Thank you for an excellent question. Many patients are surprised to learn that a facelift is designed to improve the middle and lower portions of the face, but not the brow or forehead. I will often combine fat grafting to the temple areas to provide a more comprehensive outcome, and I believe you could benefit from this technique. The advantage of using a patient's fat as a facial filler is that it will last much longer than a synthetic dermal filler. Good luck!
A SMAS facelift in my experience will lift the temple area slightly, lift the skin around the cheek area, improve the marionette lines and jowls and tighten the neck.
Different physicians have different ideas of what a facelift will include in the procedure, but in my experience including these areas as described yield the best results.
An SMAS facelift by itself will not lift the temporal area, since the operation was not designed to do that. An extended incision up into the temporal area from the facelift can give a slight amount of tightening in that area. A temporal lift can also be performed. For many examples of facelifts, please see the link below.
Thank you for your question. Based on your photograph you look excellent and I question seriously whether you need a facelift. Because you have had previous brow lifting and any attempt to lift the temple area could distort your hairline and change your look.The SMAS facelift cannot be done in the temple area because the SMAS does not extend that far and most people and the risk of injury to the facial nerve to the forehead and upper eyelid muscles is a serious risk.
The SMAS (superficial musculoaponeurotic system) is a fibrous net around the soft tissues and muscles of the face and neck. The traditional SMAS facelift suspends this or tightens this layer of tissue to lift the upper neck, jowl and lower cheek upward. A high SMAS lift will bring it to the level of the cheek bone but not above it.
There are options to further lift or fill the temporal area without a brow or temple incision. These include:
- Fat and filler grafting of the temporal fossa or the cup shaped depression just over the lateral cheek bone.
- Suture suspension to the deep temporal fascia at the time of facelift
- Sub-periosteal facelift (recognizing the limitations of this procedure)
- As of this post, the minimally invasive, Silhouette InstaLift dissolving suspension and collagen stimulating sutures to further elevate brow, temporal cheek, face and neck soft tissues without surgical incisions.
All of these procedures are advanced techniques, so please consult with an experienced and talented Board Certified Plastic Surgeon for your best evaluation and recommendations. All the best!
Congratulations on deciding to have a facelift. That is a big decision. To answer you question, it is possible to configure the incisions for any facelift so that the side of the eye area extending out into the temple are can be tightened and rejuvenated.
I hope that helps.
A facelift will not produce a lift at the level of the temples. A browlift would be a better choice. Since you are not looking to have another browlift, consider Botox, which can be used to create a more pronounced eyebrow arch, or filler/ fat grafting, which can address temporal hollowing.
A SMAS facelift works by lifting the submuscular aponeurotic system of the face. The layer is in continuity with the platysma neck muscles and the deep fat plane in the face. It does adhere to the zygomatic bone. Therefore, it offers no lift to the temple region. However, it can be combined with a temple incision by which a lateral brow lift can be made.
A face lift is not really a 'full face' lift, it addresses the lower face. If you have concerns about the temporal area, the facelift incision can be extended upward or a separate temporal area for a lateral brow lift may be beneficial
A SMAS facelift is really focused on the lower face and neck. The temporal region is not really part of a SMAS or even a High SMAS facelift. My advice to you is find a surgeon who likes doing lateral brow lifts either endoscopically or via smart hand technique.