“Although there are a multitude of techniques currently used for performing face lifts, there is no general agreement as to which, if any, of these techniques is most effective. There
may never be a definitive answer to this issue because of the highly subjective nature of aesthetics, variability among surgeons, differences in patient anatomy, and specific patient desires” (Source: Plastic and Reconstructive Surgery, 1998, volume 102, pages 878-881). That statement is even truer today. The scientific literature is filled with studies of the different techniques used to surgically cut away and recreate a younger looking face.
The art of the face-lift is extremely complicated and the choices read like a menu with too many entrees, because it can include eye tucks, a forehead lift, chin tuck, and on and on. All of these, when combined, can dramatically reduce sagging skin on the face, neck, eye, and jaw. As impressive as this cosmetic procedure can be in creating a youthful, taut visage, it can also create an overly pulled, masklike appearance, with the face drawn up in a stretched, permanent smile. This is one cosmetic procedure where you want to see the doctor’s work on someone else up-close and personal.
During this complicated, elaborate procedure, incisions are made in the hairline both in front of and behind the ears (the exact design of the incisions may differ from patient to patient, and surgeons’ personal techniques can vary widely). For younger patients, more – limited incisions may be appropriate. When necessary, fatty deposits beneath the skin are removed or repositioned, and sagging muscles are tightened. The slack in the skin itself is then taken up and the excess cut away. Scars can usually be concealed, but when things go wrong thick, obvious, scars may be seen, or the hairline behind the ear or along the forehead may be altered in such a way that it creates an unnatural, strained appearance.
Most face-lifts also involve repositioning the muscles and fat pads of the cheek that have slipped forward, causing deep lines near the mouth (laugh lines), as well as dealing with the sagging of the muscle along the chin. Face-lifts that only tighten the skin without repositioning the muscles and fat pads can cause the face to look gaunt and unnatural. Face-lifts also have limitations as to the areas of the face they can affect. Other areas require a forehead lift, chin tuck, or endoscopic repositioning of those muscles and fat pads. Likewise, wrinkles by the eyes and mouth are not affected by a face-lift alone and require additional procedures (such as laser resurfacing) that are often done at the same time the face-lift is performed. Here is a partial menu of face-lift options a doctor can select from: