Lower Facelift with Vertical Skin-pull Vectors?

Thank you for the fantastic question. Yes, this is not only possible but is the best way to achieve natural-appearing results. A vertical-vector facelift involves some changes in the incision placement and deep suturing, to orient the lift in the direction of gravity (vertical!). In my practice, I use a deep-plane facelift technique to vertically lift the lower face, neck, and midface together -- in fact, I've written a paper or two about it!. This allows me to get a great lift while avoiding the pulled or stretched look associated with a more horizontal "lift." Best of luck moving forward!

Some physicians use a vertical vertical vector when elevating the SMAS (muscle layer). By doing this, the correction of the jowls and neck laxity is maximized. I think the vertical vector can improve the face and neck in a much more powerful way than the horizontal vector. However, it does not mean that the horizontal vector will distort your face and lips. Any technique, if overdone, can create un-natural results. Consult with a surgeon that has experience with the facelift procedure.

Yes, a necklift can be achieved with vertical lifting.  In fact, this approach is the basis for one of the more recent trends in facelifting surgery, the short-scar facelift.  The neck  and lower face muscles, fat, and skin are lifted much more vertically, thus avoiding a long incision behind the ears.  Often, some limited liposuction or muscle tightening might be added just below the chin through a small incision there.  However, be aware that if someone has a lot of loose neck skin, loose in a horizontal direction, then a more traditional lower facelift with tightening of neck skin behind the ears would be indicated to get the best result.  Generally speaking, the short scar techniques with more vertical lifting are more appropriate for younger patients with less skin looseness.