Does a Facelift Result in Less Healthy Skin over Long Run?

I read an interesting article that spoke of long term damage to skin that has been cut and pulled as part of a facelift. It states that skin will get thinner and will never regain or increase its thickness given that the skin is lifted away from underlying layers in order to tighten the underlying fascia and muscles. Especially so if more than one surgery. It makes common sense that skin may not re-attach itself to underlying tissues like it was before surgery.

Doctor Answers 17

Healthy skin after repeated facelifts

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Modern facelifts rely less on pulling really tight, and more on adjusting deep volume and replacing lost volume. Extreme tightness of the skin is avoided. Therefore the effect of repeated excessive stretching that was the guiding principle of the 80's that caused the skin to stretch so much does not happen.

That much we do know. Experienced facelift surgeons have seen thousands of post facelift patients in their practice. So these observations are "anecdotal", i.e. not scientific, but are reasonable and make good sense.

There are other reasons patients with well done facelifts look good, including their skin.

Patients with well done facelifts typically take very good care of themselves. They look far better than their colleagues who don't. This "package" includes an excellent skin care system, microdermabrasions, weight control, dietary restraint, no smoking, exercise, sun avoidance, treatments such as PhotoFacial lasers when appropriate, retinoids, etc.

It would not be uncommon for somebody who likes to look "just so" to have 3 facelifts in their lifetime, with various ancillary procedures.

The "full facelift" today may contain many procedures that were not even invented in the day when tightness and eradication of the nasolabial fold through tightening was the primary goal of plastic surgery.

So I suppose the answer depends on the type of facelift you are talking about, in my opinion.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Facelift and Skin

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A facelift is designed to lift the deeper tissues of the face and reposition it into a better position.  Skin will not change after a facelift and this includes patients with acne scars, fine wrinkles, sundamaged skin, thick skin, oily skin, and large pores.  Seek skin specific procedures in order to treat the skin.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 177 reviews

Facelift will not affect health of skin

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It is not true that the skin gets less healthy after a facelift. It is important to tighten the muscles and underlying fascia at the time of a facelift to give underlying structural support. The skin reattaches to the underlying tissues just like prior to surgery. The skin itself does not become any thinner after a facelift, but there is a very small amount of fat lost during the actual procedure itself.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Thin skin after Facelift Surgery

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Facial skin will thin secondary to to the normal aging process. A well-done facelift will not cause or accelerate the loss of skin thickness or turgor.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

A facelift should not cause the skin to look less healthy over time.

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A facelift should involve manipulation and tightening of the SMAS or muscular layer under the skin after a healthy skin flap is developed. The skin is then simply redraped with any excess trimmed, this should not pull the skin too tight and should not affect the quality of the skin. Often this is combined with fat transfer under the flap that could provide stem cells and quite possibly add improvement to skin quality. On the contrary a resurfacing procedure done at the same time as a skin flap is made might run the risk of damaging the skin. A well done facelift should not damage the skin.

Robert Schwarcz, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 23 reviews

It is not the facelift that damages the skin

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A well done facelift will have no damaging effects on the skin. It is important to leave an appropriate amount of fat on the lifted skin to help protect the blood vessels that bring nourishment to the skin. However, the big abusers of skin quality are over done CO2 laser resurfacing and too much injectable steroids.

The skin of the face has an amazing capacity to heal itself, so your conception of what happens with surgical maneuvers is fortunately not correct.

When you are ready to seriously look into options for yourself, the key is to find a well qualified surgeon who you are confident in and trust will do what is best for you. Yes, surgeries can have side effects but these side effects seem to occur much less often in the right hands.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

No it does not!

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If properly done multiple facelifts do not do this. In more than 30 years of doing facelifts and seeing my patients over that period of time, there is no change even with multiple lifts on actresses who tend to have more lifts than the average person.

The skin will become less elastic and thinner in all of us even without surgery due to aging.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

A face lift doesn't harm nor rejuvenate your skin

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A modern face lift will not harm your skin because it doesn't stretch out the skin because:

  1. Your skin is not pulled tight. The underlying muscles are lifted to give a more natural longer lasting result.
  2. A significant cause for facial sagging is loss of volume in the cheeks and jawline. By replacing this lost volume with i.e. Sculptra, fat, the relative excess in skin is smoothed out requiring less lifting during the face lift. Again, avoiding unnecessary tension on the skin.

Face lift surgery doesn't rejuvenate your skin. I often recommend skin resurfacing either before or after face lift surgery. This plumps up the collagen, smooths out lines and eliminates spider veins and age spots.

Make sure your plastic surgeon is well versed in the newer face lifting techniques. Stay away from face lifts that just pull on your skin such as many of the "mini" lifts.

Good luck!

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 158 reviews

Skin thickness after Facelift

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Since nothing is really done to the skin itself during a facelift, except redraping it smoothly, it does not get thinner as a result of the facelift. What does happen with some techniques is that the underlying fat layer is thinned. This causes the tissues to appear thinner. With newer techniques, the fat, and, thus, the appearance is maintained. The skin does, however, thin with aging and sun damage. For this reason, we recommend skin care to rejuvenate and thicken the skin in conjunction with a facelift. This assures that you do not end up with aged skin that has no folds or major wrinkles.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Skin Remains Healthy After Facelift

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There is no evidence that skin will not attach to the underlying deep tissues after a facelift and then become less healthy. The blood supply through growth of new capillaries is excellent in the face and nourishment for the skin is not an issue. If anything it gets more nourishment from the growth of new blood vessels.

Just remember to protect the skin from sun and use daily skin care products.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.