Facelift surgery remains the backbone of surgical facial rejuvenation as the neck and jowls are primary motivations for seeking out age-related improvement. As part of the consideration of a facelift, patients often ask how long it will last. With understandable concerns about cost effectiveness and the trepidation about another future surgery, the longevity question is a concern but not a primary fear of a facelift.
In the July 2010 issue of the journal of Plastic and Reconstructive Surgery, a study on the longevity of a SMAS facelift procedure was published. Over a seven year period between 2001 and 2008, the authors looked at 42 patients who had both an initial and a secondary facelift procedure. Their assumption would be that the need for a secondary or revisional facelift would mark how long the initial facelift lasted. The average age of the facelift patients was 50 years and that at the time of the secondary facelift 62 years. The report concluded that it is possible that the average facelift may last as long as 12 years.
This paper presents a seemingly simple answer that would be undoubtedly satisfying to most patients. I don’t think there is any patient who believes that a facelift is permanent and most would accept a decade or so of facelift value. But, in reality, there are so many factors that play into how long a facelift lasts that a simple year value or range is overly simplistic…it may be comforting but can also be misleading.
The unsettling but more accurate answer is that how long a facelift lasts can be quite variable. While it is obviously important in how well a facelift is technically performed, the most important factors are the patient’s anatomy. How good are the tissues and bone structures on which it is being done and what is the quality of one’s ‘aging genes’? Patients with good quality skin and prominent bone structure who have held their age well get the best facelift results in my experience. They look the most natural and seem to hold the results well. While everyone , if they live long enough, will eventually outlive a facelift (and I would argue that is every patient’s goal), these types of patient hold their results longer than others. A patient with thin, stretched out skin and a lot of loose jowl and neck skin may get an initial dramatic result but relapse will happen much quicker for them.
While the type of facelift discussed so far can be referred to as a complete or full one, many of today’s facelifts are not of that variety. Younger patients with less facial aging are getting more limited facelifts, often referred to as the Lifestyle Lift, Quicklift and a variety of other branded names. These are smaller facelifts that are lesser in magnitude and produce more subtle but satisfying results. How long does a limited facelift last? No clinical reports have yet been published but it would be reasonable to assume that the duration of the results may be…more limited. Again, however, the biology and tissue structure of the patient lengthens or shortens how long the results hold up.
Despite the unavoidable fact that there is no one number of years that can define the longevity of facelifts, patients still want some sort of number. The variability of the biologic process is an unconvincing answer. Therefore, a complete facelift is in the range of 7 to10 years of visible results, a more limited facelift is 5 to 7 years. The longevity of a facelift is practically defined as when one decides they are ready for another procedure.
Dr. Barry Eppley
Indianapolis, Indiana