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What kinds of facelifts are there?

Posted October 04, 2017 in Uncategorized

We have more information available to us than ever before.  This is amazing and empowering for patients to know exactly what they want are are having done, but it can also be overwhelming.  You may have heard of or read about different surgical techniques for facelifts and were wondering how they compare.

Which is better, a SMAS (superficial musculoaponeurotic system) or facial muscle lift or a Deep Plane lift?  This is a philosophical debate that has been had at every plastic surgery meeting since we have been doing these lifts.  In the SMAS lift, we elevate the skin, then lift the muscle to where it used to be, like straightening out sheets when you make a bed, and suture it in place.  The skin is gently redraped over the muscle and the excess skin is removed so there is no tension on the skin.  This is the method that I prefer because it can have less swelling, bruising and importantly, less risk to nerves to the mouth and eyes with excellent results.

In the Deep Plane lift, there is a smaller elevation of skin, but the primary elevation is below the muscle then the muscle is lifted and sutured in place. This can have more swelling, bruising and potential risk to the nerves that move the face, because the nerves insert on the underside of the muscle.  However, the surgeons that prefer this method feel that this technique allows more movement of the facial muscles leading to more improvement in the lift in the cheeks and improvement of the nasolabial folds (parentheses).

Personally, I have seen good results with both methods.  If one was definitively superior to the other, we would have resolved this long ago and all or most of us would be doing it one way.  What is important is that your surgeon has good results with the technique that they prefer.