Are there different types of face-lift procedures?

Depending on a person’s aesthetic goals and result preferences, a surgeon will assess various applicable risks and a person’s facial anatomy before agreeing to perform any of the below types of face-lift procedures.

The type of incision used generally differentiates the various options for surgery, as well as the number of treatable tissue layers, the degree of surgical invasiveness necessary to achieve the desired result, as well as the specific area of the face in which a person desires an aesthetic change.

Some of the most popular face-lift types (techniques) are:

• The deep plane lift: Considered the gold standard for most surgeons, this option often produces the most lasting results, and fewer necessary revisions or further corrective procedures. It is mostly recommended for those with severe facial sagging. This option is a more technical procedure where incisions are made along the hairline allowing for easier lifting and repositioning of facial muscles and upper fatty tissue layers (superficial musculoaponeurotic system or SMAS). The SMAS area is just beneath the skin, and surrounding the muscles responsible for facial expression (smiling or frowning). Incisions are extended in a downward direction along the natural creases of the face along the ear lobe and ending in the crease behind the ears. A surgeon will separate the skin from the SMAS layer, before cutting into what is referred to as the ‘deep plane’ beneath. The surgeon will then release any tissue attachments, allowing for easier movement to reposition the SMAS layer and skin. Once this is done, the SMAS layer will be repositioned and any excess skin is then removed in the process. From there, a surgeon will stitch (using sutures) or staple the skin back in place along the hairline incisions. The results of this procedure can be incredibly dramatic, especially around the cheeks, jawline, chin and nasolabial folds or ‘smile lines’, and last between 10 and 15 years.
• The SMAS (superficial musculoaponeurotic system) lift: This option is ideal for tissues around the face and neck which have begun to droop with age, especially where mild-sagging has occurred. The procedure works with the superficial (top) layers of skin and tissues beneath once an incision is made at the temple, just above the hairline. Further incisions are made downwards following the natural crease ending at the edge of the top of the ear, below the ear lobe or behind the ear. A surgeon will then tighten the SMAS using sutures and remove any excess skin before making the final stitches. The greatest difference between this lift technique and the deep plane option is that the surgeon does not release any tissue attachments beneath the SMAS layer.
• Short scar lifts: This option involves several abbreviated scars (incisions) which do not end behind the ear. Examples of short scar lifts include an S-shaped incision (made at the temple or in front of the ear), or a minimal access cranial suspension lift / MACS (in which an incision ends at the ear lobe). Either option is often preferred for those in their 40s and 50s who do not have too much excess skin, or for those with very few signs of aging around the neck. This option is quite effective in tightening moderate amounts of sagging skin, and re-adjusting tissues that support smile lines or jowls.
• The endoscopic face-lift: A surgeon uses an endoscope (a pencil-shaped probe with a small camera attached at the end) to view clear video images of the internal facial structures, and transmit theses visuals to a monitor or screen. Three or more incisions are made to insert the endoscope and perform a face-lift procedure. This option is not as popular as some of the other methods due to results that aren’t as effective, but it may be considered for sagging in the cheeks (where the best results of endoscopically done lifts have been achieved).
• The mid-face or cheek lift: A surgeon will make incisions in the hairline, as well as the inside of the mouth. This option targets the middle third of the face and allows for easier lifting and repositioning of the fatty layers covering the cheekbones. The objective of this method is to improve lines between the nose and the mouth, as well as to lift dropping cheeks. Subtle freshening with minimal risk can also be done endoscopically with an isolated mid-face-lift or through the lower eyelid (along with eyelid surgery).
• The thread lift (also known as the feather lift or aptos lift): This method is often used in combination with other face-lift options as a way to provide additional tissue support in the face. A surgeon makes use of small suture barbs attached to a thread which act like a hook to tighten the skin (gathering layers of skin upward). For this method, no removal of skin or tissue generally takes place.
• The stem cell face-lift: Although called a ‘face-lift’, this option is technically not a surgical procedure. A surgeon, however, performs this method with fat injections in a two-step process. Fat cells and the stem cells within them are harvested through a liposuction procedure (often in the buttocks, thighs or tummy area where they are plentiful) and then processed. The cells are then injected into various areas around the face to contour and fill trouble spots such as the cheeks, temples, under-eye hollows, or lips.