Facelift
A facelift, known medically as a rhytidectomy, visibly and lastingly improves sagging skin, deep wrinkles and the loss of youthful facial contours.
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Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
The Facelift (also known as a facelift or facial tightening; technical term: rhytidectomy) is the pinnacle of aesthetic facial surgery. It is regarded as one of the most effective procedures for visibly and lastingly improving advanced signs of ageing, such as sagging skin, deep wrinkles and the loss of youthful facial contours. Modern techniques bear no resemblance to the mask-like results seen in previous decades.
This article explains in precise and comprehensive detail what constitutes a modern facelift, why treating the deep tissue layers is crucial, and what you can expect from the procedure.
What is a facelift?
What is a facelift?
A facelift is a surgical procedure designed to tighten and reposition the facial tissues and, in many cases, those of the neck as well. Unlike superficial treatments, a modern facelift not only corrects the skin but primarily targets the underlying supportive layer of connective tissue and muscle (the SMAS) to achieve a natural and long-lasting rejuvenating effect.
The secret to a natural-looking result: the SMAS technique
The greatest fear of many patients is ending up with an „artificial“, overly taut appearance. Modern facelift techniques address precisely this problem by tackling the actual cause of sagging.
The SMAS: The facial structure’s key supporting layer
Beneath our skin and the subcutaneous fatty tissue lies a continuous layer of connective tissue and facial muscles, which Superficial Musculoaponeurotic System (SMAS). This layer is responsible for the stability and contour of the face. As we age, the SMAS loses its support and sags, along with the overlying skin and fatty tissue – resulting in „jowls“ and deep wrinkles.
A modern SMAS facelift It does not primarily pull on the skin. Instead, the surgeon lifts the entire SMAS as a single unit and secures it in its original, more youthful position. The skin is then draped over it with minimal tension, and the excess is removed. This is the key to a result that looks refreshed but never unnatural.
What types of facelifts are there?
Mini facelift (MACS lift)
A less invasive option resulting in shorter scars. It is suitable for patients with moderate sagging, primarily in the cheek and jaw areas. The SMAS lift is less extensive in this procedure.
Classic SMAS facelift
The gold standard for comprehensive rejuvenation of the mid-face, cheeks and jawline. It involves extensive dissection and lifting of the SMAS layer.
Deep Plane Facelift
An advanced technique for treating pronounced signs of ageing, in which the skin and SMAS are mobilised and lifted together in the layer beneath the SMAS and certain suspensory ligaments.
Facelift with neck lift
In most comprehensive facelifts, additional tightening of the neck muscles (platysmaplasty) and the skin of the neck is an integral part of the procedure, in order to create a harmonious transition.
The scars: Where are the incisions?
The art of an excellent facelift also lies in the discreet placement of the scars. An experienced surgeon makes the incisions precisely along the natural lines:
- They usually start in the hairy area around the temples.
- They then run downwards, hidden from view behind the ear (often behind the small cartilaginous protrusion known as the tragus).
- They go round the earlobe and eventually end at the hairline behind the ear.
As the skin is sutured without tension at the end, these scars usually heal to be extremely fine and inconspicuous.
Risks and the importance of safety measures in facelifts
Risks and the importance of safety measures in facelifts
A facelift is one of the most complex cosmetic procedures and carries specific risks:
- Post-operative bleeding and haematomas (bruises) are the most common early complication
- Wound-healing disorders, particularly among smokers
- Injury to the facial nerves (very rare), which may lead to temporary or permanent disturbances of sensation or movement (e.g. facial expressions)
- Unsatisfactory aesthetic results or asymmetries
The treatment of such serious complications can be complex and costly. As this is a cosmetic procedure, these costs are usually not covered by health insurance. One Consequential Costs Insurance is an important way of protecting oneself against these significant financial risks.
Frequently Asked Questions about Facelifts
The costs vary considerably and depend heavily on the extent of the procedure (e.g. mini-lift versus full lift including the neck). Prices range from around 7,000 euros to over 15,000 euros.
The results of an SMAS lift are very long-lasting. It „turns the clock back by around 10–12 years“. Whilst the natural ageing process continues, you will always look younger than you would have done without the procedure.
After about 2 to 3 weeks, the worst of the swelling and bruising will have subsided, so you can go out in public again wearing make-up. However, slight residual swelling may persist for several months.
Only a specialist in plastic and aesthetic surgery with a proven track record of expertise in aesthetic facial surgery. Make sure to ask specifically about their experience with the SMAS technique.
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