Facelift surgery is not a single procedure. It’s a family of techniques, each designed for a different stage and pattern of facial aging, and the terminology alone, deep plane, SMAS, mini, thread lift, can make it difficult to know where to start. The types of facelifts available today vary significantly in what they achieve, how long results last, and who they suit.
Dr. Kashan’s approach is straightforward: match the technique to the patient’s anatomy and goals, not the other way around. This post covers the three main surgical options, when each makes sense, how the neck fits into the decision, and what non-surgical approaches can and cannot realistically achieve.
The Three Main Types of Facelifts
A useful facelift comparison starts with understanding the types of facelifts and what layer of tissue each technique addresses. That determines what it can correct, how long results last, and what kind of patient it suits best.
Mini Facelift
The mini facelift targets the lower face and jawline through shorter incisions and limited tissue repositioning. It addresses early jowling and mild skin laxity without the recovery commitment of a full facelift. Results typically last five to ten years, with most patients back to normal activity within ten to twelve days.
It suits patients in their late 30s to late 40s with subtle signs of aging. As it does not address the neck or mid-face, patients with significant neck laxity or deep nasolabial folds will need a more extensive approach.
SMAS Facelift
The SMAS facelift works on the Superficial Musculoaponeurotic System, the fibrous tissue layer beneath the skin that connects the facial muscles. Tightening or repositioning it lifts sagging cheeks and jowls at a structural level rather than simply pulling the skin. Results typically last ten to fifteen years, with a recovery of around two weeks.
It suits patients in their late 40s to early 60s with moderate facial laxity and is the most commonly performed facelift technique worldwide.
Deep Plane Facelift
The deep plane facelift goes beneath the SMAS to release and reposition the deeper structures of the face as a single unit, including fat pads and retaining ligaments. This produces the most comprehensive lift available and restores mid-face volume in a way that surface-level techniques cannot. According to a review published in the Journal of Clinical Medicine, deep plane techniques are associated with longer-lasting outcomes and lower revision rates.
Results last ten to fifteen years, and recovery is roughly two weeks. Because deeper tissue is repositioned rather than skin pulled tight, it avoids the overstretched appearance associated with older facelift techniques. It suits patients in their late 40s to early 70s with significant jowling, mid-face descent, and neck laxity. Facial fat grafting, including nanofat techniques, is sometimes incorporated to restore volume and improve skin texture at a finer level.
Where Does a Neck Lift Fit In?
The face and neck age as a unit, and Dr. Kashan performs facelifts and necklifts together in the majority of cases. A lifted jawline sitting above a lax neck creates a visible mismatch, and addressing both in a single procedure produces a more cohesive result.
A necklift addresses loose skin below the chin, visible platysmal bands, and submental fat. It can include skin removal, muscle tightening, and liposuction depending on what the anatomy requires. In some cases, a younger patient whose aging is concentrated below the jawline may be a candidate for a standalone necklift, though Dr. Kashan evaluates this individually during the consultation.
When Is the Right Time to Consider a Facelift?
There is no single right age. The timing depends on how a patient has aged, their skin quality, and what they are hoping to address. Facelifts generally deliver their best results when the skin retains enough elasticity to drape smoothly after the underlying tissue has been repositioned. Operating earlier in the aging process, while tissue quality is still good, tends to produce cleaner and longer-lasting outcomes.
Most of Dr. Kashan’s facelift patients are between 45 and 65, though he has operated successfully on patients in their 70s when health and skin conditions allow. Potential patients considering a facelift can benefit from knowing more about the age and timing considerations and also if having more than one facelift is possible.
What About Non-Surgical Options?
Thread lifts, energy-based skin tightening devices such as Ultherapy and radiofrequency, and injectable volume restoration with products like Sculptra all have a limited role for patients with early-stage aging who are not yet surgical candidates, or who want to maintain results between procedures. The American Society of Plastic Surgeons offers a useful overview of how surgical and non-surgical approaches compare.
The clinical distinction is important: non-surgical treatments tighten and add volume, but they do not reposition the deeper structures of the face. For patients with moderate-to-significant jowling, mid-face descent, or neck laxity, these options will not produce the correction a surgical facelift achieves. They are a different category of treatment, appropriate for a different stage of aging.
How Dr. Kashan Helps You Choose
At a consultation, Dr. Kashan assesses skin elasticity, the depth of jowling, mid-face descent, neck condition, and bone structure alongside the patient’s goals, tolerance for downtime, and any prior procedures. The technique recommendation follows from that assessment.
Dr. Kashan trained at the Cleveland Clinic, where his surgical background spanned over a decade of general surgery, trauma, and cancer-related reconstructive work prior to specializing in plastic surgery. That depth of training means he evaluates the full anatomy and considers the range of types of facelifts available rather than defaulting to a single approach. Surgeons performing only one technique will recommend that technique regardless of whether it is the right fit for the patient.
For patients in the early stages of deciding, a useful starting point is evaluating the main benefits of getting a facelift.
Protecting and Maintaining Your Results
The longevity of facelift results is not determined by surgery alone. Skin care before and after the procedure, sun avoidance, and smoking cessation all play a meaningful role in how long results hold and how well the skin heals.
Sun exposure is one of the primary drivers of skin aging and collagen breakdown. Consistent SPF use and avoiding prolonged sun exposure after surgery help preserve skin quality over time. Smoking significantly impairs wound healing and reduces blood flow to the skin, which is why Dr. Kashan requires patients to stop before surgery and continue abstaining through recovery.
A structured skincare routine, established before the procedure and maintained afterward, supports results long term. Treatments such as laser resurfacing and microneedling can further support skin quality and longevity of results over time. Dr. Kashan discusses this as part of the pre- and post-operative plan at every consultation.
Finding the Right Fit
The right facelift depends on where and how your face has aged. A mini facelift suits early jawline changes with minimal downtime, an SMAS facelift addresses moderate laxity across the lower face, and a deep plane facelift provides the most comprehensive and longest-lasting correction for advanced aging.
Dr. Kashan’s approach to the types of facelifts starts with a thorough assessment of the individual’s anatomy, not a preferred default technique. Every consultation is a conversation about what each approach can realistically achieve for that specific patient.
Book a facelift consultation with Dr. David Kashan in Roslyn, Long Island to find out which type of facelift is right for you. If you are ready to take that step, get in touch here.
