Facelift in Tijuana
SMAS rhytidectomy — the technique that repositions the deeper structural layer of the face, not just the skin. Performed by a Mexican Council-certified plastic surgeon in a hospital setting, with an individual medical assessment.
Facial rejuvenation · Surgery
- CMCPER, Mexican Council certification No. 2607
Verify his certification ↗
- Source
- CMCPER Directory (directoriocirugiaplastica.mx)
- Identifier
- CMCPER, Mexican Council certification No. 2607
- Last verified
- Jul 29, 2026
- Verified in Motiva’s official surgeon locator
- Hospital setting
- Bilingual care · ES / EN
No image on this page depicts an actual patient or clinical result. Editorial images are used for illustration only.
What it is — and what it isn’t
Restoring structure, not stretching skin
A facelift — technically called rhytidectomy — is a surgical procedure that addresses sagging in the mid-face, jawline, and neck. The key to a natural-looking result is not pulling the skin tighter. It’s repositioning the SMAS (Superficial Musculoaponeurotic System), the fibromuscular layer beneath the skin that gives the face its structural support.
When the SMAS descends with age, it pulls the overlying skin down with it — creating jowls, deepening the nasolabial folds, and loosening the neck. A skin-only lift treats the symptom (loose skin) while ignoring the cause (structural descent). An SMAS-based facelift treats the cause: the deeper layer is elevated and secured, and the skin is redraped over a restored foundation. That’s why the results are more durable and look more natural.
What it isn’t: a facelift is not a substitute for volume restoration. If your concern is primarily hollow cheeks, under-eye volume loss, or fine surface lines, fat grafting or injectable treatments may be more appropriate — and that distinction is part of your assessment, not assumed beforehand. A facelift also doesn’t address the upper third of the face (forehead, brow). Those are separate procedures that can sometimes be combined, but only when medically appropriate.
The facelift is frequently combined with a blepharoplasty (eyelid surgery) because the eyes and the lower face age together — addressing both in a single operation means one recovery period instead of two. Whether that combination applies to your case is determined in your assessment.
Technique
SMAS rhytidectomy — the structural approach
There are several variations of facelift technique, and the naming can be confusing. The distinction that matters most is whether the surgery addresses only the skin or also the deeper structural layer (the SMAS).
Skin-only lifts were the original technique. They pull the skin tighter without repositioning the underlying structure. The result tends to look taut and unnatural, and it doesn’t last — because the structure that caused the sagging is still in the same position. Most modern plastic surgeons have moved away from this approach.
SMAS-based techniques — including SMAS plication, SMAS imbrication, SMAS flap, and deep plane — all share the principle of treating the structural layer. They differ in how aggressively the SMAS is mobilized. A 2019 meta-analysis in Aesthetic Surgery Journal found statistically significant differences in complication rates between SMAS techniques — including temporary facial nerve injury, hematoma, seroma, necrosis, and infection — and concluded that technique should be selected based on the quality of results, not the complication profile alone (Jacono et al., Aesthetic Surgery Journal 2019).
An analysis of 11,300 facelift patients found an overall hematoma rate of 1.1% and infection rate of 0.3% (Gupta et al., Aesthetic Surgery Journal 2016). A 2025 systematic review confirmed hematoma remains the most common complication (27% of all reported complications), followed by unfavorable scarring (24%) and temporary nerve weakness (22%) (Fang and de la Torre, Annals of Plastic Surgery, 2025). The specific SMAS technique matters less than the surgeon’s experience with that technique.
What this means for your case: the specific technique — which variation of SMAS approach, the extent of dissection, whether to include neck work — is determined by your anatomy, your goals, and the surgeon’s judgment. Dr. Chama evaluates this in your assessment and explains exactly what he recommends and why, before you decide.
Ideal candidate
When it applies
- Visible sagging in the mid-face, jawline, or neck — the kind that skincare and injectables no longer address adequately.
- Generally good overall condition, without factors that elevate surgical risk (uncontrolled hypertension is particularly relevant for facelifts due to hematoma risk).
- Non-smoker, or willing to stop well before and after surgery — smoking significantly impairs wound recovery and increases complication risk.
- Adequate skin quality — some elasticity remaining. Very sun-damaged or thin skin may limit the achievable result.
- Realistic expectations: a facelift turns back the clock, it doesn’t stop it. You’ll continue to age naturally from a better starting point.
- Typically 45–70 years old, though candidacy depends on anatomy, not a number.
When it’s not appropriate
When it doesn’t apply
- Your concerns are primarily volume loss (hollow cheeks, thin lips) — fillers or fat grafting may be more appropriate.
- You’re looking to address only fine lines or skin texture — a facelift corrects sagging, not surface quality. Skin resurfacing is a separate discussion.
- You have uncontrolled hypertension — this is the single most significant risk factor for hematoma after facelift.
- You smoke actively and can’t stop before and after surgery — smoking impairs wound recovery, increases skin necrosis risk, and compromises the result.
- You have unrealistic expectations — a facelift produces a refreshed, more youthful version of your face, not a different face.
- You’re taking blood thinners or supplements that affect clotting — these must be stopped before surgery under medical guidance.
How it’s performed
The surgery, step by step
A facelift is performed under general anesthesia (or deep sedation in select cases) in a hospital setting. The estimated duration for your case is defined in your assessment.
Incisions: The standard incision begins in the temporal hairline, continues in front of the ear (or just inside the ear’s natural crease), curves around the earlobe, and extends behind the ear into the posterior hairline. When well-executed, these incisions recover into the natural creases and are difficult to detect once mature. If the neck requires significant work, a small incision under the chin may be added.
SMAS repositioning: The skin is elevated from the underlying SMAS layer. The SMAS is then tightened and repositioned — elevated, secured with sutures, and sometimes trimmed. This is the step that produces the structural correction. The specific technique (plication, imbrication, flap, or deep plane) depends on the degree of laxity and the surgeon’s assessment of your anatomy.
Skin redraping: With the deeper structure in its new position, the skin is redraped over it without tension. Excess skin is removed. The key principle: the SMAS carries the load, not the skin. When skin is pulled tight to do the lifting (as in skin-only techniques), it stretches back — and the result looks surgical. When the skin is simply laid over a repositioned foundation, it settles naturally.
Closure: Layered closure with fine sutures. Drains are sometimes placed to prevent fluid accumulation and are typically removed within 24–48 hours.
We don’t show images of the procedure itself — the information here is educational, not graphic. The surgical plan, type of anesthesia, and estimated duration are defined in your in-person assessment.
Recovery
Consultation
Virtual or in-person assessment of your case
Preparation
Personalized plan, labs, and pre-op instructions
Procedure
Hospital setting, Mexican Council-certified surgeon
Recovery
Follow-up in person or remotely from the U.S.
Week by week, with support
Days 1–3: Head elevated at all times. A compression bandage wraps the face and neck. Swelling and bruising are at their peak — this is normal and expected. Drains, if placed, are removed within the first 48 hours. Mild to moderate discomfort, managed with prescribed medication.
Days 4–7: Sutures and staples are typically removed between days 5 and 7. Bruising begins to fade but remains visible. Most patients feel well enough to move around at home. Sleeping on your back with your head elevated continues.
Weeks 2–3: Most patients feel ready to return to work and light activities by the end of week two (ASPS recovery guide). Residual bruising can often be covered with makeup at this point. Swelling is still present but improving daily. Numbness around the ears and jawline is common and resolves gradually.
Week 4: By the one-month mark, most patients are back to normal daily activities. The incision lines are maturing and fading. Significant swelling has resolved, though subtle swelling may persist for several months.
Months 2–3: Numbness continues to improve. The result begins to settle into its final position. You’re cleared for progressively more vigorous exercise.
Months 6–12: Incision scars continue to mature and flatten. Any remaining subtle swelling resolves. The final result is fully visible. According to Plastic and Reconstructive Surgery, three-quarters of patients still look younger than their pre-surgery appearance more than five years after the procedure (ASPS/PRS 2012).
Exact timing varies by patient. In your assessment you receive concrete instructions for your case, with follow-up in person or remote if you’re coming from the U.S.
In your consultation, Dr. Chama clearly explains the risks, the recovery, and what result to expect in your case, so you can decide with complete information.
Risks and considerations
Honesty first
The facelift carries surgical risks that you should understand before making a decision. We list them not to alarm you, but because informed consent requires it — and because choosing a surgeon who acknowledges the risks honestly is itself a protective factor.
Hematoma is the most common complication, occurring in approximately 1.1% of patients in a large analysis of 11,300 cases (Gupta et al., Aesthetic Surgery Journal 2016). Uncontrolled hypertension is the primary risk factor. Male patients have a significantly higher hematoma risk in the same series (relative risk 3.9x, Gupta et al., Aesthetic Surgery Journal 2016). A hematoma detected early is drained in the operating room; when treated promptly, it typically does not affect the final result.
Nerve injury: temporary weakness of facial muscles occurs in up to 1–2% of cases and usually resolves within weeks to months. Permanent nerve injury is rare (well below 1%) but possible. The nerve most at risk is the marginal mandibular branch, which controls the corner of the mouth. The temporal branch, which raises the eyebrow, is the second most at risk. Both are protected by careful surgical technique and knowledge of anatomy.
Skin necrosis: if the blood supply to the elevated skin flap is compromised, a small area of skin can die. This is more common in smokers — which is why stopping smoking before and after surgery is not a suggestion, it’s a medical requirement.
Other risks: infection (0.3%), unfavorable or visible scarring, asymmetry, earlobe distortion, hair loss along the incision lines, prolonged numbness, and the need for revision surgery. Scar quality depends on individual factors, skin type, and surgical technique.
If in your assessment Dr. Chama determines the procedure isn’t right for your case — for example, conditions that elevate risk, unrealistic expectations, or a concern better addressed by a non-surgical approach — that’s valuable information. We prefer to say so before surgery rather than operate without the correct medical judgment.
Results
How long does a facelift last?
A well-performed SMAS facelift produces results that are long-lasting, not permanent. A study of deep plane facelifts found that patients returned for revision surgery after an average of 10.9 years (Levin and Frankel, Facial Plastic Surgery & Aesthetic Medicine, 2026).
The facelift doesn’t stop aging — it resets the clock. You continue to age naturally from a younger-looking starting point. At five years, three-quarters of patients still look younger than they did before surgery (Jones and Lo, Plastic and Reconstructive Surgery, 2012). The jowl and nasolabial areas tend to hold their correction longest, while the neck may show earlier relapse.
We don’t publish photographs of facelift results yet. We’ll publish only results shown well after the surgical event, with patient consent and intimate-area censoring. In the meantime, in your assessment you can review cases directly with Dr. Chama.
Frequently asked questions
What patients ask us most
How long does a facelift last?
A well-performed SMAS facelift produces results that are long-lasting, not permanent. A 2026 study of deep plane facelifts found patients returned for revision after an average of 10.9 years. At five years post-surgery, three-quarters of patients still look younger than before surgery. The facelift resets the clock — you continue to age naturally from a younger-looking starting point.
How much does a facelift cost?
The price depends on the extent of surgery — whether it includes neck work, whether it’s combined with blepharoplasty, and the specific technique for your anatomy. We provide a personalized quote after your assessment. Message us on WhatsApp to start the conversation.
What is the recovery timeline?
Days 1–3: compression bandage, peak swelling. Days 4–7: suture removal, bruising fading. Weeks 2–3: most patients return to work. Week 4: back to normal activities. Months 2–3: cleared for exercise, result settling. Months 6–12: final result visible, scars fully maturing.
What is an SMAS facelift?
SMAS stands for Superficial Musculoaponeurotic System — the fibromuscular layer beneath the skin that gives the face its structural support. An SMAS facelift repositions this deeper layer, not just the skin. This produces more natural-looking and longer-lasting results because the structural cause of sagging is addressed, not just the symptom.
Mini facelift vs full facelift?
A mini facelift uses shorter incisions and addresses primarily the lower face and jawline — appropriate for mild to moderate laxity. A full facelift addresses the mid-face, jawline, and neck with more extensive SMAS repositioning. The right choice depends on your anatomy and degree of aging.
What are the risks?
The most common complication is hematoma (~1.1% in 11,300 patients). Other risks: temporary nerve weakness (1–2%), infection (0.3%), skin necrosis (higher in smokers), unfavorable scarring, asymmetry, prolonged numbness, and possible revision. All risks are reviewed in detail during your assessment.
At what age should I get a facelift?
Candidacy depends on anatomy, not a number. Most patients are 45–70. The question is whether you have structural sagging that non-surgical treatments no longer address. Younger patients with mild laxity may benefit from a mini facelift; more advanced changes may need full facelift with neck work.
Can it be combined with other procedures?
The most common combination is facelift + blepharoplasty (eyelid surgery), because the eyes and lower face age together. Some patients also combine with fat grafting or rhinoplasty. Decisions are made in your assessment based on safety.
Will it look natural?
With SMAS-based technique, yes. The “pulled” or “windswept” look comes from outdated skin-only techniques. Modern SMAS rhytidectomy repositions the deeper layer and redrapes the skin without tension — the result looks refreshed, not surgical. The goal is that people notice you look well, not that you had surgery.
Do I need to stop smoking?
Yes — this is a medical requirement. Smoking constricts blood vessels and impairs blood supply to the skin flap, significantly increasing the risk of skin necrosis and poor wound recovery. Most surgeons require stopping at least 2–4 weeks before and after surgery. Nicotine patches and vaping carry the same risk.
How visible are the scars?
Incisions are placed within natural creases — in front of the ear, around the earlobe, behind the ear, and along the hairline. When well-executed, they become very difficult to detect once fully matured (6–12 months). In your assessment, Dr. Chama shows you exactly where incisions will be placed.
I’m coming from the U.S. — how does it work?
We can answer initial questions through a bilingual virtual consultation. The assessment is in person in Tijuana. On the recovery timeline, sutures are removed on days 4 to 7 and most patients return to work in weeks 2 to 3. Post-op follow-up can be monitored remotely once you’re back home, while the scars keep maturing over months 6 to 12. How many nights to stay in Tijuana and when you can fly home are confirmed in your assessment.
Related Procedures
Schedule your virtual consultation
Your quote is personalized. Message us and we’ll guide you, no commitment.
WhatsApp +52 664 585 1602Results may vary from person to person. Consult your specialist.
Consultation
Schedule your consultation
Direct attention from Dr. Alfredo Chama's team, Mexican Council-certified plastic surgeon in Tijuana. Message us or call to schedule your appointment.
or if you prefer, directly:
Last updated: October 9, 2026
Plastic Surgery in Tijuana for U.S. Patients
Tijuana is Mexico's leading border city for medical tourism, located just across the San Diego border. Dr. Alfredo Chama serves patients from California, Arizona, Nevada, Texas, and across the United States with:
- Pre-surgical virtual consultation in English and Spanish
- Border logistics coordination — transportation from the crossing, hotel recommendations near the clinic
- Post-operative follow-up via telemedicine for patients returning home
- Surgeon certified by the Mexican Council (CMCPER No. 2607) operating in a hospital setting
The clinic is located at Plaza Península on Vía Rápida Oriente, with direct access from the international border.