Tightness of facelift results controllable?

Looking at "before and after" photos of facelifts, I see photos of patients with not much difference between how they look before and after. In my opinion, many could have been pulled tighter. Most people do not want a "pulled", "wind tunnel" look and that is the trend of facelifts today. However, I am considering having a facelift and I would want my face to be pulled as tight and smooth as possible. Is the degree of the correction controllable and a choice?

Doctor Answers 19

Facelift Tightness Is Controllable But Skin May Relax More In Some People

Thank you for your question. Yes it is true that the surgeon determines how tight to pull the skin during a facelift.

However after the facelift the skin always does relax a bit. In addition if there is an unusual amount of swelling following a facelift this can stretch the skin and result in loss of tightening postoperatively.

I try to anticipate this and always tighten the skin the maximal amount during the facelift so that once swelling has gone away and the patient has recovered the face retains it's improvement.

In addition it is very important that the facelift be done utilizing modern SMAS facelifting techniques. The SMAS is a deep layer of tissue which when tightened will help hold the facelift correction.

Generally speaking the thicker your skin and the healthier your skin the more long lasting will be your facelift result. Patients with very fair thin light-colored skin with lots of sun damage often do not get an optimal facelift result.

In my opinion the most important thing for you is to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, is experienced in facelift surgery and has a good reputation in your community.

Face lift tightness

Yes, a good surgeon can control the tightness of a face lift depending on your goal.

  1. Face lifts are done in various ways,
  2. I have found the mini-lift (MACS lift) easily looks over done,
  3. The SMAS flap platysma flap is the easiest to control,
  4. Heavy faces tend to have less dramatic face lift results,
  5. The best face lift results are in those of normal weight with normal to thin skin.
  6. Hope this helps. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Tightness of a facelift

To a certain extent, the tightness that the face skin is pulled is variable and a surgeon can pull "tighter" if desired. Best of luck.

Tightness of a facelift

Yes, the facelift results are controllable with regard to tightness. Remember that tightness can come from tightening the SMAS, and facial and neck muscles in addition to tightening skin. Both variables can be controlled, but it is important not to give the wind tunnel look. It's more important to look natural, than too tight. For many examples of facelifts, please see our facelift photo gallery link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Thightness in face lift

I believed there is a misunderstanding in the face lift operation. The results that look pull are produce for the tension in the skin flap. To obtain better results the key is to resolved the deep plane first and removed the redundant skin only. This warranty great and natural results

Alejandro J. Quiroz, MD, FACS
Mexico Plastic Surgeon
4.3 out of 5 stars 116 reviews

Facelift and Tight Skin

The result of a facelift does not rely on how tight is the skin. Nevertheless, it is possible to create dramatic youthful change with an expertly performed facelift. Your observation is correct – some surgeons deliver a “natural” look where you do not see significant difference in before and after photos. A goal of a world class facelift is to create beautiful results, with significant youthful changes in the before and after photos, and yet without any artificial look. It is imperative to use certain specific surgical maneuvers to create these changes. Seek out an expert facelift surgeon. Ask to see the before and after photos that show the results you desire. In our practice, we encourage prospective patients to meet with our prior facelift patients to see first hand what a well executed facelift can achieve.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.7 out of 5 stars 56 reviews

Facelifting is about redraping not tightness, laxity not skin surface features

Face lifting is a procedure designed to treat skin laxity and restore a youthful shape to the face. We are laying the skin flat without redundancy not pulling. Regardless of technique or surgeon, the laxity is never 100% removed despite the ability to pull on face skin with the fingers and completely clear the hanging skin. Also, wrinkles, and other skin surface features are not appreciably changed in facelifting, being more appropriately addressed with chemical or laser peels. That being said, facelifting is still the mainstay of restoring a youthful appearance to the face and acts as the "foundation" procedure in facial rejuvenation. The long durability compared to other fixes is also a big plus.

Every surgeon is trying to get as complete a correction as possible while preserving a natural look. Variations in patients skin elasticity can result in some residual laxity.

Lawrence Bass, MD
New York Plastic Surgeon
5.0 out of 5 stars 10 reviews

How tight can a facelift be tightened ?

The tightening of the lift is something that is determined during treatment of the underlying SMAS layer. The results of the tightening are immediately visible to the surgeon as the jowls are decreased, there is a visible improvement in the jawline and the neck profile is improved. Results vary between patients depending on underlying anatomy and type of procedure performed, so no two patients will get the same results. You should discuss with your surgeon your expectations and they will let you know what is possible.

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Facelift question from Great Neck, NY

Does anyone else see the humor of the facelift question coming from Great Neck, NY???

You're correct, we can certainly alter the amount of tension of the skin, but more tension can lead to widened scars. The ideal is a compromise between good skin redraping and the right amount of pull to give a tight but not "done" look. Some surgeons will suggest a "tuck up" surgery to lift loose skin a year or two after the facelift. Tell your surgeon your goals so you have good communication and realistic expectations.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Tightness of Facelift Results Controlled

I have never met a patient that requested a "pulled" or "wind tunnel" look. This would look very unnatural. I good facelift gives you a refreshed look. Patients comment that people look at them, but can't figure out what is different. They are asked if 'they lost weight", "changed their hair," and " relaxed on vacation," and many other comments. Consult with a Board Certified Plastic Surgeon that does lots of facelifts. Discuss your concerns and expectations to be assured that you and your surgeon are on the same page. Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 60 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.