Facelift procedures have undergone rapid evolution in the last century, with initially subcutaneous techniques now shifting to superficial musculoaponeurotic system (SMAS) manipulation and deep plane techniques, along with the popularization of concurrent volumization with fat grafting. As surgical technique in facial rejuvenation continues to evolve and long-term outcomes become better understood, experienced facelift surgeons have refined their approaches to enhance aesthetic results and improve patient safety. At the American Society of Plastic Surgeons Spring Meeting in March 2025, four leading expert facelift surgeons spoke on a panel titled, "Facelift - Looking Back: What I Do Now and What I Have Eliminated From My Facelifts," offering insights into their current practices and procedures they have chosen to no longer perform as well as their surgical philosophies. Topics discussed included the contemporary understanding of facial aging and changes, varied approaches to manipulation of the SMAS, innovations in SMAS-based techniques, and drawbacks and complications of both facial and neck rejuvenation. Drawing on 171 years of cumulative experience after training, the panelists presented a critical review of established and emerging practices, emphasizing the importance of surgical customization, critical self-assessment, and surgical technique. Their collective perspectives offer a modern, patient-centered perspective in facial rejuvenation, providing valuable guidance for plastic surgeons.
Thomas et al. (Tue,) studied this question.