Quite sure I know a facelift is surgery which requires lots of recovery time. But there are doctors who say mini-lifts are good for tightening face with less recovery time reqd. Then there is the midface lift. Will someone explain the differences please!?!
How is a Face Lift Different Than a Mini-face Lift or Midface Lift?
Doctor Answers 67
In short, a face lift, will address: Cheek...
In short, a face lift, will address:
- Cheek laxity
- Neck laxity
It usually involves tightening not only the skin, but also underlying fat and muscle.
A mini-facelift is reserved for someone with minimal neck laxity, and usually someone younger or who has had a previous facelift.
A midface lift repositions the cheek skin and muscle vertically towards the eyes. This is used for someone who has lost fullness in the upper cheek area due to descent of the tissues.
The following are some of the more popular face lift techniques:
Mini-lift - A "mini-lift" refers to a number of different techniques with limited incisions, and usually are best for patients with very early signs of aging, usually in their 30s and early 40s. In most cases, mini-lift equals minimum results.
Some techniques commonly referrred to as mini-lifts are:
- The S-Lift
- The skin-only or subcutaneous face lift
- The weekend face lift
S-lift - The so-called "S-Lift" is a type of SMAS facelift (see below) that gets it's name from an s-shaped incision in the hairline at the temple and in front of the ear. Since the incision does not extend behind the ear, the best candidates for an S-lift do not have significant laxity of the neck skin, and this type of facelift is best for people that are just starting to show signs of aging (in their 30s or 40s) and want a little tightening of the lower face without longer incisions.
An S-lift can be beneficial for mild jowling and very minimal neck laxity. When you hear S-lift, think "S" for small.
Subcutaneous / skin only - The subcutaneous lift (meaning just beneath the skin) is a facelift that addresses excess skin only and does not address aging changes in the deeper structures, such as fat pads, connective tissue, and muscle.
It is used mostly for thin women with some excess skin but good position of the underlying muscles, or for a patient who has already had a deeper facelift, but is requesting a touch up. It does not work well forheavier jowls, sagging muscle, or for neck fullness.
The subcutaneous facelift may have less risk for facial nerve injury, but the results do not last as long as deeper facelifts because the underlying structures still continue to sag and pull on the skin. While the subcutaneous or "skin-only" face lift used to be the most common face lift technique until about 10 years ago, it is not commonly used anymore due to the potential for a "windswept" or pulled look.
SMAS Face lift - The SMAS (sub or superficial muscular and aponeurtoic system) is a sheet of muscle and connective tissue on the cheek that contributes to facial expression. Over time, the SMAS can become lax and sag, contributing to jowls and deepening of the nasolabial folds.
The more common "SMAS face lift" repositions skin and the underlying muscle of the cheek to more adequately correct jowls and skin laxity. This will allow for a less "pulled" look and longer lasting results than a skin-only facelift, but a SMAS face lift does not significantly address the nasolabial area (around the nose and mouth) or a sagging malar fat pad (upper cheek fat pad).
Extended SMAS Face lift - An "extended SMAS lift" goes even further toward the nose to help correct lines around the nose and mouth. This is the same surgery as the SMAS facelift (see above), but with an extended SMAS lift, the SMAS is separated from the underlying structures more extensively toward the nose and upper lip.
This can increase the amount of improvement that is possible in the center of the face, especially the nasolabial area. Increasing the amount of SMAS lifted also increases the risk for complications of tissue death, however, especially in smokers.
Weekend Face lift - The term "weekend face lift" has been used to refer to any limited-incision face lift procedure with a quick recovery time. There is, however, a particular technique, which is specifically called the "weekend alternative to the facelift." Using this technique, a small incision is made beneath the chin, excess fatty deposits are suctioned from the neck, and then the inside of the skin is lasered with a CO2 laser to cause the skin to contract.
The muscle in the neck can be tightened, if necessary, through the same incision, and a chin implant placed at the same time. The procedure is performed with local anesthesia only.
The weekend alternative to the face lift may be beneficial for someone whose primary concern is fullness and sagging of the neck.
Some doctors advise against the internal laser portion of this procedure due to safety concerns: the laser can burn the skin and cause scarring, fluid accumulation, and sloughing or death of the skin.
Feather lift also called Aptos lift or Suture Suspension lift - Aptos (from the words anti-ptosis) is a patented name for a barbed, blue prolene (nylon) suture developed in Russia in 1999. The Aptos Lift or Feather Lift, as it's referred to in the United States, can lift sagging underlying tissues (usually the cheek and jaw line) by threading 4 to 12 of these barbed, permanent sutures with a very long needle through the skin into deeper soft tissue structures.
The name, Feather Lift, comes from the appearance of the suture.
Once the suture is in place, it is pulled, anchoring the barbs into the soft tissue and lifting the soft tissue. The end of the exposed suture is then snipped, leaving the majority of the suture buried entirely beneath the skin.
Since no skin is removed and no incisions are made, this technique is not advantageous for people with excess skin. Side effects include bruising, swelling, and tenderness. The most common complications of the feather lift are puckering where the barb is pulling, visibility of the blue thread through the skin, and recurrence of sagging.
Very few doctors in the United States have been trained in the Feather Lift procedure, but it is increasing in popularity. The suture that is used for the feather lift is pending FDA approval.
Deep Plane Face lift - A "deep plane facelift" is especially useful for changes in the upper cheeks and midface because the surgeon repositions the tissues in those areas as well as in the lower cheeks.
Because the dissection is deep, the flap is thicker than in the SMAS or subcutanoues methods, some doctors believe that a deep plane face lift may be safer for smokers because of the greater blood supply attached to the flap; however, smokers have an increased risk of complications, regardless of the technique. There is usually more swelling with the deep plane lift than with more superficial lifts.
Sub-periosteal lift - The "sub-periosteal lift" is another type of deep plane face lift commonly performed with the aid of an endoscope, a tiny camera attached to a probe to allow visualization of the surgical area through very small incisions.
The idea of the subperiosteal lift is to reposition skin, fat, and muscle all at once since the tissues tend to sag together, not individually. To do this, the surgeon goes all the way down to the bone, separating the bone from all of the tissues covering it (the periosteum is the thin sheet of tissue covering the bone, so by definition, a sub-periosteal lift goes beneath that tissue and lifts everything over the bone).
For patients in their 30s or 40s who do not require skin removal, the inicions can be very tiny and hidden in the hair. For patients requiring skin removal, standard facelift incisions will need to be made, and the surgery is thus not done with the endoscope. Facial implants may also be easily placed at the same time, since the implants are positioned directly on the bone which has already been separated from overlying structures.
Many surgeons prefer this techniqe for patients 45 and under who desire facial implants. There is more swelling with the subperiosteal lift than with more superficial lifts due to the depth of the dissection.
Composite Face lift - The composite face lift is essentially a deep plane lift (see above) with the addition of an extra step to include the muscle around the lower eyelid.
This is advantageous to address changes in the upper cheek and midface region, such as a crescent shaped sagging of the fat pad.
To accomplish this, the orbicularis oculi muscle (around the eye) is separated from its attachment to the cheek bone through an incision in the lower eyelid. It can then be lifted and sutured into place. At the same time, the arcus marginal muscle is released (AMR) and repositioned to cover the orbital bone.
The remainder of the procedure is the same as the deep plane lift. There is more swelling with the composite lift than with more superficial lifts.
Tumescent Face lift - This refers to any facelift technique performed with tumescent anesthesia, instead of general anesthesia or local with IV sedation.
Benefits of tumescent anesthesia are less bruising and swelling, less chance of nausea and vomiting, quicker recovery, less risk of anesthesia complications, ability to check nerve function during surgery, possibly reduced fees because there's no need for a separate anesthesia specialist, and overall greater safety.
Sometimes this is called the Awake Facelift, since the patient is awake during the surgery.
With over a dozen different techniques and types of face lifts, it's hard to know which one is right for you. A thoughtful discussion and careful examination with your surgeon will help determine which approach you should take.
A face lift (also known as a face and neck lift) can...
A face lift (also known as a face and neck lift) can reverse many features of the aging face and neck. The most dramatic improvement is seen in the jaw-line and the neck. Face lift incisions are carefully placed within the natural creases in front, within, and behind the ear. After re-tightening of the deeper layers, excess skin is removed from both sides and the incisions are carefully repaired. Most experienced plastic surgeons perform a ‘deep-plane’ face lift, which involves a thorough tightening of the sagging muscles of the lower face and neck, and can be custom tailored to the specific needs of each person.
A mini-lift (such as S-lift, Lifestyle lift, Quick lift) is a more limited technique of lifting the face with shorter incisions and less skin removal. Mini lifts improve the same area as a face lift does but to a lesser degree and with a shorter duration. People with minimal skin laxity (typically early to mid 40s) may be good candidates for this procedure. However, because of the shorter incisions, more conservative tightening of the deeper layers, and less skin removal, this technique is not as effective or as long-lasting as a deep plane face lift. According to the RealSelf consumer reviews, the vast majority (86%) of those who had traditional face lifts said that it was worth it, yet only less than half (48%) of those who had the more limited Lifestyle lift felt that it was worth it.
A midface lift (also known as cheek lift) differs from both face lift and mini face lift in that it primarily addresses aging around the cheekbones. Using minimal incisions, the droopy cheek tissue can be lifted up back over the cheekbone thus restoring the more prominent youthful cheek contours. Midface lifts can be combined with fat grafting to the cheeks to help improve early facial aging with minimal incisions.
Dr. Naficy has given an excellent overview of the...
Dr. Naficy has given an excellent overview of the differences between a "Face lift," "Midface lift" and a "Mini face lift." It is important to note, however, that these terms are not standardized and often mean quite different things to different surgeons.
In my view, a careful analysis of the facial features and how the facial anatomy has changed over time is a critical first-step in discussing any potential options for reaching one's goals. I ask patients to bring in facial photos or portraits from when they were younger and I use these as a helpful reference in our consultation. My bias is strongly toward procedures that give a rested, rejuvenated, natural and youthful appearance over ones that tighten, distort or change one's appearance in an unnatural way.
Analysis of the face is then correlated with one's overall goals. Often patient's goals match-up well with their procedure of interest, but this is not always the case. I loosely conceptualize treatment options as having three basic levels of invasiveness: 1) Minimally invasive with minimal or little down-time. Botox, dermal fillers and light skin peels are in this category. 2) Focused surgical procedures or perhaps "mini" procedures. Eyelid lifts (blepharoplasty), Brow lifts, intra-oral midface lifts, and maybe short-scar face lifts and fat grafting or fat-transfer procedures, when done individually or in one facial region. 3) Comprehensive facial rejuvenation.
Typically a combination of procedures are selected to address aging changes in multiple areas of the face and neck. This website is a great resource of information about the full range of facial rejuvenation procedures, and the many physician and patient comments are helpful background if you are considering a procedure or treatment. However, no amount or research can replace an in-person consultation where you can discuss your goals and have your surgeon give you an individualized recommendation after a careful examination and assessment.
My philosophy is that Plastic Surgery is a very personalized, problem solving medical specialty. There are a wide range of techniques and technologies that are released and marketed at a break-neck pace, and very commonly the "latest greatest" is soon to fade. I have seen many patients that wound up unhappy after pursuing "teaser" financing offers for surgery, offers for proprietary procedures, or "corporate" practices or offers that are marketed via infomercial or a 1-800 phone number. And the old axioms of "no-pain, no-gain," "if all you have is a hammer, everything looks like a nail," and "there is a reason something is the cheapest or best-deal" can often be taken to heart in aesthetic surgery.
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How is a Facelift different than a mini-facelift or mid facelift?
A mini-facelift involves subcutaneous elevation of skin in front of the ear, along the lateral jawline and sometimes just below and behind the ear as well. The skin is undermined anteriorly (towards the central face and mother area) for a variable distance depending on the degree of skin laxity, which allows the skin flap to be advanced towards the ear where excess skin is removed.
As with all facelift procedures, it is critical to avoid closing the incisions with significant tension – which can lead to scar widening and earlobe distortion. To avoid this, tension should be limited to superior anchoring sutures which can be placed at the top of the incisions in front of and behind the ears.
Regarding recovery, there isn’t necessarily a long recovery period after a full facelift. It is really the eye-area procedures (browlift and blepharoplasty) and ancillary procedures (such as lip fat grafting, peri-oral dermabrasion and other resurfacing procedures) that prolong the recovery into the neighborhood of three to four weeks. A High-SMAS face and necklift plus structural fat grafting, if performed as a stand-alone procedure, will often have a return-to-work (or to social activity) recovery of just ten to fourteen days.
Here’s the thing to know about ‘midface lifts’ – a lot ‘before and after’ photos that I have seen at scientific meetings, and that you will see online, for procedures that claim to ‘lift’ the midface don’t show much of a discernible difference between the ‘before’ images and the ‘after’ images. A number of procedures purported to be a ‘midface lift’ are performed through a lower lid approach as part of a lower blepharoplasty procedure. The midface lift that can be accomplished by this means, which amounts to pulling deflated soft tissues directly upwards towards the eye, is subtle at best.
The only procedure that I have found that reliably and significantly lifts the midface in an aesthetically ideal manner, both in cases presented at scientific meetings by other surgeons and in my own practice, is structural fat grafting of the midface in concert with a High-SMAS face and necklift. This combined procedure restores lost midfacial volume (by fat grafting), and then redistributes that volume in an upwards and lateral direction (by means of the High-SMAS lift). Youthful and aesthetically ideal cheeks are full along the entire length of the zygomatic arch (the cheekbone arch), not directly under the eye, and this combined procedure
For younger patients that do not need a full face and necklift, but who would benefit from a midface lift, an aesthetically ideal outcome can be achieved by combining structural fat grafting and the upper half of a High-SMAS face and necklift. In some cases, syringe fat aspiration (removing fat from adjacent areas using fat grafting cannulas) is helpful in further defining an aesthetically ideal midface. This limited version of the High-SMAS facelift procedure restricts the incisions to the temporal scalp (behind the temporal hairline) and the area immediately in front of the ear, where incisions can be easily concealed.
Mini Facelift Lifts Cheek Full Facelift Lifts Cheek, Lower Face And Neck
Thank you for your question. There are so many different marketing terms used to describe a Facelift that it is very confusing for patients. Understand that most patients do not want to have a Facelift-so Plastic Surgeons do their best to find names that tend to minimize the procedure.
In general a Mini Facelift or Mid Face Lift:
- Lifts the sagging cheek but does not tighten the jowl area and neck
- Involves incisions in the hairline and front of the ear, less often behind the ear
- Is done in younger people who have sagging cheek skin but not jowls or loose neck skin
In general a Full Facelift or Face and Neck lift:
- Lifts and tightens upper face, lower face and neck
- Involves incisions in the hairline in front and behind the ear and skin incisions around the ear and usually under the chin
- Is done in patients with jowls and loose neck skin (Turkey Neck) as well as a sagging cheek.
The most important thing is to have the proper procedure to achieve the result that you need and want. See an experienced and reputable Board Certified Plastic Surgeon and do not get hung up on the name of the procedure.
There are so many misleading names used to describe a Facelift. Choose your surgeon wisely and not be concerned about the name used to describe the procedure. Most names other than Facelift are purely marketing terms.
Mid-, Mini-, Full Facelift
The various terms applied to facelifts are not necessarily technically precise in that each term can mean different things; there a many different facelift techniques.
"Facelift": the term is used broadly for a surgical facial rejuvenation, but is even used for non-surgical techniques (LASER facelifts, "liquid" facelift, etc.). Surgery involves at least the lower third of the face, but the term can be used to include the middle 1/3, the brow and/or the neck. The procedures generally involve lifting the skin away from the deeper facial structures followed by a suturing technique to tighten or lift the face.
"Mid-facelift" addresses the middle third: cheekbone area, and nasolabial folds.
"Mini-faceliift" usually refers to a skin only tightening with little or no undermining or treatment of the tissues of the cheek and jawline: cutting out a pinch of skin in front of the ear. Because this technique just pulls on the skin without truly tightening or lifting the underlying structures, the results are very limited and short-lasting (weeks to a few months).
Facelift and mini or midface lifts work in different areas
A midface lift works to pull up your cheek so that your nasolabial folds are improved and your cheek is lifted. This can also improve the way your lower eyelid appears in relation to your cheek. he dark circles and bags under your eyes can be improved as well.
A mini lift is a variation of the facelift but just not as extensive and usually not as aggressive. A minilift limits the amount of dissection in front and below the ears and usually does not entail lifting the muscle and going deeper. The effects are also less significant as opposed to a full facelift.
A face lift extends the dissection much more and often entails elevating the platysma muscle smas layer to get a more definitive pull of the face. The recovery from a full face lift is more involved most of the time compared to a miniface lift. But variations between the two really depends on the person and the surgeon doing the procedure.
There are many variations and degrees of aggressiveness that can be carried out during this procedure. The best way to know what will take place is to really sit down and talk with your surgeon about what he is going to do. For the midface lift, I prefer to volumize the face with fillers like fat or dermal fillers like restylane, radiesse, perlane, and juvederm.
How is a Face Lift Different Than a Mini-face Lift or Midface Lift? #facelift comparison
Each of the terms you mentioned above are all categorized under facelift surgery. Depending on your concerns and what the surgeon finds to be problematic, he or she may use these terms to specify what needs to be corrected. In reality, facial anatomy changes over the years as does the volume in your face. Whatever term is chosen doesn't seem to make as much difference as does what your surgeon wants to achieve. I have always attempted to educate my patients at our clinic in Northern California Bay Area and this includes addressing multiple issues a patient may encounter. Replacing volume, re-suspending the cheek fat pad, correcting the jowl region, improving the appearance of the eyelids, lifting the brow, and correcting the neck sagging is what is most concerning. Call it whatever you want, it's a facelift and takes time to correct each of these issues. The fewer problems noted on your consultation with your surgeon, the less that needs to be performed. The "mini-facelift or midface lift" are very confusing to patients as you have encountered. Rather than focus on these terms, focus on what is most concerning to you and specify these concerns with your surgeon.
Facelift Different from a Mini Facelift
A mini facelift is usually for patients who don’t need a facelift, but can be helped with skin tightening only or fillers. I tend to use fillers and neuromodulators until a patient needs a true, real facelift. I would not recommend a mid-facelift, in most patients, as it has significant down-time and morbidity associated with it.
Facelift vs minilift vs cheeklift vs midface lift
A facelift rejuvenates the face through incisions located around the ears, and usually below the chin.
A mini facelift uses usually the same incisions but does a more limited lifting and pulling. A minilift can also be performed through the front of the ear, or from the ear back, depending on whether the upper face or the lower face is the target. We perform few mini lifts because patients are generally disappointed in the limited results they receive when they could have had a real facelift through those same incisions, and obtained better and longer lasting results.
A cheeklift addresses the area below the lower eyes into the cheeks, not addressed with a facelift. In my opinion, cheeklifts are best viewed as a smart way of doing the lower eyelid. It is often used (the subciliary version) to correct eye shape and restore an almond shaped eye when prior blepharoplasty has pulled down the eyelid. This is a highly technical operation best performed by a doctor with a specialization in the midface.
A midface lift is another term for cheeklift. It is often performed through temple and inside the mouth incisions. It does not address the lower eyelid aging. It is especially effective if patients want to increase the lateral projection of their cheeks, and is therefore not recommended for patients who already have a large intermalar distance. Also this method can cause alteration of the area around the side of the eyes.
We have several published articles on our website drbrent.com.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.