The modern facelift has evolved dramatically from its early iterations in the 20th century. Technical improvements have made the operation safer, allowed faster recovery and provide a more natural enhancement.
Today, most facelifts are performed under local anesthesia plus sedation, allowing immediate recovery and discharge home unless patients desire facility recovery. Risks of nerve damage and hematoma are reduced with improved surgical techniques and instruments, and better understanding of anatomic planes, features and topography enhance aesthetic results.
From a plastic surgeon’s point of view, the exciting part of modern facelift surgery is the variety of techniques that can be used to tailor the operation for each individual patient. This is not a one-size-fits-all surgery anymore.
1. Skin-only facelift
This procedure is designed for patients with significant skin laxity and very little deep soft tissue deficit loss or droop. Recovery can be fast, but deeper anatomy is not addressed. Typically reserved for elderly patients who desire a faster 7-day recovery.
2. SMAS facelifts
In addition to skin redraping, this procedure elevates the deep soft tissue in order to reposition the jowls to their anatomically correct position. This a very powerful procedure which optimizes facial aesthetic. 1 week to 7-10-day recovery.
This procedure recontours the neck only. Often a good option for men or patients who do not have jowling. The procedure repositions the platysma muscle to its anatomic orientation in youth – obtaining a natural contour of the neck. 5-7-day recovery.
This procedure is ideal for younger patients with no neck laxity. The procedure addresses the face only usually with SMAS treatment. The incision is usually smaller – some calling this a “short scar” facelift. Recovery 7 days.
5. Lower 2/3 facelift
This procedure addresses the face and neck skin laxity and underlying platysma muscle and SMAS in the face. The procedure is very effective and powerful. This is our most popular facial rejuvenation procedure. Combining the SMAS facelift with neck-lift. Typically, 7 to 10-day recovery.
Facelifts are often combined with fat grafting, blepharoplasty (eyelid surgery), browlifts, laser treatment and surgery of the breast and body. More recently, non-surgical skin tightening such as Ultherapy, light therapy, Botox and fillers can be used to augment and protect the results of a facelift. The procedure is as much art as it is science and is ever evolving.