The facelift remains one of the most effective procedures in the cosmetic surgeon's toolbox, particularly when combined with other techniques to provide true facial rejuvenation. Properly performed, a facelift can do wonders, and there is presently no substitute regardless of advertising claims to the contrary. But it is a highly technical procedure, and there is a wide range in results from surgeon to surgeon. The technique used may be vastly different between operators, even those performing deep plane techniques. It is imperative that the surgeon be skilled and experienced. The facelift is the centerpiece of a cosmetic surgeon's anti-aging capabilities and in many ways is his or her signature procedure for providing facial rejuvenation. It is a complex procedure which is never really mastered. Similar to rhinoplasty, the surgeon has to bring his or her A-game to the operating table. There is not much margin for error.
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A facelift will not produce a totally different look, nor will it make a fifty-year-old look twenty. Fortunately, patients usually find this comforting. Rather, it will reverse many of the undesirable effects of time and gravity. Patients find they look more like they did in old photographs. Friends and family may not realize they had surgery, but comment simply that they look good. This is true even when a comparison of before and after photographs shows a dramatic difference. I have yet to encounter a patient who tells me," I look too young."
In addition to a better understanding of the proper plane for elevating the facial tissues, we now recognize that other signs of aging, like skin surface changes such as wrinkling and brown spots from sun exposure and aging and age-related loss of volume, also benefit from treatment. These important changes of aging have been largely overlooked by plastic surgeons in the past. Fortunately, we now have the technology, using laser skin resurfacing and fat injections, to simultaneously treat the skin surface and restore volume. Most patients benefit from simultaneous treatment of these other components of aging. In my own practice, it is rare for me to perform a facelift on its own. It would be like buying an automobile without any options.