Mini Facelift (Philadelphia)

A mini lift is a targeted lift of a small anatomic area on the face. When it involves the jawline and lower face, it is called a mini facelift. It can be accomplished with an incision hidden at the hairline or above it. It can be used to tighten the neck, jawline, cheek, or brow. A full facelift involves opening up the skin of the face like an envelope and then cutting away skin; often, a mini lift involves tightening underlying structures and lifting sagging volumes.

Anybody who can achieve an improvement by pulling in a single or a few small directions can benefit from a mini facelift. This may include a single lift under the neck, and a single lift at the temple, or a lift of the cheek. Often, a mini lift can be combined with eyelid rejuvenation or laser resurfacing.

Surgery on a very healthy patient can be performed in the office. More commonly, we perform the surgery in an outpatient ambulatory surgery center setting where you can go home to the care of family or friends on the same day.

Pain is not a significant issue in patients who undergo this procedure. TYLENOL® usually suffices.

Stitches are used in the location of the mini lift. The sutures are usually dissolvable, but, occasionally, we will use inert, nonreactive sutures that need to be removed, especially if there is a history of poor healing.

A mini facelift can be performed with small, concealed incisions. Skin tightening procedures, such as Renuvion® and ThermiTight®, involve the insertion of a wand under the surface of the skin to obtain skin tightening, which produces the effect of appearing to tighten the skin. It does not lift the facial volume, but if volume elevation is needed, we can combine it with a small incision suture approach. In our practice, we also perform a cheek lift through an incision where the entire middle of the face is elevated using incisions hidden above the hairline.

A liquid facelift is a term used primarily by aesthetic providers that don’t do surgery and can’t achieve the results possible with a true lift. A liquid lift involves injecting fillers of some type to “inflate” the face. This expands volumes in the face but does not produce a lift; instead, it produces a large volume expansion of the face and can make the face look pillow-like—like the Pillsbury doughboy. We often combine mini facelift procedures with volumetric expansion, usually with the use of sculptural fat grafting. Only a portion of aging changes are related to volume loss, and a significant portion of them are related to the effects of gravity. You can’t substitute one solution for a problem caused by another without creating unnatural results. What descends should be lifted, and what volume has been lost should be replaced. During your consultation, if you would benefit from volumization using a liquid facelift, we will let you know. The best candidates for this procedure have already undergone a skin tightening procedure but are volume deficient. You can fix the volume problem with volume, replacing like for like. It’s a basic principle in plastic surgery. Similarly, if you are a candidate for a mini facelift, we will let you know.

We rarely perform full facelifts in our practice. This procedure has gone by the wayside in our practice because there are so many ways to achieve aesthetic benefit using minimally invasive, smaller incision techniques.

A ponytail lift achieves the benefit of a facelift in the brows and mid cheek—the same way it would look if you were to use a tight ponytail to achieve benefit. We have been performing lift of this sort—a micro midface lift in combination with a brow lift and volumization—for over 20 years and have published on this in a book that we coedited.

We have published our 15-year experience with small incision lifting. Based on the location of the lift, a variable benefit is achieved. The benefits of a micro midface lift, which involves a suture suspension of the brow and cheek done using an endoscopic approach, demonstrated improvement for 15 years in an article published in December 2019 in JAMA Facial Plastic Surgery. In patients who undergo mini facelifts of the lower face and neck, the procedure varies in its duration of benefit, though if you had a twin who did not have the surgery, you would look better than they did for the rest of your life regardless of timing. In general, lower mini facial procedures benefit from a refresh for three to 15 years after the original surgery, depending on the elasticity of the skin, which is in itself dependent on heredity and how you’ve taken care of your skin over your lifetime.

Based on the location of the lift, we generally do not employ bandages. If the brow or the cheek are involved in a mini lift, we do not use sutures. If the neck is involved, a 24-hour dressing is placed.

We like you to avoid excessive facial movements and head-turning for about a month after the surgery.

Exercise may be resumed within ten days after the surgery.

You can wear makeup immediately except over the incisions. If resurfacing surgery is combined, we wait until the skin heals.

The risks associated with this procedure are the same as those associated with any surgical procedure. These include the risk of anesthesia and the risk of allergy. Particular to a mini facelift and common with most facelift procedures are the risks of numbness, temporary or permanent, and paresis—interference with the movement of the face. These are exceedingly rare in practice.

The procedure in patients who have very heavy faces who are not at their desired weight or who have congenital fullness, for example, in the neck, might benefit from more invasive surgery, but this surgery, rather than being a full lift, is actually a deep procedure that involves small incisions that resculpture the deep tissues of the neck.

A consultation with us or a facial plastic surgeon would be worthwhile to determine whether you are a candidate for a mini lift.

Almost all patients who are considering a full facelift would benefit from a targeted, smaller procedure. This is best discussed at the time of consultation, either with us via a telehealth consult or in person.

Ideally, you will be off all medications that cause thinning of the blood, in a good frame of mind, not smoking or vaping (of tobacco or any other compound), using nutraceuticals and vitamins that we recommend, and carefully following up with us. You need to have the time to recover and the luxury of not caring about how you look in the immediate postoperative period. Most patients require a week to two—and up to three—before they are able to look convincingly like a younger, more attractive version of themselves. Before that, bruising and swelling are possible and can distort your appearance.

Postoperatively, we supply you with a variety of herbal and nutraceuticals and vitamins that reduce bruising and speed recovery. In the office, we have an 810 nanometer LED light source, broadband laser light, and ultrasound—all of which lessen swelling and enhance your healing.

We have over 25 years of experience in mini facelift procedures, and have published and presented our techniques nationally, and have demonstrated their success in medical journals and national meetings. We teach our techniques to other surgeons.

Most importantly, we try to individualize our approach to your particular concerns and your face. We combine an artist’s understanding with a palette of techniques and surgical approaches. We work with you to best accomplish facial rejuvenation and restoration based on you individually. We agree before surgery on how we go about accomplishing the most aesthetic and restorative rejuvenation. A consultation with us might be worthwhile in determining if our practice is right for you.