Assessing Rigor in Facelift Research: A Scoping Review of 20 Years of Reported Outcomes in the United States

Emphasis on clinical and patient-reported outcomes has transformed research and quality-improvement efforts, with a growing push for standardized, validated outcome measures. This scoping review aimed to evaluate whether aesthetic surgery is meeting the current scientific standard by analyzing the scientific rigor and uniformity of outcomes reported in facelift research. PubMed/MEDLINE, Embase, and Scopus were searched for US studies reporting outcomes following surgical facelifts between July 2005 and July 2025. Studies involving concurrent procedures were excluded. Study design, senior author characteristics, interventions, outcomes, measurement methods, and quality (by Methodological Index for Non-Randomized Studies [MINORS] criteria) were evaluated. Twenty-seven out of 2101 studies met inclusion criteria. Most were conducted at an academic institution (66.7%) without funding (92.6%) by a male senior author (96.3%) with a median of 21 (interquartile range, 10-34) years in practice. Retrospective designs (51.9%) outnumbered prospective (25.9%), and 48.1% were comparative. Mixed facelift techniques were described in 33.3% and unspecified in 25.9%. Clinical outcomes were reported in 70.4%, most commonly hematoma (59.3%) with only 25.0% defining measurement criteria, which all differed. Patient satisfaction was reported in 22.2%, and aesthetic outcomes in 18.5%, with validated instruments used in only 1 study for each outcome type. Most studies (63.0%) scored below the recommended MINORS thresholds for comparative and noncomparative studies (≥18 and ≥12), indicating moderate to low methodological quality. Outcome definitions and measurement methods vary substantially in facelift research. Broader use of validated instruments and standardized reporting would improve comparability across techniques and strengthen evidence-based aesthetic facial surgical interventions. Level of Evidence: 3 (Therapeutic).