Facial Attraction: Different Types of Facelifts

Facelifts have come a long way in the last 20 years, not only in terms of technique, but also in terms of accessibility to both women and men. In the 1970s and even into the 1980s, the facelift was a luxury reserved for the rich and famous. But it was also an apparent item of conspicuous consumption, as the “tight look” of earlier skin lifts were unnatural and often accompanied by some visible scarring. Skilled surgeons, however, since the 1980s have been employing more sophisticated techniques which avoid both stretching the skin (which can produce the tight looks) as well as the concomitant scars. These techniques deal with the actual sagging of the underlying tissues, which occurs naturally with the ageing process.

Early 40's

After facelift, blepharoplasty and chin implant by Dr Hodgkinson

After facelift by Dr Hodgkinson

The Deep Plane Facelift

The development of the deep plane facelift or SMAS (Sub-Muscular Aponeurotic System) facelift has proven wrong the statement “beauty is only skin deep” for those of us over 40. The deep plane facelift, developed in the 1980s, addresses the fact we do not get more skin as we age, but the muscles of our faces sag and lose their tone; fatty deposits commonly develop in our jowl area and under our eyes. This sagging and drooping (known as ptosis) causes the finite and existing amount of skin to stretch and lose elasticity.

It is with this stretching (due to the underlying tissues) that the problem may appear to be the skin. But it is not. Without first tightening the underlying muscles and removing the excess fat pads, the skin if tightened will still be placed under pressure – and not only will the patient have the “tight look”, they will also be more likely to develop wide, visible and unattractive scars (as well as require further facelifts sooner than had they dealt with the underlying problems initially).

In the deep plane facelift, after tightening and fixating sagging muscles and removing unnecessary fat pads, skin is re-draped and sutured under no tension. This allows a more natural appearance and minimises the pull on the sutured areas – so the scars are not stretched, as in the older style skin lifts.

The Mini Lift

The mini lift is another non-skin lifting technique which has a place in the younger woman or man (generally 35-45) who has jowling or needs to “freshen up” the appearance of his/her face around the neck and jaw line. This type of facelift also addresses the deeper tissues around the jaw line, but has less scarring. It is important to note, however, this facelift does not correct signs of ageing in the mid third of the face.

The Skin Lift

The skin lift, while still being performed today, has very limited applications in contemporary quality cosmetic plastic surgery. Except for very rare cases (especially in very thin women), the skin lift is inappropriate for reasons stated in favour of the deep plane facelift. In fact, in my over 20 years experience in facelifting, I have only found it appropriate to perform a skin lift on a few occasions.

The S-Lift and other Lifts

The S-Lift is not a new technique. It has been around since the 1920s, when the concept of facelifting was in its nascent phase. In fact,

Mid 40's

After facelift, browlift and blepharoplasty
by Dr Hodgkinson

50's

After facelift and lower blepharoplasty
by Dr Hodgkinson

60's

After facelift and blepharoplasty
by Dr Hodgkinson

through the years, many forms of facelifting have been attempted, such as the S-Lift and vertical facelift.

These other techniques have not been able to gain long-term popular support – either by doctors in the medical literature, due to the modesty of the result achieved and/or the higher probability of unacceptable scarring, or by the public for the same reasons despite the “value” they seem to represent.

In conclusion, facelifting has become a procedure as commonly embraced by everyday women and men as by media personalities. In an age where we are enjoying a vital lifestyle well into our 70s, we also find ourselves wanting to enjoy the high self-esteem and look of vitality that would seem to naturally accompany such a sense of wellness.