Analysis before treatment: What has actually aged?
Every treatment begins with a thorough and differentiated analysis. The decisive factor is not a single wrinkle, but the interplay of contour, proportion, and skin quality. A youthful-looking face is characterized by:
- clear definition between the forehead, midface, and neck
- a prominent cheekbone region
- a defined jawline
- open, alert-looking eyes
- even, elastic skin without dyschromia
What a modern SMAS facelift can achieve
A surgical facelift precisely repositions sagging structures back to their original anatomical position. Particularly effective corrections include:
- improvement of the jawline and neck contour
- repositioning of sagging facial areas
- reduction of jowls
- deep structural contouring
- softening of deep nasolabial folds and marionette lines
Particularly in neck rejuvenation, there is no comparably effective alternative to a surgical lift. In our clinic, we specifically complement the neck lift with subplatysmal sutures. This further accentuates the jawline and defines the contour more clearly, creating a harmonious transition between the face and the neck.
What a facelift cannot achieve
- removal of pigment spots, actinic keratoses, and keratinization
- elimination of superficial and deep wrinkles
- improvement of the skin’s elasticity and firmness
Skin optimization as the second pillar of rejuvenation
As convincing as structural repositioning through a facelift may be, it does not automatically improve skin quality. Photodamage, elastosis, pigment irregularities, fine crepey lines, and deep wrinkles remain unaffected by lifting alone. This can sometimes create an aesthetic imbalance: a firm contour combined with an aged skin surface. This discrepancy is perceived intuitively.
Alongside the structural repositioning of sagging facial tissues and the tightening of the neck, the targeted improvement of skin quality therefore represents the second central pillar of sustainable facial rejuvenation.
Depending on the degree of wrinkle depth, elastosis, and light-induced skin damage, different treatment modalities may be appropriate. In cases of superficial textural changes and early dyschromia, modern laser treatments can effectively stimulate new collagen formation and visibly refine the skin’s appearance.
A consistently structured medical skincare regimen—particularly with retinol or prescription retinoids—improves epidermal cell turnover, normalizes keratinization disorders, and supports the dermal collagen framework over the long term. Such skincare plays an important preparatory as well as accompanying role. Even when a purely surgical lift is planned, consistent medical skincare improves the quality of the results and helps prolong their longevity. In this sense, it forms the foundation of every facial rejuvenation strategy.
For pronounced, deep wrinkles and advanced UV-induced skin damage, a deep phenol peel is the treatment of choice. This procedure leads to controlled regeneration of all skin layers with marked formation of new collagen and elastic fibers.
Which method is most appropriate — or which combination of treatments should be used — always depends on the individual starting situation. The key lies in precisely matching the procedures to the patient’s skin type, degree of damage, and desired outcome.
In our clinic, we deliberately combine most facelifts with a localized phenol peel, for example in the periorbital area or around the mouth. This allows us not only to tighten the tissues but also to visibly improve skin quality in areas where wrinkles are particularly noticeable.
The gold standard is the combination
A facelift corrects the effects of gravity. A deep peel or laser treatment improves skin quality. Medical skincare (e.g., with retinol) stabilizes and prolongs the result. Only when contour, volume, and skin surface are in harmony does a naturally rejuvenated appearance emerge—without the stigma of having undergone surgery. The combination of structural lifting and targeted skin optimization therefore represents the current gold standard in aesthetic facial rejuvenation.
