There’s no getting away from the fact that over time the effects of gravity, sun damage and the stresses of everyday life appear on your face. Deep lines may appear around your eyes and mouth, sagging skin may fall from your cheek, jawline and neck, and fat deposits that were once full and firm become depleted, leaving hollow and sunken areas of your face.
A facelift, or medically termed ‘rhytidectomy’, is used to restore the contours of the face, correcting sagging, loose skin and repositioning fat and tissues to add volume back to the face.
By repositioning both the skin and the layer of muscle and tissue beneath (known as the superficial musculoaponeurotic system, or SMAS), the modern approach to facelifting addresses volume replacement and vectors of lift to create a younger looking appearance while avoiding the telltale signs of surgery.
Recovery from modern facelifts is typically much less extensive and lengthy compared with facelifts of the past, with less swelling, bruising, pain and recovery time. There are also different procedures, such as mini-lifts, which use smaller and fewer incisions, offering less recovery and down time.
Advances in surgical procedures and technology mean there are several different facelift types and techniques available today. They are designed to address your individual needs more specifically, helping to ensure optimal and natural-looking results.
SMAS lift
The SMAS (Superficial Musculoaponeurotic System) technique concentrates on the thin underlying connective tissue and muscle layer called the superficial musculoaponeurotic system, as well as repositioning and removing excess skin. Tightening this foundational tissue gives a smoother and improved shape without noticeable tension in the skin. This type of facelift is generally considered to be the gold standard in facelift surgery today.
Extended SMAS lift
An extended SMAS lift separates the SMAS from the underlying facial structures more extensively towards the nose and upper lip compared with the SMAS lift. This can address age-related changes in the nasolabial area (around the nose and mouth) more than the traditional SMAS lift; however increasing the amount of SMAS lifted also increases the risks of complications, such as skin necrosis.
Deep plane lift
A deep plane facelift is designed to reshape the entire face, including the upper and lower eyelids, the brow and the neck, by lifting facial tissues, fat, muscle and skin in one continuous section. Because the dissection is deep, the flap is thicker than in the SMAS method. This procedure is more invasive than other methods and may require a longer recovery period.
Subperiosteal lift
Commonly performed with the aid of an endoscope, the subperiosteal lift is designed to reposition skin, fat and muscle simultaneously since the tissues tend to sag together, not individually. This type of facelift releases tissues off the bony layer, separating the bone from all of the tissues covering it. There is more swelling with the subperiosteal lift than with more superficial lifts, due to the depth of the dissection. It also usually causes more swelling and takes longer to recover.
Composite lift
The composite facelift is similar to a deep plane lift, with the addition of an extra step to include the muscle around the lower eyelid. The orbicularis oculi muscle (around the eye) is separated from its attachment to the cheekbone through an incision in the lower eyelid and then lifted and sutured into place. The composite facelift essentially involves elevation and resection of the SMAS layer, orbicularis muscle and cheek fat pad. There is typically more swelling with the composite lift than with more superficial lifts.
S-Lift
The S-Lift is a type of facelift named after the S-shaped incision made in the hairline at the temple and in front of the ear. The SMAS and attaching skin is usually elevated as one unit and only excess skin is removed. The best candidates for an S-Lift are those who do not have significant skin laxity of the neck and jowls. It is most suited to patients beginning to show signs of facial ageing and want some tightening of the lower face without longer incisions.
Mini-lift
This type of facelift typically refers to any limited-incision facelift, usually with a quicker recovery time compared with other more invasive techniques. Also referred to as a MACS Lift (Minimal Access Cranial Suspension) and the short-scar facelift, it is typically suited for patients with early signs of ageing, usually aged in their 30s and 40s, to achieve a natural-looking facial rejuvenation. During a mini-lift, the surgeon usually makes a short incision on the front side of the ear. Via this incision, deep plicating sutures lift the deep tissues and the extra skin is then removed. Due to its less invasive approach, this type of facelift typically offers less recovery time and a lower risk of complications.
Thread lift
A minimally invasive alternative to a surgical facelift is the thread lift. Thread lifting elevates the soft tissues of the face using specially designed internal sutures and can deliver subtle yet effective results for the right candidate. The procedure involves the use of multiple fine biocompatible threads to lift and support sagging skin on the face and neck. Tiny ‘nicks’ are made to the skin, which are hidden in the sideburn area. Threads are then looped to the sagging soft tissues that support the face and neck, lifting and anchoring the facial tissue to an elevated, more youthful position.
Once in position, the body generates new collagen that surrounds each thread to maintain the lifting effect. The threads dissolve within nine to 12 months, while maintaining the revitalising and lifting effect for several years to come. The procedure is typically performed under local anaesthetic and usually takes around one hour to perform. Patients can usually return home within one to two hours after the procedure.
