Many patients ask, “What is the best facelift for me?” With so many options promoted online—threads, mini lifts, SMAS lifts, deep plane facelifts, and more—it can be confusing to know which truly work. Not all facelift procedures are equal. Some are outdated or ineffective, while others properly address the anatomical changes that occur with aging.
I’m Dr. Kevin Sadati, a board-certified facial plastic surgeon in Newport Beach, California. Over the past 20 years, I have performed nearly 5,000 facelifts, focusing on techniques that deliver natural, long-lasting results.
Understanding Facial Aging
Facial aging is primarily caused by the loss of collagen and elastin, which weakens the SMAS layer—the supportive structure beneath the skin. As the SMAS stretches, the skin, fat, and muscles begin to descend due to gravity.
This changes the face’s youthful heart shape into a longer, heavier appearance. Effective facial rejuvenation must restore this natural shape—not simply pull the skin sideways or tighten it unnaturally.
Why Thread Lifts Don’t Work
Thread lifts promise a quick lift without surgery by placing barbed sutures under the skin. These sutures are supposed to anchor and lift deeper facial tissues.
In reality, they only lift the skin temporarily, because the barbs cannot hold deeper structures like the SMAS and fat. Results often fade within a few months, leaving patients with little improvement and threads still under the skin. For this reason, thread lifts rarely provide meaningful or lasting rejuvenation.
The Problem With the “Liquid Facelift”
A liquid facelift uses large amounts of dermal filler in an attempt to lift sagging areas of the face. However, fillers are designed to add volume—not lift tissue.
When too much filler is used, it can create an unnatural “pillow face” appearance with overly full cheeks and heavy jawlines. Over time, fillers can also accumulate in the tissues and create scarring, making future surgery more difficult. While fillers are helpful for small areas like lips or mild hollowness, they are not a substitute for facelift surgery.
Does a Neck Lift Alone Work?
Many patients—especially men—believe they only need a neck lift. However, neck aging is closely connected to the face.
The platysma muscle, which defines the neck contour, attaches to the midface. When the face begins to sag, the neck follows. Performing an isolated neck lift without addressing the face often leads to short-lived results because the underlying support remains weak.
Younger patients in their 20s to early 40s with genetic fullness under the chin can benefit from a deep plane neck lift. However, patients in their 50s or older usually require a procedure that treats both the face and neck.
Mini Facelifts and Micro Lifts
Mini facelift became popular in the late 1990s and early 2000s as a less invasive alternative to traditional facelifts. These procedures use similar incisions but perform less work beneath the skin.
While recovery can be quicker, results are often limited and short-lived. Because aging continues, many patients find themselves needing another surgery sooner than expected.
Traditional SMAS Facelift
The SMAS facelift, developed in the 1970s, improved upon earlier skin-only facelifts by tightening the deeper SMAS layer. For decades, it was considered the gold standard.
However, traditional SMAS lifts often reposition tissues horizontally, which can create widened mouths or an unnatural appearance. While it was a major advancement, newer techniques now produce more natural results.
Evolution of Modern Facelift Techniques
Throughout my career, I have continually refined facelift techniques to achieve better lift, longevity, and natural appearance.
Earlier in my practice, I developed the Double-C and Triple-C SMAS plication techniques, which were published in peer-reviewed surgical journals and adopted by surgeons worldwide.
While successful, these techniques still had limitations in addressing the midface and tissue tension.
The Deep Plane Facelift
The Deep Plane Facelift addresses aging at a deeper level by releasing the retaining ligaments of the face and lifting the SMAS layer as a unified structure.
This approach allows the midface, jawline, and neck to be repositioned vertically rather than simply tightening the skin. Because the deeper structures are restored, results appear softer, more natural, and longer-lasting.
The Preservation Deep Plane Facelift
After years of refining the deep plane technique, I developed the Preservation Deep Plane Facelift.
This advanced approach maintains the benefits of deep-plane surgery while preserving tissue integrity and blood supply, thereby improving healing and recovery. My research on this technique has been published in Plastic and Reconstructive Surgery (PRS) and presented at major international surgical meetings.
Today, patients travel from across the United States and around the world to undergo this procedure in my practice because it provides natural, durable facial rejuvenation while maintaining each patient’s unique appearance.