Facelift
Also known as rhytidectomy
A facelift, medically known as rhytidectomy, is a surgical procedure designed to reduce visible signs of aging in the face and neck. The surgery addresses sagging facial skin, deep creases along the nose and mouth, jowls along the jawline, and loose skin and excess fat beneath the chin and along the neck. By repositioning deeper facial tissues and removing excess skin, a facelift restores a more youthful and refreshed facial contour.
The facelift is one of the most transformative procedures in facial plastic surgery, capable of turning back the clock by approximately 7 to 10 years [1]. Modern techniques focus on lifting and repositioning underlying muscle and connective tissue rather than simply pulling skin tight, resulting in natural-looking outcomes that avoid the "windswept" appearance associated with older surgical methods.
According to the American Society of Plastic Surgeons, approximately 79,000 facelifts are performed annually by ASPS member surgeons in the United States, making it one of the most popular cosmetic surgical procedures [1]. The procedure is most commonly sought by patients between the ages of 50 and 70, though patients in their 40s may benefit from less extensive techniques such as the mini-facelift.
Overview
The modern facelift has evolved dramatically from the skin-only procedures of the early 20th century. Early facelifts involved simply pulling the skin tighter, which often resulted in an unnatural, overly tight appearance and poor longevity. The introduction of the SMAS (superficial musculoaponeurotic system) technique in the 1970s revolutionized facelift surgery by addressing the deeper structural layer beneath the skin, leading to more natural and longer-lasting results [1].
Today, surgeons have multiple techniques at their disposal, each suited to different patient needs and anatomical presentations. The deep plane facelift, considered by many to be the gold standard, involves releasing and repositioning the SMAS layer along with the overlying skin as a single unit. This approach provides the most dramatic and long-lasting improvement, particularly in the midface and nasolabial folds, and avoids placing excessive tension on the skin.
The SMAS facelift, which tightens the SMAS layer separately from the skin, remains widely performed and produces excellent results. Variations include the SMAS plication (folding and suturing) and SMASectomy (removing a strip of SMAS). The mini-facelift, also called a short-scar facelift or limited-incision facelift, is designed for patients with early signs of aging who require less extensive correction. It involves shorter incisions, less tissue manipulation, and a quicker recovery compared to a full facelift.
The facelift is frequently combined with complementary procedures to achieve comprehensive facial rejuvenation. Neck lift (platysmaplasty) addresses bands and loose skin in the neck. Blepharoplasty (eyelid surgery) corrects drooping eyelids and under-eye bags. Brow lift addresses forehead lines and sagging brows. Fat transfer can restore lost facial volume. Skin resurfacing techniques such as laser treatment or chemical peels improve skin texture and tone. Planning a combined approach during a single surgical session reduces overall recovery time compared to staged procedures.
Patient selection and customized surgical planning are essential for optimal outcomes. During consultation, the surgeon evaluates skin quality, degree of laxity, facial volume loss, bone structure, and overall health. Factors such as skin thickness, sun damage history, smoking status, and previous facial procedures all influence surgical planning and expected results.
Techniques & Approaches
The deep plane facelift involves incisions that typically begin in the temporal hairline, continue in front of or inside the ear, curve behind the earlobe, and extend behind the ear into the posterior hairline. The surgeon releases the SMAS and overlying skin as a composite flap, lifting and repositioning the deeper tissues to restore youthful contours. This technique addresses the midface, jowls, and nasolabial folds effectively. Because the skin is not separated from the underlying tissue, blood supply is well-preserved, potentially reducing the risk of skin necrosis and promoting better healing.
The SMAS technique uses similar incisions but separates the skin from the SMAS layer. The SMAS is then tightened independently through plication, imbrication, or excision, and the skin is redraped over the newly tightened foundation. This approach allows the surgeon to address skin and deeper tissues separately, providing significant control over the degree of correction. The SMAS facelift has a long track record of safety and effectiveness.
The mini-facelift uses shorter incisions, typically limited to the area around the ear, with minimal or no incision behind the ear. It addresses primarily the lower face and jowls through limited SMAS manipulation. Recovery is faster and complications are less frequent, but the degree of correction is more modest. The mini-facelift is best suited for younger patients with early jowling and mild skin laxity who are not yet candidates for a full facelift.
Thread lifts represent a minimally invasive alternative that uses absorbable sutures with small cones or barbs to lift sagging tissue. While thread lifts offer minimal downtime and can be performed under local anesthesia, the degree of lift is limited and results typically last only one to two years [1]. Thread lifts are not considered a substitute for surgical facelift in patients with moderate to severe facial aging.
Who Is a Good Candidate?
Ideal Candidates
Ideal facelift candidates are individuals experiencing moderate to significant facial sagging, jowling, deep nasolabial folds, and loss of definition along the jawline. Most candidates are between 45 and 70 years of age, though chronological age matters less than the degree of facial aging present. Candidates should be in good overall health, non-smokers or willing to quit for at least six weeks before and after surgery, and have realistic expectations about outcomes.
Patients with good skin elasticity tend to achieve the best results, as the skin must conform smoothly to the repositioned underlying tissues. Those who maintain a healthy lifestyle, protect their skin from sun damage, and follow their surgeon's post-operative instructions typically enjoy the longest-lasting results.
Not Suitable For
Facelift surgery is not recommended for active smokers who are unwilling to quit, as smoking dramatically increases the risk of skin necrosis, infection, and poor wound healing. Patients with uncontrolled hypertension face elevated bleeding and hematoma risks. Those with bleeding disorders or who are unable to discontinue blood-thinning medications may not be suitable surgical candidates.
Individuals with unrealistic expectations, such as those seeking to look decades younger or to resemble a different person, are unlikely to be satisfied with results. Patients with significant medical comorbidities that increase surgical risk, including uncontrolled diabetes, severe cardiovascular disease, or compromised immune function, should be carefully evaluated. Very thin patients with poor skin quality may achieve suboptimal results due to limited tissue for redraping.
Risks & Benefits
Benefits
The facelift offers the most significant and long-lasting improvement for moderate to severe facial aging of any available procedure. By addressing the underlying structural causes of facial sagging, the procedure produces natural-looking rejuvenation that non-surgical treatments cannot replicate. The jawline is redefined, jowls are eliminated, nasolabial folds are softened, and the overall facial contour is restored to a more youthful state.
The psychological benefits are substantial. Many patients report increased confidence, improved social interactions, and a renewed sense of vitality. The alignment between how patients feel internally and how they appear externally is frequently cited as the most meaningful outcome. Professional benefits may also accrue, as patients often report feeling more competitive and energized in workplace settings.
When combined with complementary procedures, a facelift can achieve comprehensive facial rejuvenation in a single surgical session, reducing the need for repeated non-surgical treatments and their cumulative costs over time.
Risks & Considerations
Facelift surgery carries standard surgical risks including bleeding, infection, and adverse reaction to anesthesia. Hematoma, a collection of blood beneath the skin, is the most common complication of facelift surgery, occurring in approximately 1 to 3 percent of patients [1]. Men have a higher hematoma risk due to greater facial vascularity [2]. Hematomas that are recognized and treated promptly typically do not affect the final result.
Nerve injury is a significant concern. Temporary weakness or numbness of facial muscles occurs in a small percentage of patients and typically resolves within weeks to months. Permanent nerve injury is rare, occurring in less than 1 percent of cases [2], but can result in asymmetric facial movement or persistent numbness.
Skin necrosis, the death of skin tissue due to impaired blood supply, is more common in smokers and patients with diabetes or vascular disease [2]. This complication can lead to visible scarring and may require additional procedures to correct. Hair loss along incision lines, visible or widened scars, asymmetry, and irregularities in skin contour are additional risks. Patients should understand that revision surgery may be needed in some cases to optimize results.
Alternative Procedures
Non-surgical alternatives to facelift include injectable treatments such as dermal fillers and neuromodulators (Botox, Dysport). Fillers can restore lost facial volume and soften deep creases, while neuromodulators relax dynamic wrinkles in the upper face. These treatments are temporary, lasting 6 to 18 months depending on the product, and cannot address significant skin laxity or jowling.
Energy-based skin tightening devices such as radiofrequency (Thermage), ultrasound (Ultherapy), and laser treatments can produce modest skin tightening without surgery. Results are subtle compared to a facelift and typically require multiple treatment sessions. These devices may be appropriate for patients with very early signs of aging or as maintenance treatments after a facelift.
For patients who want improvement but are not ready for a full facelift, a mini-facelift or a neck lift alone may provide meaningful improvement with less extensive surgery and recovery time.
Preparation & Recovery
Pre-Surgery Preparation
Preparation for a facelift begins with a thorough consultation that includes a detailed medical history, physical examination, and discussion of aesthetic goals. The surgeon evaluates facial anatomy, skin quality, degree of aging, and overall health to develop a customized surgical plan. Standardized photographs are taken for surgical planning and medical records.
Patients must discontinue blood-thinning medications and supplements, including aspirin, ibuprofen, vitamin E, fish oil, and certain herbal supplements, at least two weeks before surgery [2]. Smoking cessation is required at least six weeks before and after surgery [2]. Pre-operative testing typically includes blood work, an electrocardiogram, and clearance from the primary care physician for patients with medical conditions.
Patients should arrange for a responsible caretaker to drive them home and stay with them for the first 24 to 48 hours after surgery. Preparing the home recovery area with extra pillows, prescribed medications, soft foods, button-front shirts (to avoid pulling clothing over the head), and entertainment is recommended. Clearing the schedule of social and professional obligations for at least two to three weeks is advisable.
Post-Surgery Care
After surgery, the head is wrapped in a compression bandage to minimize swelling and support the repositioned tissues. Drains may be placed to prevent fluid accumulation and are typically removed within one to two days. The compression garment is worn continuously for the first week and then at night for an additional two to four weeks as directed by the surgeon.
Patients should sleep with their head elevated at a 30 to 45 degree angle for the first two to three weeks. Cold compresses applied during the first 48 hours help reduce swelling. Prescribed pain medication, antibiotics, and anti-nausea medication should be taken as directed. Gentle walking is encouraged within the first day or two to promote circulation and reduce the risk of blood clots.
Sutures are typically removed in stages between 5 and 14 days after surgery. Vigorous physical activity, heavy lifting, bending, and straining should be avoided for at least four to six weeks. Sun exposure should be minimized, and broad-spectrum sunscreen should be applied diligently once incisions have healed. Hair coloring and chemical treatments should be delayed for at least six weeks. Follow-up appointments are scheduled at regular intervals over the first year to monitor healing and assess results.
Recovery Timeline
1-2 days
Moderate pain, significant swelling and bruising, drains may be present
3-5 days
Drains removed, compression dressing may be changed to lighter garment
7-10 days
Most sutures removed, bruising begins to yellow and fade
2 weeks
Most patients feel comfortable returning to non-strenuous work and social activities with makeup
3-4 weeks
Significant improvement in swelling, light exercise may resume
6 weeks
Most restrictions lifted, moderate exercise permitted, incision scars fading
3 months
Majority of swelling resolved, results becoming apparent
6 months
Near-final result visible, scars continuing to mature
12 months
Final result achieved, scars well-healed and typically well-concealed
Expected Results
A well-performed facelift typically produces results that last 7 to 10 years, though individual results vary based on genetics, lifestyle, skin quality, and environmental factors [1]. The procedure does not stop the aging process; rather, it resets the clock, and patients continue to age naturally from their improved starting point. Most patients report looking significantly younger than their peers years after surgery.
Initial results are visible once swelling and bruising subside, typically within two to four weeks, but the final result continues to refine over three to six months as tissues settle into their new positions and swelling fully resolves. The incision scars, placed within natural creases and the hairline, continue to fade over 12 to 18 months and are generally well-concealed.
Patient satisfaction with facelift surgery is among the highest of all cosmetic procedures, with studies reporting satisfaction rates exceeding 90 percent [1]. Patients commonly describe the results as looking refreshed and well-rested rather than surgically altered, particularly with modern deep plane and SMAS techniques that avoid an overtightened appearance.
Frequently Asked Questions
How long do facelift results last?
Modern facelift results typically last 7 to 12 years, depending on the technique used, individual genetics, skin quality, and lifestyle factors. Deep plane facelifts tend to produce the longest-lasting results because they address the deeper structural layers of the face. Patients continue to age naturally after surgery, but from a more youthful starting point, so they generally look younger than their peers for many years. Protecting the skin from sun damage, maintaining a stable weight, following a healthy lifestyle, and using quality skincare can help extend the longevity of results.
Source: ASPS, Mayo Clinic
Will my scars be visible?
Facelift incisions are carefully placed in natural creases and hairline to minimize visibility. While scars are permanent, they typically heal very well and become nearly imperceptible within 6-12 months.
What is the difference between a deep plane facelift and a SMAS facelift?
The primary difference lies in how the deeper facial tissues are handled. In a SMAS facelift, the skin is separated from the underlying SMAS layer, and each is tightened independently. In a deep plane facelift, the SMAS and skin are lifted together as a single composite flap, preserving the blood supply to the skin. The deep plane approach is generally considered to provide more natural-looking and longer-lasting results, particularly in the midface area, but requires greater surgical expertise. Both techniques produce excellent outcomes when performed by an experienced surgeon.
Source: ASPS, Cleveland Clinic
When can I return to work after a facelift?
Most patients feel comfortable returning to sedentary work and social activities approximately two weeks after surgery, once the majority of bruising has faded and can be concealed with makeup. Some swelling will still be present at this stage but is generally not noticeable to casual observers. Patients with physically demanding occupations may need three to four weeks or longer before returning to full duties. Your surgeon will provide individualized guidance based on your specific procedure and rate of healing.
Source: ASPS, Mayo Clinic
Sources & References
- Facelift — American Society of Plastic Surgeons (ASPS) Accessed March 2026
- Facelift — Mayo Clinic Accessed March 2026
- Facelift (Rhytidectomy) — Cleveland Clinic Accessed March 2026
Content last reviewed: March 16, 2026
Medical Disclaimer
Facelift results vary by anatomy, skin quality, and lifestyle. Smoking significantly increases the risk of hematoma and skin necrosis. The procedure addresses laxity but does not treat fine lines or skin texture, which may require additional treatments.
Not Medical Advice. The information on this page is provided strictly for educational and informational purposes. It is not intended to be, and must not be taken as, medical advice, a medical diagnosis, or a recommendation for any specific treatment or procedure. This content does not establish a physician-patient relationship.
Consult a Qualified Professional. Always seek the advice of a board-certified plastic surgeon or other qualified healthcare provider before making any decisions about medical treatment. Never disregard professional medical advice or delay seeking it because of something you have read on this website.
Individual Results Vary. The outcomes, recovery timelines, complication rates, and cost estimates described here are general approximations based on published medical literature and may differ significantly based on your individual anatomy, health status, surgeon experience, geographic location, and other factors. No specific results are guaranteed or implied.
Sources and Currency. Content is informed by peer-reviewed medical literature and professional society guidelines, last reviewed March 16, 2026. Medical knowledge evolves continuously, and this information may not reflect the most current research or clinical practice at the time you read it.
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Quick Facts
Cost Information
Average cost range in the US
Factors affecting cost:
Facelift costs vary considerably based on the extent of the procedure, the surgeon's expertise, and geographic location. A deep plane facelift performed by a highly experienced surgeon in a major metropolitan area will typically cost more than a mini-facelift in a smaller market. The type and number of complementary procedures performed simultaneously, such as neck lift, blepharoplasty, or fat transfer, add to the total cost.
Anesthesia fees depend on the duration of surgery and whether a board-certified anesthesiologist or a certified registered nurse anesthetist is used. Facility fees vary between hospital operating rooms, ambulatory surgery centers, and accredited office-based surgical suites. Post-operative care, compression garments, and any necessary revision procedures should be considered when evaluating total costs. Many practices offer financing options to help patients manage the investment.
Note: Costs vary by location, surgeon experience, and specific patient needs. Always get personalized quotes during consultations.
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