Is Skin Only Facelift No Longer Performed?

every patient has different needs and so there are many modifications.

minilifts, skin only lifts are less common but may be the right choice for you.

the goal is a natural , long lasting improvement,  easy and quick healing, safe and great results

Although a skin-only facelift may be the right choice for you, it may not be.  Individualized evaluation and recommendations are critical to receive the best result.  Therefore make sure to select the best plastic surgeon in your area for this advice. For hints on how to find the best plastic surgeon - see the below link.

They are still performed but if you want a long-lasting improvement then I prefer to tighten the underlying muscle layer (SMAS).  The traditional skin only facelift is rarely used today.  Posting pictures of yourself will help us make recommendations.

Most face lifts involve some form of muscle tightening as well. There are many ways to tighten the muscle and each surgeon has their own preference. Skin only lifts tend not to give as good a result and usually do not last as long.

Dealing only with the skin at the time of the facelift ignores aging in the deeper tissues. Furthermore, if tension on the skin is expected to support the lift, the result is likely to look more unnatural in the scars are likely to be worse than with a tension free repair.

A skin only facelift is rarely performed by qualified plastic surgeons. The main reason is that this technique does not give a long lasting or natural result. The immediate result is an over-pulled appearance.

Generally a skin only facelift is not a great idea:  what happens to adjusting and augmenting the deep volume of the face?  Nothing.

So all the incisions of an advanced facelift, but none of the volume adjustment.  That, by the way, is my criticism of the mini lifts as well: all the incisions, none of the results.

Sometimes we do perform skin only facelifts when the only problem is minor looseness in the neck, but then we usually perform a lacing platysmaplasty in the neck, so the skin only facelift is really a way of gracefully removing the extra skin from the neck and jowl area as an adjunct to a necklift, rather than a standalone procedure for the face.

It's just not enough for most patients to have a skin only lift with much better procedures available.

You may wish to consult a facelift expert, such as a board certified plastic surgeon with interest in facelift surgery, preferably board certified and an ASAPS member.

A skin only facelift will not give you a long lasting benefit.  The scars and healing are unacceptable. In a very young person a small skin excision may be all that is warranted but in the usual facelift candidate a deeper elevation of the SMAS layer is needed so that there is no tension on the skin. This process together with a neck lift will give you the best result.

It IS very rare to perform a facelift and just remove skin. The major issue is that creates significant tension on the skin which results in a short-lived lift and, often, very poor healing of the facelift incisions. You have probably seen facelift disasters where there are widened, depressed, white scars along with pulling of the earlobes onto the cheeks and minimal improvement in the initial problem which was, and still is, laxity along the jawline. Most contemporary facelifts remove skin after placing the tension of the lift on the deeper tissues to create a long-lasting lift and incisions that heal very, very well. I hope this information is helpful.

Stephen Weber MD, FACS

Lone Tree Facial Plastic Surgeon

Thank you for the great question. As others have said, skin only facelifts lead to some problems. First, the appearance can be unnatural -- it looks like the face is stretched or too tight. Second, the lift generally doesn't last very long because the skin is holding all of the tension and begins to stretch right away. In my practice, the only time I do a "skin-only" procedure is as a delayed touch-up or tuck-up type procedure for a patient who has already had a comprehensive face/neck lift.

A modern approach to facelifting generally involves elevation of the deeper connective tissue and muscle layer (called the SMAS). This can be done via a variety of techniques (SMAS flap, deep-plane, composite, etc.). In addition, the neck muscles are tightened and excess fat removed to improve the under-chin area.  All of the approaches can be performed at the same time as the change you desire for your cheek implants. Best of luck!