Face Lift Techniques

There are many different face lift techniques that are available to reverse the changes associated with facial aging.

Subperiosteal Lift-Some surgeons believe this procedure gives patients a more long-lasting face lift, because it deals with the tightening of the deeper tissues of the face. This method may be done endoscopically or with an open technique using a brow lift incision. By releasing the tissues off of the bony layer it believed that elevating and reshaping results will be improved. There are significant disadvantages associated with this approach. This approach repositions the origins of the zygomatic musculature (muscles starting on the cheekbones that go to the mouth) and may give excessive horizontal width to the midface. There may be more facial swelling and bruising postoperatively than with other approaches. Most authors perform the subperiosteal dissection over the anterior portion of the zygomatic arch, which places some risk to the temporal branch of the facial nerve. If there is any significant lower facial laxity another procedure must be performed in order to obtain an acceptable result.

SMAS (Superficial Musculoaponeurotic System) Face Lift-Known as the gold standard in face lift approaches. This technique builds on existing traditional face lift methods by concentrating on the thin underlying connective tissue layer called the superficial musculoaponeurotic system. The SMAS acts as a vehicle to reposition facial fat and restore the softness over the cheekbones and reposition the jowls back up into the cheeks. Tightening of this supporting tissue gives a smoother and improved shape without noticeable tension in the skin. In particular, this method works well for people who are most concerned with the folds around the nose and mouth called nasolabial folds and also improvement of the jowls.

Mid-face Lift-The mid-face lift, also known as the cheek lift, focuses on the area beginning below the eye to the lower cheek area. As the area between the lower eyelid, cheek and nasolabial fold ages, this area descends and cannot always be improved by a regular face lift procedure. The cheek lift concentrates on improving the loose skin, fat deposits and tissues of this particular area. This procedure is specifically geared toward the cheek area, and does not address the aging signs of brow, jaw line or neck. Patients who are candidates for this procedure tend to be younger patients with isolated midfacial aging and early jowls and patients who are not prepared for a more aggressive surgical procedure or those patients who reject a preauricular scar. Patients in whom there is more significant laxity of the skin require an additional lower face rhytidectomy that may involve elevation of a SMAS flap.

Deep Plane Face Lift-The deep plane system is a more invasive process that reshapes the whole face including the neck, brow and both upper and lower eyelids. By lifting the skin, facial tissues, muscle and fat all in one continuous section, deep plane lifts can affect more of the face area. The “deep plane” allows for significant tension to be placed onto the lifted flaps. The technique is limited by the fact that the skin and soft tissues move in only one vector, which may not be applicable in most patients. The postoperative course is long and marked by prolonged swelling.

Threadlift or Feather Lift-This newly approved procedure was recently approved and similarly should be as rapidly discarded. The threadlift technique uses patented self-anchoring polypropylene threads that lift and suspend tissues in the facial area. Because of the lack of longevity of the technique, the need for frequent revisions, and the complications associated with the technique the threadlift has been abandoned by credible surgeons.

Please contact Dr. Sundine at 949 706 3100 to schedule a consultation where he can review your particular concerns and determine the appropriate procedure to meet your specific concerns.