What is a facelift?

A facelift refers to any number of cosmetic procedures that are intended to lift the sagging skin of the face and/or upper neck to achieve a more rejuvenated, youthful look. Most facial plastic surgeons in today's day and age perform facelift surgery by using camouflaged incisions that are hidden around and behind the ears. With meticulous technique these incisions can heal to the point where they are barely visible. The actual lift itself is performed by elevating what is called the SMAS layer of the face. The SMAS refers to a natural tissue layer below the skin that extends across the lower face into the upper neck. It is the SMAS that actually gets cut and tightened during a facelift procedure. The skin then passively redrapes in its new position and the excess is carefully removed. The end result is a more youthful yet natural appearing face. The SMAS component of a facelift procedure is probably the most important factor in achieving long-term, natural looking results. The SMAS layer is what provides a durable lift and prevents the skin from having any unwanted tension after the lift. Elevating the SMAS is also what helps to avoid having a pulled look. The main difference between the many types of facelift options you might read about is how the SMAS is treated. For instance, in a deep plane facelift the procedure calls for going under the SMAS layer along a deeper, more extensive tissue plane. Proponents of the deep plane facelift procedure feel that going further under the SMAS translates into better long-term results. Not every facial plastic surgeon necessarily believes in deep plane facelift. Instead, others will perform what is called a sub-SMAS facelift where the SMAS is elevated and lifted sufficiently without risking the extensive dissection seen in the deep plane technique. In reality, most facial plastic surgeons are versed in a variety of facelift techniques and choose one particular method based on the individual's needs and desires. The most important factor is choosing a board certified surgeon who has proper training and experience in performing facelift surgery. Also make sure you see plenty of photo examples of their work.