When the signs of aging start to outpace what skincare and non-surgical treatments can address, a facelift often enters the conversation. Sagging cheeks, jowling, deep folds, and a loose neck are among the most common reasons patients begin researching facelift options. But facelift techniques have evolved significantly over the past few decades, and the term covers a wide range of approaches that vary in scope, depth, and results. The right choice depends on what you are trying to address and how lasting you want the outcome to be.
Here is a look at the different types of facelift surgery available today, along with the approach Dr. Turin most often recommends for his patients at Koda Plastic Surgery in Scottsdale, AZ.
How Facelift Techniques Have Evolved
The earliest facelifts focused solely on the skin. Surgeons would lift and tighten the facial skin, removing excess skin to create a more youthful appearance. The results were often dramatic at first, but they tended to fade quickly and could leave patients with the tight, pulled appearance that gave facelifts their reputation in the 1980s and 1990s.
Over time, plastic surgeons recognized that facial aging is not just a skin problem. The deeper structures of the face, including the muscle layer, fat compartments, and retaining ligaments, all shift downward with age. This realization led to the development of facelift techniques that address the face at progressively deeper levels, culminating in the extended deep-plane facelift performed today.
What Are the Different Types of Facelift Surgery?
Several types of facelifts are commonly discussed, each working at a different depth and producing different results.
Skin-Only Facelift
A skin-only facelift addresses just the surface layer. The surgeon lifts the skin, removes the excess, and re-drapes it across the face. While this approach has largely fallen out of favor, it is sometimes still performed in limited cases. Results tend to be short-lived because the underlying structural causes of aging are not corrected.
SMAS Facelift
The SMAS facelift addresses the superficial musculoaponeurotic system, a fibrous layer just beneath the skin that supports the face’s underlying structure. By tightening and repositioning this layer along with the skin, the SMAS facelift produces more durable results than skin-only techniques and can deliver real improvement for patients with moderate signs of aging.
However, the SMAS facelift does not release the retaining ligaments that anchor the face’s deeper structures. Because gravity continues to pull on those structures after surgery, results tend to fade sooner than with deeper techniques. This is the central distinction in the SMAS facelift vs. deep-plane facelift conversation.
Mini Facelift
A mini facelift uses smaller incisions and addresses limited areas, usually the jawline and lower face. Recovery is shorter, but the correction is also more limited. In the mini facelift vs. full facelift comparison, the mini version is best suited for patients with mild jowling or early laxity. For more advanced concerns, the results are typically not enough.
Midface Lift
A midface lift specifically targets the area between the lower eyelids and the upper mouth. It addresses flattened cheeks, under-eye hollowing, and early sagging in the midface. It is generally reserved for patients whose primary concerns are isolated to this area and is sometimes combined with eyelid surgery for a more balanced result.
Extended Deep-Plane Facelift
The extended deep-plane facelift is the most advanced technique available today. Rather than working at the surface or the SMAS layer, the surgeon dissects beneath the SMAS to release the retaining ligaments that cause jowling and midface descent. The cheek fat pads, jowls, and neck are repositioned at the structural level, producing results that look natural and may last considerably longer than other techniques.
Because more tissue layers are kept intact during the dissection, trauma to the face is often reduced. This can mean less bruising, less swelling, and a more comfortable recovery. Dr. Turin performs the extended deep-plane facelift as his standard approach for most patients.
Deep-Plane vs. Traditional Facelift Differences
The deep-plane vs. traditional facelift comparison often comes up, and the differences come down to depth. A traditional facelift tightens the skin and SMAS layer, but because the underlying retaining ligaments are left in place, the deeper structural forces that cause facial aging continue to work after surgery. Results can fade sooner than patients expect.
The extended deep-plane facelift addresses those structural forces directly. By releasing the ligaments and repositioning the deeper tissue layers, the procedure corrects sagging at its source. This produces results that look more natural, hold up over time, and avoid the pulled appearance.
What Type of Facelift Lasts the Longest?
A common question is what type of facelift lasts the longest. Longevity depends on the technique used, skin quality, genetics, and lifestyle factors like sun exposure and tobacco use.
Generally, the extended deep-plane facelift tends to produce the most enduring results because it addresses the structural causes of facial aging rather than just the surface. Traditional and SMAS facelifts can deliver durable change as well, though results may fade sooner. Mini facelifts tend to produce shorter-lived results and are best understood as a modest correction.
Which Facelift Type Is Best for Aging Skin?
The question of which facelift type is best for aging skin depends on the changes you are addressing. For surface concerns like fine lines, sun damage, and mild laxity, non-surgical treatments can be effective. For moderate signs of aging without significant structural descent, a mini facelift or an SMAS-based approach may yield satisfactory results.
For patients with visible jowling, midface descent, deep folds, and neck laxity, the extended deep-plane facelift is best suited to address the underlying structural issues. At that point, the most effective option is the technique that works where the aging is actually occurring.
Facial Fat Grafting Is Always Included
One important distinction at Koda Plastic Surgery is that facial fat grafting is always part of the facelift procedure. Lifting and repositioning tissue addresses sagging, but they do not restore the volume the face naturally loses with age. Without that volume, even a beautifully executed lift can look hollow or incomplete.
Fat grafting involves harvesting a small amount of your own fat, processing it, and transferring it to the cheeks, temples, and lower lids. Because the volume comes from your own tissue, the result is soft, natural, and long-lasting. Combining structural lifting with volume restoration is a core part of Dr. Turin’s approach to facial rejuvenation, producing a face that looks younger, not just tighter.
How a Neck Lift Fits In
The neck lift, or platysmaplasty, is almost always performed alongside the facelift at Koda Plastic Surgery. During the procedure, loose skin under the chin is tightened, and the platysmal muscle bands are divided and sutured together to create a firm “hammock” of tissue beneath the chin. This produces a smooth, crisp neckline that complements the facelift results above.
A neck lift is rarely performed in isolation because the face and neck age together, and addressing one without the other can produce an unbalanced result. Combining the two ensures the transition from jawline to neck looks smooth and natural.
What About Non-Surgical Alternatives?
At Koda Plastic Surgery, non-surgical options like CO2 laser treatments, microneedling, chemical peels, Botox, and dermal fillers are an important part of facial rejuvenation. Many patients use these treatments to address early signs of aging before surgery becomes the right conversation.
That said, non-surgical treatments work at the surface level. They can improve skin texture, add temporary volume, and create modest tightening, but they cannot reposition descended tissue or address the structural changes that produce significant jowling, deep folds, or a loose neck. When those concerns reach a certain point, the extended deep-plane facelift corrects the underlying anatomy in a way that no topical treatment, device, or injectable can replicate.
What to Expect at Your Consultation
Your consultation with Dr. Turin is a conversation, not a sales pitch. He will assess your facial anatomy, listen to your goals, and walk you through which approach best fits what you want to achieve. For some patients, that is the extended deep-plane facelift. For others, a less extensive procedure may be the more appropriate starting point, and Dr. Turin will tell you so honestly. You will leave with a clear understanding of what surgery can realistically deliver, what recovery looks like, and what results to expect.
Discover Which Facelift Is Right for You at Koda Plastic Surgery
Choosing the right facelift is a significant decision, and the most rewarding outcomes come from a partnership between you and a surgeon who takes the time to understand your goals and recommend the approach that genuinely fits.
Dr. Turin is a trusted facelift surgeon who brings that approach to every patient he sees. As a leading provider of facelifts in Scottsdale, AZ, Koda Plastic Surgery is proud to serve Gilbert, Phoenix, Tempe, and Mesa. Call (480) 256-8018 to schedule a consultation and find the approach that fits your goals.
