If I have an upper & lower facelift (inc. neck) as separate procedures, is this the same as a full facelift?

Question

I do not want to have a dramatic change in my appearance, and so wish to do a SMAS facelift in stages.

Ronald J. Edelson, MD · Answer

I think you need a better understanding of both the facelift itself and terminology. A lower facelift means different things to different people and different surgeons. An in person consult is needed to figure out the best way to proceed? I’ve never done or heard of a two stage facelift

Semih Yildiz, MD, FEBOPRAS · Answer

“Full facelift” is not a perfectly standardized term, so the answer depends on what each surgeon includes. In many practices, a facelift already treats the lower face and jawline, and a neck lift is commonly done at the same time. Some surgeons may add midface, brow/forehead, eyelids, or fat grafting separately, but those are not always part of a standard facelift.

Doing an upper and lower/neck procedure in stages can be reasonable, especially if you want a gradual change or shorter operations, but it is not always the same as one comprehensive plan. Staging can mean more recovery periods, higher total cost, and more scar tissue for the second operation. A natural result usually comes more from conservative planning, proper SMAS work, and avoiding over-tightening than from splitting the surgery. A consultation should define exactly which areas bother you and which lift addresses each area.

Donald Groves, MD · Answer

A facelift or "mini-facelift" (a.k.a. short scar facelift) helps with skin tightening (by surgical removal of excess skin), but also allows for adjustments to some of the deeper face structures- e.g. tightening of the SMAS layer, simultaneous fat grafting to certain areas to replenish the volume lost with aging. The nomenclature can be confusing, but a facelift addresses the lower 1/3 of the face and the neck. That is why for someone with prominent jowling, significant neck skin laxity, or neck/platysma banding, these are best addressed with some type of facelift..When performing a lower eyelid blepharoplasty (lower lid lift), some surgeons extend their dissection down into the cheeks to help pull up some of this skin during the procedure. This is sometimes termed a "mid-face lift" since it addresses the middle 1/3 of the face.,The upper 1/3 of the face (forehead & brows) are addressed with a browlift. There are several different techniques to perform this, and these procedures can be performed at the same time or separate from either of the other two above procedures I mentioned. .I would urge you to arrange a formal consultation with one or multiple plastic surgeons to really discuss your surgical goals, be formally examined, evaluate all your options (including nonsurgical), and decide on the best procedure(s) and timing for your specific case. I hope this helps!.Best, Dr. Donald Groves Plastic Surgeon

Cory Bovenzi, MD · Answer

The variety of terms used in facelift surgery can sometimes be the source of confusion. The terms facelift / lower facelift/ face and necklift are many times used interchangeably. The upper facelift is a term that more commonly is called a browlift now, but there is a chance your surgeon is meaning it to be a midface lift for the cheeks rather than your brows.

Because of all these different terms, your best source of information is at your consult so exactly what work and what results you can expect are clearly laid out for you to understand. My best estimate is in this case you would be getting a full facelift plus a possible browlift.

Stephen Prendiville, MD · Answer

A modern deep plane Facelift is a cheek, jawline, and neck repositioning.  This includes incisions around your ears and hairline, and incision under the chin, with elevation and repositioning of the SMAS, and tightening of the platysma muscle.  Ask your Surgeon to be specific with you and show you at least 20 examples of work hat he/she has performed. Not every Surgeon performs a lot of facelifts.

Sudeep Roy, MD · Answer

Thank you for this question as it is one that many people struggle with understanding partly because of how much terminology is floating out there on the web. In essence, you are right that a full facelift probably entails a lower facelift (the main feature which addresses the jowls, jawline and neck) in addition to procedure that rejuvenate the brows and eyelids. On top of that, many patients may also decide to address 1) volume concerns with a facial fat transfer and 2) skin concerns with either a chemical peel or resurfacing laser. In my consultations, I generally focus on treatments that will address specific patient concerns, although I do have patients who will ask me what the most balanced, comprehensive and natural combination of treatments is in which case I may recommend one or more procedures that would complement a lower facelift well. Remember, either way, surgery done well is the most natural result and the treatment of multiple facial zones together also results in a more harmonious rejuvenation.

Jacob Tower, MD · Answer

Hello. hope you are well. Generally speaking, it is not advisable to try to stage a facelift and/or neck lift surgery. There are technical, anatomical, and wound healing reasons that would make this challenging, but you would also create additional cost, recovery time, and likely a worse outcome by trying to do so. The eyes and upper third of the face (brows) can be treated separately when considering facial rejuvenation, but it is best to perform a complete facelift and neck lift together if needed. Even so, most patients consolidate all of the rejuvenation procedures into a single surgery. Having said that, some concepts may be 'lost in translation' and perhaps what you have in mind is something that makes sense. An in-person or virtual consultation would help to provide you a clear path forward to reach your goals.
Best,Dr. Tower

Arturo Valdez, MD · Answer

Hi thank you for your question.
A facelift and a neck lift are not 2 seperate procedures because with the aging aging process, the facial and neck changes are related with the deep tissues. The deep tissues are involved because of the deep SMAS and the continuity of this SMAS in the neck is the,  Platysmal muscle. So, when we want to do a face lift or a neck lift in patients that have several  changes due to the aging process such as,  patients over 40 years of age; they require both and so, it  is very difficult to seperate neck lift  and facelift in these patients. Usually separating a neck lift and a facelift is possible in patients who have lost significant amounts of weight, such as post bariatric patients or in a youger patients.
I hope this helps and I wish you the best.

Connie Hiers, MD, FACS · Answer

I am not certain of what you mean by "upper facelift" unless you are referring to a forehead lift and eyelid surgery.  There is a full facelift which includes all the neck, a mini facelift lift which is less neck work, and a neck lift which is very limited because the face is not done. A SMAS lift can be done with both a mini and full facelift. You might even consider micro-needling with radiofrequency like Secret for toning and tightening your face and neck with minimal downtime.

Mehdi Sina, MD · Answer

Hi,
It does not make sense to separate the procedures. A well executed deep plane facelift yields very natural results and when the face and neck are performed together, there is only need for 1 recovery phase. In certain instances, a necklift can be performed first and eventually a facelift can be done at a later time.

Best,
MS

If I have an upper & lower facelift (inc. neck) as separate procedures, is this the same as a full facelift?

Answers (13)

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