Rhytidectomy (Facelift): What It Is and How It Differs from HOF
Quick facts
- Definition
- Surgery that repositions and tightens layers of the face and neck and removes excess skin, also called a facelift.
- Key structure
- The SMAS, the fibromuscular layer that supports the face, is addressed in many techniques.
- Difference from HOF
- It works through surgery, with an incision, and treats tissue laxity; injectable HOF does not remove skin or reposition layers.
- Relevance in orofacial harmonization (HOF)
- Helps recognize when the patient's laxity goes beyond what an injectable procedure can resolve.
Rhytidectomy, known as a facelift, is surgery that treats the signs of laxity in the face and neck. Instead of adding volume, it repositions and tightens the supporting layers and removes excess skin. It is an invasive procedure, performed by a surgeon, in a surgical setting, with anesthesia.
What does it treat?
With aging, the soft tissue of the face descends, fat shifts position and the supporting ligaments lose firmness. Skin becomes redundant. Rhytidectomy works on the supporting layer of the face, the SMAS, and on the skin, repositioning the tissues higher and removing the excess.
| Concern | Mechanism the surgery addresses |
|---|---|
| Laxity of the jaw area and jowl | Repositioning of the SMAS and skin |
| Double chin and neck bands | Treatment of the platysma and cervical fat |
| Deep folds between cheek and mouth | Lifting of the cheek layers |
| Excess facial skin | Excision of the excess |
Techniques vary according to the surgeon, the extent of laxity and the patient's anatomy. The common goal is for the change to be discreet and to preserve expression.
How does it differ from injectable HOF?
HOF procedures work with injectables, threads and technologies, while rhytidectomy works with surgery. The distinction matters so the patient understands what to expect.
| Aspect | Rhytidectomy | Injectable HOF |
|---|---|---|
| Nature | Surgical | Minimally invasive |
| Main problem | Laxity and excess skin | Volume, contour, lines, skin quality |
| Recovery | Weeks | Days |
| Permanence | Long, but aging continues | Temporary |
| Risk | Surgical and anesthetic | Vascular, swelling, bruising, asymmetry |
Biostimulators and thread lifts can improve firmness in mild to moderate laxity, but have limited reach. When laxity is pronounced, the patient is usually frustrated when trying to resolve it with injectable products alone, and adding volume can worsen the look.
How do you recognize the patient who needs surgical assessment?
Common signs: evident excess skin when gently pulled upward, marked platysmal bands at rest, significant loss of jaw definition with loose skin, and a history of treatment attempts without satisfactory response. A good way to test is the gesture of lightly lifting the skin with the hands in front of a mirror: if the visual gain is large, the structure and the excess skin are the main problem, not the volume.
Also called: facelift, facial plastic surgery, facial rejuvenation surgery (popular use).
Frequently asked questions
Can filler and biostimulators replace a facelift?
No. They can improve volume, contour and skin quality in selected cases, but they do not remove excess skin or reposition structures the way surgery does.