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

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.