I’m Dr. David Stoker, a board-certified plastic surgeon in Los Angeles. A question I frequently receive in my practice is, “How many types of facelifts are there?” There’s almost an infinite number of facelifts. People have different appearances, different shaped heads, and different amounts of skin elasticity; some have more aging on their eyelids, others in their neck or jowls.
Each one is going to require different treatments. There are different degrees of pigmentation, different ethnicities, and also different desires. The basic categories include:
- Skin-only facelift
- Skin and SMAS facelift
- Deep plane facelift
A skin-only facelift is a more superficial procedure, a deep plane lift is a much deeper operation, and a SMAS lift is somewhere in between.
Who is a good candidate for a facelift?
Traceless facelift patients are typically men and women in their 50s and 60s with significant skin laxity in the cheeks, neck, and jowls. It’s also a procedure sought by patients who have lost a significant amount of weight. Younger patients with less obvious facial aging can benefit from a mini facelift. In some cases, a non-surgical approach called a liquid facelift—which combines dermal fillers and BOTOX® or Dysport® injections—can create a more youthful appearance. Patients should be in good overall health with their blood pressure under control. Candidates who smoke should stop before their procedure.
What’s the Difference Between a Mid-Facelift and Lower Facelift?
Plastic surgeons typically divide the face into thirds—the upper face, mid-face, and lower face. The upper face is everything above the eyes. The mid-face describes the area from the corners of the eyes to the corners of the mouth, including the nose, cheeks, and area above the upper lip. It also includes buccal fat pads in the middle of the cheeks that affect their contours. The lower face is the area below the corners of the mouth, which includes “laugh lines,” the jawline, and the chin. A lower facelift often includes the neck, too, and is recommended for patients with sagging jowls and nasolabial folds. A mini facelift addresses loose skin in the mid-face area but isn’t as effective for the lower face.
Combining Other Procedures With a Facelift
When you look at Dr. Stoker’s portfolio of facelift before-and-after photos, the patients typically had additional procedures combined with the facelift. This creates the facial harmony that is the plastic surgeon’s goal. Performing a standalone facelift improves the lower two-thirds of the face, but doesn’t address sagging in the eye area or rough, discolored skin.