What are the Different Types of Facelifts?
There are many different names used to describe facelifts. This can cause some confusion. In reality, all these different names refer to very similar techniques.
Mini Facelift
A mini facelift is a facial rejuvenation with reduced incisions and dissection. The goal is achieve a nice result with less scars, less OR time, and a quicker overall recovery. It typically only involves limited dissection around the ears. There is only a limited dissection into the neck area. Results after a mini-facelift can be excellent although there can be less results in the neck area.
A mini facelift is a good option for younger patients that do not have significant neck aging. It also good for older patients that want a limited procedure with a quick recovery. It is also a good option for patients that have had a prior facelift procedure.
Full Facelift (Face and neck lift)
A full facelift procedure includes access to the neck via a submental incision as well as the periauricular incisions. The dissection into the neck is more extensive than in the mini-lift variety. This allows for the removal of neck fat and suturing the platysma muscle. This adds more time for the procedure.
Not everyone needs the additional work a full facelift entails. However, if a patient presents with neck fullness and significant neck bands, wrinkles, and fat, then a thorough neck treatment is necessary. Not addressing the neck may not give the best result.
Skin-Only Facelifts
This is most basic facelift technique. The incisions around the ears are made, dissection is performed under the skin, and excess skin is removed.
This is only recommended for younger patients who desire facial rejuvenation. It is also suggested for high weight loss patients with significant skin excess.
The drawback to this technique is that it may not have the longevity of SMAS or deep plane lifts.
SMAS Face Lifts
The SMAS (superficial musculoaponeurotic system) is a layer of tissue present underneath the skin in the face. It lies just above the parotid gland. It is also just above facial nerves that power the facial musculature.
Although SMAS manipulation may increase the risk of nerve injury, in experienced hands, this is a rare complication. Combining a lift with SMAS manipulation is an excellent way to improve the longevity of the result. The SMAS layer is manipulated in different ways. Sutures can be placed to lift it. The SMAS can be excised the defect sutured closed (smasectomy). Or the SMAS can be raised as a flap and sutured to a higher position.
MACS Facelift
A popular facelift technique that uses sutures to hold up the SMAS is called the MACS lift. MACS stands for Minimal Access Cranial Suspension. It suspends the SMAS to the deep temporal fascia. An illustration showing the minimal access cranial suspension is shown below.
High SMAS Facelift
In this technique, the surgeon elevates a SMAS flap from the underlying tissue. The surgeon sutures the SMAS upwards to hold facial tissues in a higher position.
Deep Plane Facelift
The deep plane facelift involves elevation of the skin flap and the SMAS flap together in one flap. We recommend this technique in smokers who are at high risk for wound complications. It is technically more challenging with higher risk of nerve injury and longer recovery time.
Subperiosteal Facelift (Ponytail Lift)
This involves elevation of the cheek soft tissues in the subperiosteal plane. It is more of an adjunct to other techniques and helps correct cheek ptosis.
Visit us at Thomassen Plastic Surgery to learn how different facelift techniques may work for you. You can learn more about this topic at the American Society of Plastic Surgery website.
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