December 07, 2020

As you grow older, your skin becomes looser.  These inevitable changes that come with aging alter the shape and appearance of your face. The fat deposits may shrink in some areas and increase in others.

A facelift technique can help address these facial aging signs. With this procedure, your face can look years younger.

There are different types of facelift procedures, and some, like the surgical facelift, leave behind scars. That’s because the procedure involves making incisions in the skin.

This piece will explore the different types of facelifts, facelift scarring, and how to deal with it.

Let’s delve in:

What is FaceLift?

A facelift called rhytidectomy is a cosmetic procedure that helps tighten the skin’s facial skin to get a youthful, bright, and firm appearance. This procedure helps fix changes that come with age to improve the persons’ facial appearance.

The procedure can help correct jowls (that is, the fat build-up found between cheeks and chin), restore the lost cheeks (midface) volume, reduce wrinkles and deep folds, improve the neck contours, and reduce the sagging of the skin.

Types of Facelift Procedures 

There are different types of facelift procedures. These procedures can range from non-surgical, minimally invasive, to full surgical procedures. You can choose the best type depending on the results you want, recovery period, and priorities in terms of causing facial scars.

Here are the different types of facelifts: 

1. Non-Surgical Facelift

This procedure does not involve making facial incisions and thus does not cause scarring. The most common non-surgical options include Botox, injectable dermal fillers, laser resurfacing, infrared, and ultherapy.

A treatment approach can be customized for each patient based on the results required, including;

  • Reducing wrinkles, smile lines, and crow’s feet
  • Adding volume to some select parts like the lips or the cheeks.

2. Stem cell Facelift

Stem cell facelifts are one of the types of facelift without surgery. The procedure involves taking fat stem cells from another body part like the thighs or abdomen, processing them, and then injecting them in some areas of the face.

This procedure does not result in facial scars as the fat is injected, and no cutting occurs. It helps improve the appearance of the sunken or hollow facial parts.

3. Thread Lift

Thread facelift, also called feather facelift, uses “threads” with tiny hooks used to support the sagging skin. This procedure is minimally invasive.

The threads remain in place to makes the skin appear lifted. The dermatologist uses local anesthesia when performing this procedure.

4. Upper facelift

An upper facelift focuses on improving the sagging brow areas and the deep forehead wrinkles. This procedure does not treat fine lines or skin texture issues. To address these concerns, consider using other treatments. 

The doctor uses a mild sedative and then makes small incisions on the upper eyelid crease (just a centimeter above the lash line). You can choose to combine your upper facelift procedure with another procedure like eyelid surgery (blepharoplasty).

5. Mid Facelift or Cheek Lift

This procedure focuses on the areas between the corners of the eyes and mouth. It involves making adjustments on the corners of the upper lip, cheeks, and nose. Incisions are made on the lower eyelid crease (just a centimeter below the lash line). 

The doctor uses general anesthesia when performing the procedure. Some people choose to combine a mid-facelift with another procedure like nose surgery (rhinoplasty).

6. Jawline Rejuvenation/Lower Facelift with Necklift

The lower facelift helps remove or reposition fatty tissues and tightens the muscles below the mouth. In this procedure, small incisions are made along the laugh lines and jawlines, and sometimes it extends to the parts under the chin as well as the neck. 

Some people combine a lower facelift with submental or neck liposuction. Submental is a procedure that involves removing localised fat deposits from the neck and jawline. 

7. Complete Facelift

A complete facelift involves a combination of upper, mid, and lower facelift. This is performed in all face areas and works best for people advanced in age and those that want substantial improvements.

8. Endoscopic Facelift

This procedure is minimally invasive and is done through multiple small incisions. The doctor uses tiny tools and a tiny camera to make the small incisions. This can only be performed in certain parts of the face only.  So, if you want to combine your facelift with a neck lift, for instance, this will not be an ideal option.

9. Short Scar Facelift

This involves creating smaller incisions that leave lesser scars. These facelift scars mostly occur around the hairline and ear line.

10. SMAS lift (Superficial Muscular Aponeurotic System)

This type of facelift helps address both the deeper muscles on your face and the top layers of the skin. The doctor tightens the face muscles in multiple directions during the procedure.

11. Deep Plane Facelift

This is a more comprehensive and long-lasting procedure. It addresses the layers of the muscles found under the facial skin as they are the ones that cause the sagging and the drooping of the skin as you age. 

The therapist releases part of the muscle system from where they are attached, and then they reposition them well. This leaves the base of the facial skin smoother, tighter, and lifted. 

This procedure lifts the neck, jawline, and even the midface area to restore the natural face balance. This procedure tightens not only the facial skin but also the face foundation, and that’s why it’s the most long-lasting procedure.

Before you undergo a facelift procedure, the critical thing is to understand the type of facelift that will work for you. Work with your dermatologist to identify the best procedure for your face. 


Three Main Steps of Surgical Facelift (Rhytidectomy)

Step 1: Incision

Facelift surgery involves making small incisions along the hairline near the temple. Then marking out a path in front of the ear, behind the ear, around the earlobe and ending it in the hairline. If the patient also wants a neck lift, small incisions are made under the chin. These incisions must fall into the natural skin crease to camouflage them. During this phase, the doctor has to administer anesthesia.

Step 2: Procedure

It involves elevating a skin flap over the tissues that be lifted during surgery. Then the second layer of tissue, which is skin deep, is elevated and (closed) sutured. Tension is applied to this layer to improve the jawline contour and tightening of the facial jowls.

The doctor then suspends the layers of the tissue from the upper face, and it is closed roughly horizontally to allow tightening of the jawline and the lower face.

If the patient also needs a neck lift, an incision under the chin will expose the platysma muscle. These platysma muscles remain continuous to the tissue layer to help in “lifting” the face as well as tightening it to allow neck rejuvenation.

The muscle is then stitched from behind the ear to the mastoid bone using absorbable sutures for a more horizontal pull. The excess skin that may remain after the procedures is removed.

Step 3: Closure

After getting satisfied with the lift and trimming off the excess skin, the surgeon then closes the incisions with sutures. The doctor may combine permanent and absorbable sutures to close up the skin. 

Also, staples are used to close the hairline skin as they don’t damage the patient hair follicles.  The doctor then dresses the skin with a facelift bandage, which helps put enough pressure on the incision and surgical areas to limit swelling and reduce the possibility of fluid pooling in the wounds.

Facelift Scarring

A typical question facelift patients ask is, “will I have a noticeable scar?” Well, it depends on the type of facelift procedure you undergo and the therapist that performs it for you. If you undergo a procedure that involves incisions, you should expect potential scarring.

A scar is a spot that occurs on the skin after a cut or an injury. Some patients are more susceptible to scarring than others. Proper incision care after the procedure can also affect the chances of getting a lasting scar. 


Avoiding Facelift Scarring

After facelift incisions, scars are more likely to occur around the hairline, at the top, behind and in front of the ear and under the chin (if a neck lift is done). The shape of the ear may sometimes help conceal the facelift scars. The hairline transition may also hide facelift scars unless there is thinning or balding of the hair.

A good plastic surgeon trained in scar camouflage can conceal scars that become less visible or not noticeable at all. This involves closing incisions with special equipment and techniques to reduce scarring and speed up wound healing. The surgeons also educate their patients on proper post-surgical incision care.

Here are a few techniques that the surgeon can do to help eliminate facelift scarring:

  • Avoid extreme tension on the suture when the incisions are closed.
  • Using very fine micro-sutures when closing the incisions
  • Removing sutures within four days after the procedure
  •  Doing SMAS deep muscle tightening before closing the incisions to allow fewer sutures tension.
  • Proper wound care

Minimizing Facelift Scarring 

What can patients do to minimize bad facelift scars? Following the pre-operative and post-operative instructions that will be given is vital.

Here are detailed recovery instructions for all facelift patients.

  • Avoid smoking – Nicotine hampers the healing process.  Scars appear smoother and smaller if there is rapid healing. Therefore, avoiding nicotine and tobacco products before and after the facelift procedure will quicken recovery and minimize scarring.
  • Rest/Take it easy- Give yourself a couple of weeks after the procedure to heal. This, however, doesn’t mean complete bed rest. Exercising speeds up healing but don’t do the rigorous ones. Rigorous activities and heavy lifting may complicate healing.
  • Avoid sun exposure – If you expose your scars to the sun, they may darken permanently. When going outside, wear a brimmed hat and apply sunscreen until your scars heal or become barely visible.
  • Consider the use of silicone products, corticosteroid medication, microdermabrasion, chemical peeling, micro-needling and other treatments to help improve the appearance of the scars.


Bottom Line

Getting a specialist who is experienced and has a  board-satisfied specialization in doing facelift procedures is vital. A good surgeon can customise the right procedures for you that best fits your needs and desired objectives. With the right surgeon, facelift scarring is minimised, and they will help you achieve a perfect procedure.

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