What is a facelift?

A facelift is a surgical procedure designed to restore youthful facial contours by repositioning descended facial and neck tissues toward their natural anatomical position. Rather than simply tightening the skin, modern facelift surgery addresses the deeper structural changes responsible for facial aging, resulting in more natural, balanced, and long-lasting rejuvenation.

How is facelift surgery performed?

Facelift surgery is performed under either intravenous sedation or general anesthesia.

The incision typically begins within the sideburn area, extends along the natural crease in front of the ear, continues around the earlobe, and then curves behind the ear into the hair-bearing scalp. In women, the incision usually follows a post-tragal course, whereas in men it is generally placed in front of the tragus to avoid transferring beard-bearing skin into the ear canal. After the skin is elevated, the deeper facial support layer known as the SMAS (Superficial Musculoaponeurotic System) is identified and mobilized. Depending on the technique used, the SMAS and deeper facial tissues are repositioned and secured to restore youthful facial contours.

When indicated, neck contouring procedures may be performed simultaneously. These may include liposuction, platysma muscle tightening, treatment of deeper neck structures, and removal of excess skin to optimize jawline definition and neck contour.

 

Does an extended facelift technique provide superior results compared with a traditional facelift?

The face contains retaining ligaments that anchor the skin, subcutaneous fat, and SMAS to the underlying facial skeleton and deep fascia. These ligaments help support the facial soft tissues against the effects of gravity. With aging, attenuation of these retaining ligaments contributes to descent of the facial soft tissues, leading to many of the visible signs of aging. If these ligamentous attachments are not adequately released during facelift surgery, lifting forces may not be effectively transmitted to the midface. As a result, improvement may be limited to the lower face and neck while the cheeks and nasolabial folds remain relatively unchanged.

Extended facelift techniques, such as deep plane and composite plane facelifts, involve surgical release of the retaining ligaments of the midface. This allows lifting forces to be transmitted directly to the descended malar fat, restoring cheek projection, softening nasolabial folds, and producing balanced rejuvenation of the midface, cheeks, jawline, and neck without requiring a separate midface lift procedure.

Attempts to compensate for untreated midface descent with excessive fat grafting may occasionally result in an overfilled or unnatural appearance. By directly addressing the anatomical cause of facial aging, extended facelift techniques generally produce more harmonious and natural-looking results.

 

Are deep plane and composite plane facelifts more dangerous than other facelift techniques?

Preservation of the facial nerve is one of the most important aspects of facelift surgery. Safe performance of extended facelift techniques requires a thorough understanding of facial anatomy, retaining ligaments, tissue planes, and facial nerve relationships.

When performed by a surgeon with extensive experience in facial anatomy and advanced facelift surgery, deep plane and composite plane facelifts can be performed safely and predictably. In experienced hands, meticulous anatomical dissection often allows important structures to be directly identified and preserved, reducing the risks associated with blind dissection around critical anatomy.

 

Which technique does Dr. Özcan Çakmak prefer, and why?

Dr. Özcan Çakmak's preferred approach is his Modified Composite Plane Facelift with Extended Neck Dissection, originally described in the Aesthetic Surgery Journal in 2018. Conceptually similar to a deep plane facelift, this technique incorporates the lower portion of the orbicularis oculi muscle into the composite flap, creating a stronger and more effective lifting construct for repositioning the descended malar fat and restoring youthful midfacial contours. Extension of the deep-plane dissection into the neck, combined with platysma suspension, allows effective improvement of neck contours and jawline definition. When indicated, treatment of deeper neck structures may also be performed to restore a sharper jawline and a more youthful cervicomental angle.

By simultaneously rejuvenating the midface, cheeks, jawline, and neck, this technique produces balanced and harmonious facial rejuvenation without requiring a separate midface lift procedure. The objective is not to create an operated appearance but rather to restore youthful facial contours while preserving each patient's natural characteristics.

 

What can I expect after surgery?

Most patients experience mild to moderate discomfort following surgery, which is usually well controlled with oral pain medication.

Swelling and bruising vary among individuals but are generally modest. Most bruising significantly improves within the first week, and the majority of swelling subsides within 1–2 weeks.

Although patients typically appear socially presentable within a relatively short period, healing continues for several months. Final refinement of the tissues may continue for 6–12 months after surgery.

 

Will I have a drain, bandage, or dressing after surgery?

Dr. Çakmak does not routinely use drains, pressure dressings, compression garments, or head wraps following facelift surgery.

Instead, specialized hemostatic net sutures are applied to stabilize the tissues and minimize the risk of postoperative blood accumulation (hematoma). Because these sutures provide effective tissue support, bulky dressings are generally unnecessary.

The net sutures placed in front of the ears are typically removed the day after surgery, while those placed in the neck are removed on the second or third postoperative day. Removal is generally quick and virtually pain-free.

 

Will I need my sutures removed?

Skin sutures are typically removed 6–7 days after surgery. Suture removal is generally quick and causes little to no discomfort.

Will I have visible scars?

There is no such thing as scarless surgery, and every incision heals with a scar. However, facelift incisions are strategically placed within the hairline and natural contours of the ear whenever possible.

As healing progresses, these scars typically become inconspicuous and are often difficult to detect, even at close range.

How long do facelift results last?

A facelift cannot stop the aging process, and facial aging continues after surgery. However, the procedure effectively repositions tissues to a more youthful position, allowing patients to maintain a younger appearance than they would have achieved without surgery.

Although longevity varies among individuals depending on genetics, lifestyle, skin quality, and weight fluctuations, facelift results commonly remain apparent for 10–15 years or longer.

 

How long will I be away from work?

Most patients are able to return to non-strenuous work and social activities within 7–10 days after surgery.

Strenuous exercise, heavy lifting, and vigorous physical activity should generally be avoided for approximately 2–3 weeks.

 

Can I wear makeup after surgery?

Most patients may begin applying makeup approximately three days after surgery, provided the incision sites are kept clean and protected.