Evolution of Rhytidectomy: A Review

Facial aging involves progressive changes to the skin, soft tissue, and skeletal framework, driven by genetic, social, and environmental factors. Rhytidectomy, or facelift surgery, has developed from simple skin excision to anatomically based techniques that reposition deeper tissues, restore volume, and enhance natural contours. The purpose of this review is to discuss the history of rhytidectomy, key anatomical foundations, and surgical techniques. Surgical approaches covered include subcutaneous, superficial musculoaponeurotic system (SMAS) manipulation, and deep plane procedures. Rhytidectomy remains a cornerstone of facial rejuvenation, with continuous refinements aimed at improving durability, minimizing risk, and achieving natural, patient-specific outcomes.