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Type of Facelift Best for a 56-year-old Woman?

I am currently investigating facelift and lower eyelid surgery. I have two doctors that I've narrowed down to perform different types of lifts. One uses a more traditional SMAS type lift (45 degree vector) and the other an ENT Dr. suggested a deep plane lift (60 degree vector). What is your opinion of which lift might be better for a 56-year-old woman with a very saggy neck? Both doctors said they would place a suture under my neck.

Asked 30 months ago by Renee B2 in Vancouver, WA.

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Choosing between facelift types

The most important goal of a facelift procedure is what the facelift will do for you and your unique anatomy. The most effective way of accomplishing this is through a very experienced surgeon who listens to you, and creates a procedure that maximizes your result. We do not typically perform either the traditional SMAS or the deep plane lifts as they reduce tissue when the SMAS is pulled and then resected. We prefer multivector operations where volume and skin are treated differently, each... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Facelift Techniques

You have become too technical in trying to make your decision. Surgeons use different approaches to accomplish the same results. See before and after pictures of patients who look like you, and ask what tecniques where used. Ultimately, the result is important, not the technique.

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Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

The surgeon is the most important factor

The most important part of getting a good result from plastic surgery, is the surgeon you choose. Most people choose a board certified plastic surgeon. Having done extensive studies of face lift techniques on identical twins, I can personally state that it is a much more complicated topic than you realize. Your age is not as important a factor as the quality of your skin and the amount of laxity. Don't get too hung up on the type of lift. You're paying your surgeon to apply their... more

Darrick E. Antell, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Facelift Options and Choices

A very wise and very talented surgical mentor of mine put it very succinctly: in facial rejuvenation surgery, “Get the neck right.” A youthful and well-contoured neck, with no distortions of the surrounding tissues and anatomic structures, is the foundation of a beautiful and youthful-appearing face. When choosing a plastic surgeon it is imperative to select a surgeon who is certified by the American Board of Plastic Surgery. Often, plastic surgeons who perform a great deal... more

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Michael Law, MD

Raleigh-Durham Plastic Surgeon

ASAPS ASPS

Type of facelift recommended

Obviously we don't have a picture to render a more accurate opinion. In general, I am more comfortable with a SMAS lift combined with a platysmal muscle plicaton in the neck. The deep plane lift is not one that I perform. It may be advisable to look at a lot of before and after pictures prior to choosing you surgeon. Also a personal chemistry with your surgeon can be very helpful. All the best, Tal Raine MD FACS

Talmage J. Raine, MD

Chicago Plastic Surgeon

ASAPS ASPS

Facelift

The best type is the type that works. You have to evaluate the before and after photos of the surgeons and see what looks best to you. I would not concern yourself with the type as it is not the type but the surgeon that will get you the results. There are surgeons out there that will argue SMAS elevation vs. SMAS plication vs Deep Plane that they all will achieve the same results in different hands. It all depends on what your surgeon feels comfortable with and what kind of results they... more

Farbod Esmailian, MD

Orange County Plastic Surgeon

ASPS

The name of the facelift isn't as important as the results that doctor gets

The exact name of the facelift isn't as important as the actual photos of many of that doctor's patients showing what kind of results they get. Each doctor is different and so are their results. Personally, I use a SMAS lift with a directly vertical vector on the SMAS because I believe the cheek tissues descended vertically down, not at 45 or 60 degrees. Since we are both in WA, please check the facelift and cheek and neck lift photos on my web site and see if you think there are... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

The best facelift is one that addresses individual needs

We view facelift as a catch all term for techniques used in cosmetic surgical rejuvenation of facial aging. Indeed chapters and books have been written with various techniques and nuances applied to facial rejuvenation. All techniques can work if applied to each patients unique needs. Sauces comes from artfully matching just what is needed to each individual. The trends in facelift today are away from deep plane procedures, and from extensive surgery on the SMAS as well. The idea had been... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Face lift options

It sounds like you are being very thorough and seeing several doctors, which is good because the choice of surgeon is more important than the choice of technique. In general, the deep plane version should produce good long-lasting results, though whether the results are better than less invasive approaches has not been proven. The risks of nerve injury may be greater with the deep plane, and there may be more swelling that takes longer to resolve. The vector is something that should be... more

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Richard Baxter, MD

Seattle Plastic Surgeon

ASAPS ASPS

Face Lift, Mini Face Lift, The Palmer Celebrity Face Lift, Beverly Hills Face Lift

There are all sorts of Face Lift varations that I'm sure you have become aware of during your research. The key issue here is the neck and just how smooth you want it to be after the Face Lift and Neck Lift, in your particular case. If you want your neck to be as smooth as possible, IMHO this requires a full Neck Lift with suturing of the anterior platysmal bands, under the chin along with platysma tightening at each side of the neck. This will dictate that some type of... more

Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon

What is the Best Facelift Technique

This is a question that we commonly discuss during aesthetic surgery conferences. The honest answer is, we do not know! What matters at the end is not the facelift approach your surgeon favors but the result! If you are disappointed it will not matter to you whether your surgeon lifted 45, 60 or 90 degrees. Similar results can be achieved with different facelift techniques - deep plane, traditional SMAS, composite, MACS etc. But, it is really the surgeon who will make... more

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Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

Best Type of Facelift

Although there are different types of facelifts, the most important factor is the surgeon. Each surgeon will have individual talents, artistic ability, and perform technical different procedures for your facial rejuvenation. Seek a surgeon with ability to make both robust changes which appear natural. see video

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Best to select a surgeon with experience and before and after photos you like.

The 45- or 60-degree vector will not effect a change in the facial structure. The most important thing to do is to make sure that your surgeon has lots of experience doing the facelift procedure and you have looked at many of their before-and-after photos and like the results. It is important that not only the jowls are addressed, but the fat is cleaned up in the neck both above and below the platysmal muscle, anterior platysmal bands are tightened, releasing the anterior platysmal cords,... more

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William Portuese, MD

Seattle Facial Plastic Surgeon

Facelift Technique for a 56 year old woman

There are many different facelift techniques because there are many different issues that need to be addressed. The important things to consider are: 1. How much skin needs to be removed. If its a lot then a short scar lift will not do. 2. Jowling. Significant jowling is well treated by any method that vertically lifts the SMAS. 3. Nasolabial folds. Again any technique the elevates the SMAS medially will help the nasolabial folds. The extended SMAS, which I use frequently, really... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Composite facelift

Without seeing your picture, I cannot be unequivocal. However, most 56 year old patients benefit most from a thorough facelift that addresses the malar fat pad, the cheeks, the jawline, the platysma muscle chin to sternum, excess neck fat and excess skin. I use a composite facelift (skin and SMAS are not separated). Any shortcut, in my opinion will leave you with compromised results. I would be inclined to advise you to use the surgeon with the more thorough operation in mind.... more

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

The MACS-Lift short-scar Face Lift is a preferred Face Lift for most people.

I've been very pleased by my results with MACS-Lifting, which rejuvenates the neck, jowls, and midface with a small incision. The unique feature of this particular Face Lift is rejuvenating your face with a purely vertical repositioning of skin and SMAS. Several purse-string sutures are placed in the SMAS, and the neck and jowls are lipo-sculpted. Very little skin is removed. Thankfully, I have not had problems like scarring, change in hairline, or ear-lobe malposition. My patients and I... more

Eric M. Joseph, MD

West Orange Facial Plastic Surgeon

Facelift for a 56 year old

A specific age does not require a specific face lift. Different facelifts lift different things. And no one operation is the best. I wouldn't get bogged down with 45 or 60 degree vector, but would be more concerned that you get a natural looking result with good concealment of incisions, a normal ear position, and no shifting of the hairline. The specific lift used to work on the deeper tissues really depends upon the problems that need to be corrected.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

MACS Lift provides 90° lift.

There is no one right answer to your question. Both SMAS and Deep Plane facelifts give acceptable results in expert hands. The trick is for the surgeon to individualize the procedure so that he/she corrects what bothers you. I, personally, use neither. Instead, I use a modification of the MACS Lift. This was originally designed for younger people who had little problem in the neck, but, with modifications, can be used for everyone. The reason I like it is that the pull is almost at 90°.... more

Robert T. Buchanan, MD

Highlands Plastic Surgeon

ASAPS ASPS

Best facelift for a 56 year old woman

There is no good answer for you. The most important part of your decision should be the choice of your surgeon. If you trust the surgeon and like some of their results then you should be happy with their technique. I can guarantee that if you see a couple more surgeons, you will end up with a couple more surgical plans. Facelifts can be done via multiple types of techniques. Just as the saying goes "there's more than one way to skin a cat." Trust your surgeon and make that your... more

Sirish Maddali, MD

Portland Plastic Surgeon

Type of facelift

Hi! There are 2 principles of good facelifts: 1) The deep tissues (fat, fascia, muscle) need to be repositioned (not pulled) to where they were when you were 30 years younger. It is not primarily about the skin. 2) We sag downward, and the repositioning must be UPWARD, not backward. If a surgeon sticks to these principles, and is talented, you will get a good result regardless of the name of the particular technique. It is all about the individual surgeon. Ask to see lots of before and... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

What type of facelift best for a 56-year-old woman?

There is no "best type" of facelift for a 56 year old woman, just like there is no best dress for a woman. Consider first your goals. Do you want a big change or a subtle change? Do you want little down time or are you prepared for a couple weeks down time? Then consider the surgeon. Is he certified by the American Board of Plastic Surgery? It is the only board approved by the American Board Of Medical Specialties for the training of plastic surgeons. Look at pictures of his... more

Ricardo Rodriguez, MD

Baltimore Plastic Surgeon

ASPS

Depends on your specific Anatomy and desired Aesthetic Goals

Hello Renee, Good to see that you are doing your research and asking lots of questions as you embark on your facelift procedure. Both of the techniques you described are well accepted and effective techniques. They do differ in terms of the recovery time involved and potential complications (specifically involving the facial nerve which is "more at risk" during a deep plane facelift). It sounds like your Doctors have done a very good job of going over the technical aspects of each... more

Kamran Jafri, MD

New York Facial Plastic Surgeon

Facelift technique

The answer to your question is difficult without seeing a photograph or yourself in consultation. Each person is different and recommendations will vary according to the persons anatomy and desires. In general, a neck is treated differently than the face. The key to the neck is to obtain a smooth neckline that is contoured. The extra fat in the neck is removed and the muscles are tightened. I don't think a deep plane or extended smas technique makes a difference in the neck. These... more

Robert M. Wald, Jr., MD

Orange County Plastic Surgeon

ASAPS ASPS

Deep versus superficial plane for facelift

There is no correct answer to the best plane for the facelift. The best answer is for the surgeon to do the surgery that he or she does the most. Both planes lead to very nice results. Take a look at some of their before and afters or talk to some of their patients to get a better idea of the look you will achieve. Good luck with your surgery.

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