How is a Lifestyle lift different from a traditional face lift?

LifeStyle Lifts are full facelift incision minilifts, performed through a company which has licensed the name.  Doctors sign onto the service and give a percentage of their fee to the company for performing their advertising.  The advertisements show pictures of patients who have achieved excellent results.  From the patients I have seen who have had LSL procedures, these results are not at all typical.  Judging from the posts on this website, the results were unsatisfactory to a number of patients.  Why are so many patients unhappy?

The devil is in the details. 

When a facelift is performed with minimal undermining (as with a LSL), the skin does not advance properly.  You haven't reached the tissues to pull on them.  Instead, you are pulling on adjacent tissues, and the force to the target tissues (i.e. loose skin of the jowl area) is reduced.  Surgically speaking, you're not there yet.  Established facelift surgeons simply do not stop at this point, because the surgery is not done, and they know their patients would not be happy with the jowls still being there.  It is difficult enough with deep facelift techniques to achieve significant improvement, let alone if you only do half the surgery.  I suspect that many LSL patients are unhappy because they expected full facelift results from a minimal procedure, and it did not happen.

Why do so many patients complain of unsatisfactory scarring with the LSL?

In an LSL, minimal undermining is performed.  In order to tighten  the tissues beyond where the cuts are made, more tension must be placed on the incisions, and the incisions are closed tightly.  When incisions are closed tightly, the skin, a biologic material "gives way".  It stretches at the weakest point, the incision.  The scars can become wide and unsightly.  The ear can develop a deformed, scarred appearance.  Did LSL patients realize they would have all the incisions of a facelift but only minimal pulling?  You can see by the posts on this website that many did not.

Are all minilifts bad?

No.  Many patients benefit from a mini-facelift, especially women who are young and have minimal looseness.  However these mini-lifts require even more skill and finesse than a traditional facelift.  Why?  Because you are creating an incision in a young person's face.  The scars MUST look good to justify the incisions.  Every responsible doctor wants to leave his patient with minimal evidence of plastic surgery, and a nice before-after result.

What about the dangerous general anesthetic?

Any procedure, including mini-lifts and LSL procedures can be performed under local anesthesia.  Any doctor can perform a procedure under local anesthesia.  Nobody has a corner on the market on an $8 bottle of lidocaine.  Local anesthesia is not always pleasant, as the posts indicate.  Under local anesthesia, surgery is performed on you while you are awake.  You feel the needles.  You feel the pulling.  You experience pain.  Many patients feel anxious.  Many patients do not want to experience this.  Modern superlight anesthetics,  when performed by a board certified anesthesiologist in a hospital or accredited outpatient surgery center, in a patient who has been medically cleared, have an enormously high safety profile.  Patients should make decisions in an informed fashion of what the alternative are, not avoid general anesthetic because it is unsafe.

Is LSL state of the art?

No.  Modern facelifts performed by skilled surgeons do not just pull.  They pull smart.  They pull in different directions because the face is complex and not unidimensional.  They adjust the SMAS layer, restoring fullness of the cheekbones, diminishing unwanted volume in the jowls.  They restore volume in other parts of the face.  They rejuvenate the mouth, the corners of the mouth, the eye area, the cheek area, the brow when needed. 

I am not worried about the patients who reach this website.  They are informed consumers and intelligent enough to do their research and make smart choices.  I am worried about patients who never reach this website because they saw an ad, a low price and never looked back.

Buyer beware: a number of ‘limited incision’ and ‘quick recovery’ facelift procedures are currently marketed to patients with names like “The Quicklift”, “The Lifestyle Lift”, “The Weekend Facelift”, “The S Lift”, “The MACS Lift”, etc.  As with most things in life, if it sounds too good to be true, it usually is.  In my opinion, the results of surgery are in direct proportion to the time and effort that the surgeon has put into the procedure.  Most of the procedures I have listed above cut corners to arrive at a shorter surgical time and quicker recovery (which, by the way, isn’t always the case), and most of them undertreat or do not at all improve the neck.  Additionally, ‘cutting corners’ in the neck almost always leads to distortion of the neck area skin, which often is quite readily apparent in ‘before and after’ images of these procedures with gimmicky names.  Look for abnormal and unnatural-appearing skin tension lines in the lateral neck as well as below and behind the ears. I see a large number of patients who are interested in improving poor neck definition and/or loose neck skin only, but who do not want or need a full facelift.  Many of these patients are in their 30s and 40s and find that their neck is their only major facial aging issue.  However, I will also perform a necklift only for many patients in their 50s and 60s who do not want to change their upper facial appearance and who feel that it is primarily their neck makes them look older or ‘matronly’.   

These patients are particularly bothered by the appearance of their neck in profile, where the ideal sharp transition between jawline and neck has gradually faded and in some cases has completely disappeared.  Even in the absence of other signs of facial aging, a poorly-defined or sagging neck can add years to a patients overall facial appearance.  When performed expertly and with great attention to detail, a necklift surgery can dramatically restore a natural and youthful neck profile, with no outward evidence that surgery has been performed.  The adjective that immediately comes to mind when I review ‘before and after’ images of my necklift patients is elegant – for restoring a youthful neck contour truly makes the patient appear not just younger but also refined and elegant. 

Necklift surgery can consist of a variety of surgical techniques that are carefully selected to meet each individual patient’s particular needs.  It is therefore important to select a qualified physician with a great deal of experience in numerous necklift procedures.  In younger patients with good skin tone, submandibular liposuction alone may produce a dramatic improvement. For some patients with good skin tone but poor definition at the angle of the neck, I add a suture-suspension necklift to sharpen the angle between the jawline and neck.  This procedure is minimally invasive, produces no easily visible incisions, and has a very quick recovery.  It will not, however, improve the situation if a true excess of skin is present. 

Patients with more advanced aging changes in the neck generally require tightening of their neck skin as well.  The neck is the one area in facial rejuvenation where a tighter and more toned surgical result looks natural and aesthetically ideal (as opposed to the face where ‘tight’ and ‘tighter’ just looks like surgery).  Neck skin removal is accomplished through incisions around the ears which can be extended a short distance into the scalp if necessary.  If the incisions are created and closed correctly and without undue tension, a very natural looking result can be obtained with no obvious signs that a necklift has been performed.  A great deal of experience and expertise is required to avoid distortion of the ear and surrounding skin. 

Producing a level and youthful contour below the jawline often requires treatment of the soft tissues that are deep to the subcutaneous fat layer.  Through a small, hidden incision below the chin the subcutaneous fat layer is thinned, delineating the anatomy of the platysma muscles which form the two parallel anterior neck ‘bands’ in many patients as early as their forties.  The anterior borders of the platysma muscle can be sutured together in the midline of the neck, permanently eliminating the platysma bands and creating a sling effect which lifts and supports the neck soft tissues.  This procedure is called a ‘platysmaplasty’.  In some patients a prominent fat pad exists deep to the medial border of the platysma muscles which cannot be reduced by liposuction, and if necessary it is directly reduced prior to platysmaplasty to further improve the submandibular contour. 

As the jawline and neck are immediately adjacent, patients with jawline aging issues such as jowls can have those issues addressed at the same time as a necklift.  The skin of the jawline can be elevated in continuity with the neck skin to restore a smooth jawline contour.  For many patients I combine this with structural fat grafting of hollow areas and conservative liposuction of excessively full areas to produce a jawline contour that is as smooth and youthful as possible. 

I agree that all the terminology and marketing names surrounding Facelifts these days is very confusing - for Patients and Physicians alike!

Having performed the Lifestyle Lift in the past as well as all hundreds of "traditional" Facelifts I think it is important to clarify all the terms so Patients can fully understand the procedures for what they technically are and not what the marketing wants you to believe they are. 

Some key terms: Plication means the SMAS is folded onto itself and stitched in place in a higher location. SMASectomy means that a portion of the SMAS is cut out and then the cut ends are sutured together. Cranial Suspension means that a purse-string or loop suture is used to suspend a large area of the SMAS by anchoring it to the underlying bone.

Mini-Lifts: these facelifts employ minimal incisions and the underlying SMAS/Muscle may or may not be tightened.  Typically indicated for patients with mild/early signs of aging, those undergoing a "touchup" or second facelift and those who have very specific concerns. Recovery is 5-10 days.

S-Lift: this facelift features an incision that goes from the front of the ear to just behind the earlobe - hence the name as the incision resembles a "lazy S".  The underlying SMAS/Muscle is tightened either via plication or SMASectomy.  May be a primary or secondary procedure in patients with mild to moderate aging signs.  Recovery is 5-10days.

Lifestyle Lift: the incision starts at the front of the ear and goes all the way around the back of the ear and may extend into the hairline.  The SMAS/Muscle layer is plicated only.  Is a primary facelift procedure suited for patients with mild to mild/moderate signs of aging. Recovery is 7 days-2 weeks.(sorry but you will not go back to work the next day!)

Short Scar Facelfit/MACS: minimal access cranial suspension that features an incision along the front of the ear ending at the earlobe.  No incision is made behind the ear.  The SMAS/Muscle layer is elevated vertically and is very securely suspended to the strong tissues covering the cranial bones in front of the ear.  Indicated for mild to moderate signs of aging and in experienced hands can be extended or combined with necklift to address moderate-severe signs of aging.  Recovery is 1-2 weeks.

"Traditional Facelift": the incisions begin in the hairline above the ear and follow the curves of the ear around to the back of the ear.  May or may not extend into hairline.  The SMAS/Muscle layer is always addressed either by plication or SMASectomy or even both. May be used for mild to moderate severe signs of aging.  Recovery is 10-14 days.

Deep Plane/Composite Facelift: has features similar to the above but also in specific areas the SMAS/Muscle layer is lifted up off the Facial bones and moved as a whole unit.  Addresses moderate to moderate/advanced signs of aging.  Recovery is 2-3 weeks.

As far as how log the procedures last, as a general rule the deeper the dissection the longer the results: Deep Plane>Cranial Suspension>SMASectomy>Plication.  Other factors like inherent anatomy, genetics and smoking/sun exposure do factor in as well.

The best option for you is best arrived at in consultation with an experienced and Board certified Surgeon who is comfortable offering and performing the procedures appropriate for you based on your goals, health and anatomy.

Good Luck, Dr. J

Lets get all the terms correct. Any technique that is designed to improve the appearance of the face and "lift the face up" IS A FACELIFT procedure. So, Lifestyle lift, Quicklift, Mini-lift, Neck lift and all other 200 or so names are ALL modifications of facelift procedure.

The word FACELIFT has earned a significant negative connotation in today's media and is traditionally associated with un-natural pulled look that is easily visible from across the room. That is what most of our patients do not want and what most of them refer to as A TRADITIONAL FACELIFT.

What our patients want is a softer, less tight and more natural look. They are trying to avoid the longer recovery time traditionally associated with deeper and more involved lifts. The more natural lift can be created with both classic techniques and some of the "mini lift" procedures. What we know today is that the facial rejuvenation procedure should incorporate the lift of the deeper tissues, and not the skin layer alone. This way the facial rejuvenation procedure will improve the appearance of the neck, jowls and cheeks.

Skin-only procedures pull the skin alone and the deeper tissues are moved upward following the skin and are not individually supported. Skin is not very durable in maintaining the shape or position of deeper tissues. The skin can be easily stretched out. Think of the patients with breast cancer who had their breast removed and then stretched out by the implant. Same is true for patients undergoing breast augmentation procedure. That is why in my mind the skin-only surgeries do not work, or if they temporarily do, do not last as long as the lifts that incorporate deeper tissues (SMAS, aka muscle layer or fascia).

Many surgeons have a equally negative opinion of mini lifts. What is a mini-lift? A smaller and less effective version of regular facelift? Sometimes it is, sometimes it is not. "Mini lift" is as vaque of a term as "traditional facelift". I have seen some surgeons perform a facelift on a patient and the amount of lift generated was less then with some of our mini lift techniques.

The point is that not all the Mini Lifts are born equal. In my experience, some of the mini-lift techniques elevate deeper tissues very effectively and their durability and longevity is comparable to more classic SMAS facelift procedures. I am trying to avoid the phrase "traditional facelift" not to confuse the issue.

So, where does it leave you? Forget the trade names, traditional facelift or minilift or anything else. Ask your surgeon about what he or she is about to do. Ask if they are going to lift the deep tissues separately from the skin. Ask how long the surgery will take and how long the recovery is. Ask to see the pictures. Remember, chances are you will see the best results.

Ask where the incisions are going to be. Try to lift your face with your hands and stop the lifting at the level your incisions stop. Take a look in a 3 way mirror.

If you have lifted your neck and you have skin bunching on the side of your face or cheek, you may not be a candidate just for a neck lift - maybe you need a slightly more extensive procedure.

Most of all, use common sense.

With warmest regards,
BV

A "Lifestyle Lift" is essentially a heavily marked mini-lift procedure. The company, "Lifestyle Lift", advertises (via infomercials, and other media) and sells a procedure that is touted to deliver a dramatic result with a one hour procedure, without the need for "potentially dangerous anesthetics".

The concept that is conveyed in this marketing is that this procedure is equally effective regardless of the surgeon doing it. A patient must uses their sense of intuition and judgement to determine if this is likely to be the case.

The technique of mini-lift surgery is certainly not new or revolutionary, but the nature and scale of the advertising is. I would caution prospective patients to analyse the marketing information closely, talk to patients who have had the procedure, obtain second opinions from welll qualified surgeons in their area, and read opinions on websites such as this prior to signing up.

A Lifestyle lift is more or less a mini-facelift, and it does not address the 3 classic signs of aging that almost everyone seeking lower facial rejuvenation wants corrected:

• improvement of the neckline
• the jawline
• the jowls

A facelift, however, fully corrects these areas of concern, and is a much more durable operation (most facelifts can be expected to last 10-15 years).

Many patients are concerned about a "full" or "traditional" facelift because they fear the anesthesia, recovery time, the incisions, the cost, or having an unnatural or pulled appearance. Here are some thoughts to consider:

• Traditional facelift incisions, when performed properly, are very well hidden and very difficult to find once healed. In general, patients need about 7-10 days or so before they are ready to get back into their normal routine, and about 14 days for the bruising to resolve (some folks need less time, others a few more days).

• The cost of a traditional facelift may be a bit more, but it is also a more durable procedure and will correct the anatomic signs of aging by not only addressing skin but the underling tissues as well.

• Finally, if you are worried about having an unnatural or pulled look, review the doctor's credentials, training, and before and after photos carefully - this will give you an idea as to his or her work.

Dr. S