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.  In my experience I have found that the best face and neck lift result involves some degree of muscle tightening.  Foregoing this would mean that only the skin and tissue of the face and neck are lifted, which can lead to shorter lasting results or a more unnatural look.  I would recommend discussing your desired cosmetic result and the procedure at length with your board certified plastic surgeon.  At the time of your consultation not only will your candidacy be best determined but your surgeon can outline his/her surgical plan to best achieve this goal.  I hope that you find this helpful and I wish you all of the best.

There are many variations on facelift technique, and most of them involve some kind of suture tightening at least for correction of the deeper layers which includes the platysma muscle of the neck. Unfortunately many techniques including most mini facelifts involve limited or no undermining and release of the deeper layers, and rely totally on the ability of the sutures to hold.  There are significiant limitations in the duration of the results, as well as potentially in the naturalness of the appearance because some parts of deeper layers are more fixed than others, and will not move well unless released completely, resulting in uneven tension.  I strongly believe the best results in terms of long lasting results and natural appearance come from a thorough release and elevation of the SMAS (superficial musculoaponeurotic system) which includes the superficial muscles.  In my experience with approximately 250 of my own patients who have come back for a second facelift, the average time when they feel they need to repeat surgery is about 12 years.

All of my facelifting procedures involve muscle tightening.  I would imagine that most if not all board certified facial plastic surgeons and plastic surgeons are performing muscle tightening face lift procedures.  This involves tightening and securing the underlying SMAS (superficial musculoaponeurotic system) and facial muscles for strength and then removing any remaining loose, sagging skin. It is this technique that allows for face lift durability, as well as a natural-appearing result since it is not the skin that is being stretched for stability.  

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. 

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