Finding a facelift surgeon feels manageable at first. You search, you find names, you look at a few before-and-afters, and you think you have a shortlist. Then you start reading more carefully and realize there's a lot you weren't accounting for.
Facelift surgery is one of the most technically complex procedures in cosmetic surgery, and the range of skill and training among surgeons who perform it is wider than most people expect.
Choosing well requires knowing what to actually look for, beyond just a board certification and a decent website.
Portland has a number of plastic surgeons offering facelift procedures, which makes the evaluation process both easier and harder.
Easier because there are options. Harder because more options mean more noise to sort through. Here are four things that genuinely matter.
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1. Fellowship Training Beyond Board Certification
Board certification in plastic surgery is the baseline. It tells you that a surgeon completed an accredited residency and passed the relevant examinations.
What it doesn't tell you is whether that surgeon sought out additional advanced training after residency, specifically in aesthetic surgery.
That extra step, a fellowship year dedicated solely to cosmetic procedures, is where surgical judgment gets refined in ways a standard residency simply doesn't provide.
For anyone exploring a facelift in Portland, this distinction is worth raising directly in a consultation rather than assuming every board-certified surgeon has the same depth of training.
Only a small number of surgeons nationally complete ASAPS-endorsed aesthetic fellowships each year.
Practices like Matthew Lewis MD are built around that level of specialization, making it a reasonable benchmark to use when comparing your options.
The credential gap between someone who pursued that extra training and someone who didn't tends to be most visible in how complex cases are handled and how results hold up over time.
2. A Surgical Approach That Addresses the Deeper Layers
Not all facelifts are the same. Surface-level skin tightening and a SMAS facelift, which addresses the deeper muscular and fascial layers beneath the skin, produce fundamentally different results and last for very different lengths of time.
The SMAS layer is where the structural changes of aging actually happen, and repositioning it is what creates a natural, long-lasting rejuvenation rather than the pulled, overdone look that comes from skin tension alone.
When you're evaluating a surgeon, ask directly what technique they use and why.
A surgeon who can explain the reasoning behind their approach in plain language, not just use the right terminology, is demonstrating something important about how they think and how they'll communicate with you throughout the process.
According to the American Society of Plastic Surgeons, facelift procedures increased 8 percent in 2023, with patient demand for natural-looking, lasting results cited as a key driver of that growth.
Technique selection is the biggest variable in whether those expectations get met.
3. Before and After Photos That Reflect Your Situation
Every surgeon has a photo gallery. The useful question isn't whether the photos look good. It's whether those photos are relevant to you.
Look for patients with similar age ranges, skin quality, and facial structure. Look for consistency across multiple cases, not just a handful of standout results.
And look specifically for what the photos are showing: natural movement preserved, features that look refreshed rather than altered, and jawlines and necks that appear cohesive rather than disconnected from the rest of the face.
A gallery that shows a range of cases with consistently natural outcomes tells you more about a surgeon's skill and judgment than a few dramatic transformations.
The goal of a facelift done well is for people to say you look great without being able to say exactly why. Photos that reflect that outcome are the ones worth paying the most attention to.
4. Honesty About What a Facelift Can and Can't Do
A surgeon worth trusting will tell you when a procedure isn't the right fit for your situation.
That sounds obvious, but it's rarer than it should be. Some patients who come in seeking a facelift would be better served by a combination of less-invasive treatments.
Some come in expecting a facelift to address concerns that fall outside what the procedure actually corrects.
A good surgeon identifies those gaps and tells you, even if it means recommending a smaller or different procedure than what you asked for.
In practice, the consultation is where this honesty either shows up or doesn't. Pay attention to whether the surgeon is asking about your goals and anatomy or mostly pitching procedures.
A surgeon focused on what will genuinely benefit you tends to produce better outcomes than one focused on filling a surgical schedule.
That distinction in approach is one of the clearest signals you can get in a consultation room.
Putting It Together
Choosing a facelift surgeon comes down to four practical filters: advanced fellowship training, a technique that addresses structural ageing rather than just skin surface, a willingness to be honest about what's right for your situation, and a gallery that consistently reflects the kind of result you're actually hoping for.
None of those filters requires a medical background to apply. They just require asking the right questions and paying attention to how they get answered.
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