As we age, there are several constants that will occur in everyone’s face. The bottom half of the face gets heavier as jowls appear along a once smooth jawline and the neck angle drops. To counteract these aging concerns, the traditional facelift has been around for nearly a century. One popular trend in facelift surgery over the past decade has been the emergence of smaller variations that employ lesser lengths of incisions and resulting in less scar. These newer limited facelifts have become known by a lot of names due to marketing efforts such as the MACS lift and short scar facelift to name just a few. Most of the catchy names imply a faster procedure that has less recovery. But in the end, they are all part of a larger family of ‘Mini-Facelifts’.

How do these these smaller facelifts manage to remove those jowls and tighten up saggy neck skin with less scar? The reduction in scarring occurs at two specific locations along the temporal and occipital hairlines, allowing no scar to enter either area. What is the relevance of having less scarring around your ears? The avoidance of visible scars is one obvious benefit. But an equally relevant issue is not having hairline displacement which can be just as distracting as that of wide scars. When a facelift incision runs vertically up into temporal hair-bearing skin, skin flap movement will almost always displace the sideburn or preauricular tuft of hair upwards. When the incision behind the ear extends into the occipital hair, an unnatural notch in the hairline may become may be visible in short haircuts or if one wears a pony tail.

In mini-facelift versions, the incision does not go past the top of the ear or much beyond the earlobe at the bottom of the ear. Between these two points, the incision snakes along the line between the front of the ear and the face ducking in behind the tragus (bump of cartilage in front of the ear) along its ways. By keeping the incision limited to these ear points, less scarring is created and the temporal and occipital hairlines are not abnormally displaced. This allows one to wear their hair any way they want without having obvious signs that has had a ‘facelift’.

While the appeal of less scarring and a smaller procedure is significant, a mini-facelift is not for all jowl and neck aging concerns. As people today are seeking improvements at ever increasing younger ages of age 45 or 50, the size of their jowls and how much their neck skin is sagging is less than those age 60 or older. As a result a younger person needs less of a facelift than those that are older. These procedures help create a smoother jawline, soften deepening nasolabial folds and help restore a curved or more inverted triangular facial shape. In greater amounts of facial aging, a mini-facelift is not as good as improving the significantly droopy neck as that of a traditional facelift. This is why older patients with more advanced neck problems have to accept the trade-off of greater scars from more extensive facelifts.

These mini-facelifts can be combined with other limited procedures for improvement in the rest of the face as well. Such procedures as neck fat removal by liposuction, removal of excess upper eyelid skin and lower eyelid bags and skin refreshening through laser or chemical peels, that tired aging look can be reversed in matter of hours.

Dr. Barry Eppley

Indianapolis, Indiana