Types of Facelifts Explained: Traditional, SMAS, Deep Plane, Mini and More

What Is a Facelift?

The Cleveland Clinic defines a facelift, also called rhytidectomy, as a general term for any surgical procedure that improves signs of aging in the face or neck by repositioning or removing skin, fat or muscle. It can address sagging skin, deep folds between the nose and the corners of the mouth, fat that has fallen or is lacking, jowls, and loose skin and fat in the neck.

It also has limits. The Cleveland Clinic says a facelift cannot fundamentally change your appearance, stop the aging process, or treat superficial wrinkles, sun damage or skin color irregularities. It adds that results usually last around seven to ten years.

The Main Types of Facelifts

Traditional Facelift

A traditional facelift involves incisions around the ears, along the hairline and below the chin. The surgeon separates the skin from the underlying tissue, tightens the muscles and supporting structures, removes excess fat in the neck and jowls as needed, and repositions the skin. The Cleveland Clinic says it is generally recommended for people who want the best improvement from moderate to significant facial aging.

SMAS Facelift

The SMAS (superficial musculoaponeurotic system) is the muscular layer of the face. A SMAS facelift tightens that layer and trims excess skin or fat in the cheeks and lower face. The Cleveland Clinic describes it as a variation of the traditional facelift that targets the lower two-thirds of the face.

Deep Plane Facelift

In a deep plane facelift, the surgeon lifts the SMAS, fat and skin as a single unit. According to the Cleveland Clinic, deep plane lifts generally address several areas of the face at the same time.

Mid-Facelift

A mid-facelift treats the cheek area. The surgeon repositions the fat in the cheek and tightens the skin there. It is aimed at aging that is concentrated in the cheeks, rather than in the jawline and neck.

Mini-Facelift

The Cleveland Clinic describes a mini-facelift as a quicker, less invasive operation focused on the lower face and neck, usually recommended for younger people with early signs of sagging. Be aware that “mini” is not a standardized technique. One surgeon quoted by RealSelf says the term mainly describes the length of the incision and how much skin is removed (RealSelf on facelift types), so ask exactly what a surgeon means by it.

Lower Face Lift

If you are wondering what a lower face lift is, it is a facelift focused on the jawline, jowls and neck. Some surgeons treat it as a type of mini lift. It suits people whose main concern is the lower face, and it is often discussed for jowls. Our guide to sagging jowls and cheeks explains how the layers of the lower face contribute.

Cutaneous (Skin) Facelift

A cutaneous facelift works on the skin only and usually focuses on the neck and lower face. Because it does not work on deeper layers, its effect is more limited than the other types.

Preservation Facelift and Other Newer Terms

You may also see terms such as preservation facelift, high-SMAS lift or mini deep plane. These are descriptions that individual surgeons use for variations on the deeper techniques, and their meaning is not always the same from one surgeon to the next. If a surgeon recommends one, ask them to explain which layers they will work on, where the incisions go and why it suits your face.

Neck Lifts, Brow Lifts and Other Add-Ons

Many people have other procedures at the same time. The Cleveland Clinic lists eyelid surgery, rhinoplasty, facial implants, a brow lift, a liquid facelift with dermal fillers, jawline rejuvenation, chemical peels and laser resurfacing. A neck lift is a separate procedure that is often combined with a facelift.

Facelift Types Compared

Facelift Recovery, Results and Risks

Recovery depends on the type. The Cleveland Clinic says bruising and swelling usually last about two to three weeks, and that it can take two to three months before your face feels back to normal. Most people with a more invasive facelift return to work in two to three weeks, while a mini-facelift usually needs five to seven days. It advises avoiding strenuous exercise for at least three weeks.

The NHS says a facelift is usually done under general anaesthetic, that full recovery takes about 2 to 4 weeks, that the full effect can take 6 to 9 months to appear, and that results cannot be guaranteed (NHS facelift guide).

The Cleveland Clinic lists rare risks that include anesthesia problems, infection, wound healing problems, hematoma, changes in skin sensation, facial nerve injury, hair loss at the incision sites, scarring, prolonged swelling and skin color irregularities. Discuss these with your surgeon before you decide.

How to Choose Between Facelift Types

• Start with the amount of loose skin. The Cleveland Clinic says the more loose and excess skin you have, the more significant the surgery is likely to be, with a full facelift often recommended. Minimal looseness may suit a mini-facelift.
• Match the type to the area. Cheek concerns, jowls and neck banding call for different approaches.
• Think about recovery. Compare the time off work and activity limits for each type.
• Ask about the surgeon’s experience. Ask how often they perform your type of facelift and to see before-and-after photos of similar cases.
• Ask what happens if you are unhappy. Know the revision policy before you commit.

What No Facelift Changes: Where Bone Fits In

Every type above works on skin, fat, muscle or the SMAS. None of them rebuilds the bone underneath, and the facial skeleton changes with age. A 2017 study in Plastic and Reconstructive Surgery compared CT scans of the same people at least nine years apart. It found bone resorption in every patient at the pyriform aperture, the bony opening of the nose, and at the front wall of the upper jaw, plus resorption at several points of the orbital rim (PubMed abstract). Researchers still debate how large a role bone plays compared with skin and fat.

Ben Sheng Gu Yuan, a clinic in Guangzhou, China, takes a bone-first approach for people whose concern looks skeletal, such as a flat midface or recessed chin. According to the clinic, it rebuilds bone first, repositions fascia second and tightens skin last, using 2–3 mm micro-punctures instead of incisions. It is not designed for heavy skin excess, so it does not replace a facelift in advanced cases. Our guide to facial bone regeneration in Guangzhou explains the method, and the treatment programs page lists what the clinic offers.

Facelift Alternatives for Early Signs of Aging

If your signs of aging are early or mild, a surgical facelift may be more than you need. Fillers, threads and skin-tightening devices each work on a different layer, and each has limits. We compare them in our guide to facelift alternatives.

Considering Treatment in China?

If you are thinking about treatment abroad, read our safety-first guide to plastic surgery in China before you plan a trip. It explains how cosmetic surgery is regulated and how to verify a clinic. Ben Sheng Gu Yuan offers a complimentary online consultation, and its concierge packages are listed on the pricing page.