Facelift: what are the different types of facial lift procedures?

The facelift, or rhytidectomy, is a cosmetic surgical procedure intended to mitigate the effects of aging by retightening the lax soft tissues of the face. Over time, the skin loses elasticity, muscles relax, and facial volumes shift, resulting in the appearance of wrinkles, jowls, and sagging of the facial contour. The facelift aims to correct these alterations by repositioning the deep structures and removing excess skin to restore a firmer, more rested facial appearance. There are different types of facelift depending on the targeted area: the cervicofacial lift, the temporal lift, or the frontal lift. Each technique is tailored to the patient’s requirements and the degree of observed tissue laxity.

For each type of facelift, the procedure generally follows the same steps, with a few exceptions. It begins with anesthesia, which may be general or local depending on the extent of the procedure. Next, the surgeon makes incisions, often concealed in the natural skin folds or at the hairline. Once the incisions are made, the skin is gently elevated to access the underlying tissues. At this stage, excess skin and sometimes fat are removed, and the muscles and tissues are repositioned to restore facial volume and tone. The skin is then redraped naturally, and the incisions are closed with sutures. Finally, a dressing or bandage is applied to protect the surgical site. After the procedure, a postoperative follow-up care program is initiated. The surgeon advises the patient on precautions to take and movements to avoid to promote proper healing. Several follow-up appointments are also scheduled to monitor the healing process and anticipate any complications.

As with any surgical procedure, a facelift carries certain risks, although these are rare when the procedure is performed by an experienced professional.

Possible complications include the development of ecchymoses (bruising), pain or temporary discomfort, delayed wound healing, or infection. These potential outcomes are systematically addressed during the preoperative consultation to ensure that the patient is fully informed and prepared. Therefore, this stage of discussion with the surgeon is essential before any decision is made.

Facial aging manifests as skin laxity, volume loss, and wrinkle formation. These signs result from a decrease in the production of collagen, sagging of deep structural tissues, and thinning of the skin. Facelift surgery, a major aesthetic procedure, aims to correct these effects by tightening the skin and repositioning tissues to restore a more youthful and harmonious facial appearance.

The cervicofacial lift: the most common procedure.

The cervicofacial facelift is the reference procedure for treating moderate to severe laxity of the lower face and neck. It involves undermining the skin, then tightening the superficial musculoaponeurotic system (SMAS) and the skin itself before suturing to achieve a long-lasting lifting effect. This intervention also allows correction of jowls, restoration of the jawline, and reduction of neck laxity.

A retrospective study of 350 patients showed that a cervicofacial lift provides a notable aesthetic improvement in 85% of cases, with an average duration of effect of 7 to 10 years. Complications are rare but may include hematoma or asymmetry.

Temporal facelift, or upper-third facelift.

The temporal lift, also called the upper-third facelift, focuses on the temple area, the eyebrows, and the outer part of the eye. This procedure aims to correct signs of aging in this region, notably eyebrow sagging, excess skin on the upper eyelids, and a tired or drooping eye appearance. Over time, the skin of the upper face loses firmness and the subcutaneous tissues descend, which can give the face a sad or severe expression. A temporal lift repositions the tail of the brow, opens the gaze, and softens crow’s-feet wrinkles.

The procedure is generally performed under local or mild general anesthesia. The surgeon makes small incisions concealed in the scalp at the temples, then accesses the deep soft tissues to elevate them, applies natural skin tensioning, and removes any redundant skin. It can also be combined with other interventions, such as blepharoplasty (eyelid surgery) or a more extensive frontal lift, for comprehensive rejuvenation of the upper third of the face. The final outcome is a more open, rested, and expressive gaze without freezing facial features.

Malar lift for the cheekbones and tear troughs.

The malar lift, also known as the mid-face lift, specifically targets the region located between the cheekbones and the tear troughs, which is especially prone to aging. Over time, the skin loses elasticity, tissues begin to sag, and subcutaneous fat redistributes or diminishes, deepening hollow under-eye areas and reducing cheek volume. This procedure aims to reposition lax tissues to restore facial fullness and mitigate a fatigued appearance. Performed through a discreet incision (often hidden at the hairline or inside the mouth), it enables the surgeon to elevate the malar fat pad (fat and muscle) and retension the deep ligaments, thereby improving cheek contours and reducing under-eye hollows and nasolabial folds.

This technique is more targeted and is sometimes combined with a cervico-facial lift to achieve a harmonious result.

Eyelid lift, also known as blepharoplasty.

The eyelid lift, also known as blepharoplasty, is a surgical procedure involving the upper eyelids, the lower eyelids, or both simultaneously. This operation primarily aims to correct the visible signs of aging around the eyes, a particularly sensitive area where the skin is thin and prone to laxity. With age, the eyelid skin can relax, leading to excess tissue that gives the eyes a drooping, tired appearance. Moreover, the formation of fatty pockets under the eyes, often due to accumulation or displacement of orbital fat, accentuates this aging process, as do sunken dark circles or pigmented dark circles and the wrinkles around the eyes.

The eyelid lift thus allows for the removal of excess skin and, if necessary, the excision or repositioning of fat pockets to smooth the eye contour. The procedure can also reduce the fine lines around the lower eyelids, thereby restoring a fresher, more rested appearance. The surgery is typically performed under local anesthesia with sedation or light general anesthesia. The surgeon makes discreet incisions—most often within the natural crease of the upper eyelid and just below the lashes of the lower eyelid—to minimize visible scarring. Blepharoplasty results are widely appreciated because they deliver a noticeable rejuvenation of the gaze without altering the face’s natural expression. This procedure helps patients achieve a more dynamic, less fatigued appearance, improving their well-being and self-confidence. Recovery is generally rapid, with temporary swelling and bruising that subside within a few days.

Cervical lift: a solution for the face and the neck.

The cervical lift, also known as a neck lift, is a surgical procedure targeting the cervical region, meaning the lower face and neck. With age, this area frequently experiences marked skin laxity, the appearance of horizontal folds—sometimes called platysmal bands—and an accumulation of fat beneath the chin, often responsible for the double chin or “turkey neck” appearance.

The goal of a neck lift is to restore a well-defined jawline and achieve a smoother, tighter neck. The procedure may, depending on the case, involve liposuction (or suction-assisted lipectomy) to remove localized fat deposits, particularly beneath the chin. Next, the surgeon tightens the platysma muscle, a thin, superficial muscle extending from the chin to the base of the neck, to correct the muscle laxity responsible for visible neck bands. The excess skin is then redraped toward the back, typically through discreet incisions placed behind the ears and sometimes under the chin. This approach produces a natural, harmonious result without altering facial expression. The neck lift is often performed alone in patients presenting with sagging confined to the neck, but it can also be combined with a cervicofacial lift when the laxity involves the entire lower face. The results are generally long-lasting and become apparent after a few weeks, once postoperative swelling has subsided. This procedure thus restores a more youthful, defined profile with a firmer neck and a redefined jawline.

• CERVELLI V. & al. Midface-lift patient satisfaction: A 5-year follow-up study. Indian Journal of Plastic Surgery (2016).

• OH K.S. & al. A prospective evaluation of outcomes for midface rejuvenation with mesh suspension thread: "REEBORN lift". Journal of Cosmetic and Dermatology (2016).

• GOULD D.J. & al. Evaluating facelift complications and the effectiveness of the SMASectomy technique: A single center’s 15-year experience. Aesthetic Surgery Journal (2021).

• NEEL. O.F. & al. Evolution of superficial muscular aponeurotic system facelift techniques: A comprehensive systematic review of complications and outcomes. JPRAS OPEN (2023).