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 pulling and restructuring in their optimal direction for the patient's anatomy and aesthetic needs. Not every patient's tissues should be pulled at 45 degrees, or 60 degrees, to achieve the best result. Especially if the skin goes along with the deep layer (i.e. deep plane or composite), loss of the sideburn and a high lateral tension appearance can result. Nor is any one technique right for every patient. A patient with flat cheekbones requires a completely different technique than one with excessively prominent cheekbones. Volume replacement goes hand in hand with pulling, since both drooping and loss of volume have typically occurred. Good earwork is the hallmark of a top plastic surgeon. Examine the pictures carefully and critically for how the ears appear after the procedure! The neck should typically be addressed as well, not just through facelift incisions but through an incision below the chin. How this is performed varies widely, and patients should examine each plan for how logical it seems, as well as what results the patients in the before-after photos have obtained. A well done facelift often combines ancillary proeceures such as cheeklifts, upper eyelid surgery, browlifts, lip lifts, laser resurfacing, DAO release, LiveFill (R) placement, etc. The 360 facelift concept of looking at the face as a whole and addressing all (or as close to all as technology permits) is preferable to having a standard way of doing every facelift, in my opinion. As often as not, patients have had prior "work". Rather than exacerbate the problems of the past, the plan should directly target "older style work" to reduce or eliminate signs of surgery. Specific, targeted steps are necessary to accomplish any revision work in particular, and a harmonious result in general. It will not occur by chance. http://drbrent.com/360facelift-procedure.php