Lower Facelift with Vertical Skin-pull Vectors?

The move to vertical facelifting I believe has been one of the most significant technique advances to give patients a more natural, less visually "pulled" result. The use of vertical vectors is commonplace today, and various techniques on the facial and neck muscles  really focus on this issue. In my experience, one addition that has helped me gain the best results in the vertical pull direction has been the use of the new generation of  Quill  (Angiotech) suture to secure my SMAS after the deep plane pull. This new class of sutures provides a unique capacity to really distribute the tension in the vertical line over many small points of fixation. This distributed tension philosophy I believe is one of the most significant advances in facelifts over the past few years.

When performed properly, face and neck lifts should lift the tissues in a vector that is both vertical and horizontal. As we age, most of the facial soft tissues tend to drift inferiorly (toward the feet) and medially (toward the midline of the face). Both of these directions need to be addressed in order to achieve the best result. Keep in mind that what you or your surgeon may simulate by pulling on the cheeks or neck might not be an accurate representation of what surgery will do. Be sure to look at face or neck lift before and after photos to see if you like that surgeon's results, as these are the best representation of what you might be able to expect for yourself. In some cases, computer simulations might also be helpful, and this is something I routinely provide for my patients at no charge. 
Be sure to see a surgeon who specializes in facial aesthetic procedures.
All the best,

The typical vector of pull I use is superior/oblique. I have not seen the mouth pulled in an unusual way, though there is very nice improvement of the lines around the mouth. Incision is around the ears and well hidden!Best of luck!

Thank you for the fantastic question. Yes, this is not only possible but is the best way to achieve natural-appearing results. A vertical-vector facelift involves some changes in the incision placement and deep suturing, to orient the lift in the direction of gravity (vertical!). In my practice, I use a deep-plane facelift technique to vertically lift the lower face, neck, and midface together -- in fact, I've written a paper or two about it!. This allows me to get a great lift while avoiding the pulled or stretched look associated with a more horizontal "lift." Best of luck moving forward!

Some physicians use a vertical vertical vector when elevating the SMAS (muscle layer). By doing this, the correction of the jowls and neck laxity is maximized. I think the vertical vector can improve the face and neck in a much more powerful way than the horizontal vector. However, it does not mean that the horizontal vector will distort your face and lips. Any technique, if overdone, can create un-natural results. Consult with a surgeon that has experience with the facelift procedure.

Yes, a necklift can be achieved with vertical lifting.  In fact, this approach is the basis for one of the more recent trends in facelifting surgery, the short-scar facelift.  The neck  and lower face muscles, fat, and skin are lifted much more vertically, thus avoiding a long incision behind the ears.  Often, some limited liposuction or muscle tightening might be added just below the chin through a small incision there.  However, be aware that if someone has a lot of loose neck skin, loose in a horizontal direction, then a more traditional lower facelift with tightening of neck skin behind the ears would be indicated to get the best result.  Generally speaking, the short scar techniques with more vertical lifting are more appropriate for younger patients with less skin looseness.