Facts & Fallacies: Facelift Surgery (Part 1)

Summer Hardy (00:01):
Welcome to Park Avenue Plastic Surgery Class, the podcast where we explore controversies in breaking issues in plastic surgery. I'm your co-host, Summer Hardy, a medical student in New York City. I'm excited to be here with Dr. Lawrence Bass, Park Avenue plastic surgeon, educator, and technology innovator. Today's episode is part of our Facts and Fallacy series, The Facelift Part one. What are we talking about in this episode, Dr. Bass?

Dr. Bass (00:25):
There's so much written and talked about when it comes to facelifts, and that makes sense because the facelift is the big reset for the aging face and the only thing that meaningfully addresses skin laxity once it's more than minimal. For the purposes of this discussion, when I say facelift, I mean facelift, neck lift, a combination of the two, or a mini version of one or the other. So all of that lifting surgery, I'll just refer to for simplicity as facelift. Facelifting is a central topic in plastic surgery. It's very much in the news in 2026, and we'll hit a few facts and fallacies in this one episode, but we'll also circle back to cover others in future episodes.

Summer Hardy (01:22):
Yes, there's a lot of material to cover, more than enough for multiple episodes. So let's get started. Here's the first statement. Facelifts never look natural. What do you think? Fact or fallacy?

Dr. Bass (01:35):
So again, we encourage all listeners to ask yourself these questions or hear these statements and decide whether you think it's a fact or fallacy. But actually this is an easy one, but it's still something that people worry about all the time. In fact, I got asked this afternoon before I got on the recording session by one of my patients thinking about facelift or neck lift, not wanting to look pulled or unnatural. So this is actually however a fallacy. The first thing is facelift never looking natural, never is a long time. It's hard to believe that no facelift looks natural. Of course, it's normal to worry about it as I said, but in particular, the historical telltales of poorly done facelifts from facelifts decades and decades ago, the pulled windswept look, what we medically call sweep, is an undesirable thing. And of course, patients and their surgeons would like to avoid it.

(02:42):
In 2026, however, properly performed facelifts, unless there have been many lifts done previously and that individual should look perfectly natural and not have telltales that others can readily see. You end up looking rested, not done. There's been a big media push recently that the natural looking facelift is now here that somehow this newer trendy facelift has been created and there's some location saying the Paris lift or some surgeons claiming they have some unique technique to create this look and trying to generate publicity from this concept. When I hear this, it makes me laugh to say the least. I mean, in my view, this is not new in any way. It's the underlying principle of all rejuvenation surgery and other rejuvenation treatments. These treatments are designed to help you look younger, more like how you looked a few years back, not to change who you look like.

(03:54):
And we do things in plastic surgery, various procedures that change what you look like or who you look like, but rejuvenation procedures are not intended to change who you look like. And even more critically, they're pledged to avoid creating any telltales that a facelift was done. The surgeons who trained me, who were some of the most famous facelifters in the world, were dedicated to ensuring that their facelift techniques would look natural. This was a priority. So this is not something new. This is something decades old. And surgeons like me and the whole generation or two that have followed the people who trained me are committed to do the same thing. Techniques have continued to refine and evolve to help us ensure this critical issue so that the facelift is better than ever, but there's not been a revolution that has changed this.

Summer Hardy (04:54):
I'm glad to hear that facelifts look natural. Okay, are we ready for another one? Facelifts have to be redone. Once you start, you're committed to more work.

Dr. Bass (05:03):
So again, this is a fallacy. If you have a facelift, you'll never look as bad as if you'd done nothing. If you choose never to lift again or have any other work done, you will still end up looking better every day of your life than you would have looked had you not had a facelift. And some people will come back for a second lift in 15 or 20 years. Other people never come back for another lift surgery, but do some other things, peels or injectables or energy treatments to help their skin look younger and healthier. And other people come back when there's a fair amount of laxity showing as they continue to age and do a secondary. When you do continue to age after having a facelift, of course, this is not a surprise, but just common sense. Another corollary of this fallacy is that your face will somehow age more poorly if you've had a lift.

(06:11):
That also is not true. As best we can see, facelift sets the clock back. That's what we used to say in the old days, but it seems to also slow the clock. You lock things in where you want them to stay, and so you'll never look as bad as you did and you probably will age more slowly.

Summer Hardy (06:32):
That makes sense. Here's another one I've heard. Facelifts are only for older people.

Dr. Bass (06:38):
And I'll take older people to mean senior citizens. And the reality is this is a very easy question to answer. It's a data-driven answer. The American Society of Plastic Surgeons amasses extensive data about plastic surgery procedures every year. And according to ASPS 2024 statistics, the last year that's available at this time for facelift or neck lift procedures, 20% are done in people 40 to 54 years old. 20% are done in people 70 plus, 60% are in 55, 69 year olds. So that means a sizable number in people under 65, probably the majority of them. And in fact, we find that mid to mid 60s period is the highest consumption period for facelifting. So these are not people who are very old. They're people who are working, who are social, who are active, out and around and want to look their best. And they get the most use out of a facelift, so to speak, compared to people who are very much older who may not be quite as active at that time.

Summer Hardy (07:57):
Thank you for breaking down the data. So another thing people often say about the facelift is that the scars are always obvious.

Dr. Bass (08:06):
So incisions in plastic surgery in general and in facelifting specifically are placed in the hairline in creases in front of and behind the ear. So they're put in places that are hidden and everyone worries about these incisions and how they're going to look. In particular, they worry about the incision in front of the ear, which is in a little more visible location. The reality is that this incision generally heals to be inobtrusive, even though it's out theoretically where it's easier for people to see. And the other incisions tend to be in a crease somewhere or in the hairline, and so they remain hidden. So scars, while it's everyone's worry, just like looking natural is something everyone worries about is not an issue in general. There are individuals who are bad scar formers. For people like that, if they know from piercing an ear and getting a keloid or from how they healed a surgery somewhere else on the body, they may want to think a little bit more carefully.

(09:25):
Even for the bad scar formers with the exception of keloid formers, there are a number of treatments that we do to help fade and blend scars, but not really needed except in a few percent of the time.

Summer Hardy (09:40):
Okay, that's good to know. And how about this statement? Some people worry that facelifts have an extremely long recovery. Is that true?

Dr. Bass (09:49):
Yeah. It's interesting. I've heard this a lot from patients coming in for consultations. They think it's going to be months before they're back out and around and it's really going to take them out of their activities for a protracted period of time. The reality is that most patients are out of sight for one to two weeks. First few days, I like patients to just sit quietly and lounge and disconnect from all activities. But after three days or so, most people are sitting at home and doing paperwork or they're going on meetings with the video turned off, that sort of thing. But after somewhere between one and two weeks, depending how much bruising and swelling, they're back out and around returning to routine work and socializing, still a little early for high profile activities. But that relatively short period of time is the time that you need to hide out.

(10:55):
There are still things healing on the inside for several months, but that's not keeping you out of the gym. It's not keeping you out of work or social events. And so you can get back to things because in modern life, it's very hard for people to take off more than two weeks at any given time. But fortunately in this case, it's not necessary.

Summer Hardy (11:19):
That's good to hear. I've also heard that facelifts are for women, not men, right?

Dr. Bass (11:25):
So that's an interesting one and it's very psychological rather than medical. I think men recoil from the idea of a facelift and think that it might be something for women. In fact, it's something that we do for both men and women. The focus for men is typically on the jawline and heavy hanging skin in the neck, but that's something that gives a worn or tired outlook along with puffiness, droopiness in the eyelids. Those are the two areas that men most commonly work on in the aging face. ASPS statistics, again, help us answer this question, and they say that 12% of face and neck lifting overall is done by men. Now remember, men still represent a minority of plastic surgery patients. So overall, men are only 6% of all plastic surgery procedures. So proportionally at 12% for face and neck lifting, you're doing a lot more face and neck lifting than other things in plastic surgery.

Summer Hardy (12:39):
Hearing that data is also helpful. Thank you for sharing it. What about this statement? Facelift results dissipate quickly, so it's not really worth it. Is that a fact or fallacy, Dr. Bass?

Dr. Bass (12:51):
Well, again, that one is another fallacy. We expect a facelift to last a decade or more, often 15 years or more. So in that sense, it's a long period of time before you have to think about what the facelift addresses, facial shape, skin laxity. It's permanent in the sense that you'll never look as bad as if you had done nothing, although, of course, as we mentioned, you will continue to age.

Summer Hardy (13:24):
What about before and after selfies on social media? Is there truth in advertising?

Dr. Bass (13:30):
That's a great question, Summer. Theoretically, doctors must show un-retouched images. Still, as we discussed in a few podcast episodes about photography, including the inaugural episode of the Park Avenue Plastic Surgery class, differences in lighting, differences in the background, makeup in an after image or how the hair is ranged can make a big difference. So look for those things to be matching in a before and after series of pictures before you believe a result. Also use common sense. If the change looks too good to be true, it probably is. So the doctors are not supposed to be retouching their pictures, but if there's a fantasy element to how good it looks, then maybe it has been retouched. In addition to that, I want to point out another big proviso. While doctors are not supposed to show retouched images, there's no such restriction on celebrities and influencers.

(14:37):
There's scarcely any images of these individuals that aren't retouched before their release. Filter or retouch the images, and so you're unlikely to be seeing the real appearance of that individual. And that's just part of what they do as celebrities. They're not intending to make it deceptive necessarily, but just remember, they may be touting a particular procedure or surgeon, but if they don't look as they seem in real life when you see them on the internet, can you really judge the treatment or procedure? Probably not.

Summer Hardy (15:14):
That makes sense. And then when it comes to skin laxity, no other treatment can measure up to the facelift.

Dr. Bass (15:21):
This is the big example in this episode of a facelift fact, not a facelift fallacy. Much as we'd like to have a magic bullet that would substitute for the surgical facelift, a facelift in a bottle, so to speak, there's no skin cream, no regenerative treatment with platelet-rich plasma or exosomes, no energy treatment or a minimally invasive surgical option that can provide more than a small fraction of what a facelift can provide when it comes to reducing skin laxity. And when I say a small fraction, I mean something like 10%. That's not nothing, especially if you're in the early stages of aging. At that point, there's only a little laxity. Let's say you're in the first half of your or maybe second half of your face or early if you're aging slowly. At that point, there's only a little laxity. The surgical lift would be overkill.

(16:27):
So that small tighten up from the non-surgical energy-based treatment, let's say, that can provide something that's adequate for the situation. And I'm not against these non-surgical lifting treatments. I do them every week in my office. I've performed a lot of research in this area, but the reality is there's no meaningful substitute at this point in time for what the surgical facelift can deliver, and I don't see one on the horizon based on any research activities that I'm aware of.

Summer Hardy (17:02):
Okay. And here's our last one for this episode. Facelifting is very risky. Most facelifts fail or have major problems.

Dr. Bass (17:11):
Again, this is something that the internet has popularized. It's actually minimally risky. It has minimal metabolic impact compared to a lot of other surgeries, and failure is rare, but social media loves to show problems in everything, not just in facelifting, and this distorts our perception of risk. It's just like when a plane crashes, you hear about it on the news, so you're afraid to fly, but you're much more likely to die in a car crash in any given year than in a plane crash. Most of the common complications occur a few percent of cases and serious ones in a fraction of 1%. So overall, it's a very successful, reproducible, dependable procedure that's not risk-free because nothing we do is risk-free, but it's not a risky or dangerous procedure.

Summer Hardy (18:12):
Okay, great. And can you provide the takeaways for our listeners, Dr. Bass?

Dr. Bass (18:18):
So these takeaways or facts or truths that I'll try to share with you based on our discussion of some of the fallacies that we've reviewed in this episode. Basically, facelift is expected to give natural results. This is not new and it's not specific to one technique or location. It's customizable for various ages from more focused or minimal lifting to more extensive lifting, depending on the aging changes present. It has a manageable and reasonably predictable interval of recovery, addressing both skin laxity changes as well as facial shape changes. Scars are minimal, and this is the reliable gold standard treatment for facial aging, particularly for laxity or hanging loose or sagging skin.

Summer Hardy (19:17):
Thank you, Dr. Bass, for clearing up all those misconceptions or fallacies. I have a much clearer picture now. Thank you for listening to the Park Avenue Plastic Surgery Class podcast. Follow us on Apple Podcasts, write a review, and share the show with your friends. Be sure to join us next time to avoid missing all the great content that is coming your way. If you want to contact us with comments or questions, we'd love to hear from you. Send us an email at podcast@drbass.net or DM us on Instagram @drbassnyc.