A Facelift is not really a Facelift
A Facelift does not lift the “face”. It lifts the:
- Jowls (red arrow) to create a smooth jawline
- Neck to get rid of the “turkey neck”
- Cervico-mental angle to create a clear angle between the jaw and neck
A Browlift lifts the forehead and eyebrows to improve the appearance of the upper eyelids.
A Mid-Face lift is for the cheek tissue between the lower eyelid and jowl area, which improves the appearance of the eye bags and laugh lines.
It is important to know what each one does so that one does not go for treatment with unrealistic expectations.
Variations of the facelift
The full incision is one that starts near the top of the ear, goes around the ear lobe and goes half way up behind the ear.
Different surgeons have innovate with the design and length of the scar. The shorter the scar, the easier it is to persuade the patient. The more loose skin that needs to be removed, the longer the scar needs to be.
The shorter the incision, the easier it is to avoid having it done under general anaesthesia or deep sedation.
The earliest facelifts were “skin only” lifts. The sagging skin of the jaw and neck were lifted, pulled tight and the excess trimmed. It was safe, easy but the effect didn’t last long because the skin is not strong enough to support the deeper tissue for a long time. To improve the longevity, surgeons started lifting the deeper tissues. The nerves and blood vessels are in the deeper layers, so the deeper lifts are technically more difficult, more dangerous and require deeper anaesthesia.
The "Mini Lift"
When there is not a lot of loose neck tissue to be lifted, mini-lifts are perfect. The scar is shorter. The operation does not involve a large area, which means that deep anaesthesia is not necessary. The procedure can be done as an office procedure and the patient an walk out after the procedure.
These are usually the best selling items on the menu. No surgery, no scar, no down time, cheap if you buy a package of multiple treatments. They require minimal training to perform but there are no miracles in Aesthetic Medicine, yet.
The "Botulinum A Lift"
Botulinum (Botox) paralyses muscle. If you cannot smile, there are no crow’s feet. If muscles below the eyebrow are weakened, the muscle of the forehead will lift the brow. This is one way to, temporarily, improve (or cheat on?) the result of a double eyelid operation where the loose skin at the outer corners of the upper eye lid were not lifted by a brow lift.
The "Filler lift"
The deep nasolabial (or “laugh lines”) and marionette lines are due to sagging cheek tissue. The correction is, therefore, to lift the sagging tissue. Injection fillers into these grooves makes them appear shallower (link here for more info). It is a camouflage that makes the face look lifted. There is no real “lift”.
Fillers can cause blindness. Follow this link for more information.
The heat-based treatments
These are probably the most expensive treatments because they involve expensive machines. They could be the most imprecise (and possibly dangerous?) methods. The deep tissues of the face are heated with lasers, ultrasound or radio-frequency to “stimulate collagen”. It is actually causing heat injury to the deeper tissues, causing scarring in the deeper layers (aka stimulated collagen growth) which tightens the skin. It is expensive because it requires repeated treatments. The danger is because the depth of injury cannot be precisely controlled.
Surgeons who have operated on patients who have had some treatments have noticed irregular scarring in the deeper layers, making the facelift less effective and more difficult to do.
Our experience has been that the people who profited most from these treatments are the vendors of the expensive hardware and the finance companies who provide the business loans.