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Technique Options for a Facelift

There are several options that can be used when targeting aging skin. Whether to undergo a surgical facelift or a medical, non-surgical treatment depends on the intended results, targeted area, and the extent of the damage to be corrected. Read more below in this face lift patient education guide:

Non-Surgical Cutaneous Options

The following non-surgical procedures improve the appearance of neck and facial areas:

Volumizers or plumpers – Loss of facial volume or decreased fat can be treated by fillers (volumizers). Fat may be obtained by removing it from other body areas (typically the abdomen) and injecting it into the face. There are also manufactured fillers that can be used to plump the skin or fill-in creases. Volumizing injections are suitable especially when the face is gaunt or “sunken in.”

Muscle relaxers – Injections of Botox relax the facial muscles underlying wrinkles, causing the wrinkles to vanish. This is not permanent and must be repeated to maintain the desired results.

Skin resurfacing – Sun damaged skin can be treated with several techniques within the skin-resurfacing category including dermabrasion or laser therapy, which remove damaged skin and cause dermal tightening with fresh collagen growth.

Acupuncture – Acupuncturists claim that a series of tiny needles inserted in appropriate “energy lines” twice a week for five weeks will remove wrinkles, skin sagging, and eyelid droop, as well as decrease deeper facial and neck lines. While some individuals confirm the validity, this is a controversial process and not a proven alternative to facial cosmetic surgery.

Surgical Facelift Techniques

Facelift Type How it's Done Benefit
Traditional facelift (aka SMAS or superficial musculo-aponeurotic system)

After sedation is administered, an incision is made in the hairline above the ear, curving around it to the hairline behind the ear.

The skin is separated from the fat and muscle underneath. Sutures are inserted to lift, tighten, and reposition the muscle layer toward the ears. Excess skin is then removed and the incision line is sutured closed.

 Sagging of neck and lower face is corrected and facial muscles are tightened to enhance look for extended period.
Cutaneous (skin) facelift Same technique as traditional facelift, but without muscle tightening Corrects sagging of neck and lower face
Temporal facelift After local anesthesia and intravenous sedation are given, incisions are made in the hairline above the ears. Skin is dissected free from the underlying fat and muscle. The skin along the sides of the brow or forehead is lifted and pulled tight. Incisions are closed and a drain may be left in place above the hair to collect any pooled fluid or excess blood. Corrects eyebrow droop
Deep plane facelift

After sedation is administered, an incision is made in the hairline above the ear, curving around it to the hairline behind the ear.

The skin is separated from the fat and muscle underneath. A deeper plane is dissected and then muscle is lifted and repositioned.

Excess skin is then removed and the incision line is sutured closed.

 Its ability to provide a more natural outcome and give a more youthful appearance to the skin is debated.
Neck lift

After local anesthesia and intravenous sedation are given, small incisions are made under the neck and ears.

Liposuction may be performed inserting a small cannula to aspirate excess fat.

The neck muscles are manipulated and repositioned with permanent sutures to hold he tissue in place. Any excess skin is removed and the incisions are sutured closed.

 Corrects sagging neck area
Platysmaplasty

After local anesthesia and intravenous sedation are given, small incisions are made under the neck and ears.

The neck muscles are manipulated and repositioned with permanent sutures to hold the tissue in place. Any excess skin is removed and the incisions are sutured closed.

 Decreases protrusion of the muscle cords from under the skin; often performed in conjunction with neck lifts and facelifts
Midface lift

Local anesthesia and intravenous sedation are given. A small incision is made right below the lower eyelid lashes, extending out at the outer corner of the eye.

The complete midfacial tissue triangle is gingerly dissected from the bone, elevated vertically and attached to the bone at a higher level.

Excess skin is trimmed and dissolving sutures are inserted to hold the changes in place as well as to close the skin incision.

 Targets soft tissue in the cheekbone area and smoother lower eyelid region
Mini facelift Similar to traditional facelift but with much smaller incisions, so that dissection between skin and tissue is not extensive Done in the younger patient with good skin elasticity; quicker recovery; smaller incisions
S-Lift Similar to mini facelift but with an “S” shaped incision Restricted to those with mild skin looseness along jaw line; modified from mini facelift; rapid healing; short incisions
QuickLift or MACS lift

After local anesthesia and intravenous sedation are administered, an “S” shaped incision is made along the sideburn area extending along the ear, around the earlobe, and up to the hairline.

Skin is gently dissected away from the underlying tissue and connective tissue and muscles are gently lifted and tightened. Sutures are inserted to hold the lift in place.

Liposuction may be performed under the chin if needed.

Excess skin is removed and the incision closed.

 Modification of S-Lift; option for those with mild to moderate facial changes from aging; often done with liposuction or platysmaplasty; risk greater than with S-lift, but less than the traditional lift
Thread lift Sutures are inserted into the facial tissue under the skin and tension is applied. Similar to a facelift, but results are not as long lasting. Could be an option for patients concerned about surgery and healing time
Liposuction After local anesthesia or sedation is administered, a small incision is made under the chin and neck. A small tube is then inserted with a suction device attachment that withdraws the fat using suction. When used alone, is reliant on patient’s skin elasticity; often used in conjunction with facelift

Written by Barbara Hales, M.D.

Local Face Lift Specialists

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