Lower Facelift with Vertical Skin-pull Vectors?

The numbers of available facelift procedures are daunting. The technical translation from a verbal description of "what procedure a doctor does" to the final result is literally all over the board. Two doctors using the exact same theoretical technique will have very different results. More important than the type of procedure used are the reputation of the facelift specialist and the results. By now you have apparently had many consultations. No doubt you have narrowed your... more

Dear Youngrace, What you are describing is exactly what I try to achieve in what I call a "cheek and neck lift" procedure. In my procedure, the deep tissues are repositioned directly vertically and the skin is gently removed along natural vectors but with no tension that would distort the mouth. A direct vertical pull on the skin will create other distortions even if it doesn't distort the mouth.

The horizontal pull on the lips that you saw during your consultation with your plastic surgeon should not happen as a result of a well performed facelift.  When facelifts are simulated by tugging on the lateral cheeks and jowls during consultation lip pulling occurs because the pull is primarily on the skin and not underlying tissues.  The reveres is true in surgery where usually much more tightening is done of the  underlying tissue and generally the mouth or lips... more

Generally speaking, the vector of pull for a Facelift in the mid face and jowl region should be vertical.  The width of the mouth should not be elongated or widened.  I recommend that you see an experienced Facelift Surgeon, see examples of his work, and possibly speak to some of his patients.  The "overdone" look is completely avoidable.

A lower facelift is a powerful and effective procedure to recontour the lower face, the jaw, and neck. During this procedure, the deep tissue of the neck is identified, the excess fat is treated, and this tissue is resuspended to be stronger tissue around the ear and skull. The vectors used for the resuspension are important. These vectors should be more vertical and NOT horizontal in order to prevent the windblown, tight, overdone look of a poorly done facelift. With proper... more

In my practice, horizontal vectors are not utilized for the exact reason you mentioned- this vector will cause a distortion of the mouth and cheek. In my opinion, a purely vertical vector is equally bad as the distortion will be at the level of the outer eyes and temple, necessitating the need for a lateral brow lift. I typically use several vectors on each patient and carefully evaluate the pull of the inner supporting tissues (SMAS,muscle,etc) during the procedure so as not to... more

There are many different approaches to the lower face lift, including both vertical and horizontal vectors of pull. For the vertical vector approach to the lower face lift, that you are asking about, we prefer a short scar approach with vertical purse string sutures to correct laxity in the jowls and neck. The best operation for one person may not be the same for another, and it is critical to see a cosmetic surgeon with experience in different approaches, so you can choose the best one to... more

A facelift goal is to improve the areas of concern. I usually redistribute softe tissue deep to the skin and remove the excess skin without tension. Ths is the goal. A vertical vector helps some areas of soft tissue redistribution and a horizontal vector may help redistribute the skin or other tissues.

The vertical facelift is the best way to effectivly improve the jowls and improve the marionette lines and the general aging around the mouth. For the elderly patient the mouth or perioral region is where the battle is won. The deep plane facelift and smas lifts create a vector that is more upward and backward toward the top of the ear. With the modern techniques even the latter techniques don't create a pull on the lips or mouthbut there is no question that the vertical facelift is more... more

A vertical lift pulls the SMAS up and slightly outward, in the same direction as a smile. But all skin removal should be horizontal. The key to appropriate skin removal is to perform this under minimal tension. This way your skin won't look pulled or shiny.

The so-called vertical vector facelifts that are done via incisions in the temple area or in the lower lids to address the midface cannot adequately address the lower face and neck. While there may be some improvement in jowling with these procedures, it is usually not substantial. Any excess tension in an attempt to get more improvement of the jawline can result in movement of the hairline and other problems. A traditional incision around the ear is still the best approach to rejuvenating... more

A good facelift should not make your lips pulled or elongated. We usually use a combination of vertical, diagonal, and horizontal vectors in a facelift operation. Everybody agrees these days, that the pulled look is very unattractive. Talk to your surgeon about it, and perhaps see several surgeons in consultation. Review their before and after pictures to make sure you like their facelifting style.

Hello, The fear you have expressed of having a lower facelift that "stretches your lips" and pulls your skin horizontally is a very common one. Luckily, modern facelift techniques use multiple vectors of elevation to get natural looking results. Vertical vectors are highly favorable for elevating the SMAS layer (the layer of muscles / fibrous tissues that when elevated improve the appearance of jowls). The vertical elevation restores tissues to a higher and more youthful position -... more