Facelifts primarily correct sagging and deep facial folds by repositioning deeper tissues; skin resurfacing and injectables address surface wrinkles. Modern surgical techniques focus on the SMAS or deeper planes, while non-surgical options (thread lifts, fillers, energy devices) provide less dramatic, shorter-lasting improvements. Careful patient selection, realistic expectations, and combining treatments when appropriate yield the best results.
What a facelift treats
A facelift (rhytidectomy) is a surgical procedure that primarily lifts sagging facial tissues and reduces jowls, deep folds, and skin laxity. It targets descent of the deeper layers more than fine surface lines. Surface wrinkles often improve indirectly but usually require additional skin-resurfacing or injectable treatments for best results.How surgeons approach a facelift
Surgeons evaluate skin quality, elasticity, fat volume, bone structure, and facial movement when recommending a technique. Modern approaches focus on repositioning deeper layers (the SMAS or deeper planes) rather than only tightening skin. Techniques range from full deep-plane facelifts to shorter "mini" lifts; the choice depends on the pattern and extent of aging.Incisions are planned to be discreet - often around the temples, along natural creases in front of the ear, and behind the ear. During surgery the surgeon separates skin from deeper tissues, repositions or tightens muscle and soft tissue, removes or re-drapes excess skin, and closes the incisions. Recovery varies with the extent of surgery but commonly includes a few days of limited activity, bruising and swelling that improves over weeks, and gradual return to normal activity in 2-4 weeks. Final contouring can continue for several months.
Non-surgical and minimally invasive alternatives
Non-surgical options do not produce the same degree of lifting but can help younger patients or those seeking subtle improvements. Options include thread lifts, injectable dermal fillers, and neuromodulators (e.g., botulinum toxin) to smooth lines and restore volume. Energy-based devices - radiofrequency, microfocused ultrasound, and some lasers - can tighten skin modestly by stimulating collagen. These treatments have shorter recoveries and lower procedural risk, but results are generally less dramatic and shorter-lived than surgery.Combining treatments and setting realistic expectations
A facelift addresses descent and contour. Fine lines, pigmentation, and skin texture are better treated with laser resurfacing, chemical peels, or topical regimens. Many patients get the most natural, long-lasting outcomes by combining procedures: surgical lifting for sagging plus resurfacing or injectables for surface improvements.It's important to have realistic expectations. Results vary by age, genetics, skin quality, and the chosen technique. Surgeons discuss risks such as bleeding, infection, nerve injury, scarring, and asymmetry in the preoperative consultation.