Background
Randomised controlled trials (RCTs) in facelift surgery remain few and variably reported; transparent, reproducible methods are essential to interpret efficacy and safety.

Objectives
To assess the methodological quality and reporting standards of facelift RCTs using the Consolidated Standards of Reporting Trials (CONSORT) and CONSORT-NPT guidelines, identifying patterns of adherence and areas for improvement.

Methods
We conducted a PRISMA-guided systematic review of RCTs evaluating facelift techniques or perioperative strategies. RCTs focusing on facelift techniques were included based on study design and relevance. Adherence to the CONSORT 2010 or CONSORT-NPT 2017 checklist was retrospectively assessed for each included study. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and evidence quality was appraised via GRADE.

Results
Ten RCTs (n=457; mean sample 46) met inclusion. Mean CONSORT adherence was 56%, with high for intervention description and statistical analysis (both 100%) but poor for tailored interventions (10%), trial registration (20%), and trial protocol (30%). Adherence showed weak correlations with journal impact factor (R²=0.0024) and author count (R²=0.171). Only 3 trials were low risk of bias; GRADE certainty was largely low-moderate, limited by imprecision and suspected publication bias.

Conclusions
Facelift RCTs show variable, often suboptimal reporting, leaving the evidence base thin despite rising demand. Strengthening trial quality requires field-wide pre-registration and protocol publication, validated outcome measures, and consistent CONSORT enforcement; a standardized minimum dataset and registry-based reporting would further bolster evidence for facial rejuvenation surgery.