Face and Neck Lift Article 4
Skin Only Facelifts
The skin only facelift can be initiated within the temple hair above the insertion of the helix or, alternatively, begins along the anterior temple hairline and encircles the sideburn to reachthe helical insertion. The incision continues in a gently undulating fashion, hugging the preauricular helical root, tragus, and around the lobe to continue on the postauricular skin. At that point, it may descend posteriorly along the hairline or may extend to within the hairline, depending on the degree of neck laxity and anticipated skin resection. Although Dr. Hughes performs SMAS plication with skin resection for longer lasting results than skin-only facelifts, he performs shorter scar facelifts, which do not extend into the temple or the hairline.
Whereas the skin flap lift exerts tension on the paralabial cheek and the lower anterior neck, only minimal tightening is transmitted to the submental region, and correction of the anterior jaw and submental areas is often suboptimal. Consequently, some method of direct approach to the submental area with medial platysma plication is added. A submental incision is used for direct fat removal and tensioning of the platysma with midline plication sutures. The medial plication of the submental platysma tends to draw the laterally attached skin along the inferior mandibular border medially.
Most commonly, the vector line is approximately parallel to the inferior border of the mandible. Too much upward vector of lift on the cheek skin flap separates the skin edges of the superior part of the incision, making closure difficult. An additional problem is excessive elevation of the temporal hair pattern. Too much lateral rotation of the postauricular skin flap causes problems of closure of the incision at the postauricular sulcus, which can cause excessive tension on the thin skin flap with poor healing.
Click on the Additional Face and Neck Lift Article Links Below to Learn More about Facelifts:
Article 1: Lip and Marionette Line Improvement in Facelifts
Article 2: Laser Resurfacing and Treatment of Nasolabial Folds in Facelifts
Article 3: Jowl and Neck improvement in Facelifts
Article 4: Skin Only Facelifts
Article 5: Deep Plane Facelifts and Extended SMAS Flap Facelifts
Article 6: SMASectomy, SMAS imbrication, and MACS Facelifts
Article 7: Complications of Facelifts: Hematomas
Article 8: Complications of Facelifts: Infection, Skin Loss, and Nerve Injury
Article 9: Optimal Scar Placement in Facelifts
Article 10: Secondary Facelifts
Or View Before and After Photo Galleries of Dr. Hughes’s Face and Neck Lifts Below: