Preservation Facelift: Everything you need to know

Are you considering a facelift and unsure which technique is right for you? Have you heard about the Preservation Facelift but aren’t clear on how it differs from a traditional facelift or a Deep Plane Facelift?

Do you want natural results that don’t look “operated,” and allow you to return quickly to your normal routine?

The Preservation Facelift is the latest evolution of the Deep Plane facelift. It is designed to rejuvenate the face with a shorter recovery period and a more natural, long-lasting outcome.

Developed by leading global facelift surgeons—Dr. Bray, Dr. Gordon, Dr. Gualdi, Dr. Nayak, Dr. Talei, and Dr. Roskies—and described in the study “Limited Delamination Modifications to the Extended Deep Plane Rhytidectomy: An Anatomical Basis for Improved Outcomes”, this technique significantly reduces skin undermining while preserving the fibrous septa that link skin and SMAS.

By doing so, it protects the anatomical unity of skin and SMAS (kept together as a “composite flap”), as well as the associated lymphatic vessels and capillaries.

The result? Significantly reduced lymphatic disruption (and thus inflammation) and much lower risk of hematoma—resulting in a faster, more comfortable recovery.

Just as a Deep Plane Facelift, Preservation Facelift delivers:

• Natural results
• Maximum correction of the nasolabial folds and definition of the jawline
• Long-lasting effects
• Less complications than a SMAS facelift

In addition, it brings these key advantages:

• Faster recovery
• Reduced inflammation and bruising
• Lower risk of visible scarring
• Minimal discomfort—thanks to a more respectful technique
• Less need for drains
• Enhanced neck definition

The Preservation Facelift is an advanced refinement of the Deep Plane technique, which itself is a leap forward from traditional SMAS facelifts.

Today, it’s widely recognized as the most advanced technique for natural facial rejuvenation.

The difference between a Preservation Facelift and a traditional SMAS lift is significant — like comparing a horse-drawn carriage to a Formula 1 car.

• In a SMAS facelift, the retaining ligaments are not released, limiting tissue repositioning and increasing the risk of visible scars.
• In a Deep Plane Facelift, the retaining ligaments are always released, allowing more natural repositioning of tissues.
• The Preservation Facelift takes this further — it respects facial anatomy even more, reducing complications, shortening recovery, and achieving superior results, especially in the neck.

Both techniques use a deep plane approach to address facial sagging. The key difference lies in how much skin is undermined—something that greatly impacts recovery.

With its minimally invasive approach, the Preservation Facelift achieves tissue repositioning through a unified composite flap, preserving skin, subcutaneous fat, and SMAS as one piece.

This significantly reduces what are known as “dead spaces”—areas where fluid (seromas) and blood (hematomas) can accumulate, inevitably slowing recovery.

This is particularly relevant for the neck area, which is why the Preservation Facelift has become a true revolution in neck rejuvenation.

Moreover, it significantly reduces tension at suture lines, minimizing the risk of hypertrophic scarring.

One of the major advantages is enhanced respect for facial anatomy, resulting in outcomes that are more natural, harmonious, and long-lasting.

By keeping the skin, fat, and SMAS together as a single unit (“composite flap”), artificial stretches that cause a “mask-like” effect or “sweep deformities” are avoided.

Additionally, because lymphatic vessels are preserved, recovery is faster and more comfortable, with results lasting over 10 years in most cases.

Yes, absolutely, thanks to its more anatomically respectful approach.

However, there are a few nuances to consider.

If you have already had a traditional facelift (such as a SMAS lift), it is possible to perform a Preservation Facelift (or a classic Deep Plane facelift) as a secondary procedure, because they work on different anatomical planes.

Two key points must be considered:

1. The anatomy is no longer untouched. The tissues have been manipulated before, which can mean more fibrosis, possible adhesions, and increased surgical difficulty.

2. The technique must be adapted. I often see patients for secondary facelifts, and in most cases, they do not know exactly which technique was performed in their first procedure. Which is completely normal. However, it means each case is unique, and only experience allows for correctly identifying the planes and avoiding complications.

The good news? In expert hands, a secondary Preservation Facelift can significantly improve previous results and, above all, restore the natural appearance if it was lost after the first facelift.

The Preservation Facelift is a more advanced and complex technique that requires:

• Specialized training
• Exclusive dedication
• Advanced experience
• Expert surgical skill

For this reason, the price will always be higher than conventional techniques such as SMAS facelifts or mini-lifts.

Estimating a price range is difficult, as it depends greatly on:

• The surgeon’s experience
• The city or clinic
• Whether it is combined with other procedures (blepharoplasty, neck liposuction, etc.)
• The complexity of the case (secondary procedures usually cost more)

The Preservation Facelift follows the classic facelift incision pattern but is less invasive, with minimal tension on the skin, improving scar outcomes.

Here is my approach:

• Preauricular hairline incision using a trichophytic technique to preserve hair follicles.
• Extends along the natural crease in front of the ear (pretragal or retrotragal).
• Continues around the ear lobe and behind the ear.
• Occasionally, a submental incision is added for neck work.
• Hidden scalp incisions may be made when repositioning the brows.

The key to virtually invisible scars? Deep tissue repositioning avoids unnecessary skin tension, keeping sutures discreet and scars minimal.

• Jawline: redefines and tightens the lower face
• Nasolabial folds: smooths lines between nose and mouth naturally
• Neck: tightens muscles and addresses glandular hernias if necessary
• Midface: elevates the cheek slightly while preserving natural volume

It’s not about removing wrinkles or stretching — it’s about repositioning tissues where they were originally.

Absolutely. Minor procedures, such as upper and lower blepharoplasty, lip-lift, buccal fat pad removal or chemical peels can be done simultaneously to enhance harmony. Dermal fillers are used only as a complementary step, if needed — most cases require no fillers, as restoring the fallen tissues naturally recovers lost volume.

Much more manageable than with traditional facelifts.

• Preservation of lymphatic vessels
• Minimal skin undermining
• Reduced swelling and bruising
• Less pain and shorter recovery

Most patients recover within 2–3 weeks. At 10 days, visible improvements appear, and by 15 days most can resume social activities (with makeup if desired).

Compared to more aggressive techniques, the postoperative period is much gentler — physically and emotionally.