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Facial Plastic Surgery - Rhytidectomy - Face Lift Surgery



                                   Cosmetic surgery markings for a facelift or a rhytidectomy

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A face lift (also known as a rhytidectomy) - is designed to restore a youthful appearance.  There are many different types of face lifts available, some correcting or improving only specific areas of the face or neck region.  Face lifts can restore the youthful volumes and curves the face had in earlier years before gravity starting pulling things down.  As we age, the elements of the sun and gravity forces the face to lose both bony and soft tissue volume which contributes to a skeletal or hallowing effect, sagging and of course wrinkles. 

There are many options that are available for a rhytidectomy or a face lift and it is important to consider the specific areas that you want to target for improvement, how long you want to spend recovering from treatment, and what your expectations are for your post face lift appearance.


        What will improve with a face lift procedure



A mini lift refers to a number of different techniques with limited incisions:

These mini lifts are best for patients with early signs of aging who are usually in their 30's or 40's. It treats the early laxity in the buccal labial fold and jowl area.  These lifts can be performed under local anesthesia.


Read more about the Mini Face Lift Technique








This procedure is referred to any face lift technique that has a limited incision with a fast recovery time.  This technique, a small incision is made underneath the chin, excess fatty deposits are suctioned from the neck are and the inside of the skin is treated with a CO2 laser in order to cause the skin to contract.  The muscle in the neck can be tightened through the same incision.  

This procedure is performed with local anesthesia. 

The ideal candidate for this procedure is a patient whose main concern is fullness and sagging of the neck.

There are many plastic surgeons who do not endorse this procedure because of the safety concerns with the laser.  The laser can burn the skin, cause excessive scarring, necrosis or fluid accumulation.

Read more about the Weekend Face Lift Technique





The Aptos Lift or Feather Lift can lift sagging underlying tissues (usually the cheek and jaw line) by threading 4 to 12 of these barbed, permanent sutures with a very long needle through the skin into deeper soft tissue structures.  The actual name - Feather Lift, comes from the appearance of the suture. 

                                             Feather Lift Thread

                                                          Feather-Lift Thread

The suture once it is in place- it is pulled forcing the barbs to anchor themselves into the soft tissue and lifting this tissue.  The very end of exposed suture is snipped, leaving the majority of the suture behind buried into the tissue. 

A full face Feather Lift requires approximately 18 threads:

  • 2 for each brow

  • 3 for each cheek

  • 2 for each jaw line

  • 2 for each side of the neck


Side Effects of the Aptos Feather Lift:

  • bruising

  • swelling

  • tenderness

  • puckering where the barb is pulling

  • visibility of the blue thread through the skin

  • recurrence of sagging

Read more about the Feather Lift Apto Thread Suspension Technique





This face lift is known as "skin only" and is the first generation of lifts in which the skin and some underlying fat is freed up - tightened and the excess tissue is removed with the skin stitched back.  This procedure was popular in the early 1970's  however; it did have some controversy with the skin stretching if put under tension.

The problems with this method of face lift was that although the original skin only face lift relies on the straight forward method of lifting skin off of the framework of the lower face and pulling it tightly to the hairline - this is done without any repositioning or reinforcing the underlying muscles or tissues.

While the subcutaneous or "skin-only" face lift used to be the most common face lift technique until about 10 years ago, it is not commonly used anymore due to the potential for a "windswept" or pulled look.

Read more about the Subcutaneous Face Lift





The MACS (Minimal Access Cranial Suspension) face lift is often preferred face lift simply because it is less invasive and leaves a much shorter scar. With the MACS face lift procedure, sagging tissues in the neck, cheeks, chin, or near the nose can be lifted, stretched, and held up with strong suspension sutures in the deeper tissues.

The MACS-Lift has been developed in Europe over the last 10 years.  The procedure is minimal access because in contrast to traditional face-lifts, there is no incision behind the ear.  The deep tissues of the face are returned to their original position with permanent stitches secured to the deep fascia of the temple region (cranial suspension).

Read more about the MACS Face Lift





A small S-shaped incision is made in front of the patient's ear.  The surgeon works through this incision with tightening the underlying structures of the lower face - smooth the skin - and trim off the excess tissue.  This lift is for the lower third of the face including the jaw line and neck area - and can be performed under local anesthetic and oral sedation or by twilight sedation.  This procedure is ideal for the patient aged 35 - 50 years.  This procedure is often done with the Platysma Lift or neck lift through a small incision under the chin for a more dramatic rejuvenation of the neck.

Read more about the  "S Lift" Face Lift





The SMAS Face Lift is also known as Superficial (or Sub-) Muscular Aponeurotic System.  This area of the face is responsible for all facial movements. This is the underlying layer of muscle and connective and fatty tissue which are tightened along with the skin.  This type of face lift requires a longer incision than the "S Lift" - with it beginning at the temple area and extending down to loop around the ear. 

The SMAS procedure is a deep facelift that can reduce the appearance of sagging jowls, cheeks and neck skin.  The incision is hidden in the hairline and the natural creases of the face.

Read more about the SMAS Face Lift





An extended SMAS Face Lift includes the area in front of the cheek to correct nasal furrows or the nasolabial folds.  Neck muscles are repaired through an incision under the chin.  This procedure is done often with the Platysma Lift or neck lift.  SMAS face lift improves the appearance of an aging neck greatly.

Read more about the Extended SMAS Lift





The Deep Plane face lift is performed in a much deeper plane than in the standard face lift procedure.  Because of where this is performed, there is a higher risk of facial weakness after the procedure from facial nerve injury.   The procedures with an incision in the scalp for the brow lift.  Incisions are also made in the lower eyelid and inside the mouth. 

The Deep Plane procedure seems to be better suited for younger patients merely because it does not involve the neck.  The Deep Plane is similar to the SMAS lift where it addresses the nasolabial folds however; the benefits to the neck and jaw line are the same as with a standard face lift.  Swelling takes some time to go down after this face lift and the results might not be noticeable for three to six months after surgery.

Read more about the Deep Plane Face Lift





The composite face lift addresses muscle and tissue elevation and repositioning beneath the SMAS layer of tissue like the deep plane lift with the addition of incorporating blepharoplasty and a brow lift (forehead lift) into the overall procedure.  This face lift technique is different than the other face lifts in as much as that it combines additional cosmetic surgeries for total facial rejuvenation.

The composite face lift is achieved by including a number of small incisions (endoscopically) or one incision (made about 5 cm. behind the hairline) of the forehead.  Additional blepharoplasty incision is made in the lower eyelid area along the lash line.  Contouring of the cheek fat pad and the layer of fat under the eyes is easily accessible through the lower blepharoplasty incision.

Read more about the Composite Face Lift





The "Subperiosteal face lift" addresses sub-orbital area as well as the mid-facial area of the facial area and is similar to the Deep Plane Lift - except the muscles, tissues and skin are all elevated as one unit off the bones of the face.

This lift is more invasive that any of the other common face lift techniques. 

If the lift desired is to target mild sagging in the patient - then the extensive dissection of the mid to deep layers of the skin is not required - and can be performed endoscopically.  This is done through a number of small incisions placed at the hairline in the scalp or temporal region and along the sides of the face with an endoscopic camera to help guide the surgeon. 

If the patient has excess lax tissue - then the subperiosteal lift is performed with alternative face lift incisions and tools.

Read more about the Superiosteal Face Lift





Tumescent Fact Lift technique is performed with tumescent anesthesia instead of general anesthesia or local with IV sedation. 

Benefits of Tumescent Anesthesia:

  • Less bruising

  • Less swelling

  • Less nausea or vomiting

  • Quicker recovery

  • Less risk of anesthesia complications

  • Ability to check nerve function during surgery

  • Overall much greater safety

  • Referred to as the "Awake Face Lift" since the patient is awake during surgery

Read more about Tumescent Face Lift








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