Men. AAFPRS president Anthony Brissett said men are increasingly seeking eyelid surgery, injectables and facelifts (AAFPRS 2026, trends), and in the UK facelifts in men rose faster than in women in 2024 (Guardian 2025, men). Men once bled more often after a facelift; a 2026 matched study using standard prevention protocols found no difference (Vishwanath 2026, men). See Male facelift.

Women at menopause. More facial plastic surgeons than the year before said women named menopause or perimenopause as a reason for treatment (AAFPRS 2026, menopause).

Weight loss on GLP-1 drugs

Most ASPS surgeons had patients ask about surgery linked to GLP-1 weight-loss drugs in 2025, though ASPS found no sign that the drugs drove growth in any procedure (ASPS 2026). Most facial plastic surgeons report more patients seeking treatment after rapid weight loss (AAFPRS 2026, trends).

The face changes in measurable ways. In patients scanned before and after GLP-1 treatment, midface volume fell in step with the weight lost, mostly from the fat just under the skin (Sharma 2025). In a database study, patients with obesity on the drugs were more likely than controls to develop drooping brows and excess eyelid skin, and more likely to have a facelift (Saffari 2026).

Fat grafting is the open question for these patients. A 2026 scoping review found no published study of fat graft outcomes in people taking the drugs, and set out ways the drugs could reduce graft survival (Chalhoub 2026). Ezra Pak-Harvey presented an abstract on fat transfer and complications after facelift in GLP-1 users at the 2026 AAFPRS spring meeting (AAFPRS COSM 2026). Anesthesia, gastroenterology and surgery societies issued joint guidance in 2024 on managing the drugs around an operation (Kindel 2024). See Facelift and neck lift after nonsurgical treatment and GLP-1 weight loss.

Newer surgical methods

Deep plane lifts

Most facial plastic surgeons who answered a 2026 survey perform deep plane lifts, and surgeons earlier in their careers use them more often (Pak 2026). Plastic surgeons more often fold, raise or trim the SMAS (Stein 2024).

Evidence: mixed. A 2026 systematic review found that deep plane lifts have not been shown to improve the midface or to last longer (Schultz 2026). A randomized trial found deep plane, high SMAS and plication lifts equal for how much younger patients looked (Baptista 2026), and a prospective cohort found no difference in satisfaction or complications (Neel 2026). The AAFPRS survey linked deep plane lifts with more temporary nerve injury and found no link with how long results lasted (Pak 2026). On the other side, a randomized study by one surgeon found the extended deep plane lift better than the standard one for jowls, marionette lines and the neck (Golparvaran 2026).

Surgeons argue it in public. The 2026 Baker Gordon Symposium in Miami ran a session on SMAS against deep plane (Baker Gordon 2026), and the 2026 Marbella symposium staged a debate titled "Is the SMAS really the holy grail in facial rejuvenation?" (MIPSS 2026). The label can mislead. Town & Country reported in 2025 that some lifts sold as deep plane may not be, and quoted New York surgeon Sean Alemi: "Surgeons who say they're doing a deep-plane may actually think they're doing a deep-plane." (Town & Country 2025). See Deep-plane facelift.

Endoscopic lifts

Endoscopic deep plane lifts are done through small incisions hidden in the temple, behind the ear and in the scalp; Chia Chi Kao's ponytail lift series reported no flap necrosis and no permanent nerve injury (Kao 2024). Mirza Firat also reported no permanent nerve injury, with most revisions early in his series (Firat 2025), and Marc Mani described an endoscopic composite face and neck lift with no incision in front of the ear (Mani 2025). The International Society of Aesthetic Plastic Surgery (ISAPS) held a symposium on the endoscopic facelift in Boston in May 2026, co-chaired by Gerald O'Daniel and Ozan Sozer (ISAPS 2026, Boston).

Evidence: early. The published series come from single surgeons without control groups, and Firat wrote that future studies will add objective measures and patient-reported outcomes (Firat 2025).

Preservation lifts

Preservation lifts release the deep layer while separating less skin from it. Kevin Sadati's preservation face lift combines extended deep plane and high SMAS methods with minimal skin separation, and his group reported shorter drain times and fewer complications than with the extended deep plane lift (Sadati 2025). Quinodoz and colleagues describe a "conservation facelift" with limited undermining (Quinodoz 2026). Anatomy supports releasing before lifting: Minelli and Mendelson found that lifts without release drag the small support fibers of the face out of their alignment against gravity and leave the weight on the sutures (Minelli 2024, glideplanes).

Evidence: early. The comparison comes from one group's own patients (Sadati 2025). Surgeons also disagree on the direction of pull: at the 2026 Reaching New Peaks winter symposium, Manoj Abraham spoke on "Gravity, Why the Preservation Facelift Is the Wrong Vector" (FPS 2026). See Subperiosteal, vertical and preservation facelifts.

Awake facelifts

A 2026 scoping review of facelifts under local anesthesia found low complication rates, and fewer blood clots and steadier blood pressure than with general anesthesia (Beaufigeau 2026). At the 2025 BAAPS conference in London, Simon Lee spoke on moving to outpatient deep plane face and neck lifts with the patient awake (BAAPS 2025). See Anesthesia and recovery in facelift surgery.

The deep neck

A deep neck lift removes fat, part of the submandibular glands and part of the digastric muscles from under the platysma (O'Daniel 2021), and in 2026 O'Daniel published a seven-step method for gland reduction (O'Daniel 2026, glands). Most facial plastic surgeons in the AAFPRS survey do not reduce glands or digastric muscles (Pak 2026).

Evidence: debated. The main risk is the nerve to the lower lip. A 2026 review found its injury the most common complication of gland reduction (Shauly 2026), and the AAFPRS survey linked frequent gland reduction with more nerve injury (Pak 2026). The 2026 American Association of Plastic Surgeons meeting staged a debate on whether partial gland removal during a facelift is worth the risk, with James Grotting for and James Zins against (AAPS 2026). See Deep neck lift.

Bleeding control

Surgeons now choose among the hemostatic net, tissue sealants and tranexamic acid to prevent a hematoma. In deep plane lifts about one patient in a hundred had a major hematoma, with no clear winner among the three methods (Azzi 2026). ISAPS 2026 includes a debate on the net against glue (ISAPS 2026, Cancun). How bleeding became less of a risk is in Why facelifts are safer now.

Imaging and AI

Measuring results. Researchers now score before-and-after photographs with age-estimating software. In a study of photos from the ASPS gallery, combined face, neck, brow and eyelid surgery gave the largest gain, though the photos were selected, not consecutive (Rames 2026). Patients rate their own change as larger than the software does (Zhang 2021), and in a randomized trial AI estimates agreed only moderately with lay raters (Baptista 2026).

Planning. 3D photography measures change in volume and jawline after a lift (Jacono 2019, extended deep plane). Talei measures the direction of pull for each patient during surgery, after release (Talei 2024, vectors).

Chatbots. In a small pilot, ChatGPT-5 judged facelift candidacy from photographs in near agreement with plastic surgeons (Saeed 2026). An earlier test found that ChatGPT named likely complications after facelift and neck lift but often gave the wrong advice on where to seek care, and tended to overstate the urgency (Abi-Rafeh 2023).

Expectations. Nugent told The Guardian in 2026 that patients arrive with AI-beautified photos of themselves and expectations surgery cannot meet: "Once you see an image, it's wired into you." (Guardian 2026). Image generators asked for facelift pictures produced mostly female faces with lighter skin, and few men or older women (Lim 2023).

Evidence: early. Most AI studies in facial aesthetic surgery validate tools, and few test them in patient care (Colceriu 2026).

Regenerative treatments

Fat grafting is the regenerative treatment already in wide use. Facial fat grafting grew more in 2025 than any other procedure ASPS tracked (ASPS 2026), and more facelifts by plastic surgeons now include it (Stein 2024); it is less common among facial plastic surgeons (Pak 2026). Steven Cohen presented regenerative fat grafting combined with preservation deep plane facelifting at ISAPS Face Masters in 2026 (ISAPS Face Masters 2026). When volume keeps falling after the lift, O'Daniel replaces it with poly-L-lactic acid injections (O'Daniel 2022).

Nanofat, fat broken down and filtered fine enough to inject into the skin, keeps stem cells but no living fat cells (Tonnard 2013). A 2025 expert consensus defined how to make it and found that most clinical uses lack strong evidence (Arcani 2025). In one surgeon's series, topical exosomes from human skin cells shortened skin healing time after resurfacing done with a facelift (Lacerna Kimbrell 2026); the FDA states that there are no FDA-approved exosome products (FDA 2020). See Nanofat and microfat.

Limits of nonsurgical treatments

Thread lifts. A 2018 systematic review found that most thread-lift studies showed at best a very limited duration of lift, and that the only positive studies were sponsored by the thread makers (Gülbitti 2018). In a series of barbed thread lifts, the improvement faded by six months and was gone at one year (Bertossi 2019).

Energy devices. In a blinded comparison, one fractional radiofrequency treatment gave about a third of the improvement in loose skin of a surgical facelift (Alexiades-Armenakas 2010). Devices and injections also change what a surgeon later finds. O'Daniel reported scar tissue, lost tissue planes and a stiff platysma in neck lifts after fat-dissolving injections, fat freezing and radiofrequency treatments, with longer operations and contour irregularities afterward (O'Daniel 2026, nonsurgical). Cervantes, O'Daniel, the Auersvalds and colleagues set out the same problem for facelifts after fillers and devices (Cervantes 2026).

"Stem cell facelift." The 2025 Golden Globes gift bag offered a "stem cell facelift" that Allure reported was a series of injections with no incision (Allure 2025). A 2021 review found that the evidence can hardly support claims that cell-based injections improve skin quality (Atiyeh 2021).

Open research questions

  • Which lift gives the best and longest result. Reviews find no consensus, and validated measures of satisfaction and appearance are rarely used (Schultz 2026; Hornick 2026).
  • How long a facelift lasts. Studies measure the time to a second lift in patients who return to the same practice (Levin 2026; Mandelbaum 2026).
  • How fat grafts behave in GLP-1 users, and when to operate after the weight loss. A 2025 review called for clinical guidelines (Chalhoub 2026; Daneshgaran 2025).
  • Whether endoscopic and preservation lifts hold up against open deep plane lifts over time (Kao 2024; Firat 2025; Sadati 2025).
  • Whether nonsurgical treatments make later surgery harder when tested against untreated patients. The current data are one surgeon's series (O'Daniel 2026, nonsurgical).
  • Whether partial gland removal is worth its nerve risk (Shauly 2026; AAPS 2026).
  • Whether AI tools improve care when surgeons use them (Colceriu 2026).

What surgeons do now is in The modern facelift, and the people who built it are in The surgeons behind the modern facelift.

Sources

Records and pages checked 2026-10-06.

Society statements and statistics

  • AAFPRS 2026, menopause. AAFPRS. AAFPRS highlights growing conversation around menopause and facial aging. PR Newswire, 2026-09-16.
  • AAFPRS 2026, trends. AAFPRS. AAFPRS reveals the trends defining facial plastic surgery (2025 member survey). PR Newswire, 2026-02-24.
  • ASPS 2026. ASPS. Lift procedures led growth as demand for restoration drove plastic surgery in 2025. 2026-09-01.
  • FDA 2020. US Food and Drug Administration. Consumer alert on regenerative medicine products including stem cells and exosomes. 2020-07-22.

Meeting programs

  • AAFPRS COSM 2026. AAFPRS Spring Meeting at COSM 2026, Phoenix, program.
  • AAPS 2026. American Association of Plastic Surgeons 2026 Aesthetic Symposium, program.
  • BAAPS 2025. BAAPS 2025 annual conference, London, programme.
  • Baker Gordon 2026. 60th Baker Gordon Educational Symposium, Miami, program.
  • FPS 2026. Reaching New Peaks in Facial Plastic Surgery: Winter Symposium 2026, program.
  • ISAPS 2026, Boston. ISAPS Mini Symposium: Endoscopic Facelift, Boston, 2026-05-15.
  • ISAPS 2026, Cancun. ISAPS World Congress 2026, Cancun, program.
  • ISAPS Face Masters 2026. ISAPS Face Masters: Live Anatomy and Surgical Strategy, St. Louis, program.
  • MIPSS 2026. 9th Marbella International Plastic Surgery Symposium, program.

Press

  • Allure 2025. There is a facelift in this year's Golden Globes gift bag. 2025-01-03.
  • BBC 2025. A facelift at 28? Why young people are turning to plastic surgery. 2025-10-11.
  • Fortune 2026. How "Ozempic face" is pushing Gen X to the facelift table a decade early. 2026-06-24.
  • Guardian 2025, men. Social media and weight loss drugs drive UK rise in facelifts in men and people in their 40s. 2025-09-25.
  • Guardian 2025, young women. Why young women are having facelifts. 2025-10-28.
  • Guardian 2026. The rise in plastic surgeons asked to create "AI face". 2026-05-23.
  • Town & Country 2025. Did you get a bargain basement facelift? 2025-08-21.

PubMed

  • Abi-Rafeh 2023. Abi-Rafeh J et al. Complications following facelift and neck lift: implementation and assessment of large language model and artificial intelligence. Aesthetic Plast Surg.
  • Alexiades-Armenakas 2010. Alexiades-Armenakas M et al. Blinded, randomized, quantitative grading comparison of minimally invasive, fractional radiofrequency and surgical face-lift to treat skin laxity. Arch Dermatol.
  • Arcani 2025. Arcani R et al. Nanofat use in regenerative medicine: a systematic literature review and consensus recommendations from expert opinions. Facial Plast Surg Aesthet Med.
  • Atiyeh 2021. Atiyeh B, Ghieh F, Oneisi A. Nanofat cell-mediated anti-aging therapy: evidence-based analysis of efficacy and an update of stem cell facelift. Aesthetic Plast Surg.
  • Azzi 2026. Azzi JL et al. Prevention of hematoma in patients undergoing facelift (rhytidectomy): a systematic review and meta-analysis. Facial Plast Surg Aesthet Med.
  • Baptista 2026. Baptista VS et al. Perceived age reduction after rhytidoplasty: a randomized clinical trial comparing three surgical techniques using human and AI assessment. Facial Plast Surg.
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  • Bertossi 2019. Bertossi D et al. Effectiveness, longevity, and complications of facelift by barbed suture insertion. Aesthet Surg J.
  • Cervantes 2026. Cervantes A, O'Daniel G, Auersvald L et al. Facelift surgery in patients with prior dermal fillers and energy-based device treatments: challenges and strategic considerations. Aesthetic Plast Surg.
  • Chalhoub 2026. Chalhoub X, Yang Ng Z. Do GLP-1 receptor agonists sabotage fat grafts? A scoping review. Aesthet Surg J.
  • Colceriu 2026. Colceriu AA et al. The impact of artificial intelligence on facial aesthetic surgery: a systematic review. Aesthet Surg J Open Forum.
  • Daneshgaran 2025. Daneshgaran G et al. "Ozempic face" in plastic surgery: a systematic review. Aesthet Surg J Open Forum.
  • Firat 2025. Firat M. Endoscopic deep plane facelift: a classified approach. Aesthet Surg J.
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  • Gülbitti 2018. Gülbitti HA et al. Thread-lift sutures: still in the lift? A systematic review of the literature. Plast Reconstr Surg.
  • Hornick 2026. Hornick MM et al. Assessing rigor in facelift research: a scoping review of 20 years of reported outcomes in the United States. Aesthet Surg J.
  • Jacono 2019, extended deep plane. Jacono AA, Bryant LM, Ahmedli NN. A novel extended deep plane facelift technique for jawline rejuvenation and volumization. Aesthet Surg J.
  • Kao 2024. Kao CC, Duscher D. The ponytail lift: 22 years of experience in 600 cases of endoscopic deep plane facial rejuvenation. Aesthet Surg J.
  • Kindel 2024. Kindel TL et al. Multisociety clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surg Obes Relat Dis.
  • Lacerna Kimbrell 2026. Lacerna Kimbrell M. Enhanced healing and outcomes with human dermal fibroblast exosomes. Aesthet Surg J.
  • Levin 2026. Levin M, Frankel A. Thirty years of deep plane facelifts: characterizing outcomes and longevity. Facial Plast Surg Aesthet Med.
  • Lim 2023. Lim B et al. Using generative artificial intelligence tools in cosmetic surgery: a study on rhinoplasty, facelifts, and blepharoplasty procedures. J Clin Med.
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  • Minelli 2024, glideplanes. Minelli L, Brown CP, van der Lei B, Mendelson B. Anatomy of the facial glideplanes, deep plane spaces, and ligaments: implications for surgical and nonsurgical lifting procedures. Plast Reconstr Surg.
  • Neel 2026. Neel OF et al. Deep plane versus SMAS plication facelift: a prospective cohort study of clinical outcomes and complication rates. Aesthetic Plast Surg.
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  • O'Daniel 2022. O'Daniel TG, Kachare MD. The utilization of poly-l-lactic acid as a safe and reliable method for volume maintenance after facelift surgery with fat grafting. Aesthet Surg J Open Forum.
  • O'Daniel 2026, glands. O'Daniel TG. Safe submandibular gland reduction in 7 steps: the Carina technique. Aesthet Surg J.
  • O'Daniel 2026, nonsurgical. O'Daniel TG, Patton S. Neck lift after nonsurgical treatments: fibrosis, fat loss, and surgical complexity. Aesthet Surg J.
  • Pak 2026. Pak KY, Salehi PP, Azizzadeh B. Evaluating facelift outcomes and technique trends in the United States. J Craniofac Surg.
  • Quinodoz 2026. Quinodoz P, Scampa M, Belhaouari L. Conservation facelift: the mesoface. JPRAS Open.
  • Rames 2026. Rames JD et al. Objectifying outcomes in facial aesthetic surgery using artificial intelligence. Plast Reconstr Surg.
  • Sadati 2025. Sadati K et al. Advancements in face lift techniques: preservation face lift with a rotating pedicle flap. Plast Reconstr Surg Glob Open.
  • Saeed 2026. Saeed AT et al. ChatGPT-5 matches surgeon-level assessment of facelift candidacy: a pilot proof-of-concept study. Aesthetic Plast Surg.
  • Saffari 2026. Saffari PS et al. Periorbital changes following glucagon-like peptide-1 receptor agonist use: a retrospective cohort study. Ophthalmic Plast Reconstr Surg.
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  • Zhang 2021. Zhang BH et al. Turning back the clock: artificial intelligence recognition of age reduction after face-lift surgery correlates with patient satisfaction. Plast Reconstr Surg.