The greatest risks in facelift surgery include injury to the facial nerve, a motor nerve that supplies movement of all areas of the face, and unsightly scar formation. There have been a number of well accepted facelift techniques over recent years that have ranged from a more superficial SMAS elevation technique to a deplane facelift to minimal access types facelifts, including the S-Lift, endoscopic facelifts and--what I believe is an outdated technique called the threadlift.
The most important part of the decision is to chose the appropriate technique to address your specific, common individual concerns. These may include excessive jowling, skin laxity in the midface and prominent muscle bands in the neck. I believe that a deplane facelift adds risk of injury to the facial nerve that is not proportional to any improved results that this technique offers. Any minimal access type of technique may be appropriate for a younger patient with a less significant skin laxity or facial aging, but a limited access approach also occasionally exposes the patient to a greater risk because of less exposure.
In my hands, variations of a more traditional SMAS technique have yielded very safe and effective results. I hide any scars above the hairline, behind the cartilage in front of the ear, and in the post-auricular crease behind the ear. In this way, the scars are so well hidden that the risk of poor wound healing is very minimal.