What types of facelifts are there?

Cutaneous (skin only) Facelift

The traditional facelift has been performed for many years. It is a technique where the skin is lifted from the underlying tissues and tightened backwards and upwards. While the overall facial appearance will be improved there is no improvement to the deeper facial tissues. This technique does not give a very long lasting result.

SMAS Facelift

Beneath the skin of the face lies a deeper layer to which the muscles and soft tissue is attached (Superficial Musculo-Aponeurotic System – SMAS). This can be used to elevate the soft tissues of the face to provide a longer lasting result than with the classical facelift where only skin is tightened. This can be achieved either by removing a portion of the SMAS and tightening it (the SMASectomy Facelift) or by folding a portion of the SMAS itself to preserve volume (SMAS plication Facelift). These types of facelift are useful when there is a need to restore fullness to the cheekbone area as well as removing jowls and redefining the neck.

The ‘MACS’ Facelift (Minimal Access Cranial Suspension)

Suitable for patients with mild to moderate jowls but no loose skin in the neck. Permanent sutures are used to elevate the soft tissues of the face and suspend them in a more youthful position. This operation has a shorter scar behind the ears and a relatively quick recovery, although it may not be as long lasting as the SMAS type facelifts.

The Short Scar Facelift

All of the facelifts above can be performed with a shorter scar which means that in addition to the normal scar in front of the ear, the rest of the incision behind the ear is limited and does not extend into the scalp. This does mean that the ability to tighten the neck may also be somewhat limited. Anybody with a moderate amount of loose skin in the neck will be better served with a slightly longer scar to accommodate this. However for patients who need tightening predominantly in the face it provides a useful alternative. These patients are usually in the younger age group (early 40’s).

The Volumetric Facelift

Facial ageing often results in loss of fat in the face and a gaunt or hollow appearance. This procedure uses a different approach to restoring a youthful appearance. Volume can be added by either injecting a patient’s own fat into the face, or by moving the cheek tissues from a lower to a higher position over the cheek bone. Recent advances have made fat transfer a more predictable and reliable option than was previously the case.

Subperiosteal Facelift (mask lift) and Endoscopic Facelifting (endoface)

The mask lift is a completely different concept from other types of facelift. It was developed by a French plastic surgeon, Dr Paul Tessier with ideas which arose from reconstructive techniques which were adapted for cosmetic use.

The soft tissues of the face are released from their deeper attachments, lifted and repositioned to the site which they occupied before gravity produced its downward drift. The most suitable patients are in a relatively younger age group (35 to 45), and have heaviness of the brows, sagging of the outer corners of the eyes and cheeks but without changes in the neck or jowl.

The endoscopic facelift is exactly the same procedure but uses small incisions within the hair and an incision in each lower eyelid rather than a long incision in the scalp

Neck Lift and Platysmaplasty

All deep plane (SMAS) facelifts tighten the muscle of the neck to improve both the jowl area and jaw line. The aim of a neck lift however is to eliminate vertical folds in the neck, to tighten the skin and reduce excess fat beneath the chin. This can usually be accomplished through the incisions made for a facelift although a small incision under the chin may also be required for fat removal or to tighten the neck muscles centrally (known as a platysmaplasty).

The facelift surgery that is right for you will be discussed in detail with you at your consultation with board certified plastic surgeon, Dr. Sieveking in our Nashville, TN office. Call us today and we can help provide a great and effective solution.