Facial Lifting & Rejuvenation
Facial and cervicofacial lifting surgery restores firmness and facial harmony while respecting each patient’s natural anatomy, avoiding a forced or artificial result. It is one of my most established areas of work: I am the author of the Lifting Surgery chapter in the reference manual of the Spanish Society of Oral and Maxillofacial Surgery (SECOM CyC, 2025).
When is it recommended?
- Skin laxity in the mid and lower third of the face and neck.
- Loss of definition along the facial oval and jawline.
- Drooping brows or cheeks that age the overall facial expression.
- A wish for a natural result that preserves the patient’s own features.
My approach
I work on the deeper planes of the face — mainly the SMAS — rather than simply tightening the skin, which allows the facial support structures to be repositioned for a more natural, longer-lasting result. Every surgical plan is designed individually, prioritizing facial proportion over excessive skin tension.
Types of facelift
There is no single facelift, but several techniques chosen according to anatomy and degree of laxity. The cervicofacial lift is the most complete: it addresses the middle and lower thirds and the neck in a single procedure. The deep plane facelift releases the retaining ligaments and mobilizes the tissue as a block, allowing the cheek and nasolabial fold to be repositioned with less tension on the skin. The mini-lift or short-scar lift is reserved for younger patients with laxity limited to the jawline. And the upper-third lift — brow or forehead — treats brow descent and a tired-looking gaze, and is often combined with blepharoplasty. The choice is not a matter of trend, but of which specific structure has descended in each face.
The first consultation: what we assess
The first consultation is not a formality: it is where the result is decided. I assess skin quality and thickness, the degree of descent of the deep tissues, volume loss in the cheeks and temples, the state of the jawline and neck, and brow position. I also review relevant medical history — smoking, anticoagulant medication, blood pressure — because these affect both safety and healing. Understanding what the patient expects matters just as much: someone who wants to "look like a different person" and someone who wants to "look like themselves but rested" need different conversations. That consultation produces a concrete surgical plan, with the intended techniques, the estimated recovery time, and an honest explanation of what surgery can and cannot achieve.
Scars: where they are and how they evolve
This is one of the most common concerns and deserves a clear answer. Facelift incisions are designed along the natural creases: in front of the ear following the contour of the tragus, around the earlobe and continuing through the retroauricular groove into the hairline. Well planned, they stay hidden and are hard to identify even with the hair tied back. Their evolution is predictable: during the first weeks the scar is red and slightly raised, looks its worst between the first and third month, and from then on gradually fades until fully maturing at around one year. Working on the deep planes helps precisely here: because the result is not held by skin tension, the scar closes without traction and matures better.
Risks and how they are minimized
A facelift is a safe operation when performed with the right indication and preparation, but like any procedure it carries risks worth knowing. The most common are hematoma — the most frequent complication, prevented by strict blood pressure control in the immediate postoperative period —, temporary altered sensation around the ear and cheek, which recovers over weeks or a few months, and unfavourable scarring, more likely in smokers. Facial nerve injury is uncommon and in most cases temporary; knowing the precise course of its branches is exactly what craniomaxillofacial surgical training provides. Stopping smoking before surgery, pausing certain medications and controlling blood pressure are the three measures that most reduce risk.
Recovery
Initial swelling and bruising subside within 1-2 weeks, after which most patients resume their social life. The definitive result, once residual swelling settles, becomes visible from the third month onward.
Frequently Asked Questions
At what age does a facelift start to make sense?
There's no fixed age: it depends on the degree of skin laxity and each patient's anatomy, not on the number of years. I generally consider it once the skin and deeper tissues start losing support, which varies widely from person to person.
Does a facelift also treat the neck?
Yes, in most cases a cervicofacial lift includes the neck, since laxity in the facial oval and in the neck are usually related. Treating only the face without addressing the neck can leave an unbalanced result.
What is the difference between an SMAS facelift and one that only tightens the skin?
A facelift that only removes and tightens skin can look impressive at first, but it tends to relax sooner and create an unnatural pull along the scars. Working on the SMAS — the muscular and fibrous layer beneath the skin — allows the deeper support of the face to be repositioned, giving a more natural and lasting result, with the skin acting as coverage rather than the sole element holding the correction in place.
Is a facelift painful?
Less than most people expect. Surgery is performed under anaesthesia, and afterwards the dominant sensation is usually not pain but tightness, swelling and numbness in the area. Sharp pain is uncommon and is well controlled with standard analgesia; if intense, one-sided pain appears in the first hours it should be reported, as it can be the first sign of a hematoma. What patients find most uncomfortable is usually the pressure of the dressing and not being able to sleep on their side for the first few days.
How long does a facelift result last?
A well-planned facelift working on the deep planes holds its effect for 7 to 10 years, though this varies with genetics, skin quality, smoking and sun exposure. It is important to understand what that means: surgery does not stop ageing, it returns the face to an earlier point. From there ageing continues, but from a better starting position. Ten years on, an operated patient usually still looks better than they would have without surgery, even having lost part of the initial effect.
Can a facelift be combined with fat grafting?
Yes, and for many patients this combination is exactly what gives the best result: the facelift corrects sagging and tissue descent, while structural fat grafting restores volume lost in the cheeks, temples or under-eye area — something a facelift alone cannot address.