In a digital era overflowing with trending cosmetic procedures—from thread lifts to deep-plane facelifts—patients are more confused than ever about what truly works. Social media highlights “miracle lifts,” celebrities showcase impossibly smooth jawlines, and marketing promises quick transformations without downtime. But according to renowned facial plastic surgeon Dr. Amir Karam, not everything that’s popular is effective—and some techniques may actually make you look worse.

At EstetikTV, we break down medical aesthetics with clarity and accuracy. Below is our expert review of Dr. Karam’s insights, revealing which facelift procedures deliver real, anatomical rejuvenation—and which ones are little more than expensive gimmicks.

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Why Many Facelifts Fail: The Anatomy Behind Aging

A youthful face forms a balanced heart shape, with lifted cheeks and a refined jawline. Over time, the fascia (the supportive layer beneath the skin) elongates. This causes the skin, fat, and underlying muscle to drift downward, creating a longer, rectangular shape.

Any facelift that doesn’t address this deeper structural descent is destined to fail—or worse, produce unnatural results.

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⭐ Procedure-by-Procedure Ranking (0–10)

(Based on natural outcome, longevity, anatomical accuracy & safety)

1. Thread Lifts — 0/10

“Bottom of the barrel.” – Dr. Karam

Thread lifts promise a surgical result without incisions by inserting barbed sutures under the skin. Sounds ideal—until you look at the science:

• Threads do not lift fascia, only the superficial tissue.

• Barbs fail to hold; results can collapse within 3–6 months.

• Patients are left with no improvement, visible irregularities, and foreign material under the skin.

Best for:
No one. Even young patients gain no lasting benefit.

EstetikTV Verdict:
High risk, no reward. Not a recommended anti-aging solution.

2. The Liquid Facelift — 1/10

Using fillers to “lift” the face was once considered innovative. Dr. Karam, who previously trained physicians in filler techniques, acknowledges this trend—then explains why it fails:

• To lift sagging tissue with volume, injectors must overfill the midface, creating the “pillow face” or avatar look.

• Filler masking along the jawline only makes the face look heavier.

• Long-term filler buildup leads to distortion, fibrosis, and can complicate future surgery.

Best for:
Only tiny enhancements—lips, fine lines—not actual lifting.

EstetikTV Verdict:
Great for contouring, terrible for lifting. Proceed with caution.

3. Isolated Neck Lift — 1–2/10

Many patients fixate on their neck, believing the problem is isolated. Dr. Karam explains the opposite:

• The neck ages because the platysma muscle loses support from above.

• If the face isn’t lifted, the neck will sag again—often faster and more noticeably.

Best for:
Patients in their 20s–30s with genetic fullness or fat under the chin, not laxity.

EstetikTV Verdict:
Not appropriate for age-related sagging. Works only for select young candidates.

4. Mini Lift / Micro Lift — 2–3/10

Born from the fear of looking “pulled,” mini lifts offer a conservative approach. But less is not more:

• Limited repositioning of deeper tissues

• Short-lived results

• Often leads to a repeat facelift within years

Best for:
Those wanting minimal downtime, knowing results will be modest and temporary.

EstetikTV Verdict:
Doesn’t address the true cause of aging. Not ideal for long-term rejuvenation.

5. SMAS (Traditional) Facelift — 5/10

Introduced in the 1970s, the SMAS facelift replaced the early “skin-only” approach. While historically important, it has major issues:

• Tissues are repositioned horizontally, not vertically

• Can create a wind-tunnel effect

• Provides better durability than mini lifts—but often unnatural aesthetics

Best for:
Still widely performed, but outdated compared to newer techniques.

EstetikTV Verdict:
Reliable but cosmetically limited. Most patients now seek more natural options.

6. Brow Lift (Traditional vs. Lateral) — 3/10 vs. 8–10/10

Older brow lifts raise the entire forehead, often producing:

• Over-elevated brows

• A surprised expression

• Altered facial identity

Modern understanding shows only the lateral brow descends with age. Dr. Karam exclusively performs lateral brow lifts, restoring a natural, refreshed contour without the “wide-eyed” look.

Ratings:

• Traditional brow lift → 3/10

• Lateral brow lift → 8/10 (alone)

• When combined with full facial rejuvenation → 10/10

EstetikTV Verdict:
One of the most powerful yet subtle enhancements—when done laterally.

7. Deep Plane Facelift — 9/10

The new gold standard.

The deep plane facelift has surged in popularity—rightfully so. It addresses the real anatomical source of aging by releasing the ligaments and lifting the facial fascia vertically, not horizontally.

Why it works:

• Repositions facial structures without tension

• Restores the midface—something SMAS techniques cannot do

• Produces more natural, youthful results

• Long-lasting due to extensive ligament release

• Better scars thanks to low-tension closure

The challenge?
It requires advanced surgical skill and in-depth anatomical knowledge, meaning relatively few surgeons perform it at a high level.

EstetikTV Verdict:
The most comprehensive, natural-looking facelift available today.

Final Takeaway: What Truly Makes You Look Younger

Facial rejuvenation isn’t about pulling skin tight—it’s about restoring the vertical support system of the face.

According to Dr. Karam’s 20+ years of experience:

• Temporary “quick fixes” rarely work

• Volume cannot lift a face

• The neck cannot be rejuvenated without lifting its upper anchor

• Natural results only come from vertical repositioning of the deep fascia

For patients serious about aging gracefully, the deep plane facelift—often combined with a lateral brow lift—remains the most effective and anatomically sound solution.