How Modern Facelift Technique Differs
The older approach stretched the skin and produced the windblown result people recognise. Current technique repositions the tissue beneath it instead. This page explains the difference and what it changes.
Visible ageing generally begins to appear after the age of thirty — first as expression lines, later as descent of the tissue itself. The operation that addresses the second of those has changed substantially, and the change explains why current results look different from the ones people picture.
The older approach, and its problem
Earlier facelift technique worked on the skin: the skin was lifted, pulled taut and the excess removed. The tension was carried by the skin itself.
Skin is not a structural tissue and does not hold tension well. It stretches again, and while it holds it distorts the features around it — the windblown appearance that is still the first thing most patients say they want to avoid.
The current approach
Modern technique repositions the tissue underneath rather than stretching what is on top. The deeper layer is released from its attachments and moved back to where it sat, and the skin is then redraped over that new position without tension.
The consequence is that the result depends on the position of the tissue rather than on the tightness of the skin, which is why it both looks more natural and holds better.
Within the same operation, the surgeon addresses the muscles of the neck and jawline and the fat deposits in the cheek. Fat may be transferred from elsewhere on the body to restore volume where it has been lost — descent and volume loss occur together, and correcting one without the other produces a hollow result.
What area is treated
The treatment area extends from the collarbone to the outer corners of the eyes, including the cheeks and mid-face.
Above the level of the eyes, a brow or forehead lift is the relevant operation. Partial facelifts, addressing a defined area only, are available where the change is confined.
What it achieves
Loose skin is addressed, the facial contour is improved and the underlying muscle is tightened, with incisions placed where they are concealed by the hairline and the natural creases around the ear.
Results last in the region of five to ten years, depending on skin quality, genetics and how the face is looked after — sun protection and not smoking being the two factors with the largest effect. Most patients return to daily activities within a few weeks.
The part that matters most
Technique of this kind depends on the surgeon executing it. Releasing and repositioning the deeper tissue layer is a more demanding operation than tightening skin, and the difference between a good and a poor result is correspondingly larger. Choose on demonstrated experience with this specific operation.
The procedure this relates to
Rhytidectomy — surgery that addresses the descent of the face and neck by repositioning the deeper tissues, tightening the underlying muscle and removing the skin that is left over. Results typically last up to ten years.
Before you act on this
Everything here is general. What applies to you depends on your anatomy, your history and what you are trying to achieve, and none of that can be assessed from a page. If a question here is yours, bring it to a consultation.