"One year post-op, the apparent age is about 6 years younger"—this is objective data calculated by AI.
In this article, based on medical papers, we explainfacelift's effect data and duration.
- The face measured by artificial intelligence (AI)—liftits rejuvenation years (research data)
- The importance of "SMAS (fascia) handling" related to lasting effect
- Changes in effect from combined procedures
- The effect duration based on long-term follow-up data
faceliftFor those who wish to maintain the effect long-term, we explain the durability of the effect in detail, based on data from authoritative medical papers.
Differences in Rejuvenation Effect by Technique
Research shows that facelift effects differ depending on the chosen technique.
Gibstein et al. (2021) conducted a study using artificial intelligence (AI) to measure the "degree of apparent-age rejuvenation" at one year post-op in 105 female facelift patients (average age 58.7).
In this AI (convolutional neural network) analysis, the rejuvenation result of the skin-only method that lifts only the skin wasan average of 2.95 years. However, it should be considered that AI age assessment has individual variation and that the evaluation criteria and accuracy have limits.
On the other hand, the "SMAS plication method" that handles deep tissue showedan average of 5.35 years, and the "SMAS-ectomy method" that excises excess tissue showedan average of 5.85 yearsof rejuvenation, as confirmed.
Please understand these figures are averages and that actual effects vary by individual. It is reported that adding internal fascia handling may improve the rejuvenation effect.
The Importance of the "SMAS (Superficial Musculoaponeurotic System)" for Lasting Effect
An important factor in the lasting effect of a facelift is the way the SMAS layer is handled. We'll explain this in detail later, but first it is important to understand the role of the "SMAS."
The SMAS (Superficial Musculoaponeurotic System) refers to the fascial layer deep beneath the skin. Facial sagging is not just a surface skin problem; it arises from a complex interplay of this SMAS layer and the descent of fat.
Surgery that pulls only the skin not only produces an unnatural taut feeling but may also cause sagging to recur over time due to the skin's viscoelasticity (its tendency to stretch) (Gibstein et al., 2021）。
This is the important part.
By appropriately handling the SMAS, facial volume is repositioned to the correct location, and a natural result that avoids excessive tension on the skin can be expected. Furthermore, because the internal tension is maintained,it may prevent the recurrence of sagging and extend the duration of the effect, it is thought.
Comparing the MACS Lift With the Conventional Method
"So which one is best, after all?"—You're probably wondering that. In recent years, diverse techniques have emerged, requiring selection according to the patient's condition.
Attracting attention in recent years is the "MACS lift (Minimal Access Cranial Suspension)," which lifts tissue vertically without extending the incision behind the ear.
A study by Buchanan et al. (2018) shows that the MACS lift has shorter operating time than the conventional method (average 165.3 minutes vs. 222.1 minutes) and may shorten the recovery period.
However, it cannot be applied to all cases. According to reports by Buchanan et al. (2018) and Chopan et al. (2019), the MACS lift is saidpatients with mild to moderate skin laxity and little neck fatto be suitable for.
When there is abundant neck fat with strong "bagginess," or severe skin laxity, the "conventional facelift" with wider incisions and skin excision is recommended. Choosing a technique matched to one's bone structure and sagging condition is an important factor in long-term durability of the effect.
Changes in Effect From Combined Fat Grafting
The rejuvenation effect gains "another 2.1 years"—this is the research result when a specific procedure is combined.
Gibstein et al. (2021)'s AI analysis showed that patients who combined "fat grafting" with the facelift, compared with those who did not,gained an additional average of 2.1 years (5.88 years vs. 3.78 years) of rejuvenation. However, please understand these figures are averages with individual variation.
Furthermore, in a survey using the patient self-satisfaction index (FACE-Q), the group that combined fat grafting also recorded higher scores in areas such as "satisfaction with the result (78.1 vs. 69)."
The reason fat grafting is important is that facial aging progresses not only through "tissue descent" but also through a complex interplay with the "volume loss (atrophy)" of fat and bone (Azoury et al., 2021).
According to Strong et al. (2024), classifying harvested fat by size and injecting it into deep layers as "macrofat" or "microfat" may reconstruct lost dimensionality (such as the roundness of the cheeks).
Furthermore, "nanofat" processed to an extremely fine size is rich in stem cells and the stromal vascular fraction (SVF), and injecting it into the dermal layerimproving skin texture and elasticity and reducing pigmentationis reported to be achievable.
The effect duration based on long-term follow-up data
Online, it's sometimes said that "a facelift reverts to original in a few years," but actual long-term follow-up data show different results.
Chopan et al. (2019) reported on the long-term effect of the MACS lift, finding that in a follow-up of up to 8 years, an effect duration equivalent to the conventional method was maintained.
Furthermore, regarding treatment using fat grafting, Coleman (2006) reported a case of facial fat grafting in which,even 11 years and 7 months post-op, significant volume improvement was maintained,as demonstrated.
Coleman (2006) further mentions the possibility that injected fat not only maintains volume but may continue to improve the surrounding skin quality long-term (such as pore reduction and softening of wrinkles).
The effect duration of a facelift does not uniformly end within a few years. By combining the "lift" of appropriate SMAS handling with the "volume replenishment" of fat grafting, a good state may be maintained over the long term. However, please understand that effects vary by individual.
Points to Confirm During Consultation
In cosmetic medicine, the most common question during consultation is this: "Doctor, how many years will the effect last in my case?"
The answer depends on "how appropriately the surgery can be structured for your bone structure and sagging condition."
As Strong et al. (2024) point out, injecting fat into the wrong layer or improper handling risks contour irregularity (bumpiness) or an unnatural result.
Based on anatomical knowledge, establishing an "individualized treatment plan" tailored to each patient is important for obtaining the best result.
It is important to choose a physician who does not propose the same technique to all patients but accurately identifies the causes of sagging and volume loss and appropriately combines the necessary techniques.
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Summary of This Article
- By handling not only the skin but also the SMAS (fascia), improvement in the rejuvenation effect and duration may be expected
- It is important to choose the optimal technique—MACS lift, conventional method, etc.—to match one's own sagging and fat condition
- There is data showing that combining fat grafting to replenish facial volume loss can be expected to yield additional rejuvenation
- It is reported that by combining appropriate treatments, the effect may be maintained over the long term, such as 8 to over 10 years
If anything concerns you, please feel free to consult us first. Zetith Beauty Clinic offers consultations based on medical evidence.
About the Author
Hiromitsu Nakamura M.D.
Zetith Beauty Clinic Ginza, Osaka, Fukuoka
Has a track record of research presentations at domestic and international conferences, and is also involved in technical guidance and education across Zetith Beauty Clinic. Specializing in precise rhinoplasty based on anatomical evidence, he pursues natural results tailored to each person's bone structure and tissue.
References
- Stein M, Shah N, Harrast J, et al. Clinical Practice Patterns in Facelift Surgery: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery. Aesthetic Plastic Surgery. 2024 (DOI)
- Gibstein A, Chen K, Nakfoor B, et al. Facelift Surgery Turns Back the Clock: Artificial Intelligence and Patient Satisfaction Quantitate Value of Procedure Type and Specific Techniques. Aesthetic Surgery Journal. 2021 (DOI)
- Wan D, Small K, Barton F. Face Lift. Plastic and Reconstructive Surgery. 2015 (DOI)