What is a SMAS facelift?

Think of your skin as saran wrap loosely draped over a container. Older facelifts pulled the saran wrap tighter at the edges, which is what created that visibly tight, artificial look. A SMAS facelift lifts the container instead. The SMAS (Superficial Musculoaponeurotic System) is the fibromuscular layer beneath your skin, and it forms the structural foundation of the face. When this layer is repositioned first, the skin settles naturally on top without any tension. The result still looks like you, just rested.

Am I a good candidate for a facelift?

Good candidates are in good general health with visible signs of facial aging that nonsurgical treatments can no longer adequately address. This often looks like jowling, loss of jawline definition, or significant skin laxity. Age matters less than skin quality and anatomy, and patients range from their 40s through their 70s and beyond. A thorough consultation is the only reliable way to determine candidacy.

Will I look natural, or like I’ve had work done?

Natural. Because the lift comes from the SMAS layer rather than the skin, there is no pulled or stretched look. Dr. Armstrong plans each facelift around your own features, and her conservative approach is as important to the result as the surgical technique itself. Patients look like themselves, not done.

Is fat grafting part of the procedure?

Fat grafting is a standard part of every facelift we perform. Volume loss is just as responsible for facial aging as skin laxity, and lifting alone cannot restore it. Fat is harvested from your own body and carefully placed in the cheeks, temples, and any other areas where volume has diminished over time. We incorporate it into every facelift because the results are simply more complete.

How long does it take, and what anesthesia is used?

A facelift usually takes a few hours, depending on whether it is combined with a neck lift or other refinements. It is performed under general anesthesia so that you are completely comfortable throughout, and the exact approach will be discussed with you at consultation.

What does recovery involve?

Recovery happens in stages. For the first two days, you’ll rest with your head elevated and dressings in place. Swelling and bruising peak during the first week, then gradually fade. By week two, most patients pass what we call the grocery store test — going about everyday errands without anyone noticing they’ve had surgery. At the 30-day mark, roughly 80 to 90 percent of the swelling is gone. Results continue to improve over the following months as tissues settle and scars mature.

How long do facelift results last?

Results are shaped by several factors: the surgical technique used, skin quality, genetics, sun exposure, and lifestyle all play a role. We perform SMAS plication facelifts, folding and securing the SMAS layer onto itself to reposition the deep foundation of the face. This produces a significantly longer-lasting result than skin-only approaches and, for the majority of patients presenting with mild to moderate aging, delivers superior outcomes. A stable weight, consistent sun protection, and a medical-grade skincare regimen all help sustain the result over time.

Will scars be visible?

Incisions are positioned within the natural contours of the face — in the crease in front of the ear, around the earlobe, and behind the ear along the hairline. Because tension is carried by the SMAS rather than the skin at closure, scars heal consistently well and become progressively faint. With diligent sun protection and appropriate scar care, most are virtually undetectable by 12 to 18 months post-operatively.

Every surgical procedure carries some degree of risk. Most issues that arise after a facelift are minor and resolve with proper care. Serious complications are uncommon. Your surgeon will walk through everything relevant to your specific health history before surgery so you feel fully informed going in.

In the weeks before surgery, we provide a personalized preparation plan. This typically covers optimizing your health, pausing medications and supplements that can increase bleeding, and avoiding nicotine, which impairs healing. We’ll also help you plan the practical details — time off work, prescriptions, and arranging a ride home with some support for the first day or two.

What should I expect during the consultation?

Your consultation begins with a conversation. Dr. Armstrong wants to understand what you see and what you hope to change. She examines the area and walks you through your options with complete candour, including what surgery can and cannot achieve. You leave with a clear recommendation, realistic expectations, a personalized quote, and answers to every question you came in with.

Is the surgeon board-certified?

Yes. Dr. Katie Armstrong is a Royal College–certified plastic and reconstructive surgeon (FRCSC) with hospital affiliation in Toronto. Certification reflects years of accredited surgical training and a commitment to ongoing standards of safety and excellence.

Where is it performed?

Surgery is performed at GraceMed Mississauga, in partnership with the McLean Clinic — Dr. Armstrong’s primary practice, home to a fully accredited surgical facility and an experienced surgical team, with dedicated anesthesia care throughout. Your consultation, pre-operative appointments and follow-up care all take place at the same location: 50 Burnhamthorpe Rd W, Suite 343, Mississauga, ON L5B 3C2.

Facelift Toronto | Rhytidectomy & Neck Lift

Overview

What is a facelift?

A facelift (rhytidectomy) corrects sagging, jowls, and deep folds in the lower face by repositioning the underlying tissue and refining the skin. The result should look rested and natural, not altered.

Dr. Armstrong specializes in the SMAS plication facelift, which folds and secures the SMAS, the deep supportive layer beneath the skin, to lift and support it without pulling on the skin itself. Because the lift comes from below, the skin settles naturally and the result holds over time. Fat grafting restores lost volume, and many patients combine a facelift with a neck lift so the two areas complement each other.

The process

What to expect

Step 1
Consultation
Meet with Dr. Armstrong to discuss your goals, explore your options, and receive personalized recommendations and a detailed quote.
Step 2
Surgical planning
We confirm your procedure, select your surgery date, and provide guidance on the next steps.
Step 3
Pre-operative appointment
About one month before surgery, our RN reviews your medical history in detail and explains how to prepare for surgery, what to expect on the day, and how to manage your post-operative care.
Step 4
Surgery day
Your procedure is performed by Dr. Armstrong and her surgical team, with your safety and comfort closely monitored throughout.
Step 5
Recovery & follow-up
Dr. Armstrong and her team monitor your healing, answer your questions, and support you throughout your recovery.

Candidacy

Am I a candidate?

A facelift tends to suit patients who recognize themselves in most of the points below. The only way to know for certain is an in-person assessment, and Dr. Armstrong will confirm your candidacy at your consultation.

You notice sagging, jowls or deep folds in the lower face and neck
You are in good general health and a non-smoker (or willing to stop around surgery)
You want a rested, natural refresh — not a dramatically different face
You can set aside roughly two weeks for the visible part of recovery

Healing, step by step

Recovery timeline

Every patient heals at their own pace. This is the typical arc, and your personal plan and follow-ups are tailored to you.

Day 1
You return home the same day and rest comfortably as healing begins.
Week 1
Swelling and bruising peak, then begin to settle. Your first follow-up takes place this week.
Week 2
Most patients feel comfortable returning to social activities and desk-based work.
Weeks 3–6
Normal routines gradually resume, and early results start to come through.
Months 3–12
The result refines as the last of the swelling resolves, and the rested, natural look continues to improve.

Before & after

Facelift results

A few of Dr. Armstrong's most recent facelift results, shared with patient consent. She'll walk you through more — matched to your goals — at your consultation. Every result is individual.

Before

After

Patient 1

Facelift

Individual results may vary.

Before

After

Patient 2

Facelift

Individual results may vary.

Before

After

Patient 3

Facelift

Individual results may vary.

View the full Facelift gallery →

Your investment

Planning for Facelift

Every surgical plan is individual, and your exact quote is provided after your consultation. Starting prices are listed on our pricing page, and financing is available through our partner, Beautifi, should you wish to spread the cost over time. To begin, we invite you to book a consultation.

Facelift

What is a facelift?

What to expect

Consultation

Surgical planning

Pre-operative appointment

Surgery day

Recovery & follow-up

Am I a candidate?

Recovery timeline