Facelift

A modern facelift therefore does not address the skin alone. What matters is understanding how the different tissue layers have changed, and which structures need to be treated to rebalance natural contours and proportions.

The aim is not to tighten the face as much as possible, or to exactly recreate an earlier state. The goal is a face that appears more rested and defined, without losing its individual expression.

At Clinic Selnau in Zürich, we plan facelift surgery with particular attention to natural contours, preserving personal facial features, and an anatomically grounded repositioning of the tissue.

Our Approach

Every face ages differently.

Facial shape, bone structure, skin quality, fat distribution and the condition of the deeper tissue layers all determine how a face changes over the years. Genetic factors, facial expression and individual lifestyle habits also influence this process.

For this reason, planning a facelift does not begin with a particular technique. It begins with the face as a whole.

We look at which contours have changed, where tissue has descended, and which features remain characteristic of your face. Equally important is the question of which areas should not be changed.

Face, Contours & Expression

Ageing changes rarely affect only a single area of the face.

Volume can shift, cheek contours can lose definition, and the jawline can soften. At the same time, changes can develop in the neck. These areas are anatomically connected and are therefore considered together during planning.

A facelift may be considered for changes including:

• Loss of clear contours in the lower face
• Descended tissue in the cheek area
• Changes along the jawline
• More pronounced jowls
• Deepened folds and transitions in the lower face
• Excess skin and tissue around the face and neck
• Loss of definition between the chin, jawline and neck
• Asymmetric ageing changes

Not every visible change in the face needs to be treated surgically. Nor is a facelift the right treatment for every form of skin ageing.

What matters is which structures are responsible for the perceived changes, and whether surgery offers a meaningful approach to addressing them.

Planning & Analysis

Careful analysis is an essential part of every facelift plan.

During consultation, we examine your face from different perspectives and assess changes to the skin, the soft tissue and the deeper structures. The cheeks, jawline and neck are not considered in isolation, but in relation to one another.

Your natural facial shape and any individual asymmetries also play an important role. A round face places different demands on planning than a narrower or more defined face.

Standardised photography supports this analysis and helps us discuss changes and treatment goals together.

What matters is not prescribing a particular facelift outcome. Planning is guided by your anatomy, your features, and the changes that have developed over time.

The Procedure

There is no single facelift for every face.

Which areas are treated, and how extensive the procedure is, depends on the individual starting point. What matters is which tissue layers have shifted position, and which structures need to be repositioned or stabilised.

For this reason, a modern facelift does not simply remove excess skin and tighten what remains. A significant part of the correction takes place in the deeper tissue layers.

A central role is played by the SMAS, a connected layer of tissue beneath the skin that links to the deeper structures of the face. Depending on the technique, this layer can be mobilised, repositioned or tightened to varying degrees.

The skin then follows the repositioned structures, without the correction relying mainly on tension across the skin. This allows contours to be treated more precisely and helps avoid an overly tightened appearance.

The incision pattern is also planned individually. Incisions typically follow natural transitions around the hairline and the ear, with the aim of positioning any resulting scars as inconspicuously as possible.

Which approach makes sense depends on where the main changes are located, how pronounced they are, and what anatomical conditions are present.

Deep Plane, SMAS, Mini or Mid-Facelift?

Terms such as Deep Plane facelift, SMAS facelift, mini-facelift or mid-facelift describe different surgical approaches and treatment areas. They are not quality levels, nor are they entirely separate categories.

These techniques differ, among other things, in which anatomical plane is dissected, how the SMAS is treated, and to what extent supporting structures are released and tissue mobilised.

In a SMAS facelift, the deeper SMAS layer is treated directly. Depending on the starting point, different variations of this technique are available to reposition descended tissue and improve contours particularly in the lower face and along the jawline.

In a Deep Plane facelift, dissection takes place at a deeper anatomical level. Certain supporting structures can be released in a targeted way, allowing tissue units of the mid and lower face to be repositioned. This approach can be particularly useful for more pronounced changes to the cheeks, midface and jawline.

A mini-facelift generally refers to a more limited procedure. It may be considered for earlier or less pronounced changes to the lower face and jawline. A smaller procedure, however, does not automatically mean a more natural result. Where more extensive changes are present, a limited approach may not adequately address them.

A mid-facelift focuses more specifically on the midface. The emphasis is on descended tissue in the cheek area and the transition between the lower eyelid and the cheek. Depending on the starting point, treatment of the midface can be performed on its own or as part of a more comprehensive facelift.

For this reason, these different approaches are not in competition with one another. The name of a technique does not determine the quality of a facelift. What matters is which anatomical structures need to be treated, and which surgical approach is suited to that.

Face and Neck as One Unit

The boundary between face and neck is fluid.

Changes along the jawline are often directly connected to changes in the neck. If only one area is considered, a transition can result that does not sit harmoniously with the rest of the face.

For this reason, when planning a facelift, we always assess the contours of the chin, jawline and neck together.

Depending on the starting point, a facelift can be combined with targeted treatment of the neck. This may take skin, fat tissue and deeper structures into account.

Not every facelift automatically requires extensive neck lifting. The extent depends on individual anatomy and on which structures are actually affected.

If your main concern relates to the neck and the contour between the chin and neck, you can find more detailed information under Neck Lift.

If a facelift has already been performed and the existing result is to be corrected or further refined, different anatomical conditions apply. You can read more about this under Revision Facelift.

Complementary Treatments

Not every change in the face can be addressed by a facelift alone.

Changes to the eye area and the upper face may require their own treatment approaches. Depending on the starting point, an upper or lower eyelid lift, a brow lift or a forehead lift can form part of a broader treatment concept.

Volume loss also changes the proportions of the face. A fat transfer to the face can be used to restore lost volume in a targeted way and soften certain transitions. Changes around the upper lip can be addressed independently through a lip lift.

Where the primary concern is skin quality rather than tissue position, biostimulators or a broader regenerative facial rejuvenation concept may be more appropriate, and smaller volume changes can sometimes be addressed with dermal fillers rather than surgery.

Changes in the lower face are, in turn, often closely connected to the neck. Depending on anatomy, a neck lift can therefore make sense.

Combining several procedures, however, is not automatically necessary. What matters is which changes genuinely belong together, and which treatment is meaningful in achieving a balanced overall result.

Naturalness Comes From Depth

A natural facelift does not come from doing as little as possible. What matters, rather, is treating the right structures.

If deeper ageing changes are addressed mainly through tension on the skin, an unnaturally tightened appearance can result. If, instead, the deeper tissue layers are precisely repositioned, the skin can follow the new contours more naturally.

The aim, therefore, is not maximum tightening. It is about allowing contours to appear clearer again, without changing the characteristic features of the face.

The eyes, mouth, expression and individual features should continue to belong to you.

A successful facelift should not reveal how much has changed. It should preserve what makes your face yours.

Healing & Results

A facelift, too, develops over time.

Swelling and bruising are part of the early healing phase and gradually subside. In the first weeks, the face may feel unfamiliar or tight as the tissue adapts to its new position.

As healing progresses, contours become clearer and the result appears more natural. Scars also change over several months and become increasingly inconspicuous.

How quickly the final result develops depends on the extent of the procedure, tissue quality and individual healing response.

A facelift does not stop the natural ageing process. The face will continue to change after surgery.

The aim, therefore, is not to stop time. It is to change the position and contours of the tissue, and to create a result that continues to develop naturally with you.

Consultation

A facelift begins with understanding what has changed in your face, and what you want to preserve.

During your consultation at Clinic Selnau in Zürich, we take time to assess your facial anatomy, skin quality and the changes across the different tissue layers. The cheeks, jawline, neck and adjacent areas are considered together.

We discuss which changes concern you, and which of these can meaningfully be addressed through a facelift. Equally important is the question of which features define your expression and should remain unchanged.

On this basis, a treatment plan is developed that is guided by your anatomy, not by a standardised facelift technique. We discuss which surgical approach makes sense, and whether individual areas should be treated together.

We also speak openly about what result can realistically be expected, how the healing phase unfolds, and what limitations and risks need to be considered.

The aim is not to design a younger face.

It is to treat the changes of time in a way that lets your contours appear clearer again, while your face remains unmistakably yours.