What Type of Facelift Should I Get?
German surgeon Eugene von Hollander introduced facelifts to the world of medicine in 1901. Since this time, significant advances have been made in the world of facelifts—and now, it remains an incredibly popular way to achieve younger-looking skin. Medically known as rhytidectomy, this procedure is 1 of the top 10 cosmetic surgery procedures in the United States.
However, while a facelift can address the effects of aging and improve deep wrinkles, it is not the best treatment for fine wrinkles. Cosmetics fillers, botulinum toxins, and even superficial chemical peels, are good alternatives for mild signs of aging. As such, it is important to know which results you desire—before going under the knife.
What is facelifting?
A facelift can help rejuvenate your appearance. Facial shape depends on the function of the skin, soft tissues, and its skeletal support, and these components change with age. As the skin loses elasticity, it becomes wrinkled, and subcutaneous tissues shift due to the constant force of gravity. Luckily, facelifts can correct this.
Standard facelift vs liquid facelift
The term liquid facelift is an inaccurate designation, since the procedure is not really a facelift, nor is it done surgically. The procedure most likely acquired its name due to the positive results it achieves in contouring the face, reducing wrinkles and folds, and improving the overall youthful appearance of the face.
Liquid facelifts are performed by combining advanced dermal fillers (Juvederm, Restylane, and Radiesse) with botulinum toxins. The combination depends on the physician performing the procedure, and it is possible to receive a liquid facelift without the involvement of botulinum toxin. This minimally-invasive procedure may be advised to patients who prefer a nonsurgical method of facial rejuvenation. Though it’s an excellent alternative to cosmetic surgery, liquid facelifts are not a replacement to traditional facelifts, as certain conditions can only be treated with a surgical approach.
Different Types of Facelift Techniques
Subcutaneous Facelift (Skin Only)
This technique is the simplest to perform, with less risk of causing injuries to the facial nerves. It achieves greater results for thinner individuals with sound underlying bone structure and good skin tone. It involves undermining (cutting the dermal layer away from the fascia or connective tissue) the subcutaneous layer only, leaving the SMAS (superficial muscular aponeurotic system), and other structures untouched. However, this has limited application and doesn’t involve mid-face correction. There is also limited improvement of the jowl area.
Short Flap Rhytidectomy, more popularly known as mini-lift or weekend lift, is a safe technique that achieves subtle improvement in an aging face. This is recommended for younger patients with mild degree of skin laxity, and without significant sagging in the midface. This technique has an excellent safety record and short downtime, but the results are limited and short-lived. Some surgeons refer to it as the S-lift because of the shape of the incision used or the short scar produced.
The SMAS technique involves cutting the superficial layers of the skin and the deeper tissues of the face and neck. Aside from stark improvement of the jowl area, it provides longer lasting benefits. The main advantage of this technique over a skin-only lift is its ability to manipulate the underlying vectors of the deep tissues and skin. Multiple variations of this technique are being performed, including extended SMAS and lateral SMAS. Traditional SMAS dissection produces better outcomes in minimizing the jowls and highlighting the mandibular angle.
MACS Facelift (QuickLift)
Minimal Access Cranial Suspension (MACS) lift was first described by Belgian cosmetic surgeon Patrick Tonnard in 1999. This full-face lift allows for the correction of mild to moderate sagging with minimal recovery time, less scarring, and fewer complications. MACS lift is a modification of the S-lift that promises more dramatic results. Its safety profile is excellent and there is less risk of bleeding and nerve injury.
Midface lift or cheek lift incisions are placed along the hairline and inside the mouth. It targets the problem areas in the middle third of the face. The recovery time is shorter than that of a traditional facelift. It is often combined with other rhytidectomy techniques and blepharoplasty or eyelid surgery.
This technique is suitable for patients who have previously undergone facelift surgery. The procedure involves the lifting of all mid-face soft tissues using a subperiosteal plane of dissection. Forehead lifting is often done concomitantly. The procedure has advantages and disadvantages and may require endoscopic assistance depending on the type of incision to be made. The upper and middle thirds of the face can be improved greatly, while swelling after the procedure can be profound.
Deep-plane technique involves sub-SMAS dissection without significant undermining of the subcutaneous tissues. This lift is said to improve the appearance of nasolabial folds. However, more extensive dissection increases the risk of nerve injury. Bruising and swelling may also be persistent, prolonging recovery periods.
The composite technique is a type of deep-plane facelift designed to address the sagging of orbicularis oculi muscles—the muscles that close the eyelids. This technique may also involve additional eyelid surgery (blepharoplasty). It provides longer lasting and natural looking results but requires longer downtime.