Effect of Age on Complications in Facelift Surgery

Facelift surgery is increasingly performed in older adults yet data on age-stratified risk remain limited.

The aim of this study was to update a previous 2011 single-surgeon series and evaluate whether advancing age, including age greater than 75 years, is associated with complications after facelift surgery.

A retrospective review was undertaken of 10 years of consecutive primary or secondary facelifts by a single surgeon using either an extended superficial musculoaponeurotic system (SMAS) or an SMAS plication technique. 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 5 strata (≤60, 60-65, 66-70, 71-75, and ≥76 years) and at dichotomous cutoffs (≥66 years, ≥71 years, ≥76 years). Multivariable logistic regression evaluated age-complication associations.

A total of 541 patients underwent facelift: ≤60 years (28%), 60-65 years (24%), 66-70 years (24%), 71-75 years (17%), and ≥76 years (7%). Major complications were rare (0.4%) and did not differ by age (P = .08). Minor complications occurred in 7.6% of patients and were not associated with age on univariate (P = .4) or multivariable analysis. On subanalysis, age was not associated with any complication (major or minor) after adjustment, including among patients older than 75 years (odds ratio, 1.82; 95% CI, 0.51-5.19; P = .3).

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.

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