One of the most common facial aging problems is the development of jowls and a sagging neck. While a facelift is the most effective treatment, early aging changes do not justify the traditional approach. As a result, facelift surgery techniques have advanced in the past decade to limit the extent of incision and scarring that occur with the traditional methods of facelifting which I will refer to as a full facelift.

Smaller forms of facelifts have evolved which lift up sagging jowls and provide some neck changes and do so with less scarring. These procedures have become popular largely because they recruit an additional set of patients, those who are younger and whom have less fallen facial tissues. These procedures have become known by a lot of names which either indicate the limited extent of the operation (e.g., short scar facelift, MACS lift, limited facelift, Swiftlift), a rapid or short recovery after the operation (e.g., Lifestyle Lift) or the location or shape of the incisional/scar pattern. (e.g., S- lift) In the end, however, despite their nuances they are all ‘Mini-Facelifts’.

The scarring that is eliminated in any of these Mini-Facelifts is in two specific hairline places, the hair-bearing areas of the temples above the ear and in the skin crease behind the ear. What is the significance to eliminating scarring in these areas? Because it reduces scar widening and hairline displacement. When a facelift incision goes up into the temporal hair, it will always move the sideburn hairlinje upward. This is not of great importance for most men since they can just restore their sideburn hair by beard growth. For women, however, there is no means of hairline replacement or recovery. When scars extend from away from the back of the ear skin crease, they will become noticeable in those that have very short hair or wear their hair back ina ponytail.

The incisions for a mini-facelift starts at the top of ear, goes inside it behind the tragus (bump of cartilage in front of the ear), and then tucks around the earlobe. It stops in the back crease of the ear just above the earlobe. This incision pattern (and ultimately the scars) prevents loss of the location of the sideburn hair and eliminates visible scarring behind the ears. This allows one to wear their hair any way they want without being ‘discovered’.

While less scarring is appealing to any operation, these mini-facelifts are not for everyone. The vast majority of patients that benefit by them are younger by facial again standards, usually being between 40 and 55 years of age. As many people seek neck and jowl improvement at younger ages than ever before, a mini-facelift may be a good procedure to stem the visible signs of jawline and neck aging. These short scar procedures are designed to smooth out the jawline, soften the nasolabial folds and restore a more sinuous and curved facial shape. As one ages, sagging of facial skin and jowls create a more square or ‘bulldog’ look for some. A mini facelift reverses this facial shape change into a more triangular shape which is more synonyous with youth.

The one disadvantage to a shorter scar facelift is it is not as good as improving the significantly droopy neck as that of a traditional lift. This is why older patients with more advanced neck problems have to accept the trade-off of greater scars from more extensive facelifts.

Many mini-facelifts are done with other facial aging procedures as well to get the maximal benefit. When potentially combined with such procedures as liposuction of neck fat, removal of excess eyelid skin and chemical or laser skin resurfacing, that tired aging look can be completely wiped away in a few short hours.

Dr. Barry Eppley

Indianapolis, Indiana