What happened
Last week Barbara Corcoran, 77, opened a new season of her television show by posting photographs from before and after her facelifts, and told her followers she had decided to have one every ten years. The same week an actress recalled the advice her grandmother, a Hollywood star of the 1950s, had given her: always get a facelift before you need one. A few days earlier another actress, 66, had said she was still torn about whether to have one at all. Three women, three sentences, and together they contain the two questions I am asked most often by patients over fifty: when, and how many times.
Both questions have better answers in the literature than the quotes suggest, and the answers are more interesting than “every ten years”.
The common misconception
The misconception is that a facelift is a subscription: do it early, renew it on a schedule, and the face stays where it is. The opposite misconception is that a facelift is a single event, done once at the right moment, after which further surgery is either unnecessary or a sign that the first one failed. The data describe something in between. A facelift does not stop aging; it moves the face back along the curve and the curve continues. How far back and how fast the return depends on what was lifted, how, and in whom. A second facelift is not failure, and a schedule is not a plan.
The clinical reality
The ten years are real, and they come from data, not from a calendar. A Beverly Hills surgeon reviewed thirty years of his own revision facelifts, 93 patients who came back after a deep plane lift: the average interval between the first and the second operation was 10.9 years. A Dallas series of 811 facelifts found 60 secondary procedures at an average of 9.0 years after the first, and the ten patients who had a third did so 7.5 years after the second, with no statistical difference in durability between the first and second rounds. So “every ten years” is approximately what happens when patients are left to decide for themselves when they want more. It is a description, not a prescription.
“Before you need one” has a measurable version. In the Beverly Hills series the patients who had their first facelift at 53 or younger came back for the second after 12.4 years on average; those who were older than 53 came back after 9.3. Younger tissue holds a lift longer. The authors of the Dallas long-term review say the same from the other direction: their most durable results were in younger patients with fuller faces, and their highest relapse rates were in patients with fuller necks. There is a real anatomical reason to operate on a face that has started to descend rather than one that has finished, because the tissue that is lifted is the tissue that must hold the lift. What the grandmother’s advice does not say is that “before you need one” still means that something has moved. A face with nothing to reposition gets nothing from a facelift except scars.
The first operation decides the second. Surgeons who write about secondary facelifts describe the same inheritance: thinner, scarred skin, a deep layer that has been sutured once already, and the stigmata of the first operation, an earlobe pulled down into a point, a hairline pushed back, a lateral sweep across the cheek from skin pulled too hard. The Dallas group summarized its approach in five words, resect, release, refill, reshape and redrape: cut the old scar, free the deep layer where the first surgeon fixed it in the wrong direction, add fat where volume has gone, and only then re-suspend and lay the skin back without tension. A primary facelift done on the deep layer with the skin left loose is a primary facelift that makes the second one easier, which is one reason I do not perform skin-only lifts, and why a deep plane lift on this site is documented at twelve months rather than two.
A second facelift carries the same risks as a first, not more. That is one of the more useful findings in the Dallas series: complications in the 60 secondary patients were one seroma, one small area of skin loss and one temporary weakness of a nerve branch, 2 percent, with three minor revisions, in line with primary surgery. The 11,300-patient database I cited when writing about the menopausal face did not find age itself to be a risk factor either. The second operation is technically harder for the surgeon; it is not more dangerous for the patient, provided the surgeon has done it before.
What a second facelift cannot do is undo the first. If the first lift was skin-only, the deep layer is where it always was and the second operation becomes, in effect, a first deep plane lift on scarred skin. If the first lift pulled in the wrong direction, the second can release and redirect, but the earlobe and the hairline keep some memory of what was done. This is the one place where “before you need one” cuts the other way: an unnecessary early operation done badly uses up some of the tissue a necessary later one would have needed. The timing question and the surgeon question are the same question.
The interval is set by the face, the patient and the technique. Weight changes, sun, smoking, the thickness of the skin, how much fat was added at the first operation, and whether the neck was properly treated all move the date. A patient who maintains her weight, protects her skin and had a deep plane lift at 52 may not think about a second until her mid-sixties; one who lost 20 kilograms at 60 after a lift at 55 may be back sooner, and that is the weight loss, not the surgery. I tell patients to expect a decade, to understand that it is an average, and to come back when the face asks, not when the calendar does.
The practical takeaway for patients
If you are considering a first facelift, send photographs and ask the surgeon what has moved: the cheek, the jowl, the neck. If the answer is “nothing much yet”, you are being sold a subscription. If the answer names a structure, the operation has a job to do, and doing it on tissue that still has elasticity is an advantage.
If you had a facelift years ago and are thinking about a second, send photographs now and, if you have them, the photographs from before and just after the first one. Tell me what was done, skin-only or deep layer, and whether anything about the ears, hairline or scars has bothered you since. Those details decide the plan more than the number of years.
Do not book a second operation to a schedule. Ten years is what most patients choose when the face tells them; it is not a date to put in the diary at the first operation.
Expect the second operation to include fat, not only lifting. Faces that are ready for a second lift have usually lost volume as well as position, and fat grafting is part of most secondary plans.
Honest limits
The interval data come from two surgeons’ own practices, one in Beverly Hills and one in Dallas, and they count patients who came back; patients who went elsewhere or never returned are invisible, so the true average may be longer or shorter. The 53-year cut-off is a statistical finding in 93 people, not a threshold I would plan around. There is no randomized trial of early versus late facelift and there never will be. And a public figure’s decision to have a facelift every ten years is hers; it tells me what she chose, not what her face needed. What I have added about technique and the order of a secondary operation is how I work, and other good surgeons sequence it differently.
If you are wondering whether your face is ready for a first facelift, or for a second, send unedited photographs in daylight, front and both sides, to +90 544 772 0772. The surgical team reviews them the same day.
Dr. Mustafa Aydınol is a plastic, reconstructive and aesthetic surgeon in Istanbul and a member of ISAPS.
Sources
- The Daily Beast, 2 October 2026: Shark Tank star shares photos from before and after facelifts. Link
- People, 3 October 2026: Billie Lourd reveals the plastic surgery tip she got from her late grandmother. Link
- Levin M, Frankel A. Thirty years of deep plane facelifts: characterizing outcomes and longevity, 93 revision facelifts, mean interval 10.9 years, 12.4 years when the first lift was at 53 or younger. Facial Plast Surg Aesthet Med, 2026. DOI
- Beale EW, Rasko Y, Rohrich RJ. A 20-year experience with secondary rhytidectomy: a review of technique, longevity, and outcomes, 811 facelifts, 60 secondary, 10 tertiary, intervals 9.0 and 7.5 years, complications 2 percent. Plast Reconstr Surg, 2013. DOI
- Rohrich RJ, Narasimhan K. Long-term results in face lifting: observational results and evolution of technique, 1,089 patients over 25 years. Plast Reconstr Surg, 2016. DOI
- Hatef DA, Sclafani AP. Secondary rhytidectomy: stigmata of the primary facelift and revision principles. Semin Plast Surg, 2009. DOI
- Khoury S, Almubarak Z, Khan H, et al. The deep plane versus SMAS facelift: a systematic review and meta-analysis, 21 studies, 2,896 patients. Aesthetic Plast Surg, 2025. DOI
- Gupta V, Winocour J, Shi H, et al. Preoperative risk factors and complication rates in facelift: analysis of 11,300 patients. Aesthet Surg J, 2016. DOI
