Surgeons have made significant improvements in facelift techniques over the years. They’ve replaced the windswept look of early procedures with subtly rejuvenating results, customized to each patient’s needs, which are the hallmark of today’s facelifts.
Where it was once easy to tell that someone had had a facelift, that’s no longer the case. A modern facelift re-sculpts the face by lifting and tightening the underlying musculature, shifting the position of fat for youthful-looking volume enhancement, and smoothing the skin to eliminate lines, wrinkles, and sagging. You’ve probably met people who’ve had facelifts in the last few years and noticed how great they looked without guessing they’d had surgery.
Based on incomplete records and reports, we can estimate that the first facelift probably took place between 1901 and 1906. From the little we know, these early facelifts were simple skin-tightening procedures. A surgeon would have removed a section of skin around the face’s edge, then pulled the remaining skin tight to eliminate sagging and smooth wrinkles.
World War I brought advances in reconstructive surgery, including some improvements to facelift technique. By the late 1920s, surgeons were separating the skin from the underlying fat before tightening, and strategically placing incisions to make scars less visible. That’s where the art of the facelift remained for several decades, and where it got a bit of a bad reputation for unnaturally stretched-looking results.
Advances from the 1960s to the 1980s
With a better understanding of facial anatomy, some surgeons in the 1960s began to refine their facelift techniques. They started by shifting the position of facial fat as part of the procedure. Then, in the late 1970s, innovative practitioners began to include work on the superficial musculoaponeurotic system (SMAS) — the muscles and connective tissue that cover the bones — as part of a facelift.
This shift to lifting and re-sculpting the face from the muscles up was a crucial breakthrough, leading to far more natural-looking results. Enhancements in the 1980s included steps to reshape fat and tighten skin along the jawline for an even better effect. These breakthroughs enable surgeons to give the face a younger look while removing less skin. Their patients did not have the stretched appearance typical of earlier facelifts.
The Facelift Today: Deep-Plane and Volumetric Techniques
Re-sculpting the SMAS is now a standard technique with skilled facial plastic surgeons. But the best of them go even deeper, releasing the SMAS from underlying ligaments and reattaching the tissue higher on the face — reversing the effects of gravity for a naturally younger look. This technique is the “deep-plane” method.
To that, today’s plastic surgeons add a “volumetric” approach — restoring lost facial volume and removing it from where gravity has pulled it. Hollowed cheeks, sunken areas under the eyes, jowls, and a hanging chin are examples of how facial volume shifts with age. A volumetric facelift corrects these shifts by using fat grafting or dermal fillers to create younger-looking facial contours.
With all these techniques now available to them, and a sophisticated understanding of facial anatomy and the varieties of facial aesthetics, the best plastic surgeons can customize your facelift for beautiful results. The advances in surgical technique have brought other benefits, too, including minimized scarring and a speedier recovery.
Learn More in a Personal Consultation in Annapolis
Dr. Henry Sandel is a double board-certified plastic surgeon with extensive experience in cosmetic and reconstructive facial procedures. He has a well-earned reputation for his beautiful and natural-looking results and his caring attention to patients’ health. Contact us today to schedule a consultation in Annapolis.