Facelift Disasters – Why They Happen and How to Avoid One

Avoid bad facelift

Magazines often feature stories about facelift disasters – disastrous facelift results.  This really is news, because in a major satisfaction survey, after one year, 97.8% described their results as “very good or beyond expectations.”  Even after 12 years, 61% still felt that way.


Editor’s Note: Dr. Brian Machida is a double-board certified plastic surgeon practicing in metro Los Angeles. He taught facial plastic surgery for years at the University of Southern California.  He can be reached at Second to Creation Plastic Surgery in Ontario, CA, part of California’s Inland Empire (see Contact below).


All the media attention on “facelift disasters” can give the wrong idea to people who are considering the many advantages of improving their looks.  Still, as we can see, they clearly do happen sometimes.  And some patients, while not experiencing “disaster,” are not completely happy with their results.  We’ll consider the answers to these questions:

  • What’s behind many of these problems?
  • How can you be sure to get the look you want and avoid the kind of results you don’t want?

The basis of many unsatisfactory facelifts

Patient 4 Before & After (Dr. Machida)Problems can occur if your surgeon doesn’t have the level of experience necessary to do a good job with the procedure you need.  Industry statistics show that the average plastic surgeon, who works on the entire body, may perform only 15 to 17 facial plastic surgeries in the average year.  In contrast, a number of my colleagues and I have each performed more than 2,500 facelifts in our careers.  Practice really does make a difference.

For example, the once popular Deep Plane facelift can provide outstanding results.  But it is a very demanding operation with a steep learning curve that requires a highly experienced surgeon.  If the surgeon does not perform it regularly enough, there is higher risk of damage to the facial nerve.  .

Patient 4 RS Before & After (Dr. Machida)The SMAS facelift targets a layer of tissue that covers, surrounds and attaches to the deeper tissues and structures of the face and neck.  It’s attached to the platysma, the superficial muscle covering the lower face and neck.  The SMAS layer underlies the entire cheek area.

Tightening the SMAS and the underlying muscles effectively lifts and rejuvenates the face.  Once the surgeon removes the excess skin, the new look can “turn back the clock” 10 years or even more.  Unlike the “windblown” look that less experienced surgeons or other techniques may produce, the effect can be very natural and attractive.  In the right hands, the SMAS facelift can provide reliable, excellent results.

Promising more and delivering less

Another source of unsatisfactory results (though not the disasters featured in the media) is selecting an inappropriate procedure.  It’s the surgeon’s responsibility to tell the patient exactly what it will take to achieve their (realistic) goals.

But in some areas competition is stiff.  It can be very tempting to allow a patient to believe that a lower-cost Mini Lift will give them the look they want when they really need a full facelift.  True candidates for less expensive Mini Lifts are primarily people whose facial aging is just past the point where non-surgical treatments can help.

Turkey NeckSo, if you have a double chin, a “turkey neck” or excessive neck fullness and your surgeon recommends a Mini Lift, ask:

  • What will you do to correct the laxity (or fullness) in my neck?
  • Will you tighten my platysma?

If your surgery will not address these areas, you would probably be happier with the results a different surgeon would provide.  It’s better for the doctor to under-promise and over-deliver than the other way around.

“Nightmare” Prevention

Effect of cigarettes on face-CUMany “plastic surgery nightmares” publicized in the national media appear to come from two main sources:

  1. Problems in the healing process
  2. Too many procedures

Both of these can often be avoided by better communication with your surgeon.  If you smoke, have diabetes, or are on blood thinners, be sure to tell your doctor.  All of these can get in the way of good healing, which could lead to a “nightmare.”  If the surgeon takes the right precautions regarding healing, you’re already halfway to good results.

Many of the “plastic surgery nightmares” I’ve seen result from too many procedures.  Again, here is where honest communication is crucial.  Patients who expect miraculous results are likely to be disappointed if their procedure results in anything less.  They may visit another surgeon.

Unfortunately they always manage to find someone willing to take their money and perform one more surgery.  But too many procedures can leave a face looking worse than not having needed work performed.  This can result in the “nightmare” photos we often see.

Realistic expectations, and consulting with an experienced, skilled, honest and straightforward plastic surgeon can make the difference between a disappointing result and getting the new look you really want.

Patient 4 Before & After (Dr. Machida)

Feature Photo (at top):  Renowned Italian fashion designer Donatella Versace at TIME 100 – photo by David Shankbone

About Dr. Brian Machida, MD, FACS

Dr. Brian K. Machida, MD, FACS is a double board certified facial plastic surgeon. He has an exceptional level of experience, having performed ( read more )

Articles by Dr. Brian Machida, MD, FACS

Neck Lift Without Facelift – How Well Does It Work?

Can you get good results from a neck lift without facelift surgery? See what an expert facial plastic surgeon who taught for years at the University of Southern California’s medical school recommends. [Read More]

Need a Platysmaplasty – Neck Lift – with Your Facelift? Not Necessarily

If you have both face and neck aging, you may have heard you need both a facelift and a neck lift. What if a facelift could give you a much younger-looking face and neck without a platysmaplasty? An expert Inland Empire California facial plastic surgeon shows you how. [Read More]

How to Make a $24,000 Beverly Hills-Quality Facelift Cost Much Less

How much should an outstanding facelift cost? A highly experienced facial plastic surgeon, who performed 4,000 facelifts and taught at the University of Southern California, shows how the right surgeon using the right methods can make a great facelift much more affordable. [Read More]

Nasolabial Folds – Can You Improve Smile Lines for Years?

Can you improve nasolabial folds long-term? An expert facial plastic surgeon shows how to improve smile lines for years. [Read More]

Is the Mini Lift or Mini Facelift Cost Really a Bargain?

Can a mini facelift really make you look younger? Is the mini facelift cost worth the money? How much does a mini lift cost? Who’s a good candidate? Highly experienced, board-certified facial plastic surgeon Dr. Brian Machida provides the answers. [Read More]

Want the Best Facelift? Small Innovations Can Improve Your Results

The best facelift is a combination of a great procedure by the surgeon and good healing by the patient. What can your surgeon do to help you heal better after surgery? An expert facial plastic surgeon from Inland Empire California describes some healing innovations and how they work. [Read More]

Do I Really Need Facial Plastic Surgery?

Many who want to look younger wonder if they really need facial plastic surgery. Inland Empire, California facial plastic surgeon Dr. Brian Machida, who taught for years at USC’s Medical School provides some key factors in determining whether you need a surgical procedure. [Read More]

Need a Facelift?  Who’s Not a Good Candidate for Plastic Surgery?

If you’ve got wrinkles, deepening nasolabial folds, and marionette lines you might want to consider a facelift. But are you a good candidate for plastic surgery? A highly experienced expert at facial plastic surgery discusses factors that could disqualify you from getting a procedure. [Read More]

Will Laser Resurfacing Really Eliminate my Lines and Wrinkles?

If lines and wrinkles have started to appear, you probably wonder how you can reduce or eliminate them. Is laser resurfacing best? Will microneedling work? Do you need a facelift? Expert facial plastic surgeon Dr. Brian Machida, MD, FACS discusses your best options. [Read More]

A Better, Safer Facelift Smooths Nasolabial Folds and Marionette Lines that Others Can’t

People with significant facial aging, deep nasolabial folds and marionette lines want [Read More]