The facelift today's patients have in Manhattan (and around the world) is one of the oldest cosmetic procedures performed by modern doctors. It began in the early 1900s as an operation to correct wrinkles and excise loose skin. Surgeons then used horse hair and silver wires to suture the resulting incision. Early day facelifts would look something like what you see in this drawing.
In the subsequent 100+ years, facelift techniques were constantly modified and improved to achieve better and longer-lasting result. Today, surgeons employ a whole range of methods to achieve the most effective facial rejuvenation in people of different age groups, with various types of types of facial structures and a wide range of aging changes. However, as a result of rapid facelift technique improvements and continuous development, facelift terminology became quite difficult to navigate, even for the most educated consumers.
Furthermore, in recent years, many nonsurgical facial rejuvenation procedures were named "facelifts," thus further contributing to the confusion and difficulty of facelift terminology. When I discuss the subject with my patients, I find it helpful to separate all the commonly used facelift names into three broad categories:
Non-facelift "lifting" procedures
Non-facelift facial rejuvenation
Here are some of the most commonly used facelift names and their brief description:
These rely on lifting and removal of the sagging skin for their rejuvenating effect.
Mini facelift is a procedure that is reserved for the early stages of facial aging. Some of the sagging facial skin is lifted and excised, hiding the incisions around the ears. Mini facelift is able to improve jawline definition and neck contour by removing some of the loose skin. However, these results typically do not last as long as other facelift techniques.
This type of facelift is most suitable for people in their late 30s and early 40s who are bothered by early signs of facial aging. People with more extensive aging changes are usually better served with other, more extensive facelift techniques.
MACS facelift is a form of a mini facelift. The main feature of this type of facelift is the different location of the incisions compared with most other methods. The incisions are placed around the temple hair tuft and then curve around the ears, but do not extend into the back of the ear and posterior hairline. Otherwise, this method offers results and longevity very similar to a mini facelift.
SMAS lift is not really a name of any particular facelift type, but rather a descriptive term. SMAS (the submuscular aponeurotic system) is located right under the skin and is being used by surgeons to place the sutures that create the actual "lift" of the facelift. Any facelift type where the tightening sutures are placed in the SMAS layer is actually a SMAS facelift. That makes virtually 100% of the facelifts SMAS lifts.
Full facelift: Just as in the SMAS facelift, this is not a name of any particular facelift type, but rather a term that distinguishes a more extensive facelift procedure from smaller or partial facelift techniques, such as mini facelift, MACS, or neck lift. Today, the term "full facelift" is most commonly used to designate a very extensive traditional facelift procedure.
This is achieved by releasing the deeper ligaments of the SMAS (see above) and limiting skin dissection. Many surgeons believe that deep plane facelift is the most effective facelift technique today.
Neck lift is a partial procedure where the surgeon places the most attention on improving neck contour, rather than jowls or sagging cheeks. This type of procedure is more popular with men and involves making incisions under the chin and behind the ears. Neck lift is not a procedure that suits everyone, so proper patient selection is very important.
These are surgical and nonsurgical procedures that are designed to elevate facial tissue but do not remove any sagging skin.
Endoscopic facelift (midface lift) has very limited ability to lift the facial skin. This procedure is primarily performed to improve cheek contour; however, cheek elevation comes at the price of changing the structure of the cheekbones, which makes them appear wider. Today, this type of facelift is far less popular then other facelift types and has been largely replaced by facial fillers.
Thread lift is a minimally invasive procedure that elevates the skin of the face with specially designed threads that are placed through a small, inconspicuous incision. The result can be quite pleasing; however, the longevity of this type of a lift limits its popularity. Since no loose skin is removed, the results typically last for only 6 to 9 months.
Nefertiti lift creates mild elevation of the facial skin by injecting the neck with BOTOX® Cosmetic. An overactive neck muscle called platysma can sometimes be responsible for pulling the skin of the face down. Once this muscle is treated with BOTOX, the skin lifts.
Non-Facelift Facial Rejuvenation
These procedures utilize the word "facelift" in their names, but do not result in facial tissue elevation or removal of the loose skin.
Vampire Facelift® relies on improving the quality of the skin and enhancing the contour of the cheeks to achieve a rejuvenated look. No real lifting takes place, so the name rather refers to the overall rejuvenated appearance of the patient, rather than a process that reverses sagging skin of the face.
Dr. Konstantin performs a live Vampire Facelift®, or platelet-rich plasma (PRP) treatment.
Liquid facelift is achieved with extensive use of dermal fillers that are strategically placed to camouflage early aging changes. Cheek enhancement and effacement of nasolabial folds and pre-jowl grooves are the most common strategies of a liquid facelift rejuvenation. As with Vampire Facelift®, no actual lifting takes place.
Stem cell facelift is a procedure similar to a liquid facelift, but instead of hyaluronic acid, a patient’s own body fat is used as a natural filler. Some doctors believe that the fat naturally contains a high amount of stem cells, which can enhance the rejuvenating effect of the injections.
So, with all the different facelift techniques out there, how does one find out which type of facelift is the best for them? Answering this question can be even more complicated than figuring out confusing facelift terminology.
The good news is that you don’t have to figure it out all by yourself. Talk to a surgeon who specializes in facelifts and ask him or her to show you all the options, and rely on that surgeon's expertise to select the best one for you.
If you're interested in learning whether facelift surgery at Dr. Konstantin's New York City practice is right for you, contact us online for a consultation, or call
to speak to a member of our team.
Dr. Konstantin is a double board-certified facial plastic surgeon specializing in artful treatment of the aging face, eyelids, and neck. He performs more than 1,000 facial cosmetic procedures annually, making him one of the busiest facial plastic surgeons in Manhattan.