Why do some facelifts not last and others do? And why do some look more dramatic?

Question

I am looking to get a facelift and have been researching surgeons and have noticed some facelifts don't even last 2 years? I have noticed these patients have a return of laxity, especially around the jowls. But other patients after 2 years post op or more still have the same results as when they first had the facelift, in other words the facelift is still holding up. All the patients have had a deep plane facelift, so why do some lose their results within 2 years? Also, some patients look significantly younger and youthful while others have a nice but subtle difference which has mainly addressed laxity only. Is this the patient's choice or the surgeon's technique or does the deep plane facelift look different on everyone?

Stephen Prendiville, MD · Answer

Thank you for the great question.  First of all, it has to be understood that there are many variables involved which I will enumerate and the fact that a deep plane facelift will not stop the aging clock (which moves faster for some).  The variables include: 1) Individual Surgeon: look for at least 2 decades of experience and/or at least 1500 facelifts, 2) Technique: a true deep plane facelift is maximizing elevation and repositioning, so there is literally nothing else that can be done to lift the jowls.  In my experience, deep plane facelift results are superior to and have greater longevity than other techniques, 3) Starting patient indications: some patients have much more substantial aging changes), 4) Patient tendency to fluctuate in weight: adversely affects facelift results), 5) Patient lifestyle and stress: excess stress, a severe health issue, and/or an unhealthy lifestyle will accelerate aging.

Lucian Ion, FRCS · Answer

Thank you for your question. It covers a multitude of aspects, and it is not possible to provide a definitive answer. Without doubt, there are differences in the way surgery is performed, as some surgeons have more skill and expertise than others. However, beyond surgical technique, the most significant factors influencing the outcome and longevity of a facelift seem to be related to soft tissue laxity and the weight of the tissues.

Individuals with a relatively low BMI generally have lighter soft tissues in the lower face. Consequently, if the surgical technique is the same, they tend to achieve and maintain better results compared to those with heavier tissues, which are more prone to being pulled down by gravity over time.

Another critical factor is sun damage, which significantly affects skin elasticity. Sun damage has an even greater impact on the loss of correction following a facelift than tissue weight. Regular use of sunblock, even if sun damage has already occurred, helps protect the remaining skin elasticity and can improve the longevity of facelift results.

Finally, it is important to consider whether you are comparing patients who underwent only a facelift or those who had additional procedures such as a neck lift, temporal lift, eyelid surgery, or fat transfer. Combined interventions can produce more dramatic changes but may not always be desired or suitable for every patient seeking facelift surgery.

Erman Ak, MD · Answer

Great question! The longevity and outcome of a DEEP PLANE FACELIFT depend on a few factors: your skin’s natural elasticity, the surgeon’s skill, lifestyle habits (like smoking or weight changes), and whether the goal was a subtle or dramatic result. Aging doesn’t stop, so some changes over time are normal.
What’s most important in this type of procedure is ENHANCING the patient’s Natural Features, not creating an overly “done” look... A skilled surgeon will work with your unique anatomy to achieve results that look natural, youthful, and balanced.

Bianca Knoll, MD · Answer

thank you for your great question. Next to the known factors like  genetics, skin and soft tissue quality - the outcome  and longevity of a "deep plane facelift" depends  mainly on the release of the tissue during surgery. If the release of the so-called "deep plane" is insufficient, or not a "deep plane" , results can be different. Weight changes, and lifestyle habits are certainly contributing factors to the longevity of a deep plane facelift result as well. The term deep plane facelift is often confusingly used. More information to answer your question you will find by clicking on the link below.
I hope this helps

William Portuese, MD · Answer

It's a very difficult question to answer without looking at specific results. There are many variables on the aging process, which is usually genetic, in addition to factors like sun exposure and smoking. The results are also variable based on what age the patients get the procedure performed. In addition, there are many variables on how to perform a facelift procedure, and many surgeons have slightly different techniques. Look for a board certified Facial Plastic Surgeon with an extensive portfolio of before and after facelift results that you like, and that look natural. Make sure the hair is tucked behind the ears so you can look in the after photos to see how well the incisions have healed. In our practice, most of the before and after photos are taken from 4 to 6 months apart. A properly performed facelift should last 10 to 15 years.

Mustafa Aydinol, MD - Account Suspended · Answer

The longevity of a deep plane facelift depends on several factors like skin quality, lifestyle, genetics, and the surgeon’s technique. Some patients naturally age faster or don’t follow post-op care as closely, which can lead to earlier laxity.
As for the difference in results, it often comes down to the patient’s goals and anatomy. Some want a more dramatic change, while others prefer subtle refinement. The surgeon’s approach also plays a role, tailoring the procedure to each person.
Since every face is unique, even the same technique will look different on everyone. The key is finding a skilled surgeon who understands your goals and ensures the best outcome for you.

Why do some facelifts not last and others do? And why do some look more dramatic?

Answers (6)

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