Does a face and neck lift always include muscle tightening?

Thanks for a simple, but very important, question regarding facelifting.  Having performed almost 6,000 lower facelifts and necklifts over the past 11 years, I would say with 100% certainty that this lift must have a muscle tightening component.  The platysma and SMAS layer (the jawline muscle layer) should be tightened internally in every lift.  In my opinion, this is what gives most of the result, along with longevity to the lift.  Of course, there is excess skin that is removed, but the workhorse of the lift should be on the internal muscles.  This always should occur from the sides of the face (around the ears).  Sometimes the muscle under the chin needs to be tightened as well, usually as the discretion of the surgeon.The easiest way to find out if your surgeon tightens the muscle is to just simply ask!  It is a completely reasonable, and common, question.  Good luck!!!-Doc L.

Thank you for your question. You are entitled to see your operation notes post surgery so you can be sure the muscle tightening was performed. Without tightening the muscle to results will not last as long and the results will not be as noticeable. Please ensure you speak with a board registered surgeon prior to receiving any treatment 

A facelift that only tightens the skin will generally not last as long.  That is why current facelifts involves some form of SMAS (fascial layer over the facial muscles) tightening, either with plication sutures or flap elevation.  Your surgeon should discuss his technique with you beforehand. 

Almost all surgeons with proper training and experience will tighten up the muscle (more specifically, the SMAS), or do a deep plan (which includes the SMAS), so the short answer is yes.  There are exceptions to every case of course, in my experience. 

Thank you for the
question. To have an effective
and long-lasting lift, most surgeons believe in tightening the underlying 
musculoaponeurotic layer, which is known as SMAS. Skin is allowed to lie
naturally. In addition, it's common to also use your own fat to fill the
specific fat compartments of your face, in what is known as "lift and
fill" facelift by many authors. Combining the two is a very powerful tool
in facial rejuvenation. I would consult with a plastic surgeon and
discuss your specific goals. Please ask your surgeon
to show your before and after pictures of his/her patients to get a clear
understanding of what is involved in the procedure.
Pej Aflaki, M.D.
Johns Hopkins-trained plastic surgeon

This is a very good question.  There are many techniques available for facial rejuvenation.  The longest lasting results involve both muscle and skin tightening. In a skin only face lift, only the skin is elevated and re-positioned.  The standard face-lift today consists of elevation and tightening of the deeper structures of your face and neck muscles, combined with skin re-positioning. Avoid quick lifts and lunch time lifts, that are marketing ploys.  Please see a board certified plastic surgeon.

Yes, if the neck muscles are loose, muscle tightening will increase the longevity of your procedure. Well done, a facelift should turn back the clock about 8 to 10 years and last about a decade. At that point, you may opt for a revision facelift. However, if you keep your skin in top shape with chemical peels, sun avoidance and high-quality skin care, it may last even longer than that. It’s fine to have more than one facelift; once every 10 to 15 years or so is the norm. I hope this helps.

The short answer is if the muscles of the neck are loose, and they usually are, then tightening them will have a beneficial effect and provide a longer lasting result. Having said that, there are those patients that have little muscle laxity due to genetics, age or previous surgery. The treatment, as always, must be individualized. Ask your surgeon about it. If you have trust issues then you may want to find another doc.
All the Best,
Dr. J

HI Minkymartine,  I think that you will have a longer lasting result if you have the muscle tightening. Every person is different, so you should discuss this issue with your surgeon who can do a thorough exam of your face and evaluate what is best for you. Always choose a Board certified plastic surgeon who has done many of these cases and ask to look at pre and postop photos as well.Good Luck!Dr. Christine Rodgers

When contemplating a facelift procedure, smart advice would take you to a Board Certified Facial Plastic Surgeon with vast experience managing the aging face.  Your visit will start with a careful history, followed by a methodical facial physical exam - which invariably will lead to a discussion of your concerns followed by a technical breakdown as to how your lucky chosen surgeon will plan to surgically address your concerns.  Most current surgical approaches to the aging face would indeed plan to address the face with a component of muscle tightening, which in theory will lead to a  surgical outcome which generally will be longer lasting than those procedures that do not involve some component of muscle tightening.  Ask your surgeon what he plans to do, and why he plans to do what his gameplan suggests-there you will find the answer you are seeking.  Good luck to your facial muscles and may they be tightened to ensure a fantastic result !!