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.
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.
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.
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.
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.
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.
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.
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.
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