You start reading about facelifts, and within an hour, your head is spinning. One page says you need a deep plane lift. Another swears by a mini version. A third warns you about looking pulled and windblown. Most of it never answers the one thing you want to know: what is right for your face.
That confusion is normal. Facial aging is more complex than a few wrinkles, and the choices are real. The changes are structural, not just skin deep. With age, the skin gradually loses collagen and elasticity, while facial fat, muscles, ligaments, and bone also change. Knowing how that works helps you choose calmly instead of guessing.
This guide is here to give you that footing. At Prendiville Facial Plastic Surgery in Fort Myers, FL, double board-certified facial plastic surgeon Dr. Stephen Prendiville has focused only on the face for 25 years. The pages ahead cover how a facelift works, the main techniques, what surgery and recovery look like, the real risks, and how to choose a surgeon you trust.
A facelift, known medically as a rhytidectomy, does not just tighten skin. It moves the deeper structures of the face back where they belong. To see why that matters, it helps to know what aging actually does.
With age, skin loses collagen and elasticity. The deeper fat pads slide down and shrink. The bone underneath slowly changes shape, too. The result is jowls, a softer jawline, loose neck skin, and deeper folds beside the mouth. A facelift treats those deeper changes, not the surface alone.
There is an honest limit here. A facelift is great for sagging and structure. It is not a fix for everything. It does not erase fine lines like crow's feet, and it does not undo sun damage or skin tone, as dermatology references on facelifts explain. Those concerns usually need lasers, peels, or good skincare alongside surgery.
Older facelifts were pulled mainly on the skin. That is what created the tight, windblown look people fear. It also did not last very long. Modern surgery works under the skin instead. That is what lets the skin close with no tension and look natural.
The layer that makes this work is the SMAS. In plain terms, it is the deeper support sheet of muscle and tissue under your skin. When a surgeon lifts and resets the SMAS instead of the skin, the result holds better. It also avoids that operated-on look. One way to picture it is a carpet and its liner. You reset the liner underneath first. Then you trim only the small bit of extra carpet on top, so nothing is stretched tight.
One more point surprises many patients. Lifting the deeper layers is partly self-volumizing, because raising the tissue restores some fullness to the cheeks on its own. Added fat or a collagen-building product is used only when the face is more deflated. It is not a routine step. In a surgeon's terms, a full facelift means the cheeks, jawline, and neck. It does not include the brow or eyelids, which are separate procedures.
Not all facelifts are the same. That is the most important thing to understand before a consultation. Each technique works at a different depth and suits a different face. The goal is matching the method to you, not picking the trendiest name.
The deep plane facelift is one of the leading modern facelift techniques. It was first described by Dr. Sam Hamra in 1990. It works in the natural plane below the SMAS, releases the ligaments that tether the face, and lifts the cheek fat pad back into place. A 2025 systematic review of 2,896 patients found a 94.4 percent satisfaction rate for the deep plane method, compared with 87.8 percent for traditional SMAS lifts. Because it is more involved, it carries a somewhat higher risk of minor issues. That is the tradeoff for its reach and longevity.
As Dr. Prendiville performs it, a deep plane facelift also includes a deep neck lift. That can involve removing fat beneath the platysma muscle, reducing the anterior belly of the digastric muscles under the chin, and reducing the submandibular glands along the jawline. Not every patient needs this step, but it is commonly performed, and it greatly enhances the neck result.
A traditional SMAS facelift tightens that same support layer with less deep work. It suits mild to moderate sagging and has a slightly easier recovery. It does less for the midface, though. Limited-incision or short-scar lifts use shorter incisions and shorter operating times. They are generally best suited to patients with earlier or more localized lower-face laxity and relatively limited excess skin, and their ability to improve the neck depends on the exact technique and the patient's anatomy. A facelift does not stop aging, and no procedure has a guaranteed lifespan.
This is where experience changes the result. Dr. Prendiville's own version of the deep plane facelift is the Prendiville Signature Lift™. It combines deep structural lifting for long-lasting definition, subtle repositioning to restore youthful harmony, and a precision technique that avoids the pulled or "windblown" look.
There are no templates and no shortcuts. Each lift is tailored to your own facial anatomy and performed personally by Dr. Prendiville, so you look rejuvenated, never "done." He often notes that a deep plane facelift repositions the deeper facial tissues and, when combined with individualized neck-lift techniques, addresses the jawline and neck in a coordinated manner.
Louise, a Prendiville Facial Plastic Surgery patient who chose a deep plane facelift, shared her experience:
"I recently underwent a deep plane facelift, CO₂ treatment, and lip lift with Dr. Prendiville, and I could not be more thrilled with my experience. From my very first consultation, I felt completely confident and at ease."
Not sure which approach fits your face? That is the perfect question for a consultation. Seeing your own anatomy assessed is far more useful than comparing techniques online. When you are ready, you can request a private consultation, in person or virtually, to talk it through.
Knowing what happens, start to finish, takes a lot of the fear out of surgery. The process is careful and well-established. Most of it is built around two goals: a natural result and hidden scars.
Prep usually starts about two weeks ahead. You will be asked to keep your blood pressure well controlled. You will also be instructed to stop aspirin, anti-inflammatory medicines, and certain supplements that raise bleeding risk, on the exact schedule Dr. Prendiville's team gives you. This lowers the chance of a hematoma. Antiseptic showers before surgery cut the bacteria on your skin and lower infection risk. A dedicated pre-operative visit walks you through every step, and the consultation always starts with your health history, because safety comes first.
Facelift incisions are planned to disappear. They usually begin in the hairline at the temple. From there, they follow the natural crease in front of the ear, curve under the earlobe, and continue into the hairline behind the ear, as surgical anatomy references describe. The incision sits right at the edge of the small bump in front of the ear. Skin is removed under no tension, so the earlobe stays natural and the scars are hard to see. Facial skin also heals unusually well, thanks to its rich blood supply.
During surgery, the surgeon raises a skin flap. Next comes work in the deeper plane to release the tethering ligaments. The SMAS is lifted and secured, the skin is redraped, and only the small excess is trimmed. Anesthesia is either general or IV sedation, chosen for your case and health.
Small drains are usually placed for about 48 hours. They help the skin settle against the deeper tissue, and they almost always come out at that two-day mark. Most patients do not wear a bulky wrap, though a light dressing may be used for brow work or for men.
One detail matters more than any other. The core steps of your surgery are performed by your lead surgeon, not handed off. Dr. Prendiville personally performs the procedure and shows only his own patients' before-and-after photos. He urges every patient to expect the same from any surgeon they consider.
Deborah, a Prendiville Facial Plastic Surgery patient who had a deep plane facelift and neck procedure, shared her experience:
"I was nervous about getting such a major surgical procedure, but after meeting Dr Prendiville and his staff, I felt so much more at ease and excited. I booked a facelift and neck, deep plane."
Recovery is more predictable than the internet makes it sound. Most of what will concern you happens in the first two weeks. And despite what you may have read, many patients report more tightness and discomfort rather than severe pain. Knowing the timeline helps you plan your life around it.
In the first 48 hours, swelling and bruising peak. Gentle walking is encouraged right away to keep your circulation moving. Over the next two weeks, bandages come off within a few days, and sutures are usually removed around day seven. You are asked not to bend over or lift anything heavy during this stretch. By weeks two to three, most patients are ready for desk work and outings, while the final tissues keep refining for several months.
A few things protect your result. Temporary numbness around the ears, cheeks, and neck is common and generally improves gradually over several weeks or months. Permanent sensory changes are uncommon but possible. Temporary facial-muscle weakness is uncommon, and permanent facial-nerve injury is very rare. Follow Dr. Prendiville's instructions regarding prescription pain medication, acetaminophen, and when it is safe to restart aspirin or anti-inflammatory medications. Avoiding all smoking and nicotine matters too, as does daily sunscreen. Both affect healing and how long your results last.
For patients traveling in, planning helps most. Out-of-town patients stay local for about one to two weeks so healing can be watched closely. The practice offers concierge support, including recovery-suite coordination, transportation, and on-call nursing. Travel should be approved by your surgeon based on your recovery, though staying still for too long in the first few days is discouraged to lower clot risk.
Coming from another city? The out-of-town patient resources explain how travel and recovery are handled from start to finish, so reach out if you would like to plan your trip.
Every honest guide has to cover risk. The reassuring news is that a facelift is very safe in the right hands. Knowing the real numbers, instead of the scary headlines, helps you weigh the choice clearly.
A large database study of 11,300 facelift patients found a major complication rate of just 1.8 percent. Hematoma and infection were the most common, and both are still uncommon. Nerve injury is the most feared risk. Yet a meta-analysis of more than 15,000 patients put permanent nerve damage well below one tenth of one percent. The reason is simple. Facial anatomy is complex but very consistent, so an experienced surgeon knows where the nerves run and works carefully around them.
A hematoma is a collection of blood under the skin. It is the most common issue to watch for, and it usually shows up within the first day as fast swelling or one-sided firmness. A larger one is treated promptly in the operating room, while small ones are managed simply. You can lower your own risk, too. Stop all smoking and nicotine products, including vaping, patches, and gum, as Dr. Prendiville instructs; keep your blood pressure controlled; and follow the pre-operative instructions closely.
This is the strongest reason to choose carefully. Operating in accredited facilities with a specialist's training keeps rates low. Large board-certified surgeon groups report overall rates under 1 percent. Dr. Prendiville is double board-certified and fellowship-trained, focused only on the face, and screens every patient's health, because a safe candidate is the start of a good result.
Ana, a Prendiville Facial Plastic Surgery patient who valued a careful, honest approach, shared her experience:
"Certified and experienced Doctor, expert on face and neck lifts, supported by an excellent staff, outlines the best procedures for each case without forcing products or services."
If you started this guide feeling overwhelmed, that feeling should be lighter now. A facelift is structural surgery that restores the cheeks, jawline, and neck. The deep plane approach is one of the leading modern techniques for natural, lasting results. Recovery centers on the first couple of weeks. And serious problems are rare when an experienced surgeon is at the table.
The best next step is seeing how these ideas apply to your own face. You can explore real results and the deep plane technique at your own pace. When you feel ready, a private consultation, in person or virtually, will tell you far more than any article can.
Dr. Prendiville and the team in Fort Myers build every plan around one quiet promise. Results should look refreshed and natural, never done, so you still look like yourself. If you have questions or want to talk through what is bothering you, you can reach the practice at 239-437-3900 or request a private consultation. Thank you for reading, and for taking the time to make this decision well.
