Question: a face lift with skin pulled back or pulling facial muscles back? What is the difference in recovery?

Doctor Answers 30

Skin vs. SMAS

I personally always address the SMAS when performing a facelift but techniques are going to vary with every doctor you talk to. Addressing the SMAS typically provides a longer lasting result but will also create more bruising and swelling initially. I encourage you to have several consultations with Board Certified Plastic Surgeons and choose someone you are comfortable with and whose before/after photos yield the results you're looking for. Best of luck to you!

Coeur d'Alene Plastic Surgeon
4.1 out of 5 stars 12 reviews

Facelift Recovery

A skin only facelift is really what many people refer to as a mini lift, where the only the skin is lifted and pulled, often with a limited or short scar incision.  While this can be effective, the mini lift, sometimes called a quick lift, an S lift and the type of life that the LifeStyle Lift company did, it does not have very good longevity according to the facelift research.  Most bone fide plastic surgeons will do a something to the underlying structures since the muscles and their overlying structure, the fascia (in the face it is the SMAS)  since tightening of these structures gives a much longer lasting result.
The recovery is about the same for all of these lifts although the more extensive lifts like a deep plane lift will take longer as there is more work and as a result more injury.  The one thing that shortens recovery is the use on conscious sedation where a lot of tumescent local anesthesia is used.  This reduces the swelling and bruising after surgery and allows for much faster recovery.
I hope that helps.
Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

Facelift recovery

Most facelifts involve pulling the muscles back.  Therefore, for my patient the recovery is about five to ten days.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

Question: a face lift with skin pulled back or pulling facial muscles back? What is the difference in recovery?

Most facelifts today do not address the skin only. To get a good, lasting result, the tissues below the skin (SMAS and muscles) need to be addressed as well. There are a variety of techniques to address the deeper tissues. An experienced surgeon can explain the differences in techniques. Discuss these with your surgeon and feel comfortable before having surgery.

Warren J. Katz, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Facelift Techniques

Thank you for your question.  There are different techniques for performing a facelift.  In the more common type, two different layers are pulled and rewrapped.  The deeper layer is called the SMAS layer which is the strength layer.  That is pulled tighter the bring the descended fat and soft tissue back up for a more youthful appearance.  The skin us also somewhat undermined and pulled tighter as well.  In our practice, we have developed a very nice technique with fast recovery and under sedation and local anesthesia that involves tightening the SMAS and removing the excess skin.  Best to speak to a board certified plastic surgeon.  All the best, 

Keshav Magge, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 44 reviews

Facelift techniques

Facelift techniques, and many varieties, with different proponent of each. I think that as long as the deeper layer called the SMAS is addressed, the result relies more on the scale of the surgeon. If it is skin only, then that puts too much tension on the skin and makes it last only briefly and has more potential of poor scarring.
In my training, one excellent surgeon would swear by one technique, and another excellent surgeon would swear by another. Yet another had his own technique which, in his hands, yielded excellent results. I would go to the plastic surgery national meetings hoping to resolve the issue, but even there, renowned surgeons would argue on panels about this very question. One famous surgeon even described how he started off his first 15 years one kind of procedure, but after trying a another, he could not tell the difference when reviewing his photos, so he switched.
So, the bottom line is that it matters less on the technique and more on the surgeon. Different surgeons do different things to yield their own excellent results. The key is finding an excellent surgeon, with experience, whom you trust.
Best of luck!
Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 65 reviews

Types of facelifts

In adding to the other responses, yes there are multiple ways to do a proper facelift. However, doing only skin pulled back will be shorter recovery, however the results won't be long lasting. The deeper issue is the deeper underlying muscles will continue to drop if it wasn't addressed because the aging process continues. The skin will drop as a result of the weight of the underlying musculature. Be weary of those surgeons who promise long lasting results with just skin only facelifts. Such a procedure may only give you a year or two of good results.

George S. Miguel, DO
Troy Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Subcutaneous facelift vs SMAS facelift - difference in recovery?

It is difficult to answer this question in a meaningful way - there are many different techniques of altering the SMAS (facial muscles) and each has there own recovery - a plication probably having the least significant difference from a subcutaneous lift, followed by SMASectomy and deep plane face lift, followed by subperiosteal. In short: the deeper and more aggressive the facelift, the longer the recovery. I hope this helps.

Bryan Correa, MD
Houston Plastic Surgeon
5.0 out of 5 stars 15 reviews

No significant difference in convalescence between facelift techniques.

Almost all patients regardless of the facelift technique, if it has been executed properly, will be passable in about two weeks. It takes considerably longer for all swelling to totally resolve.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

What is the difference in recovery between face lift with skin pulled back or pulling facial muscles back? =It depends #facelift

There are multiple types of facelift.

A facelift that only "pulls the skin"back is called a cutaneous facelift. It addresses only the excess of skin and is well know for having a short duration of results.

A facelift that "pulls the facial muscles back" is generally known as an SMAS facelift. The SMAS is the deep tissues of the face. They are the ones that give he shape to the face and covering skin. 

A SMAS facelift that pulls "back" may give an unnatural operated look ( "wind tunnel look"). An SMAS facelift that pulls  vertically ( towards the vertex of the head), by neutralizing the effects of gravity ( that pulls down), reshapes the face to a more youthful natural looking appearance. The malar fat pad facelift is a type of facelift that includes a vertical SMAS pull.

The differences in facelift recovery depends of multiple factors. Minimal skin facelift tend to recover faster than a more involved facelift that includes SMAS pull.

Patients interested in a natural looking facelift  should make a consultation with a Board Certified Plastic Surgeon specialized in facelift plastic surgery.

John Mesa MD
Board Certified Plastic Surgeon
New York City (#NYC) & New Jersey (#NJ)

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 128 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.