The mini facelift was developed in the 1980’s as an answer for a less invasive procedure that would cost less and be “safer” because it was “less” surgery than the traditional facelift. Trouble is, it was short lived, often not lasting more than about 6 months. The mini facelift never had much of a following, and it rapidly fell out of favor.
Now some 20 years later, we have a resurgence of new “mini” face lifts that have similar “promises” for a more youthful appearance at less cost with “less risk” and a more rapid recovery. Physicians are re-inventing a wheel that has already been shown not to work. These new procedures have sexy names, like the “thread” lift, weekend lift, one or two stitch mini face lift and are all touted on web sites as the answer to avoid more complicated procedures. A web site typically says “the best candidates are those in good health with MILD to MODERATE facial aging.
In our own practice, patients who have mild to moderate facial aging are often started on an advanced skin care program and the scalpel is kept in the drawer until we see what type of results we can achieve with a skin care program. More often than not, these patients are happy to have avoided surgery all together.
Is Mini Face Lift Right for you?
There are several reasons why these mini face lifts don’t work. Probably the most important reason is that unless the tissues are dissected, released and repositioned, one or two sutures that simply envelope the tissues and are tightened do not hold. With time, the sutures cut through the tissues and any temporary benefit is lost. This is true whether we are speaking about “threads”, “one or two stitch facelifts” or any other such approaches. I have yet to see published literature showing the long-term benefit of these mini procedures.
Another reason they work poorly is that often they address only one part of the face. You can test yourself at home to easily see the fallacy of this reasoning. If you pull just one area of the face or neck tight, you will see bunching up of the tissues elsewhere, requiring a release and tailoring which requires additional scars. Limited neck rejuvenation can be done with a “re-draping” of the neck tissues without additional scars elsewhere; however, this requires a large internal dissection. Please refer to our section on Neck and Chin Rejuvenation.
To publish a paper in either of our two leading plastic surgery journals (“Plastic and Reconstructive Surgery” or “Aesthetic Plastic Surgery”), the author has to pass rigorous testing in peer review and the editorial board. Submitted photos need to be taken from similar angles, and more and more, a proper length of time post-op is required. Controversial procedures are typically followed by a “discussion” in which one or two plastic surgeons well recognized in the field, “discuss” the publication.
Presentation at our national meetings, such as the annual meeting of the “Elite Plastic Surgery Group” and the “European Society for Aesthetic Plastic Surgery” are equally rigorous. “New” concepts such as “mini face lifts” periodically make it to the podium so that the membership stays informed of current procedures; however, the discussion that follows tends to be very critical. These papers are in the minority. Most board certified plastic surgeons still subscribe to the tenets of time-proven, proper dissection of the tissues with adequate release and repositioning to achieve lasting results. There are a number of different proven approaches that can be used in the more traditional facelift; nevertheless, the goals of a rejuvenated face, done safely, remain the same.
During the past 30 years, we have been performing facelifts under local anesthesia with sedation (an occasional patient requests general anesthesia). The concept that a mini facelift is safer because it does not require general anesthesia is another one of the many misleading statements to convince patients that less is better. Patients are requested to have medical clearance pre-op and full safe monitoring is done during the surgery. In hundreds of patients, we have had the rare patient that required a return trip to the operating room because of bleeding and one superficial infection. There have been no deaths and no major complications requiring hospitalization. The safety record speaks for itself. The long-lasting results of a properly performed facelift also speaks for itself, and is only rarely not successful in patients who have poor elasticity to their skin due to sun damage. We continue to see patients 10-15 years post-op that still look better than their pre-op photos.