Vertical Facelift

Verticle Facelift
The best facelift technique to correct the jowls and marionette lines is the vertical facelift.

There are many different facelift techniques available and some are more sophisticated than others. A certain technique may be perfect for one person and not for another. The vertical facelift is the most effective technique to rejuvenate people with severe aging changes that are most noticeable around the mouth or perioral region, i.e. marionette lines and jowls. The marionette lines are the lines that start at the corner of the lips and head down toward the chin, and the jowl is the accumulation of tissue that drops below the jawline. These changes are seen on most aging faces and are the most difficult characteristics to correct. The loose neck and jawline, in contrast, are much easier problems to correct than the jowls and marionette lines.

The best facelift technique to correct the jowls and marionette lines is the vertical facelift. The vertical facelift is an aggressive, sophisticated facelift that requires the skin to be elevated from the ear to the corner of the nose and mouth. This is a large dissection in contrast to the deep plane facelift or mini facelift - where the skin is only elevated a few inches away from the ear. This extensive skin elevation allows the surgeon direct access to the jowl as well as the SMAS (muscle layer) that corresponds to the marionette lines, such that those regions can be elevated with a vertical vector or towards the eye. This vector is in contrast to the deep plane facelift or mini facelift muscle tightening vector that lifts the SMAS up towards the top of the ear.

The vertical facelift is more effective at correcting the severely aged face for two main reasons. The first reason is that it allows the surgeon to place the sutures directly into the loose SMAS responsible for the aged appearance (because of the extensive skin elevation), in contrast to the deep plane facelift where the sutures are placed into the SMAS layer lateral to jowls. The closer that sutures are placed to a given region, the more effective the tightening to that region.

The second reason is that the vertical vector of pull creates more tension on the loose SMAS corresponding to the jowls and marionette lines, and therefore allows for a more effective correction to those regions. The vertical facelift requires a more extensive dissection, and therefore a longer healing process. There will be a higher chance of fluid collections when compared to the deep plane facelift. There will also be a higher likelihood of having minor lumps or irregularities with the vertical facelift due to the large skin flap that has to reattach to the SMAS layer after the large elevation. These minor irregularities will resolve over a few weeks to a few months depending on how fast you heal.

The vertical facelift can create a more dramatic change to a face, and therefore, may not be as subtle and natural as the deep plane facelift. For these reasons, I use the vertical facelift technique on people who are looking for dramatic changes because of severe aging. For people with severe aging changes, the deep plane facelift or mini facelift techniques are not very effective techniques. The determination of which facelift technique that will be best for you will be decided upon based on your anatomical findings, as well as your particular goals for surgery. Dr. Diamond is an expert at all variations of facelift techniques which will assure you that you have a procedure that is tailored specifically for you.

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