Behind the Facelift
A new survey reveals what's trending among facial plastic surgeons in 2026.
If you’re curious about the nuances of facelifting—the distinctions between techniques, who’s doing what, and why—you’ll want to check out this new article, “Evaluating Facelift Outcomes and Technique Trends in the United States,” in the Journal of Craniofacial Surgery.
Facial plastic surgeon Babak Azizzadeh, MD, president-elect of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), along with his coauthors Kaitlynne Pak, MD, and Parsa Salehi, MD, surveyed AAFPRS members about their facelift preferences and practices—particularly those related to buzzworthy modifications, like submandibular gland reduction and fat grafting—and examined surgeons’ backgrounds and mindsets through the lens of evolving trends in facial rejuvenation surgery.
Most AAFPRS members are facial plastic surgeons, it’s worth noting, so this survey specifically captures their unique POV. As the authors state, the study’s focus on facial plastic surgeons may limit the applicability of its findings. In other words, trends in facial plastic surgery may not translate to general plastic surgery.
What’s the difference? Beyond scope of expertise—general plastics operate all over the body while facial plastics concentrate on the neck up—each speciality has its own educational pathway.
Facial plastic surgeons complete a residency in otolaryngology and typically follow it with an aesthetic fellowship in facial plastic surgery. (Fellowship is an optional year of advanced training in cosmetic procedures.) Most facial plastic surgeons are board-certified by the American Board of Otolaryngology – Head and Neck Surgery as well as The American Board of Facial Plastic and Reconstructive Surgery.
General or comprehensive plastic surgeons, on the other hand, complete a plastic surgery residency, are board-certified by the American Board of Plastic Surgery, and may also pursue a fellowship.
In the context of facelifts, I tend to associate facial plastic surgeons with the deep plane approach. This isn’t a hard-and-fast rule, however; there are certainly exceptions. And preferences seem to be evolving generationally, with more younger surgeons embracing the deep plane ethos.
Among comprehensive plastic surgeons, those who’ve been operating for decades are often (not always) loyal to the SMAS lift. But in general plastics, too, we’re seeing younger surgeons adopt deep plane maneuvers. Again, this is merely an observation and, yes, I am generalizing. I’m sure we can all name a veteran plastic surgeon who does (or did) a deep plane and an up-and-comer who’s famous for their SMAS lift.
