Question:
There seem to be many different facelift techniques: the deep plane lift, the S lift, the SMAS lift, etc. Can you describe the main differences between these many different techniques and which are considered best?
Answer:
The main difference in the facelift technique is the length of incision, incision placement and the degree to which the SMAS is undermined and pulled. Adding to the confusion is that many of the same procedures are called by different names. Eg. Minilift and S-lift.
In our practice, we use a graduated approach to our face lifting technique. In patients with a thin neck that doesn’t need liposuction, lacks significant platysmal banding and does not sag to a severe degree, we will discuss a limited incision (S-lift, mini lift) approach. The limited incision approach involves making an incision around the ear, lifting the skin, then incising the SMAS (submuscular aponeurotic system), undermining the SMAS for a short distance and suspending it, and then removing the redundant skin and closing. This procedure is done in the office with oral sedation and local and has about 5-7 days of recovery.
For patients with heavier necks, significant platysmal banding or a desire to have the tightest neck possible, we will offer a facelift that involves making a small incision under the chin and performing liposuction and platysmaplasty where the muscles of the neck are anchored together in the midline. We will then open the skin around the ear and address the SMAS as above, however in patients that require it, we will dissect the SMAS for a much greater distance allowing for a greater lift.
The best technique is one that is tailored to the patients anatomy and expectations.
Posted by Dr. Buckingham
