Isn't a Full Face Lift Riskier Than a Mini Face Lift with Respect to Complications, Etc?

The first thing that all should understand is that there is no standard definition of a "mini-facelift" and a "full facelift."  What each of those terms means may differ dramatically from one surgeon to the next.  Below, I will briefly outline what a Mini-Facelift and a Full Facelift means to John Bitner:

Full Facelift-


incision running from the hairline on the neck, behind the ear, through the earlobe, behind the tragus and up into the temporal hair

undermining 7-8 cm out onto the cheeks

removing a strip of SMAS from in front of the ear

elevating underneath the SMAS about an inch

repositioning the SMAS up and back

sewing the SMAS back down in its new position with a permanent suture

staples and sutures used to close skin are removed at 1 week after surgery


Mini-Facelift


incision running from behind the ear, through the earlobe, behind the tragus and up into the temporal hair (the incision is just shorter and ends behind the ear)

all the rest of the steps are the same as that for a full facelift


The recovery from both these procedures is about a week when sutures are removed and makeup can be put on.  Again, this depends on your definition of a recovery.  For the right person, usually younger, the minilift can get all the results of a full lift.  But, if a person has alot of heaviness, they need the full lift.  Cutting corners will leave the person unhappy with the overall results.  Find someone with lots of before-and-after pictures who does both a full lift and a minilift and they can help guide you to the best result.   

Well, more dissection and more surface area encountered in a full face lift probably translates to greater risk.  But you may be talking about raising the risk of, lets say hematoma, from 1 percent to 1.5.  Exposure (the ability for the surgeon to see the area encountered in surgery) is better in the full lift.  So one could also reason that the better exposure more than makes up for the increased risk.  So consider the choices carefully.  Ultimately, if a mini lift is the wrong operation,  no amount of risk reduction makes sense.  I'd go with a surgeon you trust and do whatever operation you both feel is the right one, with your goals in mind.

Hi and thanks for your question.  Although both procedures should have very low complication rates, the mini-facelift should have even fewer possible complications then the full.  The smaller procedure has less of a chance of any bleeding issues and a smaller chance of any skin healing issues.  In the right patient who doesn't have a lot of extra fatty tissue in the face and neck and doesn't have an extensive degree of aging, the mini-facelift is an excellent procedure.

It really depends on what your definition of a mini lift is. The problem with the mini lift is that it may not give you the correction you desire.  The risks, such as bleeding or infection are really about the same.

You are correct in that the less surgery you have the less the risk but also the less the improvement

In general, mini facelifts offer fewer complications than full facelifts simply because the procedure is less invasive, and performed in about half the time.  Most mini facelifts can be performed in an office setting under local anesthetic making it more safe than the higher risks of general anesthesia.  Risks of nerve injury and hematoma (bleeding), though rare, is higher as well.  I like to combine fat transfers with my mini lifts to get the best overall result.  For patients with more skin laxity and neck sag, a full facelift is often required in addition to a platysmaplasty. 

In general it is true that the more complicated the procedure the higher the risk involved. However, I would not choose a procedure based on the difference in risk between a mini Facelift and a full Facelift as  the difference in risk of complications between the procedures is very small.  You should decide, with the help of a Board Certified Plastic Surgeon what type of procedure you need and consider that procedure.

The question posed is the difference in risk and natural results between  a full and mini facelift. As for risks, they are more or less the same for both operations. The nature of the particular "mini" facelift will dictate the amount of risk involved. In most mini-facelift procedures the incision ends behind the ear and there is little or no dissection of the neck. In a full facelift the neck is completely dissected in most surgeons hands. That being the case, there is a very small risk of nerve injury for two nerves in the neck. one of these nerves allows for feeling in the earlobe and the other has to do with the movement of the lower lip on that side. These nerves may or may not be at risk with a mini-facelift.

As for the natural results, this is completely based upon the technique of the surgeon. Whether a mini or full operation, your results will depend upon the style and skill of the surgeon, not the choice of technique. While you might think that less is more and a mini would lead to more natural looking results that is simply not the case. Having a mini-facelift can give you a very "done" look while a full facelift can give you a very natural looking result. It depends upon your anatomy and your surgeon. You should choose the procedure that solves the issues that make you look aged. In good hands you can safely achieve great results.

The nature of complications and the relative rates of these complications is very similar for min lift and Facelift.  The only exception is that Facelift carries a slightly higher risk of hematoma.  However, a mini lift, when performed on a patient that required a more extensive procedure (Facelift) is more likely to lead to a sense of dissatisfaction.  Recent mass marketing has promoted the idea that a quickly performed, one hour procedure under local anesthesia is somehow less risky than a conventional Facelift.  There is absolutely no data to support this assertion and there are (unfortunately) many patients who now regret that they believed the marketing.

 

My advice is that you make your decision based on the aging changes that bother you and the advice of your chosen surgeon.

In surgery, as in life, when you do more work, you get more of a result out of it.  

A full facelift will improve the jawline and neck, a mini facelift won't.  It's more important to choose the correct procedure for your needs AND a top quality surgeon who cares about his/her work.  

Don't try to rationalize having a lesser procedure.

 

All the best,

So which is safer and more natural, a full facelift or a minilift?  

Safety, first of all depends on an individual's rate of specific complications occuring such as nerve damage, hematoma, infection, etc.  Two surgeons can theoretically perform the same technique, however the risk of complications will always differ between surgeons.  Ask your surgeon what is his/her rate of complications?  

Natural Results- Less is not always more when it comes to creating a natural result.  While a minilift may sound appealing, in most cases, it involves a limited incision in front of the ear and does not address neck laxity well.  A minilift struggles in the sense that it tends to want to lift the face vertically.  Most patients benefit from lifting the face posteriorly and superiorly.  This is a more natural vector of aging.  So even though a full facelift may have a larger incision, its design may more effectively lift and distribute skin better than a minifacelift.

Overall, choose a surgeon who has the following characterisitics:

Board certified in either facial plastic surgery or plastic surgery

Performed minimum of 500 facelift

Perform minimum of 50 facelifts per year

Demonstrate superior before and after photographs

Base facelift on anatomy and ability to use advanced techniques