Male facelift

What it is

A male facelift lifts the deep layer of the cheek, jawline and neck and removes loose skin, as in any facelift, with the incisions, lift direction and neck work adapted to a man's face (PMID 32866978, PMID 36696315).

The goal differs. An attractive male face is less tied to youth than a female one, so men generally ask for a rested, masculine face with no sign that surgery was done (PMID 35367032).

The anatomy differs too. Men have denser fat under the skin, more blood vessels, and in the neck often a thick digastric muscle and a visible submandibular gland, which change how the neck is shaped (PMID 40889761). The hair follicles in the skin that is moved have to be protected (PMID 28125532).

Where it came from

In 1977 Baker described the male facelift as a different operation from planning to final result, and reported large hematomas in his male patients more than twice as often as in women (PMID 909960).

Later series confirmed male sex as an independent risk for hematoma, alongside high blood pressure, aspirin and smoking (PMID 11513508, PMID 24912427). In 2005 Baker's institution reported that strict blood pressure control before, during and after surgery had cut the rate of hematomas needing a return to the operating room in men by more than half over 30 years (PMID 16327611). A national insurance database later put men at nearly 4 times the hematoma risk of women (PMID 26578747).

Rohrich's 2017 review of 20 years of male facelifts set out the modern rules: incisions designed around the direction of hair growth, dissection that spares follicles, and no deliberately lowered blood pressure during surgery (PMID 28125532). Deep-plane surgeons have since published male versions of the deep-plane face and neck lift (PMID 40889761, PMID 38936991). In 2026 a matched comparison found no more hematomas in men than in women treated under the same prevention protocol (PMID 42154486).

Who it suits

• Jowls, a soft jawline and a loose neck. A deep-plane face and neck lift rebuilds the angle of the jaw and the angle under the chin (PMID 38936991, PMID 40889761).
• A full neck with firm skin. A deep neck lift that removes fat and shapes the structures under the platysma muscle, without removing skin, may be enough (PMID 40992434).
• Loose skin under the chin only. A direct neck lift removes the skin through an incision on the front of the neck and avoids scars around the ear; it suits men whose laxity sits above the Adam's apple, with little jowling, who accept a visible neck scar (PMID 40992434).
• Neck and jawline aging with a firm midface. A short-scar neck lift through limited incisions around the ear treats the neck with less surgery than a full deep-plane facelift (PMID 40962266).
• Bald men. The scars cannot hide in hair, so they must be as short as possible (PMID 31881604).
• High blood pressure. A systolic pressure over 160 before surgery predicted hematoma, so blood pressure is brought under control before the operation (PMID 24912427).

How it is done

Incisions, sideburn and beard

Incisions follow the pattern of hair growth so the sideburn and beard stay where they belong, and the dissection protects the hair follicles (PMID 28125532). Bevelled (trichophytic) incisions, cut at an angle so hair grows through the scar, and careful placement are the male-specific details (PMID 32866978). In bald men, a dedicated way of trimming the excess skin keeps the scars short (PMID 31881604).

The deep layer

The male deep-plane facelift releases the ligaments that hold the cheek down, repositions the SMAS layer and separates the skin from the layer below as little as possible (PMID 40889761, PMID 38936991). Measured in the operating room, the deep layer in men is lifted at a less vertical angle than in women, and the surgeon sets the direction for each side after the release (PMID 38657095).

The neck

A defined male neck depends on the structures under the platysma. Through an incision under the chin, surgeons reduce deep fat, shape the digastric muscles, reduce part of a visible submandibular gland and tighten the platysma (PMID 40889761). The dual-plane approach treats volume under the platysma first and then redrapes the muscle and skin with little tension (PMID 35367033). For a direct neck lift, skin-removal patterns under the chin range from a simple ellipse to shapes designed to hide the scar (PMID 40992434, PMID 38936992).

Volume

Fat grafting can restore lost volume in the male face, alone or with a lift; each area needs its own technique to avoid a feminine look (PMID 38936996).

Results and how long they last

Men and women had similar results and similar revision rates across 25 years of one practice's facelifts (PMID 27348643). Deep-plane surgeons report from their own experience that vertical deep-plane surgery is more durable and relies less on added fat (PMID 38936991).

Bald men given a deep-plane lift rated their scars and overall result highly at one year, and none regretted the operation (PMID 31881604). Age-estimating software judged men about 2 years younger 3 months after surgery, in a group too small to be conclusive (PMID 36706713).

Risks and how surgeons lower them

• Hematoma (blood collecting under the skin). The complication most often linked to male sex. Older series found it in men twice as often or more (PMID 909960, PMID 26578747), and in one matched series in about 6 in 100 men against no women (PMID 28125532). The newest matched study found no hematoma in men under a standard prevention protocol, although their operations were longer and they lost more blood during surgery (PMID 42154486).
• How surgeons lower it. Strict blood pressure control before, during and after surgery (PMID 16327611); a protocol using a clonidine skin patch and close blood pressure monitoring held hematomas under 1 in 100 overall (PMID 25811571); no deliberately lowered blood pressure during surgery (PMID 28125532); and stopping aspirin and anti-inflammatory drugs and smoking, which were also linked to hematoma (PMID 11513508).
• Other complications. Across a national database, about 2 in 100 facelifts had a major complication, most often hematoma (PMID 26578747). In Rohrich's male series, hematoma was the only complication: no hair loss, skin loss, infection or nerve injury (PMID 28125532).
• Blood clots in the legs. The risk rose when surgery lasted more than five hours, and both patients who had one also had other procedures combined with the facelift (PMID 22446820).
• A feminine look. Fat grafting, lift direction and neck shaping are each adjusted to keep a male face male (PMID 38936996, PMID 38657095, PMID 40992434).
• Visible scars. In bald men there is no hair to hide them, which is why scar length and placement get the most planning (PMID 31881604).

Recovery

• Blood pressure control continues after surgery: in the clonidine protocol, most patients who developed a hematoma had high blood pressure in the recovery room (PMID 25811571).
• A neck-only operation recovers faster: in selected men, the short-scar neck lift had less operating time, fewer problems and a shorter recovery than a deep-plane facelift (PMID 40962266).
• After a direct neck lift, recovery is faster with scar care, drain care, head positioning and massage to move lymph fluid, and control of saliva flow (PMID 40992434).
• The scar result in bald men was judged at one year (PMID 31881604).

With a facelift

• Deep neck work (fat reduction, digastric shaping, gland reduction, platysma tightening) is added to the facial lift through a small incision under the chin (PMID 40889761).
• Fat grafting can be added to the lift to restore volume (PMID 38936996).
• A short-scar neck lift can be combined with liposuction under the chin, platysma tightening and skin-tightening devices (PMID 40962266).
• Combining other cosmetic operations with a facelift raised the major complication rate, to as high as 3.7% (PMID 26578747).

Questions to ask a surgeon

• How will you control my blood pressure before, during and after surgery? (PMID 16327611)
• What is your hematoma rate in men, and what is your prevention protocol? (PMID 42154486)
• Which medicines, such as aspirin, should I stop before surgery, and when? (PMID 11513508)
• Where will my incisions run relative to my sideburn, beard and hairline? (PMID 28125532)
• I am bald or thinning: how long will my scars be, and where? (PMID 31881604)
• Do I need a full facelift, or would a direct or short-scar neck lift treat my neck? (PMID 40992434)
• How will you keep my jawline and neck masculine? (PMID 40889761)
• How long will my operation take with everything combined? (PMID 22446820)

Open questions

• Whether modern protocols have closed the hematoma gap: the 2026 matched study found no difference, but it had few men and one surgeon (PMID 42154486); earlier prevention evidence in men is retrospective (PMID 25811571, PMID 16327611).
• Deep plane against SMAS techniques in men: the male deep-plane articles describe technique and experience without a comparison group (PMID 38936991, PMID 40889761).
• How men weigh a scar under the chin against scars around the ear has not been measured (PMID 40992434).
• Measuring how much younger a man looks: age-estimating software is new and the male groups are small (PMID 36706713).

Terms

• Hematoma: blood collecting under the lifted skin; the most common serious complication after a facelift (PMID 26578747).
• Trichophytic incision: incision bevelled so hair grows through the scar (PMID 32866978).
• Hypotensive anesthesia: deliberately low blood pressure during surgery; avoided in men to prevent hematoma (PMID 28125532).
• Clonidine: a blood pressure drug, given as a skin patch in one hematoma-prevention protocol (PMID 25811571).
• Deep-plane facelift: a lift made under the SMAS layer, with the facial ligaments released and little separation of the skin from the layer below (PMID 40889761).
• SMAS: the layer of muscle and fibrous tissue under the facial fat that a facelift lifts (PMID 38657095).
• Gonial angle: the angle of the lower jaw (PMID 38936991).
• Cervicomental angle: the angle between the underside of the chin and the neck (PMID 40889761).
• Direct neck lift (direct cervicoplasty): removal of loose neck skin through an incision on the front of the neck (PMID 40992434).
• Dual-plane neck lift: deep volume reduction under the platysma, then redraping of muscle and skin (PMID 35367033).

Papers