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Deep tissue facelift. What does deep tissue mean?

Dr. Dean Kane Q & A. 7K0A0079 Q. Hi, is there a facelift that treats deep tissue? And also one that treats a ligament? What is different? What does deep tissue mean? Is it SMAS? Or ligament? A. ​​​This is a fun anatomy question. The levels of the face age at different rates according to many factors such as UV sun damage and weathering, aging, heritage, tobacco use, etc. ​I use the “bed analogy” for my patients so they understand what level and why I choose different face lifts for them.
  1. ​Skin and fat  =  2 layer bedspread
  2. ​Muscle and SMAS/ligaments = top sheet
  3. ​Periosteum = fitted bottom sheet
  4. ​Bone = mattress
Yes, even the periosteum and bone change over time and can be used as a support or layer to lift and redrape or fill and re-shape the face. ​ ​About 25 years ago, a study of different facelift techniques was performed on twins. It showed that while initial results during the first year were slightly different, the long term effects (7-10 years and more) were similar. If this is true, then choose the best and least risky facelift for you to obtain the results you wish. ​ ​Today, most facelifts are redraping of the skin and soft-tissues (ie fat layer and muscle layer) due to the many variations particularly with the use of fillers including fat to add the loss of volume in the temples, cheeks and sometimes jawline. ​ ​The more contemporary facelifts elevate the skin and redrape both the muscle/ligament tissues and the skin in a more upward direction with minimal “windswept” back pulling noted in facelifts of decades past. Fat grafting for volume shaping and skin peels and lasers may be added for tightening as well. ​ ​Deeper facelifts are used for particular circumstances. These are where the incisions and lifting go through or under the muscle / ligaments or under the periosteum to pull up the entire face with no change to the skin or soft tissues above. Many times, fillers and chemical peels or lasers are combined with these deeper lifts for more superficial shaping and skin tightening. ​ ​Each surgeon has different perspectives, talents and skill just as you have unique qualities. Please obtain consultation from a well experienced, Board Certified Plastic Surgeon or ENT facial surgeon for examination and to review your options. ​ ​I hope this was helpful. All the best!
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