Facelift in Seoul: SMAS Lifting for Natural Renewal

What is a facelift?

A facelift, or rhytidectomy, is surgery that addresses sagging in the lower two-thirds of the face and the upper neck. As we age, the soft tissue of the cheeks drifts downward, the jawline loses its crisp edge and jowls form, the folds from nose to mouth deepen, and the neck loosens. These changes happen mostly in the deeper layers, not just the skin.

That is why a modern facelift works beneath the skin. Rather than stretching the surface, which can produce a tight, windswept look, it lifts and secures the underlying support layer, then lays the skin back over it with little tension. The skin follows the deep tissue, and the face keeps its natural movement and expression.

Who is a good candidate for a facelift?

A facelift may suit you if you have:

• jowls that blur the jawline;
• deepening nasolabial folds caused by descent of cheek tissue;
• loose skin and soft tissue under the jaw and in the upper neck;
• realistic expectations and good general health, with conditions such as high blood pressure or diabetes well controlled.

It may not be the right choice if your main concern is fine surface wrinkles or skin texture, which respond better to skin treatments; if laxity is still mild, when a mini facelift or thread lift may be enough; or if you smoke and cannot stop. Some people are also better served by first restoring lost volume. An honest assessment of which layer has changed is where every plan begins.

How Dr. Kim designs a facelift at Will Be

At Will Be, Dr. Kim Jun-young personally sees you at consultation, designs the lift, performs the operation and carries out every follow-up. There is no hand-off to another surgeon at any stage. In facelift surgery, where the direction and amount of lift are judged in millimetres on each side of the face, that continuity matters.

Design begins with how your face has changed, not with a standard procedure. Dr. Kim studies older photographs where helpful, notes asymmetries, and looks at how the cheek, jawline and neck move when you speak and smile. He then chooses vectors, the directions in which tissue will be lifted. For most faces these are more vertical than horizontal, because ageing tissue has mainly descended. A predominantly sideways pull tends to flatten the face and widen the mouth, which is part of what gives some facelifts an unnatural look.

Incisions are planned to follow natural contours in front of and behind the ear and into the hairline, with attention to preserving the sideburn and hairline position.

The anatomy: SMAS and retaining ligaments

Beneath the skin and fat of the face lies the SMAS, the superficial musculo-aponeurotic system. It is a continuous fibrous and muscular sheet that connects the facial muscles and supports the fat above it. In the neck, it continues as the platysma, a thin sheet of muscle. When the SMAS loosens and descends, the cheek fat moves with it, which creates jowls and heavier folds.

The face is anchored to the underlying bone by retaining ligaments, tough fibrous bands such as the zygomatic ligaments over the cheekbone and the mandibular ligaments along the jaw. With age, tissue sags around these fixed points. If a lift pulls on the SMAS without releasing the relevant ligaments, much of the tension is wasted, and the result can fade quickly.

In an SMAS facelift, Dr. Kim elevates the skin over a planned area, then either lifts and folds (plication) or partially removes and re-sutures (SMASectomy) the SMAS, or elevates it as a flap and releases key ligaments where needed. The deep layer is fixed in its new position with durable sutures. Only then is the skin redraped and excess trimmed, with minimal tension on the closure. Where the neck is involved, the platysma can be tightened as part of the same procedure.

How to prepare

Preparation for a facelift begins at consultation, where Dr. Kim reviews your medical history, medications and previous treatments. Stop smoking and nicotine products for several weeks before and after, because nicotine narrows the small vessels that nourish lifted skin and increases the risk of delayed healing. Blood thinners, aspirin, some anti-inflammatories, fish oil, vitamin E, ginkgo and similar supplements may need to be paused under medical advice to reduce bleeding and bruising. If you colour your hair, doing so about a week before surgery is sensible, since you will need to wait several weeks afterward.

Pre-operative tests are reviewed before the day. Arrange a companion to take you back to your accommodation, and prepare soft foods, extra pillows so you can sleep with your head raised, and cold packs. If you have had fillers, threads or earlier surgery in the area, tell Dr. Kim exactly what and when; these change tissue planes and affect planning.

Anesthesia and surgery time

A full facelift usually takes around three hours, depending on whether the neck is included and whether additional procedures are combined. It is performed under general anesthesia or deep IV sedation with continuous monitoring throughout, and you are observed closely as you wake. Small drains may be placed for a day to reduce fluid collection, and a light compression dressing supports the tissues at first.

How long does facelift recovery take?

• Days 1–2: tightness, swelling and mild discomfort. Drains, if used, are usually removed.
• Days 10–14: sutures are removed in stages. Bruising moves down toward the neck and fades.
• Weeks 2–3: many patients feel comfortable in public with light makeup; numbness around the ears is normal.
• Weeks 3–4: most return to social life and work; exercise is reintroduced gradually.
• Months 3–6: residual swelling, firmness and sensation changes continue to settle; scars mature over a year.

The facelift recovery guide explains each stage in more detail.

Risks and how they are minimised

Facelift risks include hematoma (a collection of blood under the skin), infection, prolonged swelling, numbness, visible or widened scars, hair loss near incisions, skin healing problems, asymmetry, and injury to branches of the facial nerve, which is uncommon and usually temporary but can occasionally be long-lasting. Results also do not stop ageing; the face continues to change.

Dr. Kim reduces these risks by careful blood-pressure control around surgery, meticulous control of bleeding, working in anatomically defined planes where the facial nerve branches are protected, keeping tension on the deep layer rather than on the skin, and precise incision placement. Stopping smoking and following aftercare closely are two of the most important things a patient can do.

How long does a facelift last?

For many patients, the improvement from an SMAS facelift remains visible for many years, often around seven to ten, though individual results vary with skin quality, bone structure, weight changes, sun exposure and genetics. The clock is not reset; ageing continues from a better starting point. Protecting the result with good skin care, sun protection and a stable weight helps, and many patients find that small maintenance treatments over the years keep the face in harmony.

Combinations to consider

A facelift is often combined with an endoscopic forehead lift for heavy brows, with eyelid surgery, or with PRP micro fat grafting to restore lost volume, since lifting repositions tissue but does not replace what has thinned. Dr. Kim will advise whether combining is sensible for your health and operating time.

Staying in Korea as an international patient

For this procedure, most international patients plan to stay in Seoul for around 14 days. This allows for drain and staged suture removal and at least one review after the major swelling has begun to settle. Flying earlier is not usually recommended, because swelling can increase on long flights and because it is important that Dr. Kim sees the healing tissue himself before you leave.

Choose accommodation close to Sinsa so that follow-up visits are a short, easy journey. Build a few genuinely restful days into your plan, and bring a scarf, a hat and loose clothing that opens at the front. The page on how long to stay in Korea helps with planning, and after you return home, Dr. Kim continues to review your progress through photographs and messages as described in follow-up care abroad. Because one surgeon follows you from consultation onward, the person reading your photos is the person who operated.