Facelift surgery: 8 common questions answered by an expert

Facelifting terminology is confusing. Cutaneous facelift, deep plane facelift, subperiosteal facelift, endoscopic facelift, SMAS facelift, composite facelift, MACS facelift, midface lift, volumetric facelift, browlift, and neck lift (to name a few!), present a bewildering choice. Advances in surgical techniques can avoid the unnatural ‘over-pulled’ appearance that is too often seen. Expert plastic surgeon Mr Matthew James answers common questions on different facelift procedures.

What is Facial Rejuvenation Surgery?

It is best to regard ‘Facial Rejuvenation Surgery’ as carefully chosen surgical techniques addressing ageing for each person. Several different techniques may be important to maintain a sense of facial balance, which should result in a fresher, natural and more youthful appearance with well concealed scars. The most common types of facelift are SMAS facelifts.

What are SMAS facelifts?

SMAS stands for Sub-cutaneous Musculo-Aponeurotic System, a layer of facial tissue beneath the skin to which the facial muscles are attached. Many techniques that lift this deeper layer of the face have been described, accounting for many different facelift names. By lifting the SMAS, longer lasting and more natural contours of the face can be achieved.

What is a cutaneous (skin only) facelift

The skin is lifted from the underlying tissues of the face and pulled upwards and backwards towards the ears where the scars are hidden. A simple technique with short recovery time but the ageing deeper structures are not treated, rejuvenation is not so long-lasting and distortions of the face can occur.

What is a midface lift?

Baggy lower eyelids and a deep groove along a line between the lower eyelid and the cheek, and a groove between the nose and the corner of the mouth is a concern for many. Midface lifting addresses this problem and restores the youthful continuity between the lower eyelid and cheek. Midface lifts are performed at different levels and are often very rejuvenating but more complex procedures with a longer recovery time.

What is a volumetric facelift?

Some people lose the plump fullness of the face. Volumetric facelifts restore the volume of the face by fat grafting techniques.

What is a neck lift or platysmaplasty?

To help tighten vertical folds in the neck, and restore the angle between the neck and the chin, a procedure known as an anterior platysmaplasty may be appropriate.

What are browlifts, endoscopic browlifts and forehead lifts?

Eyebrows tend to droop, leading to ‘heavy’ and tired looking eyes. Lifting the eyebrows to a youthful position is very effective at rejuvenating the eyes in conjunction with upper eyelid blepharoplasty. Endoscopic or keyhole surgery now allows the eyebrows to be lifted with small incisions hidden within the scalp hair.

What’s the best age to have a facelift and what’s the age limit?

The most common time that people request surgery is in their 40’s and 50’s but there is no specific age limit. Your surgeon should assess your level of fitness for any procedure being considered.

How long does it take to recover from facial rejuvenation surgery?

This depends on what surgery you’ve had and what work you do. In general, it is wise to allow two to four weeks recovery time. It takes longer to recover from deeper plane facelifting and may take up to twelve weeks for all the signs to disappear.

How long does facial rejuvenation surgery last?

Generally, the deeper the level at which a facelift is done, the longer lasting the results which should be many years. However, the more extensive the surgical procedures the longer the recovery time.

What are the best non-surgical facelift treatments?

A wide variety of non-surgical treatments are available to treat fine lines and skin tone but none can treat the gravitational drooping effects of ageing that can be achieved with surgery.

To schedule in an appointment today with Mr Matthew James, simply visit his Top Doctors profile.