In truth, there are nowadays a full range of facelifts and in addition a whole range of add-ons. Plastic surgeons used to have their own adaption of a facelift, but it was the same for everyone. We at Cadogan Clinic now tailor the procedure to the individual patient’s requirements, which will include age, skin type and condition, facial morphology and above all, the patient’s expectation.
We might call the procedures full, mini or micro facelift, but they can all be broken down into certain parts.
Firstly, the length of skin excision. The longest could be across the top of the head in front of or behind the hairline, down in front of the ears, skirting the earlobe, up behind the ear and back down into the hair. The trend, however, is towards shorter and shorter scars and virtually never across the top of the head. The shortest scar is the micro lift, which is also known as the one-stitch facelift, with a tiny scar below or above the ear.
Secondly, the extent of undermining of the skin. We now never undermine from ear to mouth and meeting under the chin, but just enough to avoid bunching in front of and below the ear.
Thirdly, the degree of undermining and treatment of the SMAS, the muscle of the skin. The wide dissection, a source of risk, is now avoided and very often it is simply repositioned with stitches.
Fourthly, the method of suspension. Small dissolving sutures can be useful for the nuance of the result, but more permanent and strong nylon sutures can be inserted without the necessity of tissue dissection, and they last longer.
A word of warning - we are not impressed by the clever dissolving threads, which need no surgery and therefore are used by less skilled operators. They are not cost-effective and have only temporary effect with an unacceptable rate of complications.
Now, what about the add-ons?
The most frequent add-on is the restoration of lost facial volume by fat transfer. Your fat is used to augment the cheekbones, cheeks, temples, brow, chin and anywhere else it will improve facial balance. Fat contains those all-important stem cells, which also improve scars and skin quality. At Cadogan Clinic we are able to enhance the transferred fat with extra stem cells.
We might also address the long wrinkled ear lobe, the eyelids and the droopy nose.
We discuss and decide with the patient what is going to help you meet your expectations in a cost-effective way, and arrive at a suitable procedure. Sometimes this will be a full facelift. More often it will be a mini or micro lift, quite possibly with fat grafting and stem cells.