Facelift

The facelift performed here is the orthodox dual-plane technique: the SMAS is dissected above and below so that the retaining ligaments can be released individually, and skin and SMAS are then repositioned along different vectors because the face does not age uniformly across its layers.

Dissecting two planes separately raises the technical difficulty of the operation. What it buys is that both the skin and the deeper structures move, rather than the skin alone being pulled tighter over structures that have not been addressed. The incision runs behind the ear, which is what keeps scarring out of view and allows the jawline and neck to be corrected along with the face.

Surgery is not the default answer. Loose and descended skin is assessed by palpation first, and an operation is recommended only where it is the most effective option — where it is not, non-surgical lifting is proposed instead.

Who it suits

• Descent that no longer responds to energy-based liftingWhere laxity has passed the point at which ultrasound or RF can reposition it.
• Jawline and neck togetherThe retro-auricular incision allows the neck line to be addressed in the same operation.
• Patients who want the structure moved, not the skin stretchedDual-plane dissection is what separates a repositioned face from a tightened one.

Questions