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!