Facelift and facial surgery procedures
What each operation does, who it suits, how recovery goes and what can go wrong, in plain words, with the research behind every claim.
Facelift
A modern facelift lifts the deeper tissue of the cheek, jowl and jawline, not just the skin, and closes the skin without tension through incisions around the ear. The techniques differ in how deep the lift goes and which ligaments are released.
Deep-plane facelift
A deep-plane facelift releases the ligaments that hold the cheek down and lifts the skin, cheek fat and underlying muscle layer together as one flap.…
SMAS facelift techniques
The SMAS is the layer of fibrous tissue and muscle under the facial fat, and nearly every facelift done by board-certified plastic surgeons tightens…
Short-scar facelift and MACS lift
A short-scar facelift uses a shorter incision, usually in front of the ear only, and less skin undermining than a full facelift, for a less visible…
Subperiosteal, vertical and preservation facelifts
These facelifts lift the face upward more than back toward the ear. A subperiosteal lift frees the soft tissue from the bone and moves the whole…
Facelift anatomy
The face is built in layers: skin, fat, a layer of fibrous tissue and flat facial muscles that surgeons call the SMAS, a deep fascia, and the facial…
Facelift incisions and scars
A facelift scar runs along the temple, in front of the ear, around the earlobe and behind the ear, and where each part sits decides whether the…
Facelift by age
Most people who have a facelift are in their 50s and 60s, and the average age is about 61. Health matters more than age: carefully selected patients…
Male facelift
Men are about 1 in 10 facelift patients in the United States, and their operation follows the same principles as a woman's with changes for the male…
Facelift in skin of color and Asian patients
Faces of Asian, African, Hispanic, South Asian and Middle Eastern descent often show aging later and often carry thicker, heavier tissue over a…
Secondary and revision facelift
A secondary facelift is a second facelift, usually about a decade after the first, for aging that has continued; a revision corrects a result that…
Neck lift
A neck lift tightens the platysma muscle and removes fat and skin under the chin and along the jawline. A deep neck lift also treats the fat, digastric muscles and salivary glands below the platysma.
Deep neck lift
A deep neck lift treats the structures under the platysma muscle (deep fat, the digastric muscles and the submandibular salivary glands) as well as…
Platysma bands and platysmaplasty
Platysma bands are the vertical cords at the front of the neck, formed by the inner edges of the platysma, the thin muscle under the neck skin.…
Submandibular gland reduction
Submandibular gland reduction trims the part of the salivary gland that bulges below each side of the jaw, so the neck keeps a clean line after a…
Submental liposuction and neck contouring
Liposuction under the chin removes the fat that lies just under the skin through small incisions, and it works best when that fat is the main problem…
Facelift and neck lift after nonsurgical treatment and GLP-1 weight loss
Fat-dissolving injections, fat freezing, energy devices and threads can leave scar tissue in the neck that makes a later neck lift longer and deeper,…
Midface and cheek
Midface surgery lifts the cheek fat back over the cheekbone, restores lost volume with fat, or removes buccal fat to slim the lower cheek.
Midface lift and cheek
A midface lift raises the soft tissue of the cheek, including the malar fat pad and the fat under the eye muscle (SOOF), to shorten the lower eyelid…
Buccal fat removal
Buccal fat removal takes out part of the buccal fat pad, a deep fat body in the cheek, through a small cut inside the mouth to slim a full lower…
Fat grafting and volume with facelift
A face ages by losing volume as well as by sagging, so many surgeons add the patient's own fat during a facelift to refill the cheeks, temples and…
Eyelid surgery
Eyelid surgery removes or moves skin and fat of the upper and lower lids, fills the tear trough, tightens the outer corner of the eye and raises a drooping lid.
Upper blepharoplasty
Upper blepharoplasty removes excess skin from the upper eyelids, sometimes with a strip of the muscle beneath and a little fat. It suits adults whose…
Lower blepharoplasty
Lower blepharoplasty treats bags under the eyes by removing, moving or regrafting the fat that bulges below the eye, and by removing loose skin when…
Tear trough and lid-cheek junction surgery
Tear trough surgery smooths the groove between the lower eyelid and the cheek: the surgeon releases the ligament that tethers the groove and fills it…
Canthoplasty and canthopexy
Canthopexy and canthoplasty anchor the outer corner of the eyelids (the lateral canthus) to the bony rim so the lower lid stays against the eye and…
Blepharoptosis repair
Ptosis repair raises an upper eyelid whose edge sits too low, either by reattaching and tightening the lid's lifting tendon through a crease incision…
Brow lift
A brow lift raises a low or heavy brow through small scalp incisions, the temple, the hairline, the eyelid crease or an incision above the brow.
Endoscopic brow lift
An endoscopic brow lift raises low eyebrows through a few short incisions in the scalp, using a thin camera, and weakens the frown muscles between…
Temporal and lateral brow lift
A temporal (lateral) brow lift raises the tail of the eyebrow and the hooded skin at the outer corner of the eye through a short incision in the…
Hairline brow lift and forehead reduction
A hairline brow lift raises the eyebrows through an incision along the front hairline and removes forehead skin, so the hairline does not move back…
Browpexy and direct brow lift
A browpexy holds up the outer eyebrow with stitches placed through the upper eyelid incision during a blepharoplasty, so the brow does not drop below…
Skin resurfacing
Resurfacing removes the damaged upper layers of the skin with a laser or a chemical peel so new skin forms. It treats wrinkles, sun damage and texture that a facelift does not change.
CO2 laser resurfacing
CO2 laser resurfacing removes the outer layer of skin and heats the layer beneath it, so wrinkles flatten, loose skin tightens and new collagen…
Erbium laser resurfacing
Erbium:YAG laser resurfacing removes thin layers of skin with each pulse and leaves little heat damage in the tissue around them. It treats fine to…
Phenol-croton oil peel
A phenol-croton oil peel is a deep chemical peel: painted on the skin, it wounds into the dermis, and the skin heals with a new band of collagen that…
TCA and medium-depth peels
A medium-depth peel uses trichloroacetic acid (TCA), usually at 35% after a first coat of Jessner's solution, to remove the outer skin and the top of…
Resurfacing with a facelift
A facelift moves skin and deeper tissue but does not change fine wrinkles, lip lines or uneven pigment, so surgeons add laser resurfacing, a chemical…
Lips, chin and fat
These operations shorten the upper lip, lift the mouth corners, enlarge or move the chin and graft processed fat into the face.
Lip lift
A lip lift removes a strip of skin just under the nose to shorten the upper lip, so more of the red lip and a few millimeters of the upper teeth…
Corner lip lift
A corner lip lift removes a small piece of skin at each corner of the mouth to raise a corner that turns down. It treats mouth corners that droop…
Chin implant
A chin implant is a shaped piece of silicone, porous polyethylene or ePTFE placed on the chin bone, through a small cut under the chin or inside the…
Sliding genioplasty
A sliding genioplasty reshapes the chin by cutting the lower front of the jawbone through an incision inside the mouth, moving the chin segment and…
Nanofat and microfat
Microfat is fat collected through small-hole cannulas and injected in tiny parcels to add volume, and nanofat is microfat broken down and filtered…
Safety and recovery
How surgeons prevent bleeding, nerve injury and skin loss after a facelift, how anesthesia and blood pressure control keep patients safe, and what recovery looks like week by week.
Facelift complications and outcomes
Serious complications after a facelift are uncommon: about 1 patient in 55 needs an emergency visit, a hospital stay or a second operation, most…
Signs of a bad facelift
A facelift looks bad when the surgery shows: a face pulled sideways, an earlobe dragged down onto the cheek, a moved hairline or lost sideburn,…
Facelift recovery timeline
The first night after a facelift carries the main risk, bleeding under the skin, and most people are back to social life in about a week. Return to…
Anesthesia and recovery in facelift surgery
A facelift can be done under general anesthesia, intravenous sedation or local anesthesia, in a hospital or an office operating room. The anesthetic…
Preventing bleeding after a facelift (hematoma)
A hematoma, blood that collects under the lifted skin, is the most common serious early problem after a facelift. The best-supported protection is…
The history of the facelift
The facelift began in the early 1900s as a strip of skin cut away beside the ear, and for its first sixty years the skin alone carried the lift, so results stretched out and faded. Today the operation lifts the deeper SMAS layer and the cheek fat, releases…
The research by topic
What the studies show about each part of the operation.
Lower blepharoplasty
Lower blepharoplasty treats lower eyelid bags by removing or moving fat through the skin or inside the lid.
Neck lift and platysma
A neck lift tightens the platysma muscle and removes excess fat and skin from the neck and jawline.
Upper blepharoplasty
Upper blepharoplasty removes excess upper eyelid skin, and sometimes muscle and fat, through a crease incision.
Blepharoptosis repair
Ptosis papers raise a drooping upper eyelid by shortening or reattaching the levator or Muller muscle.
Brow and eyelid with facelift
Combined procedure papers cover brow lift, forehead lift and blepharoplasty done with a facelift.
Canthoplasty and canthopexy
Canthal papers tighten or reset the outer corner of the eye to support the lower lid.
Facial fat grafting, nanofat and microfat
Fat grafting papers move processed fat into the face for volume, lips and skin quality.
Lasers, peels and energy devices
Adjunct papers pair facelift with laser resurfacing, peels and energy devices for the skin surface.
CO2 laser resurfacing
CO2 laser papers resurface facial skin by vaporizing thin layers, fully or in fractional columns.
Eyelid surgery complications
These papers report dry eye, lid malposition, vision loss and revision surgery after eyelid surgery.
SMAS techniques
SMAS techniques reposition the superficial musculoaponeurotic system by plication, imbrication, excision or a raised flap.
Midface and subperiosteal lift
Midface lifts reposition the cheek fat and tissue over the cheekbone, often in the subperiosteal plane.