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

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.

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.

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.

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.

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

Your skin is not pulled tight. The underlying muscles are lifted to give a more natural longer lasting result.
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!

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.
Regards

Facelifts if done correctly have little impact on the overlying skin; however, if the skin is stretched too tightly as is done in some facelifts then it can affect the overlying skin texture and quality of the skin. Normal facelifts done today typically involving lifting the muscle and redistributing the fat and are less reliant on pull of the skin itself. In fact, only the excess skin created after securing the muscles and deep tissue should be removed to avoid changes in skin texture. Also, by leaving a sufficient layer of fatty tissue under the skin when performing a facelift, this should not damage the underlying skin architecture and result in changes to the texture or quality of the skin. I hope this information helps.

A facelift should not have any adverse effect on your skin quality. However, addressing the skin is an extremely vital part of facial rejuvenation. Think of it like the canvas of a painting. You want to make sure your skin matches the facelift because it does not look natural to have poor skin after the effect of gravity has been addressed.
In the majority of my facelifts, I do a fractionated ablative laser (Fraxel Repair) with the facelift. This restores the skin quality (color, tone, texture, pore size, etc) at the same time as the facelift.

To some degree this may be true and it does make some scientific sense that repeated episodes of fibrosis from flap elevation and rearrangement may result in "aged" skin. However, I am not aware of any study which has "proven" this.

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.