1901-1930: skin excision and undermining
- Hollander is often credited with the first facelift: in 1932 he stated it was done in 1901 on a Polish aristocrat; he first mentioned the procedure in a 1912 chapter (Barrett 2016, PMID 29204547; full text https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Hollander and Lexer performed the first facelifts in Germany independently; Hollander only resected skin, while Lexer undermined the skin several centimeters and included the superficial temporal fascia in his sutures (PMID 32408370).
- Lexer reported in 1931 a 1906 operation on an actress with S-shaped temporal excisions and elliptical forehead and hairline incisions (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Charles Miller published on his techniques in 1907, possibly the first American facelift (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Joseph, Passot and Bourget described elliptical excision techniques in the same era (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Joseph introduced the post-tragal incision in 1928 (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML); Joseph's 1921 "Hangewangenplastik (Melomioplastik)" appears in Kim 2015's reference list (PMID 26430622; full text https://www.ebi.ac.uk/europepmc/webservices/rest/PMC4579162/fullTextXML).
- Suzanne Noel performed a rhytidectomy in France in 1912 (PMID 38809028) and published a 1926 book on facial and neck surgery (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Noel's "petit operation" set principles used in the mini-lift and short-scar facelift (PMID 31637506).
- Bettman 1920: continuous temporal scalp, preauricular, postauricular and mastoid incision, close to today's facelift incision (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Bames (1927, "Truth and fallacies of face peeling and facelifting") described subcutaneous undermining and skin redraping (Kim 2015, PMID 26430622; full text https://www.ebi.ac.uk/europepmc/webservices/rest/PMC4579162/fullTextXML).
- French facelift surgery grew from First World War facial reconstruction (Morestin), then Passot, Noel and Bourguet between the wars (PMID 20869800).
- A 1927 view of cosmetic surgery, reprinted commentary (PMID 11039392).
1960-1976: the deeper layer
- Aufricht promoted suturing deep to the superficial fat in 1960 (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Skoog is credited with the first facelift that dissected the deeper fascial layer: the superficial fascia ("buccal fascia") lifted in continuity with the platysma and fixed superoposteriorly; presented 1973, published in his 1974 textbook (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML; https://www.ebi.ac.uk/europepmc/webservices/rest/PMC4579162/fullTextXML).
- Lemmon and Hamra 1980: Skoog rhytidectomy in 577 patients over 5 years (PMID 7355165).
- Guerrero-Santos 1974: muscular lift in cervical rhytidoplasty (PMID 4843119).
- Tipton 1974 and Rees and Aston 1977: split-face comparisons found no difference between skin-only and SMAS sides (PMID 4832464, PMID 928550; https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
- Mitz and Peyronie 1976 described the SMAS in the parotid and cheek area (PMID 935283).
- Mitz 2026: fifty-year retrospective on the SMAS (PMID 42481023).
- Owsley 1977: platysma-fascial rhytidectomy (PMID 928549); 1983 SMAS-platysma face lift (PMID 6828592).
- Baker 1977: the male rhytidectomy; large hematomas more than twice as frequent in men (PMID 909960).
- Connell 1978: platysma muscle flaps to eliminate neck bands (PMID 365042).
- Baker and Conley 1979: facial nerve anatomy and injury avoidance in rhytidectomy (PMID 515227).
1989-2002: ligaments, deep plane, composite, subperiosteal
- Furnas 1989: retaining ligaments of the cheek (PMID 2909050).
- Tessier 1989: subperiosteal "mask-lift" (PMID 2473674).
- Hamra 1990: deep-plane rhytidectomy, 403 patients (PMID 2359803).
- Ramirez 1991: extended subperiosteal lift reduced nerve injury compared with Psillakis and Tessier approaches (PMID 1852815).
- Stuzin, Baker and Gordon 1992: relationship of superficial and deep facial fascias (PMID 1741467).
- Hamra 1992: composite rhytidectomy (PMID 1615067).
- Mendelson 1992: extended SMAS dissection with periosteal fixation, 135 patients (PMID 1561253).
- Barton 1992: SMAS release and the nasolabial fold, later the high-SMAS technique (PMID 1409995, PMID 19332004).
- Owsley 1993: lifting the malar fat pad for the nasolabial fold (PMID 8438018).
- Ramirez 1994: endoscopic full facelift (PMID 7817884).
- Stuzin 1995: extended SMAS dissection for the midface (PMID 7634739).
- Connell and Marten 1995: trifurcated SMAS flap (PMID 8526157).
- Baker 1997: lateral SMASectomy (PMID 9252623).
- Mendelson 2002: prezygomatic space (PMID 12172155).
- Saylan's 1999 S-lift modified into the MACS lift by Tonnard and Verpaele in 2002 (PMID 11994618; https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML).
2007-2019: volume and fat compartments
- Rohrich and Pessa 2007: facial fat compartments (PMID 17519724).
- Mendelson 2008: premasseter space and the jowl (PMID 18183455).
- Rohrich 2014: lift-and-fill face lift (PMID 24569422).
- Auersvald 2014: hemostatic net (PMID 23949130).
- Barrett 2016: the pendulum swung from deeper dissection toward less invasive options and from repositioning to added volume (PMID 29204547).
2019-2026: current shifts
- AAFPRS survey: 90% of responding facial plastic surgeons perform deep-plane facelifts (PMID 41251721).
- ABPS tracer data 2006-2021: secondary facelifts 4% to 18%; fat grafting 15% to 24%; MACS 10% to 6% (PMID 38302713).
- Hemostatic net renamed "surgical net" with uses beyond hematoma (PMID 38806160).
- Platysma segmental innervation defined (PMID 37186556).
- Submandibular gland reduction standardized in 7 steps (PMID 42759497).
- Endoscopic deep-plane lifts without preauricular incisions (PMID 40576459, PMID 38152870).
History reviews
- Mangat and Frankel 2017, "The History of Rhytidectomy" (PMID 28571059).
- Charafeddine 2019, "Facelift: History and Anatomy" (PMID 31514803).
- Hashem 2020, "Facelift Part I: History, Anatomy, and Clinical Assessment" (PMID 30843042).
- Luu and Friedman 2021, history, anatomy and recent innovations (PMID 32937672).
- Kim 2015, thirty years of face lifts (PMID 26430622).
- Labbe 2010, French innovations (PMID 20869800).
Glossary
- Rhytidectomy / meloplasty: medical terms for facelift (PMID 28571059).
- Subcutaneous facelift: skin-only lift with undermining (PMID 29204547).
- SMAS: superficial musculoaponeurotic system (PMID 935283).
- Skoog flap: superficial fascia and platysma lifted as one unit (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC4579162/fullTextXML); 577-patient series (PMID 7355165).
- Deep plane: Hamra's sub-SMAS release past the nasolabial fold (PMID 2359803).
- Composite rhytidectomy: deep plane plus orbicularis in one flap (PMID 1615067).
Papers
| PMID | First author | Year | Journal | Title | Finding |
|---|---|---|---|---|---|
| 29204547 | Barrett DM | 2016 | World J Otorhinolaryngol Head Neck Surg | Evolution of the rhytidectomy. | Evolution of the rhytidectomy: history review 2016 (landmark) |
| 935283 | Mitz V | 1976 | Plast Reconstr Surg | The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. | Mitz and Peyronie describe the SMAS, 1976 (landmark) |
| 2359803 | Hamra ST | 1990 | Plast Reconstr Surg | The deep-plane rhytidectomy. | Hamra deep-plane rhytidectomy, 1990 (landmark) |
| 32408370 | Locher WG | 2020 | Handchir Mikrochir Plast Chir | [The early days of aesthetic surgery: facelift pioneers Eugen Holländer (1867-1932) and Erich Lexer (1967-1937)]. | Hollander and Lexer: first German facelifts |
| 26430622 | Kim BJ | 2015 | Arch Plast Surg | Development of Facial Rejuvenation Procedures: Thirty Years of Clinical Experience with Face Lifts. | Thirty years of face lifts; Bames and Skoog history (landmark) |
| 38809028 | Jung SG | 2024 | J Craniofac Surg | Rejuvenation: From the Fictional Dr Heidegger (1837) to Pioneering Modern Plastic Surgeons (1901-1912). | Hollander, Lexer 1901; Noel 1912 |
| 31637506 | Ritchie D | 2020 | Aesthetic Plast Surg | Contributions of the First Female Plastic Surgeon to Modern-Day Rhytidectomies. | Suzanne Noel's petit operation |
| 20869800 | Labbé D | 2010 | Ann Chir Plast Esthet | [French innovations in aesthetic surgery of the face]. | French innovations in facial aesthetic surgery (landmark) |
| 11039392 | Ryan RF | 2000 | Plast Reconstr Surg | A 1927 view of cosmetic surgery. | A 1927 view of cosmetic surgery (landmark) |
| 7355165 | Lemmon ML | 1980 | Plast Reconstr Surg | Skoog rhytidectomy: a five-year experience with 577 patients. | Skoog rhytidectomy, 577 patients (landmark) |
| 4843119 | Guerrero-Santos J | 1974 | Plast Reconstr Surg | Muscular lift in cervical rhytidoplasty. | Guerrero-Santos muscular cervical lift 1974 (landmark) |
| 4832464 | Tipton JB | 1974 | Plast Reconstr Surg | Should the subcutaneous tissue be plicated in a face lift? | Tipton 1974 split-face plication (landmark) |
| 928550 | Rees TD | 1977 | Plast Reconstr Surg | A clinical evaluation of the results of submusculo-aponeurotic dissection and fixation in face lifts. | Rees and Aston 1977 split-face SMAS (landmark) |
| 42481023 | Mitz V | 2026 | Aesthet Surg J | Fifty Years of the Superficial Musculoaponeurotic System: The Evolution of Modern Facelift Surgery. | Mitz: fifty years of the SMAS |
| 928549 | Owsley JQ Jr | 1977 | Plast Reconstr Surg | Platysma-fascial rhytidectomy: a preliminary report. | Owsley platysma-fascial rhytidectomy 1977 (landmark) |
| 6828592 | Owsley JQ Jr | 1983 | Plast Reconstr Surg | SMAS-platysma face lift. | Owsley SMAS-platysma face lift 1983 (landmark) |
| 909960 | Baker DC | 1977 | Plast Reconstr Surg | The male rhytidectomy. | Baker male rhytidectomy 1977 (landmark) |
| 365042 | Connell BF | 1978 | Ann Plast Surg | Cervical lifts: the value of platysma muscle flaps. | Connell platysma muscle flaps 1978 (landmark) |
| 515227 | Baker DC | 1979 | Plast Reconstr Surg | Avoiding facial nerve injuries in rhytidectomy. Anatomical variations and pitfalls. | Baker and Conley facial nerve 1979 (landmark) |
| 2909050 | Furnas DW | 1989 | Plast Reconstr Surg | The retaining ligaments of the cheek. | Furnas retaining ligaments 1989 (landmark) |
| 2473674 | Tessier P | 1989 | Ann Chir Plast Esthet | [Subperiosteal face-lift]. | Tessier subperiosteal lift 1989 (landmark) |
| 1852815 | Ramirez OM | 1991 | Plast Reconstr Surg | The extended subperiosteal face lift: a definitive soft-tissue remodeling for facial rejuvenation. | Ramirez extended subperiosteal lift 1991 (landmark) |
| 1741467 | Stuzin JM | 1992 | Plast Reconstr Surg | The relationship of the superficial and deep facial fascias: relevance to rhytidectomy and aging. | Stuzin superficial and deep fascias 1992 (landmark) |
| 1615067 | Hamra ST | 1992 | Plast Reconstr Surg | Composite rhytidectomy. | Hamra composite rhytidectomy 1992 (landmark) |
| 1561253 | Mendelson BC | 1992 | Plast Reconstr Surg | Correction of the nasolabial fold: extended SMAS dissection with periosteal fixation. | Mendelson extended SMAS with periosteal fixation 1992 (landmark) |
| 1409995 | Barton FE Jr | 1992 | Plast Reconstr Surg | Rhytidectomy and the nasolabial fold. | Barton SMAS and nasolabial fold 1992 (landmark) |
| 19332004 | Barton FE Jr | 2002 | Aesthet Surg J | The "high SMAS" face lift technique. | Barton high SMAS 2002 (landmark) |
| 8438018 | Owsley JQ | 1993 | Plast Reconstr Surg | Lifting the malar fat pad for correction of prominent nasolabial folds. | Owsley malar fat pad 1993 (landmark) |
| 7817884 | Ramirez OM | 1994 | Aesthetic Plast Surg | Endoscopic full facelift. | Ramirez endoscopic full facelift 1994 (landmark) |
| 7634739 | Stuzin JM | 1995 | Clin Plast Surg | Extended SMAS dissection as an approach to midface rejuvenation. | Stuzin extended SMAS 1995 (landmark) |
| 8526157 | Connell BF | 1995 | Aesthetic Plast Surg | The trifurcated SMAS flap: three-part segmentation of the conventional flap for improved results in the midface, cheek, and neck. | Connell and Marten trifurcated SMAS flap 1995 (landmark) |
| 9252623 | Baker DC | 1997 | Plast Reconstr Surg | Lateral SMASectomy. | Baker lateral SMASectomy 1997 (landmark) |
| 12172155 | Mendelson BC | 2002 | Plast Reconstr Surg | Surgical anatomy of the midcheek and malar mounds. | Mendelson prezygomatic space 2002 (landmark) |
| 11994618 | Tonnard P | 2002 | Plast Reconstr Surg | Minimal access cranial suspension lift: a modified S-lift. | Tonnard MACS lift 2002 (landmark) |
| 17519724 | Rohrich RJ | 2007 | Plast Reconstr Surg | The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. | Rohrich and Pessa fat compartments 2007 (landmark) |
| 18183455 | Mendelson BC | 2008 | Aesthetic Plast Surg | Surgical anatomy of the lower face: the premasseter space, the jowl, and the labiomandibular fold. | Mendelson premasseter space 2008 (landmark) |
| 24569422 | Rohrich RJ | 2014 | Plast Reconstr Surg | Lift-and-fill face lift: integrating the fat compartments. | Rohrich lift-and-fill 2014 (landmark) |
| 23949130 | Auersvald A | 2014 | Aesthetic Plast Surg | Hemostatic net in rhytidoplasty: an efficient and safe method for preventing hematoma in 405 consecutive patients. | Auersvald hemostatic net 2014 (landmark) |
| 41251721 | Pak KY | 2026 | J Craniofac Surg | Evaluating Facelift Outcomes and Technique Trends in the United States. | AAFPRS survey: deep plane 90% |
| 38302713 | Stein MJ | 2024 | Aesthetic Plast Surg | Clinical Practice Patterns in Facelift Surgery: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery. | ABPS practice shifts 2006-2021 |
| 38806160 | O'Daniel TG | 2025 | Facial Plast Surg | Evolution of the Surgical Net. | Surgical net |
| 37186556 | Minelli L | 2023 | Aesthet Surg J | The Functional Anatomy and Innervation of the Platysma is Segmental: Implications for Lower Lip Dysfunction, Recurrent Platysmal Bands, and Surgical Rejuvenation. | Platysma segmental innervation |
| 42759497 | O'Daniel TG | 2026 | Aesthet Surg J | Safe Submandibular Gland Reduction in 7 Steps: The Carina Technique. | Carina gland reduction |
| 40576459 | Firat M | 2025 | Aesthet Surg J | Endoscopic Deep Plane Facelift: A Classified Approach. | Endoscopic deep plane lift |
| 38152870 | Kao CC | 2024 | Aesthet Surg J | The Ponytail Lift: 22 Years of Experience in 600 Cases of Endoscopic Deep Plane Facial Rejuvenation. | Ponytail lift |
| 28571059 | Mangat DS | 2017 | Facial Plast Surg | The History of Rhytidectomy. | History of rhytidectomy 2017 (landmark) |
| 31514803 | Charafeddine AH | 2019 | Clin Plast Surg | Facelift: History and Anatomy. | Facelift history and anatomy 2019 |
| 30843042 | Hashem AM | 2020 | Aesthet Surg J | Facelift Part I: History, Anatomy, and Clinical Assessment. | Facelift Part I history 2020 |
| 32937672 | Luu NN | 2021 | Facial Plast Surg | Facelift Surgery: History, Anatomy, and Recent Innovations. | Facelift history and innovations 2021 |
| 8942899 | Ivy EJ | 1996 | Plast Reconstr Surg | Is there a difference? A prospective study comparing lateral and standard SMAS face lifts with extended SMAS and composite rhytidectomies. | Split-face 1996 no difference at 1 year (landmark) |
Open questions / controversies
- Priority for the first facelift: Hollander's 1901 date comes from his own 1932 account (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC5698509/fullTextXML); Lexer is called the pioneer of modern technique for undermining and fascial sutures (PMID 32408370).
- Skoog date: presented 1973, textbook 1974 (https://www.ebi.ac.uk/europepmc/webservices/rest/PMC4579162/fullTextXML).
- Bames 1927 original not in PubMed; citation taken from Kim 2015 reference list (PMID 26430622).
- Controlled comparisons are few: split-face studies in 1977 and 1996 found no late difference between techniques (PMID 928550, PMID 8942899).