Effect of Age on Complications in Facelift Surgery

BACKGROUND: Facelift surgery is increasingly performed in older adults, yet data on age-stratified risk remain limited. OBJECTIVES: This study updates a prior 2011 single-surgeon series and evaluates whether advancing age, including age greater than 75 years, is associated with complications after facelift surgery. METHODS: We retrospectively reviewed 10 years of consecutive primary or secondary facelifts by a single surgeon using extended SMAS or SMAS plication. Demographics, comorbidities, and operative details were recorded. Complications were classified as major (unplanned admission, reoperation, persistent motor nerve injury) or minor (outpatient-managed). Age was analyzed in five strata (less than 60, 60-65, 66-70, 71-75, and 76 or older) and at dichotomous cutoffs (66 years or greater, 71 years or greater, 76 years or greater). Multivariable logistic regression evaluated age-complication associations. RESULTS: 541 patients underwent facelift: less than 60 years (28%), 60-65 (24%), 66-70 (24%), 71-75 (17%), and 76 or older (7%). Major complications were rare (0.4%) and did not differ by age (p=0.08). Minor complications occurred in 7.6% of patients and were not associated with age on univariate (p=0.4) or multivariable analysis. On subanalysis, age was not associated with any complication (major or minor) after adjustment, including among patients older than 75 (OR 1.82 [0.51-5.19], p=0.3). CONCLUSIONS: In this single-surgeon cohort with strict preoperative screening and standardized management, facelift surgery remained safe across all age groups, including age greater than 75 years. Chronological age alone is therefore not an independent predictor of adverse events after rhytidectomy.