Mini Facelift

Mini Facelift Picture

The term mini facelift can be confusing because this means different things to different surgeons. There are many different facelift techniques that I will discuss and many of them can be considered a mini facelift. As a matter of fact, any facelift technique can be considered a mini facelift if the dissection is kept more limited than a standard facelift dissection. In order to get a better understanding of what I consider a mini facelift to be, I would like to discuss some of the necessary things that have to occur in order to rejuvenate the lower third of the face (a facelift). Of note, the two main components of lower facial rejuvenation include a good cervico-mental angle and an attractive jawline.

One characteristic of any youthful face is a smooth neck and good cervico-mental angle, which is the junction where the neck meets the chin. An attractive cervico-mental angle is one where there is a sharp change in direction in this location. You could think of a good cervico-mental angle as being close to 90 degrees. A less attractive cervico-mental angle is one that is blunted or curved, and therefore less angular. If the cervico-mental angle is not sharp then there is a need to make changes in the area called the submental region.

"The benefits of a mini facelift are less swelling and faster healing times, because the dissection is more limited."

There are four layers of tissue in the submental region that I can address to create an attractive cervico-mental angle. The first layer of this tissue that can create a problem in the neck is the skin. Clearly there can be loose skin in the neck, and this can be removed and improved with a neck lift. The second layer of tissue that can create a problem in the neck is the subcutaneous fat layer, which is the fat layer beneath the skin. This layer can be removed with submental liposuction or by direct excision. Either technique can be performed at the time of facelift surgery. The next layer of tissue that can create a problem in the neck is the platysma muscle. This is the muscle layer that starts in the region of the cheek and extends down the face and neck, and ends in the region of the collar bone. The platysma is the layer that when loose is responsible for the bands that are visible in an aged neck known as the "Turkey Gobbler". This layer can be addressed at the time of facelift by tightening the loose platysma. The final layer that can create unwanted fullness in the submental region is the subplatysma fat layer or the fat layer underneath the platysma muscle. This fat layer can be excised directly, but cannot be removed with liposuction.

I should mention here that all of the tissue layers in the neck can be corrected with a necklift, which only requires a small incision under the chin and small incisions behind the ears. The necklift will only correct the region below the jawline, but will not correct any sagging above the jawline.

The next characteristic of the attractive lower third of the face to consider is the jawline. An attractive jawline is one that is sharp and extends from the angle of the jaw to the chin in a straight line without any drooping or sagging. When there is sagging of the facial skin that extends below the jawline, then this is considered a jowl, which is an undesirable facial characteristic. The jowls form as a result of saggy skin, excess fat, and loose underlying ligaments and muscles. The jowl is a very difficult area to correct because it is comprised of so many different layers. The best way to correct the jowl is to perform a facelift where the dissection extends out to the region of the jowl such that the tissue layers in that region can be tightened. This would not be considered a mini facelift. A mini facelift is a facelift that requires a very limited dissection in front of the ears and is appropriate for people who have mild sagging of facial skin, but it is not appropriate for patients with significant jowls.

In general, when the only layer in the submental region that needs to be addressed is the subcutaneous fat layer, then liposuction is all that is needed in the neck. When a person requires only liposuction in the neck at the same time as their facelift, I consider this a mini facelift because there is no significant dissection performed in the neck. Furthermore, if there is no need for any submental intervention at the time of facelift I also consider this a mini facelift. Anytime the skin, platysma, or subplatysma fat layers need to be corrected in the neck as part of the facelift, this would not be a mini facelift, but rather a lower facelift or standard facelift.

The benefits of a mini facelift are less swelling and faster healing times, because the dissection is more limited. The goal of any facelift, whether it is a mini facelift or standard facelift, is to create a natural and youthful rejuvenation to the lower third of the face and neck. In order to determine which procedure is right for any given individual, a personal consultation or internet consultation with photos is the first and best course of action.

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