Question: I’m interested in getting a facelift; however there are so many techniques out there. It seems like there is a new type of facelift every day. Can you explain to me what some of the more common or more effective facelift techniques are and what they’re best in treating?
Answer: Facelift surgery in Toronto has undergone a revolution in the last 15- 20 years. There are a number of techniques involved in the facelift. The medical term for facelift is rhytidectomy and it can be performed in many ways. The best way to think of a facelift is that it’s a procedure performed to enhance the appearance of the midface. Facelift is most effective in improving the area between the eyes and the neck, and the neck is frequently performed on using a lifting procedure which is done in conjunction with the facelifting procedure. The types of facelift can be looked at really in 2 broad groups: one group is the length of scar and the second is the tissue plane that is used for the facelift. In general, the facelift scar curves around the ear and may go in front or behind the ear, and curves up behind the ear and then curves back down to the edge of the hairline. This incision can be made in varying lengths. In fact, some incisions are very short. In general, the shorter incisions are done for the mini facelift or the lunch time lift, and these incisions generally involve lesser dissection and less surgery. The advantages of these are the shorter anesthetic time, shorter procedure, less dissection and bruising, and the patient returns to their preoperative status earlier and would be able to go out in a much shorter time. The disadvantage is that the results would not be as long lasting than the traditional procedure, and it may also not be cost effective since you may need to have more mini procedures in a very short period of time whereas one complete rhytidectomy may have given you the result you desired and lasted a longer time. The next way to classify facelifts is the tissue that is dissected. Facelifts can be done on the skin only, or they can be done with a procedure that tightens up the SMAS which is a layer of fascia, or they can be done in a sub periosteal plane. They can also be done endoscopically using special instrumentation. In general, skin-only facelifts have been abandoned except for a very limited use in facial revision cases because this will not result in a long-lasting procedure. Most procedures involve some tightening or treatment of the thick muscular and facial tissue layer which is a little bit deeper. This generally provides long lasting results. Occasionally, the facelift can be done in a very deep plane, the sub periosteal plane, and may result in longer postoperative swelling of the face. Endoscopic techniques are also very good to treat the forehead and the neck and the face and these are evolving very rapidly. In summary, facelifting and rhytidectomy are very complicated procedures. It is very important to discuss the present options. It is also important to have a surgeon who has extensive knowledge of all the new techniques coming on the market so they can be evaluated in an objective fashion to determine whether or not these techniques would work and are appropriate for you.