A facelift, medically known as a rhytidectomy, is a surgical anti-aging procedure designed to give a more youthful facial appearance.
There are several different methods for performing a facelift. If you’ve done some research online, you may have seen the terms “deep plane facelift” and “SMAS facelift.”
Your surgeon at Mountain Lake Plastic Surgery will be able to discuss pros and cons of various surgical techniques with you and explain which one best suits your personal needs and aesthetic goals.
Skin-only facelift: The simplest facelift is a “skin-only” facelift, in which the skin is elevated, redraped, and the excess removed. This procedure does not address the deeper layers of the face, aka the SMAS (superficial muscular aponeurotic system), which also becomes loose and saggy over time, just like the skin.
While results may appear impressive at first, a skin-only facelift does not last as long as techniques that address the SMAS. Consequently, it is rare that we recommend this technique for patients. Typically, a “mini facelift” or “lunchtime facelift” is a skin-only facelift with a limited dissection (or may include minimal tightening of the SMAS). In many patients, these procedures can be performed under local anesthesia or sedation, without the need for intubation or general anesthesia.
SMAS facelift: What is the SMAS? The SMAS is a layer of fibrous tissue, fat, and some of the superficial facial expression muscles, that lies below the skin. To have long-lasting results, a facelift must include tightening of the SMAS, either by a SMAS facelift or a deep plane facelift.
In a SMAS facelift, the skin and SMAS are separated and each tightened one at a time. There are several techniques to tighten the SMAS, including:
- SMAS flap- lifting up and repositioning the SMAS
- SMAS plication- tightening the SMAS with a suture line
- SMASectomy- cutting out redundant SMAS and sewing back together
SMAS facelifts allow for more control when it comes to deciding the tightness of each layer. By lifting them separately, they can also be tightened in two different directions to achieve the smoothest appearance. Once the layers are properly lifted, the extra skin is removed.
Some SMAS techniques are also considered safer because there is minimal exposure of the delicate facial nerve branches. Both SMAS and deep plane facelifts are performed under general anesthesia.
Deep plane facelift: A deep plane facelift lifts involves lifting and tightening the skin and SMAS layers together, as one piece of tissue. It is referred to as “deep plane” because after making the skin incisions, the dissection proceeds quickly to a level underneath the SMAS. The ligaments under this layer are disconnected and then all layers of skin, muscles, fat, and connective tissue are lifted together.
One of the major advantages of this technique is that the skin maintains robust blood supply and wound healing issues are rare. Patients also may have less swelling during recovery.
While all the above facelift techniques are meant to treat signs of aging and restore vitality to the face, there are different benefits, recovery times, and levels of invasiveness that should be considered before deciding which one is right for you.
The best technique for you will also depend on your anatomy, which your surgeon will evaluate during the consult.
A facelift is otherwise known as a “lower face and neck lift” because it addresses mostly the lower half of the face and neck. It will help smooth the nasolabial folds, marionette lines, and jowls, define the jawline, and get rid of loose skin under the chin (turkey neck). However, many patients also need other areas addressed to regain the youthful appearance they are hoping for.
Part of customizing and choosing the right facelift procedure for you is deciding which complementary procedures may be helpful.
During your consultation, your surgeon will do a global facial assessment and make recommendations based on what they see.
Facial aging creates volume loss and hollowing of certain areas of the face. Sometimes repositioning the tissues with a facelift are not enough, and volume needs to be added to these areas with fat grafting. This involves harvesting of fat from an area of excess (typically the abdomen or inner thighs) and transferring the fat to areas of deficiency in the face.
Whereas aging causes fat loss in some areas, it can also cause fat excess in other areas, like the jowl. For patients with heavier jowls, fat removal with micro-liposuction may be necessary to completely smooth the jawline. This technique is occasionally used in other areas to smooth contour.
A facelift does not create any lift in the upper face. To correct low or drooping eyebrows and hooding of the eyelids, a brow lift may be necessary.
Upper and lower blepharoplasty may be done at the same time as a facelift to improve droopy eyelids, prominent fat pads, and/or dark circles underneath the eyes.
Are you considering a facelift and curious about how you can achieve your desired look? Contact our team of aesthetic and medical experts at Mountain Lake Plastic Surgery to have all your questions answered. Request a consultation online for a personalized approach to addressing your aesthetic concerns.