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.   

A mini face lift does mini improvement.   If that is what you want and need it may be fine.  Will a mini improvement satisfy you?  If you have maxi expectations and get mini results will you be happy?  Can a surgeon accomplish more in 1 or 2 hours or in 4 or 5.  You get what you sign up for and pay for often.   We all want great gains in all we do with minimal risk exposure.   Good plastic surgeons do fine surgery and do right by their patients.  If problems  occur they know how to fix them and do fix them.  If your need is for a normal good natural facelift,  and you sign up for a mini you are wasting you money.  I have seen this often over my 30 year career as patients com in disappointed with a mini effort.   I often here things like...."Will Doc. now that I have wated $7000 for a mini, I want you to do the proper faclift for me. " I will say that in some people a mini effort has very little anatomical benefit,  but possibly some psychological benefit.   Or is it that after wasting $7000, its hard for a person to admit they made a silly mistake.   Then there is the question of what a mini facelift really is?    Basically it is many procedures that have fallen into a basket termed mini lift. From chin lipo, to the famed liquid lift, to thermage, to the string lift, to the barbed lift, to the Russian lift...........?    PLEASE SAVE YOUR MONEY AND SPEND IT ON A REAL FACELIFT BY A REAL ABPS SURGEON.   IF MINI IS YOUR GOAL HOWEVER, AND MINI WILL PLEASE YOU, THEN HAVE A MINI.  PLEASE JUST DONT HAVE A MINI EXPECTING MAXI MIRACLES.    GOOD LUCK.

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.

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, chose 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

No matter what you call all the many uniquely named mini-lift procedures or facelifts, what matters the most is that you get the procedure that is right for YOU from a skilled, board certified surgeon. Establish a healthy doctor-patient relationship so that you can communicate your expectations and understand what realistic results are possible from the procedure that you and your surgeon decide will best achieve your aesthetic goals. From anesthesia to combined fillers and CO2 at the time of your surgery, make the most of your surgical experience to get your best results. Seek the BEST surgeon for your procedure, research their experience reputation and credentials. Remember you are doing this for YOU so make sure to advocate for your best facial health and get the optimal procedure to attain your cosmetic outcome.

This is a complicated question to answer because first you have to define what a mini facelift is.  A facelift technically is a procedure that is used to restore the appearance of the lower part of your face (jowels) and the neck. Some more advanced facelift techniques, such as the deep plane facelift, also restore the mid-face/cheek area.

Each surgeon has a different defintion as to what a mini-facelift is because it is not a defined medical term.  Patients like to hear the word mini and for this reason it has been used for marketing by physicians and there is no uniformity in its definition.

 A lift that is less extensive does not meant that it will look more natural. In fact it is quite the opposite.  Facelift techniques used many years ago where only the skin was removed and pulled tightly had resulted in the wind-swept look which is not desireable.  Newer, more advanced tecniques involve re-positionng the deepest layer of muslce in order to give more natural results.

Your best bet is not to look for a procedure, but first undertstand what you would like to achieve. This is the best way to achieve the most natural possible results. Cookie cutter surgery is the worst way to go, and will likely lead to  unnatural results.  Meeting with experienced facelift surgeons will help you understand the best way to achieve a natural appearance.

Please see a board certified plastic surgeon to see if indeed you are a candidate for these "mini" facelift procedures.  Often, we hear of patients getting these "mini" procedures which essentially undercorrect signs of facial aging and require secondary revisional procedures.  Review some of the patient questions and experiences on realself to see.   Now, I'm not saying a mini facelift procedure may not be right for you.  But visit with an experienced surgeon to learn more about your options.  I hope this helps.

All of your general statements about facelifts are true...less is always less. The more limited the procedure, the risk of complications and the amount of recovery all go down...as does the amount  of result. More limited or mini-facelifts are great for those that have earlier signs of neck sagging and jowling that does not justify a more extended or complete facelift procedure. For more advanced facial aging problems, such as those with significant jowl sagging and more of a turkeyneck, a limited facelift will produce a very limited result and an unhappy patient. These patients need a complete or full facelift procedure to get a satisfying result which will be associated with some higher risks of complications and amount of recovery. This is a good example that less is definitely not more.