What are the Different Types of Facelifts?

Facelift woman

What are the Different Types of Facelifts?

There are so many different names used to describe facelifts that it can get confusing. In reality, all these different names refer to very similar techniques

Mini Facelift vs. Full Facelift (Face and Neck Lift)

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.

A full facelift may not be that different from a minilift in some practices. In our practice what makes a facelift a full facelift vs. mini is additional dissection under the chin.

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.

Full facelift neck procedure
Additional procedures performed in the neck that makes for a full facelift. Medial suturing of paired platysma muscles with partial transection of the anterior border. [Reprinted with permission from Stuzin JM. MOC-PSSM CME article: Face lifting. Plast Reconstr Surg. 2008;121(1 Suppl):1–19.]

Not everyone needs the additional work a full facelift entails. However if a patient presents with a full neck and significant neck bands, wrinkles, and fat, then not going into the neck to address this may not give the best result.


This is most basic facelift technique. The incisions are made, dissection is performed under the skin, and excess skin is removed.

This is recommended in younger patients desiring facial rejuvenation and sometimes in high weight loss patients who have a significant skin excess.

The drawback to this technique is that it may not have the longevity of SMAS or subperiosteal lifts.

Skin only facelift procedure


The SMAS (superficial musculoaponeurotic system) is a layer of tissue present underneath the skin in the face. It lies just above the parotid gland and its covering and also just above facial nerves that power the facial musculature.

SMAS anatomy
The five layers of the face, analogous to layers of the scalp and neck. The facial nerve travels deep to layer 3, becoming more superficial within layer 4. (Reprinted with permission from Mendelson B. Facelift anatomy, SMAS retaining ligaments and facial spaces. In: Aston SJ, Steinbrech DS, Walden JL, eds. Aesthetic Plastic Surgery. London: Elsevier; 2009:57.)

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 more extensive the SMAS dissection, the more the technique starts becoming a full facelift and not a mini-lift.

MACS Facelift

During a Mini Lift, the SMAS can be plicated, where sutures are placed to hold it up. This has been popularized with the MACS lift (Minimal Access Cranial Suspension). Illustration showing the minimal access cranial suspension lift with loop sutures tethering soft tissue to the deep temporal fascia.

MACS facelift
A MACS facelift technique uses cable sutures on the SMAS to lift the tissue. The skin is then redraped over this. Tonnard PL, Verpaele AM, Morrison CM. MACS face lift. In: Aston SJ, Steinbrech DS, Walden JL, eds. Aesthetic Plastic Surgery. London: Elsevier; 2009:138.

High SMAS Facelift

In this technique, the surgeon dissects the SMAS from the underlying tissues and forms a flap of tissue.  The surgeon sutures the SMAS upwards to hold facial tissues.

SMAS flap facelift
Illustration showing Barton’s “high SMAS,” with cheek soft tissue raised along with overlying skin. (Reprinted with permission from Barton FE Jr, Meade RA. The ‘HIGH SMAS’ facelift technique. In: Aston SJ, Steinbrech DS, Walden JL, eds. Aesthetic Plastic Surgery. London: Elsevier; 2009:133.)

Composite Facelift (Deep Plane Facelift)

The composite 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 and not used often.

Composite facelift
Illustration showing Hamra’s original composite face lift flap, with orbicularis, malar fat, and platysma raised in continuity with overlying skin. (Reprinted from Hamra ST. Composite rhytidectomy. Plast Reconstr Surg. 1992;90:1–13.)

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.

Endoscopic Midface Lift
Via a small temporal hairline incision, dissuction proceeds in the subperiosteal plane of the cheek to elevate the cheek soft tissues.

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