Facelift - Process and Procedure

The Process

A SMAS facelift works well to give a more defined jawline and eliminate jowls. It is often combined with a brow lift to rejuvenate the eyebrows and forehead, with submental (under the chin) liposuction to improve the angle under the chin or with a midface lift. A midface lift elevates cheek tissues so that the cheeks then assume a more youthful fullness in this elevated position, and the face looks more rested and less drawn and tired. An even simpler office procedure needing only a small incision behind the hairline in the temple uses fine sutures to suspend the cheek fat in a more pleasing position. Each of these procedures is designed to produce a specific improvement, and they can be combined to suit the individual needs of the patient.

The Procedure

The facelift is performed through an incision that begins in the scalp of the temple, wraps around the front of the ear, behind the earlobe, along the back surface of the ear and then sometimes extends into the scalp behind the ear. Rather than simply tightening the skin, as was popular in the 1960's and 1970's, a dense connective tissue called SMAS can be tightened to resuspend the tissue of the face. In contrast to suspending the skin, using the SMAS to reposition facial tissue is more long- lasting, as the SMAS will not stretch out in a few months like skin.

A midface lift is performed through incisions on the inner surface of the lower eyelid (and can be combined with a lower blepharoplasty) and also under the upper lip. Through these incisions, the tissue of the cheek can be effectively mobilized and suspended in an upward direction.