What Is a Ponytail Facelift and Do You Need One?

If you’ve ever pulled your hair up at the crown of your head and noticed the tightening effect it had on your skin, you’ve, in essence, given yourself a natural ponytail facelift. While the definition of a “ponytail facelift” varies across experts, it generally defines a minimally invasive procedure, the results of which mimic the way your face looks when your hair is slicked into a high and tight ponytail. We talked with experts to get a better understanding of this trending procedure.

What is a ponytail facelift?

You may be surprised to learn that a ponytail facelift is not a medical term or a new concept. “It is a marketing term,” explains Scottsdale, AZ plastic surgeon Bryan W. Gawley, MD. “A ponytail facelift is a form of facelift which will give you a similar result as if you are drawing your hair upwards tightly in a ponytail fashion, thereby drawing your face skin as vertically as possible,” says New York facial plastic surgeon John Kang, MD. The process of achieving a ponytail facelift may ultimately mean slightly different things to different surgeons. However, the technical Ponytail Facelift Technique, trademarked by Dr. Chia Chi Kao, involves small incisions behind the ears within the hair, through which doctors perform a minimally-invasive lift.

Who is a good candidate for a ponytail facelift?

“This type of facial rejuvenation is ideally suited for patients with minimal or no significant lower facial and neck skin laxity and those that simply need more volume or lift in the upper face, cheeks, eyelids and brow area,” says Dr. Gawley. “It is not appropriate for older patients or those patients with a significant amount of laxity in the jowl or neck skin.” Encino, CA plastic surgeon George Sanders, MD, notes that if a patient suffers from severe jowling and neck laxity, they would benefit more from a traditional facelift. 

Additionally, Dr. Kang notes that a ponytail facelift “really benefits patients with wide profile faces” by preventing them from looking windblown. “Very often, classic jaw and neck lifts can lend a windblown look as the vector of the pull is more oblique and backward rather than direct vertical pull,” says Dr. Kang. “Just sit in front of a mirror and use fingers to pull more backward (classic approach) versus upward (ponytail approach) and see which approach benefits you more.”

What makes it different from a regular facelift?

With a ponytail facelift, the greatest improvement is seen in the midface, explains Dr. Kang. “If the main issue is jowling and neck laxity, the patient will be a better candidate for classic jaw and neck [procedures] through periauricular incision approach or composite (combined) approach, which is my preference,” he adds.

Dr. Sanders notes that the ponytail facelift lacks the flexibility of a traditional facelift. However, it’s a great procedure to consider for younger patients with minimal issues.

What are the benefits of a ponytail facelift?

If well-performed, the benefits of a ponytail facelift include a shorter recovery time, a refreshed, natural look, no visible scars and long-lasting results.

What is the recovery like?

According to Dr. Kang, recovery generally lasts for about a week, which is half of the time that a classic jaw and neck approach would keep you down. Dr. Sanders says you’ll likely experience face swelling and some bruising after surgery.

How long do the results last?

While it varies a bit from patient to patient, results tend to last a while. “When you are performing true midface lift through ponytail approach, you must pass through zygomatic arch at the level of the bone of the cheekbone, and by this definition, you are in the deep plane and pulling up all the attached skin with the deep plane lift,” explains Dr. Kang. “Deep plane lift always provides longest holding power.”

According to Dr. Gawley, since this approach is usually taken for “patients with mild or minimal amounts of skin laxity, the results will potentially last about five to 10 years. But it really depends on the amount of volume loss, laxity and skin damage that an individual patient has.”

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