A facelift is typically an outpatient procedure, though I advise clients to remain at the outpatient surgical center overnight for observation and support from our 24 hour nursing staff. There are several different facelift techniques, with varying areas of focus. The type of facelift you receive will depend on your desired results.
Most facelift techniques focus on the lower facial areas, such as the jawline, jowls, and cheeks. In some techniques, deeper facial tissues may be repositioned or tightened to restore a more youthful contour. In other techniques, it may be necessary to remove or add fat or other soft-tissue fillers to achieve the best results.
Today, many different techniques exist with outcomes that can be consistently reliable, safe, and durable.
The type of facelift determines the length of incision used. As the name suggests, a short-scar facelift uses a shorter posterior incision. For a full facelift, Dr. James Rosing will make an incision that starts in the temple area and extends downward along the natural ear curves, around the ear lobe and back up to the bone along your hairline behind your ear (see illustration for the most common incision types). The skin is then elevated, and the muscle and tissue underneath (SMAS) is tightened. The nuance in face lifting is in the SMAS dissection. Depending on each patient’s unique facial skin characteristics, soft tissue volume, shape, symmetry or asymmetry, neck obliquity, skeletal contour, and animation characteristics, Dr. James Rosing alters the SMAS dissection and tightening to fit these features. Once the SMAS has been addressed, the skin is then re-draped over the facial soft tissue, excess is trimmed, and the incision is carefully sutured. The incision is beveled at the hairline to allow for follicles to grow through the scar and is sewn along a natural crease to camouflage the incision area.
By default, when performing a facelift that involves elevating and tightening the SMAS layer, the neck is also tightened. This is the result of normal facial anatomy as the SMAS and neck muscle (platysma) are connected. The dissection will commonly also tighten sagging jowls (lower cheeks along the jawline) in front of the ear as the layers of the neck and lower face are in continuity.