Facelift with muscle stitching. What are the pros and cons of this?

Do you like the "wind blown" and "Stretched" look?  I do not.  If you are very young and without sag ( do not really need a facelift) - a skin lift only works great.  Short recovery and quick operation.If you have true aging with Jowls and skin of the neck - you want to put the tension on the underlying SMAS ( muscle/fascial) structure.  You maintain the shape and put the fat "sag" back where it belongs and just redrape the skin over it - cut off the excess, and then close  with a very NATURAL look.

Most surgeons do some form of muscle tightening during a face lift to improve the profile of the neck and jowls.  However there are many different ways of working on the muscle.  Some are more invasive and deeper than others.  The deeper approached may increase your risk of nerve injury and it’s uncertain whether these deeper approaches add any noticeable benefit.

Thank you for your question.  If you just have a facelift which targets the skin, after a few months you will look the same as you did.  Unfortunately, skin is very elastic so the longevity of the result is poor.  When the SMAS muscle is targeted this is what ensures the longevity of the results.  Why a facelift is suggested to last about 5-10 years.  Not all facelift which target the muscle are very invasive.  I perform a facelift under local anaesthetic meaning patient are fine to return to work in a week.  The results can be very nature as well. Please make sure you find a reputable and qualified plastic surgeon.  Good Luck. 

I agree that a facelift should involve tightening  both the SMAS and skin.  I do not know of any surgeon wanting to just tighten the skin unless its a second or third facelift and just some skin needs to be tightened.  Typical the platysma muscle is sutured together and sometimes cut inferiorly and the SMAS is lifted, trimmed, and tightened in face.  There are varying ways surgeons tighten the SMAS to give a longer lasting and natural appearance to the face.

The SMAS layer of tissue under the skin when sutured or raised as a flap helps extend the longevity of a facelift procedure and that is why it is recommended.  It also looks very natural.  Without this step, the skin sagginess may relapse quite early. 

In the mid and lower face, the SMAS layer, which sits below the skin and on top of the facial muscles is re-positioned and sutured under tension to lift the face.  In the neck, the platysma muscle is sutured under the chin and sometimes elevated and sutured laterally to give a more refined angle.  "Skin only" facelifts aren't utilized in my practice because this technique doesn't allow for adequate tension without distortion. 

Thank you for the
question. In general, it's best to avoid pulling the skin too tight; it gives
an unnatural look and the results won't last long. To have an effective
and long-lasting lift, most surgeons believe in tightening the underlying muscle 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. Combining the two is a very powerful tool
in facial rejuvenation. I would consult with a qualified 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

A face lift with SMAS or muscle stitches tend to give a longer lasting result. Most of my facelift cases include some type of muscle stitches to elevate the Neck platysma muscle and the oral musculature. A nip and tuck can be done in a younger patient for limited problems or for a touch up procedure in an older patient.

Hello,The standard of the modern facelift has involved SMAS or deeper layers to reshape the face for over 25 years. Skin only facelifts are inferior, and only temporarily tighten skin. Best of luck!

Britt.  Most plastic surgeons tighten the underlying muscles of the face and neck during facelift procedures to improve the result and make it longer lasting. It is a Standard technique and considered an integral part of most facelifts. Be certain to consult with a board-certified plastic surgeon. Good luck.