Evaluating Facelift Outcomes and Technique Trends in the United States

Objectives: Highlight current trends in facelifting as facelift techniques continue to evolve as surgeons seek to improve outcomes and longevity. Methods: A REDCap survey was distributed to AAFPRS members. Results: A total of 150 surgeons responded (11.7% response rate). Most were in private solo practice (58.7%) and had over 20 years of experience (44.7%). Deep-plane facelifts were performed by 90% of respondents, with SMAS plication and imbrication techniques being most used among nondeep-plane surgeons. Surgeons in practice for <20 years were significantly more likely to use deep-plane techniques ( P =0.04). Longevity of results was not significantly associated with deep-plane techniques ( P =0.3). Facial nerve monitoring or stimulators were rarely used. Transient nerve injuries occurred in 1% to 5% of cases, most commonly affecting the depressor labii inferioris (75.8%), zygomaticus major/levator labii (22.1%), and frontalis (16.9%). Higher rates of nerve injury was significantly associated with deep-plane facelifts and frequent submandibular gland reduction ( P <0.05 each). Fat grafting, gland reductions, and digastric resections were not widely adopted. Conclusion: The deep-plane facelift is emerging as the preferred rhytidectomy technique among facial plastic surgeons. This underscores the need for additional studies to clarify which surgical techniques minimize risks and optimize outcomes. Level of Evidence: Level III—observational study.