Which Facelift is Best for Me?

Having a Facelift is one of the biggest decision you will make as a patient having plastic surgery and the rewards of having a nip and tuck of the face include looking younger, fresher, less tired more confident and ready to unleash your inner beauty and fire. To decide which Facelift is right for you we first should briefly re visit the anatomy of the ageing face in our post The High SMAS Face Lift.

The face consist of 5 concentric layers . Layer 1 is Skin and Layer 2 is the superficial fat. Layer 3 is the all important superficial muscle aponeurotic system (SMAS) or the muscles of the face, Layer 4 consists of the large ligaments and nerves and Layer 5 is deep tissue or bone depending on whether you are in the neck or forehead, respectively.  As we age the facial ligaments weaken and facial fat is either lost or moves southward, the skin also shifts down. This results in a number of changes which I will illustrate from top to bottom.

The upper eyelid and brow descend causing eyelid wrinkles and a drop of the eye brow. The mid face and lower eyelid skin droops down and fat bulges out causing eyelid bags, heavy cheeks and a deeper nasolabial fold (NLF). The NLF is the line connecting the side of your nose with the corner of your mouth. Further down the face the lower jaw ligament drops and facial skin moves toward the neck causing jowling. The neck skin also loosens and the muscle of the neck weaken causing a turkey neck. These features of a turkey neck, jowling, dark circles around the lower eye, wrinkles on the upper eyelid and a droopy brow are all explained by ageing of the 5 facial layers.

Reversing or repairing these age related changes help each individual area and the area that concerns you most is the facelift technique most appropriate for you. As a Facelift Plastic Surgeon who loves operating on the face I offer the following types of Facelifts.

Artiste Celebrity Makeover

Artiste Celebrity Face and Neck Lift

Artiste Signature Facelift

Artiste Shirt Scar Face Lift

Artiste Express Mini Lift (this is only suitable for those between 35-45 years of age and simply tightens the lower cheek area)

Generally speaking a Facelift addresses the cheek and mid face and jowl and a neck lift is required for the neck. Eyelid surgery is necessary for the eyes and a brow lift for the eyebrow . As part of my Facelift menu I offer a Celebrity makeover which includes the eyes, brow and face and neck to complete the package. My Celebrity Facelift is a High SMAS and a High SMAS technique has the advantage of lifting the lower eyelid area without performing a lower eyelid procedure separately .

If you study the next diagram (click to make larger) you will see the options with the Face Incision and what is done with the SMAS and the resulting beneficial effects. You can also gaze at the bottom of the chart and see what you want to address (Jowls, neck or eyes) and work out which Facelift option is best for you. 

The options include the type and length of the facial incision and whether you have a neck lift incision under the chin. A Full Facelift incision involves an incision hidden in front of the ear extending into the temporal hairline and behind the ear extending into the posterior hairline. A Short Scar Facelift incision involves the incision in front of the ear and into the anterior hairline only.

A Neck Lift incision includes the Full Facelift plus a 3 cm access incision below the chin. One of the most common questions I get from patients that I have helped is can you get a Short Scar Facelift and a Neck Lift, and the answer is no. Not because I don’t want to do it, but to perform a Neck Lift you need to access the neck from a posterior ear and face incision meaning it automatically becomes a Full Facelift incision.

The next choice is what to do with the all important SMAS where all the ageing occurs. You can lift the SMAS as a flap which is the most powerful way of rejuvenating it like renovating a kitchen. The next step which I do is to take it up a level and do a High SMAS Flap incision that helps the mid-face and eyes and this is akin to a kitchen re-build.  You can just suture the SMAS together as in plication or resection which tightens the SMAS like painting the kitchen and replacing the bench top.

You don’t have to worry about which option to choose from as I have simplified it below based on what you want to achieve. While a High SMAS Celebrity Facelift addresses the whole face, if only the jowls are of concern to you then a Short Scar Facelift is appropriate.

The most common areas requested for improvement are the lower eyelid region, cheeks, nasolabial fold midface and jowls. Jowling is one of the most common areas requested and the good news is that all the Facelift techniques address the jowls as a minimum. Other request also include the neck and overall skin tightening in the direction of up…

My personal unique Artiste Facelift Menu

Celebrity Makeover:

• Full Facelift incision
• Neck lift incision
• High SMAS flap
• Fat grafting
• Lip augmentation
• Dermabrasion
• Chemical peel
• Eyelid surgery
• Brow Lift

Best for whole face below eyes

• Lower eye
• Mid face
• Cheek
• NLF
• Jowls
• Neck
• Upper eyes
• Brow

Celebrity Facelift:

• Full Facelift incision
• Neck lift incision
• High SMAS flap
• Fat grafting
• Lip augmentation
• Dermabrasion
• Chemical peel

Best for whole face below eyes

• Lower eye
• Mid face
• Cheek
• NLF
• Jowls
• Neck

Signature Facelift:

• Full Facelift incision
• Neck Lift optional
• SMAS plication or resection

Best for lower face and cheek

• Cheek
• Jowls
• Neck with neck lift

Short Scar Facelift:

• Short incision
• SMAS plication or resection.

Best for lower face only

• Jowls

Express Mini Lift:

• Ultra short incision
• Best to tighten loose skin

If you have loose jowls and that is your only concern then a Short Scar or Signature Facelift is great

If you have jowls, mid face issues then a Celebrity or Signature Facelift is the right solution.

If your eyes, face and neck concern you most then a Celebrity Facelift is the best option.

Disclaimer: At Artiste Plastic Surgery, our Plastic Surgeons led by Dr Jack Zoumaras have been trained to the highest possible degree. All surgery has risks and it is always advised to get a second opinion. Risks are very real and we cannot guarantee any result. Results are illustrated as a guide only. All risks are managed and any need for revision surgery or complications (1-5%) can be managed by our specialist plastic surgeons.

Any statements on how you will feel is based on Level V Evidence:

Level V:  How you will feel after plastic surgery varies between individuals, depending on psychological and physical factors. Our internal research is based on how patients in our practice feel after surgery.

The blogs are not a substitute for a medical consultation and do not form as part of the doctor to patient relationship.