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experiences and viewpoint as my day unfolds

One of the great misconceptions about a facelift is what is actually done in the operation. A facelift operation is all about tissue layers and vectors of lifting. The lifting off of the skin from the underlying tissues over the side of the face (to the cheek area) and across the neck through incisions placed in and around the ears is obvious in any diagram of a facelift operation. And movement of loose skin pulled back and over the ears at about a 45 degree angle to the face probably accounts for about 80% – 90% of the result created by a facelift.

Often this is the only tissue moved in a facelift. This is the simplest, quickest and safest approach. More recent facelift developments have been to lift up tissue layers deeper than the skin. These deep layer that can be moved independent of the skin, is a special layer of tissue over the muscle. This tissue, known as SMAS, is raised and sutured up in a more vertical direction compared to the direction of the skin pull, closer to 60 degrees usually. Erroneously, the public is under the impression that facial muscles are moved which cannot be done. On top of the muscle sits the SMAS.

There is considerable debate as to whether the ‘deeper’ versions of the facelift produce better long-term results than skin movement only. The neck-jowl lift, known historically as a facelift, can lift two different layers of sagging facial tissues in two slightly different up and backward directions.

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