Background: The facelift is the workhorse of the treatment of lower facial aging. Changing the neck angle and smoothing out the jawline is what the operation primarily accomplishes. But it is not an ‘all or none’ type procedure. Facelift techniques can be modified, and should be, for the extent of the facial aging that is being treated.
While there are numerous variations of facelift techniques, I think of them as three basic types or levels. The levels are based on the extent of skin flap elevation, the type of SMAS manipulation and the type of neck work done. (if any) The level 1 facelift is actually the most well known because of how it has been historically marketed. Name such as Lifestyle Lift, Quicklift etc speak to the more limited nature of the facelift. With that comes less surgery and a quicker recovery, and the marketing that comes with those issues….but it is not for every patient.
In the spirit of ‘matching the solution to the problem’, the level 1 facelift is best applied to patients with less advanced signs of facial aging.
Case Study: This middle-aged male, who had been thin all of her life, had developed loose skin around her mouth, jowls and neck.
Under general anesthesia a jowl tuck procedure (level 1 lower facelift) was performed with retrotragal preauricular and limited postauricular incisions. A SMAS plication (non-flap elevated) was performed
With a more limited facial aging problem that did not involve excessive fat, posterolateral soft tissue repositioning is all that is required. No specific neck work is needed with this early level of facial aging. While providing good improvement one should not expect these results to be sustained for ‘decades’.
Case Highlights:
1) In thin females skin laxity of the face and neck becomes the primary facial aging concern.
2) A modified facelift known as a jawline tuck provide good improvement.
3) Such jawline facelifts can expected to have ‘life expectancy’ of 5 to 7 years before a touchup procedure would be required.
Dr. Barry Eppley
Indianapolis, Indiana