What the research shows
Bleeding risk. Men are about a tenth of US facelift patients (Rohrich 2023). Early series found large hematomas in men more than twice as often as in women (Baker 1977), close to 1 man in 10 in one review (Lawson 1993). Strict blood pressure control before, during and after surgery cut hematomas needing surgery in men to about 4 in 100, still above the 1 to 3 in 100 reported in women (Baker 2005). Across cosmetic surgery, men had the same overall rate of major complications as women but more hematomas, and facelift was one of the operations where men fared worse (Kaoutzanis 2018). Under a modern prevention protocol, matched men and women had the same hematoma rate, although the men's operations took longer and lost more blood (Vishwanath 2026). One surgeon's safe, consistent results rested on incisions that follow hair growth, protecting hair follicles, and avoiding low blood pressure during anesthesia (Rohrich 2017).
Keeping the sideburn and beard in place. A man's face has a hairless strip of skin in front of the ear, which a facelift should preserve (Sturman 1976). Incisions designed for men leave the hair in front of the ear where it grew and keep beard from growing so close to the ear that shaving becomes hard (Webster 1982). An incision just behind the tragus, used in women to hide the scar, works in men if the hair follicles carried onto it are removed (Cremone 1983). Rotating the temple skin keeps the sideburn's width and position, with scars hidden in hair and beard (Muller 2026). For bald men, whose scars cannot hide in hair, a deep plane lift with a specific way of trimming skin gave scars that patients and an expert panel rated very highly (Pascali 2020).
A masculine result. In 3D simulations, a lift pulling along a double-T pattern made men's faces look more masculine and attractive, while the V-shaped lift used in women made faces look more feminine (Leifeld 2021). Deep plane technique for men pays special attention to the neck, with fat reduction under the neck muscle, contouring of the digastric muscle, partial reduction of the submandibular gland and a corset tightening of the platysma (Saadat 2026). Forehead lifts in men often need a technique customized for a high hairline and heavy skin (Feist 2025).
Neck-only options. Some men want only the neck treated. A direct neck lift through the front of the neck suits men with loose skin above the Adam's apple and little jowling who accept a visible scar (Velargo 2026); in one series every man felt the better neck outweighed the scar, and none asked for a revision (Gradinger 2000).
How others see them. Strangers rated men more attractive, likeable and trustworthy after facial surgery; a facelift raised likeability and trustworthiness, and a neck lift raised perceived masculinity (Parsa 2019).
Where surgeons disagree
- Are men still at higher risk of bleeding. Long-running and database studies say yes (Baker 2005, Kaoutzanis 2018); single-surgeon matched comparisons found the difference too small to confirm or gone (Rohrich 2017, Vishwanath 2026).
- Full facelift or neck lift alone. Direct neck lifts avoid scars around the ear and a feminized look but leave a scar on the front of the neck (Velargo 2026); a deep plane face and neck lift treats both together (Saadat 2026).
What is new
- A deep plane facelift described specifically for male anatomy (Saadat 2026).
- A sideburn technique that keeps its width and position (Muller 2026).
- Matched data suggesting modern protocols bring men's bleeding risk in line with women's (Vishwanath 2026).
What is still unknown
- Outcomes measured from men's own point of view, and how hormones and weight affect fat grafts in men (Nagappan 2026).
- Whether the matched hematoma finding holds in larger groups; the newest comparison included few men (Vishwanath 2026).
Key papers
- Baker 1977: the male facelift differs, and men bled more often.
- Webster 1982: incisions that respect the beard and sideburn.
- Baker 2005: blood pressure control halved hematomas in men.
- Rohrich 2017: lessons from two decades of male facelifts.
- Kaoutzanis 2018: complications in men across cosmetic surgery.
- Parsa 2019: how others see men after facial surgery.
- Pascali 2020: facelift scars in bald men.
- Leifeld 2021: lift direction and a masculine look.
- Vishwanath 2026: no difference in bleeding with modern protocols.