Evaluating Facelift Outcomes and Technique Trends in the United States.

[OBJECTIVES] Highlight current trends in facelifting as facelift techniques continue to evolve as surgeons seek to improve outcomes and longevity.

[METHODS] A REDCap survey was distributed to AAFPRS members.

[RESULTS] A total of 150 surgeons responded (11.7% response rate). Most were in private solo practice (58.7%) and had over 20 years of experience (44.7%). Deep-plane facelifts were performed by 90% of respondents, with SMAS plication and imbrication techniques being most used among nondeep-plane surgeons. Surgeons in practice for <20 years were significantly more likely to use deep-plane techniques (P=0.04). Longevity of results was not significantly associated with deep-plane techniques (P=0.3). Facial nerve monitoring or stimulators were rarely used. Transient nerve injuries occurred in 1% to 5% of cases, most commonly affecting the depressor labii inferioris (75.8%), zygomaticus major/levator labii (22.1%), and frontalis (16.9%). Higher rates of nerve injury was significantly associated with deep-plane facelifts and frequent submandibular gland reduction (P<0.05 each). Fat grafting, gland reductions, and digastric resections were not widely adopted.

[CONCLUSION] The deep-plane facelift is emerging as the preferred rhytidectomy technique among facial plastic surgeons. This underscores the need for additional studies to clarify which surgical techniques minimize risks and optimize outcomes.

[LEVEL OF EVIDENCE] Level III-observational study.