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Lifting without a “Facelift”

Posted September 26, 2017 in Uncategorized

Many people desire a lift, but get nervous hearing the word “facelift”.  So, what other options are out there?

Siloutette lift

The Siloutette lift is a relatively new product, but not a new idea.  This lift uses 3 threads to lift the facial skin, which is the same idea as the “thread lift” from years ago.  The differences are that the threads are made from the same material as dissolvable sutures, which means that they stimulate collagen and will dissolve over time.  They also have multiple cones facing each direction that catch the skin and hold it in the lifted position.  This procedure can be done under local anesthesia in the office relatively quickly, which is like fillers but lifts in a way that they do not.  Since you are depending on only 3 sutures, you cannot recreate the strength or multidirectional element of the lift needed to create the natural age reversal you get in facelifting.  Also, you are only addressing the cheeks, not the neck.  So, this is best for someone with a great neck and just a little laxity in the cheeks and nasolabial folds.

Liquid facelift

Liquid facelifts are a catchy name for using soft tissue fillers, Juvederm, Restylane, Voluma or Restylane lift, to volumize the face, particularly the cheeks to give a quick lift.  The most important part of the face to fill to get this lift is the side of the cheek just in front of the ears.  Just a little bit here gives a nice lift to the cheeks and nasolabial folds.  Unfortunately, it doesn’t lift the jowls that well just the way the anatomy is.  A small amount of filler can be placed in the prejowl sulcus (dip in front of the jowl and behind the chin) or even behind the jowl along the jawline to create a smooth jawline.  These last between 1-2 years depending on the fillers used.

Mini-Lifts

The least involved lifts are the MACs or Minilifts.  These can be marketed by many different names.  Basically, these all fall under the category of “short scar facelifts”.  This is what it sounds like.  The incision is smaller than that of the full facelift.  The incision usually starts in the hair tuft in front of the ear, goes behind the square cartilage on the front of the ear (tragus) and just under the earlobe.  This gives the surgeon access to the cheek, but minimal access to the neck.  Therefore, lifting sutures are placed in the cheek area and maybe one suture to lift the neck maybe not.  Sometimes this is combined with an incision under the chin to perform liposuction here.  Most of the time, this results in improvement in the cheeks and nasolabial folds (parenthesis around the mouth), but not as great definition in the jawline and neck.  The number of sutures placed in the cheek can correlate to the naturalness and longevity of the lift.  Also, if only 1-3 sutures are placed (which some surgeons do), and one of those breaks that is much more impactful on your result than if 5-10 are placed on each side.  So, ask your surgeon about their technique.

Neck Lift

Many people will say that the only want a neck lift, which is often because they think that a facelift includes the whole face including brows and eyes.  This is an understandable misunderstanding, since that is what the name sounds like.  A facelift lifts the cheeks, jowls (making a more defined jawline) and the neck.  A neck lift can be done using an incision from behind the ear into the hair behind the ear, but this does not improve the jawline or cheeks.  Also, consider that the neck is the longest, most involved part of the facelift, so adding the cheeks and jawline doesn’t add that much OR time, surgical risk or visible incision (since it is hidden in hair and around the ear).  This also gives you a better overall result, since the lower part of the face and neck will “match” and a defined jawline is what really makes a neck look great!

Midface lift

The midface lift is a way to elevate the cheeks in an isolated fashion.  This is good for people with a nicely defined jawline and neck, but have more descent in their cheeks than they would like.  Usually, an incision is made within the hair and sutures are used to elevate the cheek muscles and fat.  Another approach is through the same incision as a lower eyelid surgery and is useful for people who have lower lid bags and don’t have as much cheek projection or fullness as they would like.  I have seen surgeons transition to using the approach with the lower eyelid surgery, since the procedures work together and it seems to have a better overall result.

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