Face lift, or rhytidectomy, is a major cosmetic procedure designed to enhance and improve facial features as we age. A typical surgery can take two to three hours and last indefinitely. Common problems that can be corrected include loose skin, wrinkles, deep lines, jowls, pigment changes, and loss of muscle tone or volume.
There are a wide variety of operations types that differ according to the type of incision made, the number of tissue layers treated, the area of the face and the degree of invasiveness. Some examples include SMAS, deep plane, short scar, endoscopic, mid, thread, secondary, and combination procedures.
The superficial musculoaponeurotic system (SMAS) is a procedure that lifts the deeper tissues of the face and neck that tend to lose muscle tone and sag with advanced age. A long incision is made at the hairline temple and extended downward, along the creases, at the edge of the ear, below the earlobe and behind the ear. The SMAS is then elevated, tightened, and excess tissue is removed. Stitches keep the SMAS and the superficial top layers of the skin in their new, higher position.
Deep plane is similar to the SMAS, but also includes facial muscles and upper fatty tissue layers. This type of surgery is more extensive than other procedures, which can prolong healing and may lead to further post-operative complications such as nerve weakness or damage.
The short scar version involves a single S-shaped incision at the temple or in front of the ear on each side. Surgeons can tighten and support smile lines and jowls with this surgery and it usually involves a shorter recovery time and smaller scar.
Endoscopes can be used to allow the surgeon to see below the skin with minimal incisions and scarring. This type is only effective for cheek sagging and does not tighten the neck or jowls.
The mid-face lift is a procedure that uses incisions in the hairline and mouth to reposition the natural fatty layer over the cheekbones. This option can be used to improve nose-to-mouth lines and enhances sagging cheeks. Often, it is included with the SMAS or deep plane procedure.
Thread or feather lift procedures are designed to be noninvasive improve sagging facial skin with tiny suture barbs. No skin is cut away and no incisions are made. This option is a good choice for those with mild to moderate sagging and can be done under local anesthesia, thus reducing recovery time.
Secondary face lift surgery occurs after a primary procedure and is intended to reposition or re-tighten when it starts to loosen and sag again.
Operations and procedures done in combination with face lift surgery might include facial implants, thread lifts, thermage, eyelid surgery, brow lift, chin augmentation or reduction, neck lifts, and otoplasty.