Face and Neck Lifts, (often referred to as rhytidectomies), are specific surgical procedures designed to alter the appearance of the face and neck area. These procedures have gained popularity for their ability to address concerns such as excess, loose skin, wrinkles, and jowls. Face and Neck Lifts are performed by skilled plastic surgeons and are tailored to each patient’s unique needs. Below we explore the key aspects of different face and Neck Lift procedures, to help individuals make informed decisions about which procedure may best suit their needs.
Types Of Neck and Facelift Procedures
Over the years, plastic surgeons have developed several variations of the facelift procedure to provide more personalised options for patients. If you’ve been researching either face or neck lifts to try to work out which one is best for you, you’ve probably come across infinite and confusing terminology. So, if you want to understand the different types of facelifts, keep on reading.
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Why are there different types of Facelifts?
The problem with the confusing terminology is that many of the Facelift terms used are not standard terms and their meaning differs from one surgeon to another. For example, the term “S-lift” might mean a skin-only Facelift with one surgeon, while with another surgeon it might include deeper tissue (SMAS-superficial muscular aponeurotic system) lifting. The key to understanding the different types of Facelifts is by understanding the basic anatomy of the face, and particularly the SMAS (superficial muscular aponeurotic system). Your face is made of; skin, muscles, and fat pads. You can think of the SMAS (superficial muscular aponeurotic system) as the framework holding all of these tight together. The SMAS, running right beneath your facial skin, is basically what keeps your face lifted and all its components in place. When the SMAS and the skin overlying it lose elasticity and become lax, you may start showing signs of ageing.
So, what are the different types of facelifts?
We can categorise Facelifts depending on the degree of SMAS (superficial muscular aponeurotic system) lifting, the size and location of the scar, as well as, the part of the face they address. Below is a simplified list of the different variations of facelifts.
1. Skin-only Facelift
As the name implies, the skin-only facelift (or cutaneous), lifts only your facial skin. It is a superficial facelift procedure that does not involve facial muscles and SMAS ((superficial muscular aponeurotic system)) lifting. Historically, this type of Facelift was common during the ’90s, however, with the advancement of face-lifting procedures, it’s rare nowadays. By only lifting the skin, the cutaneous Facelift ignores the most important part of a Facelift; lifting the SMAS (superficial muscular aponeurotic system). Since the SMAS’ laxity and weakness is the actual reason behind lost facial elasticity, skin-only facelifts provide only short-term results that are not really comparable to a full Facelift. The procedure involves a small 1-2 cm incision in front of your ear. The surgeon will pull the skin tight and cut out any excess. The skin-only Facelift is offered to patients where only excess skin is the problem, but this is rarely the case. It’s essential to note that individual experiences and results may vary, and the procedure’s suitability should be determined through consultation with a medical professional.
Advantages:
- Procedure time – around 30 mins to complete
- Short scar (1-2 cm) in front of the ear
- Downtime is shorter than that of a full Facelift
- Swelling may be significantly less than swelling after a more in-depth facelift as there is less disruption to the underlying tissue and muscles.
Disadvantages:
- Short-term results (6 to 12 months)
- Limited aesthetic alternations
It’s essential to note that individual experiences and results may vary, and the procedure’s suitability should be determined through consultation with a medical professional.
2. S-Lift (sometimes called a partial-lift, or short scar Facelift)
The S- Lift may be the right choice for individuals who have mild to moderate signs of facial ageing, specifically in the middle and lower face. This includes patients with facial wrinkles, cheeks and jowls that have lost elasticity and volume, and lax skin in the upper neck. The S-Lift addresses all of these to outline your jawline and reduce wrinkles and lines. During a S-lift, your surgeon will perform a small incision in front of each ear and extend it slightly around and behind your earlobe. After that, the surgeon will pull up and lift the SMAS (superficial muscular aponeurotic system) into a higher position. Any excess skin will be cut out and the wounds will be closed with fine sutures. Compared to the traditional facelift, the S-Lift offers a smaller incision and more streamlined healing process. However, the results may be less noticable than those you would expect with a full or deep plane Facelift.
Advantages:
- Concealable scar
- A potential solution for mild to moderate facial and neck ageing
- Results may last longer
Disadvantages:
- Less comprehensive than a full Facelift
- Does not address upper face wrinkling
- Does not address lower neck
It’s essential to note that individual experiences and results may vary, and the procedure’s suitability should be determined through consultation with a medical professional.
3. Traditional (SMAS – superficial muscular aponeurotic system) Facelift
The traditional Facelift can also be called a Full Facelift or a SMAS (superficial muscular aponeurotic system) lift. It is usually suitable for those with moderate to severe signs of face and neck ageing. A full Facelift focuses on lifting the whole face and neck. It helps address signs of ageing, such as excess, loose skin and muscle laxity on the face and neck. The procedure can take 3-4 hours to complete. It involves making incisions along the hairline, temples, and behind the ears to access the underlying SMAS (superficial muscular aponeurotic system) layer, which is a network of tissues that provide support to the face. Once this layer is exposed, it is carefully lifted, repositioned, and tightened to address any laxity. This step alters the contour of both the face and neck. Any excess skin is trimmed away, ensuring a tighter appearance.
Advantages
- Comprehensive Facelift procedure
- Scarring is typically discreetly hidden within the hairline and natural creases of the skin
- Lifts the whole neck and platysma
- Results may last longer
Disadvantages
- Longer recovery time
- Larger incisions (larger scar)
- Does not address the forehead
It’s essential to note that individual experiences and results may vary, and the procedure’s suitability should be determined through consultation with a medical professional.
4. Deep-plane Facelift
The Deep-Plane Facelift is performed by a skilled plastic surgeon. It involves making incisions along the hairline and around the ears to access the deeper layers of facial tissue known as the deep-plane. Once the deep-plane layer is reached, it is meticulously lifted, repositioned, and tightened. This technique provides comprehensive rejuvenation by addressing muscle, skin and tissue laxity. Any excess skin is carefully trimmed away to achieve a smoother appearance. Since there are many blood vessels, nerves, and other structures running in the deeper layers of your face, these may be injured during a deep plane facelift. One of the only advantages of a deep plane facelift is that it offers slightly more lifting of the cheeks than the Traditional Facelift mentioned above. On the other hand, the rate of complications and injuries is much higher. This has led many surgeons to avoid deep plane lifts since they don’t offer any valuable benefit over other types of facelifts.
Advantages
- Slightly more lifting in the middle face region
Disadvantages
- Lengthy recovery time
- High risk of nerve or vessel injury
- More postoperative pain, bruising and swelling
Read more about the Advantages of a Deep Plane Facelift here.
5. Mid Facelift (Cheek Lift)
The cheek lift may be suitable for individuals who only want to address lax cheeks (nasolabial folds). A mid-facelift does not address jowls, excess neck skin, or any other areas of your neck. The procedure starts with two small vertical incisions on each side of your face behind your hairline. Through this incision, your surgeon will grab the SMAS (superficial muscular aponeurotic system), pull it higher and fix it with sutures. They will also remove any excess skin and then close the incisions with sutures. The whole procedure takes around 2 hours to complete. The cheek lift is very similar to the S-Lift, however, the latter offers more extensive results that involve the jawline and upper neck. Advantages
- Shorter time in surgery compared to other Facelift procedures
- Focused on the cheeks
- Small incision
Disadvantages
- Does not address the lower face (jawline)
- Does not address any neck laxity
- Less comprehensive than a full facelift and mini-facelift
6. Liquid Facelift – A Non-Surgical Facelift
A liquid facelift is a non-surgical alternative using injectable dermal fillers. Your injector will inject dermal fillers under your facial skin to plump up the volume and flatten any wrinkles. Dermal fillers can contour your face and augment your cheeks, giving you a fuller appearance. A liquid facelift can combat ageing and may flatten wrinkles around your lips, eyes, cheeks, temples, and jowls. Moreover, dermal fillers can augment and contour your lips, cheeks, and even your chin. Nevertheless, liquid facelifts are unsuitable for those with moderate or severe signs of ageing. If you have excess skin, a liquid facelift is unlikely to cause any noticable improvements.
Advantages
- Short procedure time (20-30 mins)
- No invasive surgery involved
- Less financial outlay
Disadvantages
- Does not address excess skin
- Short-term results only (6 to 8 months)
- Repeat procedure to maintain results
- Only suitable for those with minimal signs of ageing
7. Thread Lift – Non-Surgical Face Rejuvenation with PDO Threads
Thread lifts have been gaining popularity as another non-surgical alternative to the traditional Facelift. This procedure may be suitable for patients with mild to moderate signs of ageing (mild skin laxity, soft wrinkles, jowls, and hollow cheeks). A thread lift may give you a tighter and fuller face and flatten out wrinkles and fine lines. A thread lift is done using a specialised set and suture lines available in different brands. A needle, with a biocompatible thread attached to its end, is inserted through your skin, into the deeper fat planes, and then out of your skin. The thread is pulled tight to straighten the skin and pull up the underlying tissue. These threads are specially designed to hold their position tight, and within a few months, they are dissolved. However, during this time, they will stimulate your body’s natural healing response to bring in more collagen to your face.
Advantages
- Procedure time (20-30 mins)
- Non-invasive surgery, no surgical incisions
- Suitable for those with mild and moderate signs of ageing
Disadvantages
- Less comprehensive than surgery
- Does not address excess skin
- Short-term results (12 to 18 months)
8. Brow Lift or Forehead Lift
A brow lift is practically a type of facelift, in the sense that it lifts an important part of your face – your forehead. Since the different types of facelifts do not address the eyelids and the forehead, a brow lift might be suitable for some patients. A brow lift alters the appearance of forehead wrinkles and folds and pulls up your upper eyelids which may give you more alert eyes. There are several techniques to browlifts, however, the “coronal lift” is the most commonly performed. A horizontal skin incision is done along your forehead hairline. The subcutaneous tissue is pulled up and fixed with sutures. The skin is pulled tight, any excess is removed, and the incision is closed with fine sutures.
9. Full Neck Lift
The full Neck Lift may be suitable for people who have moderate to advanced signs of ageing showing on their necks. A neck lift incision compromises a segment of the full facelift incision. It usually starts vertically in front of your ear and extends around your earlobe, and then upward and backward along your hairline. Your surgeon will pull the subcutaneous tissue and fix it higher up to flatten the neckbands and give your neck a tight look. Any excess skin is then removed and the incisions are closed.
10. Single incision Neck Lift
A single incision Neck Lift (also called submental platysmaplasty) may be suitable for individuals who only have an isolated concern on their necks. Patients who may benefit from this procedure are those who have a small double chin, mild signs of ageing on their neck, some excess stubborn fat, and minimal skin laxity. Those with advanced signs of ageing and excessive skin may likely require a full Neck Lift (or a full facelift). A single incision is made right under your chin prominence. Through this incision, your surgeon will pull the platysma muscle and deeper layers up and fix them with sutures. No skin is removed during the single incision neck lift, and the skin is left to redistribute itself.
Advantages
- Single small incision
Disadvantages
- Not suitable for those with moderate to severe signs of neck aging
- Does not address excess skin
If you’re considering surgery, our plastic surgeons can offer you a personalised experience, ranging from liquid and non-surgical facelifts to full deep-plane lifts.
Further Reading and Medical Sources:
- Risks of Neck Lift Surgery and Why People get Neck Lifts
- Facelift (Rhytidectomy) FAQs
- American Academy of Dermatology Association. on Cosmetic Fillers
- PubMed Review Article on Short Scar Neck Lift: Neck Lift Using a Submental Incision Only
- John Hopkins Medicine Article on Is a Liquid Face-Lift Right for You?
- PubMed article on Safety and Adjuncts in Face Lifting
- John Hopkins Medicine on Treatments and Procedures: Facelift and Mini-Facelift
- What are the steps of a facelift procedure? Article on PlasticSurgery.org
- National Library of Medicine on Facelift – current concept of complex facial rejuvenation
- National Library of Medicine on A Comparison of the Full and Short-Scar Face-Lift Incision Techniques in Multiple Sets of Identical Twins
- National Library of Medicine Review article on Evidence-Based Medicine: Face Lift
- US National Library of Medicine National Institutes of Health on Getting Better Results in Facelifting
- National Library of Medicine Review article on A systematic review of comparison of efficacy and complication rates among face-lift techniques
