The surgical foundation
SMAS and deep plane — chosen by anatomy
The face ages in three dimensions — skin loses elasticity, soft tissue descends, and volume redistributes unevenly. Coherent facial rejuvenation requires structural planning that considers the midface, jawline, and neck together rather than treating the skin surface alone.
SMAS-based planning and deep plane surgery are selected according to the patient's anatomy and the degree of descent. The aim is structural correction without unnecessary tension at the skin closure. Fat grafting, brow lift, blepharoplasty, lip lift, or resurfacing are added only where they are genuinely indicated — not as routine.
A combined plan, only where indicated
Facial rejuvenation is often most coherent when structure, volume, skin quality, and selected regenerative support are planned together. That does not mean adding procedures by default. It means deciding, case by case, which elements genuinely improve the overall result and which do not need to be included. For many patients, especially those travelling internationally, a well-planned combined session can be both clinically appropriate and practically efficient.
Combined components
What is typically included
The components below represent the range of procedures that are combined with facelift and neck lift in a single session. Each is included based on individual assessment — the labels below reflect how often each component is considered in practice.
In most cases
Fat Grafting
Nano fat and micro fat — harvested from the patient's own tissue — are used to restore volume in the temples, tear troughs, cheeks, and perioral area. Volume restoration is a structural complement to the lift, not a separate step. In selected cases, SVF (stromal vascular fraction) is added for its regenerative properties alongside the graft.
Frequently combined
Blepharoplasty
Upper and/or lower eyelid surgery addressed in the same session. Upper blepharoplasty corrects lid ptosis and hooding; lower blepharoplasty addresses fat herniation and skin redundancy. Combining with facelift avoids the need for a separate recovery period and allows the periocular and midface zones to be planned as a coherent unit. For more detail, see the dedicated blepharoplasty page.
Frequently combined
Resurfacing + Biological Support
CO2 laser or chemical peeling is applied intraoperatively to improve skin texture, tone, and fine lines beyond what the lift alone addresses. This is combined with exosome, PRP, or SVF — selected based on the patient's skin condition and regenerative goals — to support healing, enhance collagen remodelling, and optimise long-term skin quality.
Selected cases
Brow Lift & Lip Lift
Brow lift — endoscopic or direct — is added when brow descent contributes to upper face heaviness and is not adequately corrected by the facelift vector alone. Lip lift (subnasal bullhorn) shortens the philtrum and restores upper lip show where elongation has occurred with age. Both are assessed individually at consultation.
Surgical approach
How the procedure works
01
Planning & facial analysis
The consultation involves a detailed analysis of the facial thirds, tissue descent, volume loss, and skin quality. Photographs and three-dimensional assessment guide the surgical plan. The combination of components to be included in the session is agreed together — the plan is specific to the patient's anatomy and goals, not a standard package.
02
Fat harvest
Where fat grafting is planned, donor tissue is harvested — typically from the abdomen or inner thighs — at the start of the procedure under the same anaesthetic. The harvest is processed into nano fat and micro fat fractions, and SVF is prepared where indicated. This sequencing ensures the graft is ready when needed during facial surgery.
03
SMAS or deep plane facelift
Incisions begin within the temporal hairline, continue around the ear, and extend discreetly behind the ear into the posterior hairline. Their placement is planned to remain as inconspicuous as possible within natural contours and the hair. The SMAS layer is addressed through plication, imbrication, or full deep plane release and repositioning, depending on the technique selected. Skin is redraped without tension and the excess is excised. Neck work — platysma plication, submental liposuction, and/or platysmaplasty — is performed concurrently where the anatomy warrants it.
04
Adjunctive procedures
Blepharoplasty, brow lift, and lip lift are performed within the same anaesthetic. Fat grafting is placed in the planned recipient zones. Resurfacing is applied to the indicated skin areas, and the biological support agent — exosome, PRP, or SVF — is applied or injected according to the plan.
05
Closure & dressing
Layered closure with fine dissolvable and skin sutures. A supportive facial dressing is applied for the first 48 hours. Drains are placed and removed within 24–48 hours. The patient is observed overnight in hospital.
Who is suitable?
Ideal candidates
Face and neck lift surgery produces the most consistent results in patients presenting with the following:
Midface and jowl descent with visible facial volume loss
Neck laxity, platysmal banding, or submental fullness
Skin with sufficient residual elasticity for redraping
Non-smoker or willing to cease smoking pre-operatively
Good general health with no uncontrolled systemic conditions
Realistic understanding of what surgery can and cannot achieve
Recovery
What to expect after surgery
Recovery after face and neck lift surgery is progressive rather than immediate. Swelling and bruising are usually most noticeable in the first 10–14 days, then settle gradually. Most patients feel comfortable being seen socially after around 3–4 weeks, although refinement continues beyond that point. Where fat grafting or resurfacing is included, the result evolves further over the following months. Scars continue to mature over time and are planned to remain discreet within natural facial contours and the hairline.
1–4 d
Hospital stay
7–14 d
Istanbul stay
3–4 wk
Socially presentable
4–6 mo
Final result
FAQ
Common questions
Both techniques work at the SMAS level rather than simply pulling skin. In SMAS-based approaches, the SMAS is plicated or imbricated — tightened and folded — while remaining attached to the overlying skin. In deep plane rhytidectomy, the SMAS-skin composite is fully released from its retaining ligaments and repositioned as a single unit. The deep plane provides greater correction of the nasolabial folds and midface, and because the skin is not under tension at closure, scar quality tends to be better and results more durable. The appropriate technique depends on the degree of descent, the anatomy of the retaining ligaments, and the overall surgical plan.
The operated appearance associated with facelift surgery is almost always the result of excess skin tension at closure — the pulled, swept look comes from treating the skin as the primary vector of correction. Working at the SMAS and deep plane level means the structural tissues bear the correction and the skin is redraped without tension. Combined with volume restoration through fat grafting, the result is a face that looks rested and coherent rather than surgically altered. This is the principle that guides the surgical plan.
Because facial ageing rarely affects only one layer. Descent, volume loss, skin quality, and periocular change often overlap, so treatment planning sometimes works best when these are addressed in a coordinated way rather than in isolation. That does not mean every patient needs multiple procedures. It means the plan is built individually, with additional steps included only where they meaningfully improve the overall result.
Face and neck lift surgery can provide a long-lasting structural improvement, but it does not stop the ageing process. How long the result remains strong varies from patient to patient and depends on factors such as skin quality, anatomy, genetics, sun exposure, and lifestyle. Fat graft retention, where grafting is included, is assessed over the first few months, while resurfacing outcomes also continue to mature over time. The aim is not to create a fixed number of years, but a result that remains balanced and credible as the face continues to age.
Most international patients plan a stay of 7–14 days in Istanbul. Consultation, pre-operative assessment, surgery, and early follow-up all take place during this visit. Depending on the extent of surgery and the adjunctive procedures added, the in-city recovery period may be shorter or longer within that range. After returning home, follow-up continues via scheduled video consultations and direct WhatsApp access. Photographs at 1, 3, and 6 months allow the result to be assessed and any concerns addressed remotely.