Facelift techniques have been around for many years. Throughout this time, the evolution of the procedure has been significant. Initially, it was not uncommon for the patient to be hospitalized and on strict bed rest for several days. Much of this was due to the fact that older techniques resulted in more bleeding and swelling. This required prolonged dressings and drains. Another downfall with early lifts was an incomplete correction of the aging or sagging of the skin–as only the skin, and not the underlying muscles and ligaments, were treated.
The two major advances in face-lifting were understanding of the role of the ligamentous layer (termed the SMAS) to support a more substantial, longer lasting lift and controlling the bleeding with special instrumentation. For the traditionalists, these techniques were not readily embraced because treating the SMAS required more skill and time and newer instruments were not always welcomed. For those who embraced these advancements, we owe a great deal of credit for developing the most significant and lasting facelift, commonly termed the SMAS lift or deep plane facelift … what many of my patients refer to as a full facelift. Utilizing modern instrumentation and understanding the SMAS ligament has enabled specialists in facial plastic surgery to create the most significant amount of lifting with the longest lasting results while maintaining a very natural appearance. The procedure is more involved and therefore requires more healing time than a “mini-lift.” The usual “downtime” for the procedure is 10 to 14 days until the patient feels comfortable with their public appearance. This is primarily due to swelling. Bleeding is drastically reduced when the surgeon uses a laser-like scalpel. The patient has a very important role in the healing process and end result of their facelift. It is imperative that the patient refrains from taking any blood thinners, including alcohol, and discontinue the use of caffeine, nicotine and strenuous physical activity around the time of surgery to avoid causing more swelling and bruising. The payoff is substantial for the compliant patient that elects this procedure as their results would be undoubtedly more rejuvenating and again, longer lasting.
The level of activity enjoyed by today’s younger cosmetic patients has widely popularized less invasive procedures such as the mini-lift. The principles are similar. However, the amount of lifting and the longevity of the results are oftentimes much less than a true SMAS lift. The amount of loose tissue that is corrected is less, therefore the result is less bruising and swelling and a slightly shorter period of “downtime.” Patients feel comfortable with their public appearance in a few days to one week and need to take the same pre- and post-operative precautions as a SMAS facelift. The mini-lift can be done under a local anesthetic which is appealing to many patients but most elect for a general anesthetic.
The key for choosing the right procedure for you is to understand the results that are achieved from both procedures and the amount of time you are willing to devote to your recovery. In summary, the traditional SMAS lift is safe as long as the patient refrains from blood thinners, caffeine, nicotine and straining. The results are more significant and longer lasting. The patient requires a general anesthetic and approximately 10 to 14 days of healing time. The mini-lift is also safe with slightly less downtime (a few to several days), but may require a tuck up sooner than a SMAS face lift. The mini-lift can be performed under a local anesthetic with less cost. Knowing these factors will help the patient and the surgeon choose the right procedures for each individual’s needs.
Dr. Marc E. Yune, who founded ASC in 1998, is a double board certified fellowship trained facial plastic and cosmetic surgeon who serves as a consultant to CNN, Discovery Health Channel and a variety of other media.
Aesthetic Specialty Centre
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