When it comes to achieving natural facelift results, one key philosophy stands out: releasing is more important than tension. The ideal facelift should have minimal to no tension.
Early facelift techniques focused on pulling the skin very tightly, which often led to an unnaturally tight appearance and increased risks of complications. Tension lines, pixie ear deformities, and wide scars were common issues. Additionally, the lift didn’t last long, as the skin would relax relatively quickly.
The introduction of the SMAS facelift marked a significant improvement. By targeting the SMAS layer, which is situated beneath the skin and less elastic, this technique provided a more durable lift. However, many SMAS lifts still rely on pulling the tissue tightly, which isn’t ideal. After all, a youthful face doesn’t have an overly tight SMAS, so why would this be necessary in a facelift?
It’s not uncommon for patients to seek revision facelifts after experiencing an initial procedure that resulted in overly tight sides of the face while the central area remained lax. The contrast between the tight and loose areas can be quite noticeable and unnatural.
That’s why I prefer to perform an extended deep plane facelift, which emphasizes releasing tissues rather than pulling on them tightly. By thoroughly releasing the SMAS from the underlying tissues across most of the face, the tissue can be easily repositioned to a more lifted, youthful position without the need for excessive tension. The result is a significant lift that looks natural and lasts longer.
In the operating room, once the SMAS is fully released, I allow it to drape naturally into a more youthful position, securing it with sutures. Afterward, any excess skin is removed, and the incisions are meticulously closed.
The outcome is a significant, yet natural-looking improvement. Often, even friends won’t suspect that you’ve had a facelift. By focusing on proper release and repositioning instead of brute force pulling, the typical signs of a facelift—such as tight skin, displaced earlobes, overly high sideburns, and stretched corners of the mouth—can be avoided. This approach avoids distorting your characteristics and ensures a natural-looking rejuvenation.
