“Am I a candidate?” is the first question most patients ask, often before they ask anything about the surgery itself. It is the right question. A facelift is not a single operation that suits every face, and the Endoscopic Deep Plane Facelift is designed for a specific kind of patient and a specific kind of ageing. This article explains what Dr. Artur Díaz Carandell, Facial Surgeon in Barcelona, looks at when he decides whether this technique is appropriate for you.
What the Endoscopic Deep Plane Facelift is designed to treat
The Endoscopic Deep Plane Facelift is a full-face procedure. It repositions the deep structures of the face — not just the skin — to restore the contours of the forehead and brow, the midface, the jawline and the neck. It is performed through four small incisions on each side, hidden inside the scalp in the temporal area, with the help of an endoscope: a thin camera that gives the surgeon a magnified view of the anatomy.
That means the ideal candidate is someone whose main concern is descent of the tissues: a lower, heavier brow, cheeks that have moved down, a softer jawline, or early changes in the neck. The aim is a face that looks rested and like yourself — not tight, not “operated”.
For the full description of the procedure, see the Endoscopic Deep Plane Facelift page.
The typical candidate
Age and skin quality
In Dr. Carandell’s practice, candidates are usually between 35 and 55 years old, and up to around 60 when skin quality is good. Age on its own is not the deciding factor. What matters is how much the deep tissues have descended, how much excess skin there is, and how elastic the skin still is. Two people of the same age can have very different faces, and very different surgical plans.
Facial structure
Not every face needs the same facelift. In faces with more volume and heavier tissues, working in the deep planes allows the tissues to be repositioned better, for a more stable and natural result. This is one reason why the consultation focuses on the structure of your face rather than on wrinkles alone.
What bothers you
The best candidates can point to specific changes that bother them: tired-looking eyes caused by a heavy brow, flattening of the cheeks, loss of definition along the jaw, or the beginning of laxity under the chin. When the concerns are mainly fine lines or skin texture, surgery that repositions deep tissues may not be the right answer on its own.
The neck: when a deep neck lift is added
The Endoscopic Deep Plane Facelift improves the jawline and the upper neck. When the neck needs more correction, it can be combined with a deep neck lift during the same operation. Whether you need it is decided during the consultation, by examining the neck at rest and in movement.
Do I also need eyelid surgery?
Not always. Lifting the brow and repositioning the cheek can improve some of the excess skin around the eyes, so some patients who arrive expecting eyelid surgery find that it is not needed, or that less is needed. This is assessed individually.
General health: the factors that matter
A facelift is elective surgery, so good general health is part of being a candidate. The published facelift literature points to several factors worth discussing openly with your surgeon.
Smoking and nicotine
Smoking affects blood supply to the skin and healing. In a 2026 scoping review of smoking and wound healing after facial procedures, Chouksey and colleagues summarised four facelift studies; the oldest of them, by Rees and colleagues (1984), reported that smokers had about 12 times higher odds of skin slough than non-smokers. The same review notes that the advice on how long to stop before and after surgery varies between studies.
Dr. Díaz Carandell asks patients to stop smoking — including nicotine and vaping — at least one week before surgery, and to cut down as much as possible during the month before.
Blood pressure
Bleeding under the skin (haematoma) is one of the complications most discussed in facelift surgery. In a review of short-term facelift complications, Sinclair and colleagues (2021) describe raised blood pressure and male sex among the factors associated with a higher risk of haematoma, and describe strict perioperative blood pressure control as part of prevention. If you have high blood pressure, it should be well controlled before surgery.
Medicines and supplements
The same review identifies aspirin and anti-inflammatory medicines (NSAIDs) as a risk factor for haematoma. Tell your surgeon about every medicine and supplement you take; you will receive precise instructions on what to stop and when.
Realistic expectations
A good candidate wants to look like a refreshed version of themselves, not like someone else. A facelift does not stop ageing: it places the face at a more favourable point in the process, and how it evolves depends on genetics, skin, habits and technique. Every result is individual.
Practical considerations
Being a candidate is also about timing. The operation takes about 4 hours, usually under general anaesthesia, at Clínica Sagrada Família in Barcelona, with one or two nights in hospital. Most patients need around three weeks to feel well and about one month before returning to exercise. If you are travelling from abroad, plan your stay and your return accordingly.
Who is the surgeon?
Dr. Artur Díaz Carandell is a Facial Surgeon, with the Endoscopic Deep Plane Facelift as his signature technique. He has been a board-certified maxillofacial surgeon since 2008 (residency at Hospital Universitari de Bellvitge, Barcelona) and a Fellow of the European Board of Oral and Maxillofacial Surgery (FEBOMFS) since 2016. He is faculty at Kassir’s NYC Facelift & Rhinoplasty Mastercourse and at FaceAcademy 360° (Mayo Clinic), and founder and director of ENDOFACE Masters Barcelona.
Frequently asked questions
Is there a strict age limit?
No. Candidates are usually between 35 and 55, and up to around 60 when skin quality is good. The decision depends on your anatomy and skin, not on age alone.
Can I have the surgery if I smoke?
Smoking is associated with healing problems after facelift surgery. You will be asked to stop at least one week before the operation and to reduce as much as possible in the preceding month.
I only want to treat my neck. Is this the right procedure?
It depends on the rest of the face. If the brow, cheeks and jawline have also descended, the Endoscopic Deep Plane Facelift can be combined with a deep neck lift. This is decided at consultation.
Where are the incisions?
Four small incisions on each side, hidden inside the scalp in the temporal area.
Can I find out if I am a candidate before travelling to Barcelona?
Yes. Send three photos (front, profile and three-quarter) and Dr. Carandell will tell you whether this technique suits you.
Find out if this technique suits you
The most reliable way to know whether you are a candidate is an assessment of your face. Send your photos or book a video consultation with Dr. Artur Díaz Carandell, in English, French, Spanish or Catalan.