Atlanta SMAS Facelift
Dr. Mark Mitchell Jones of Atlanta Plastic Surgery Specialists is an expert in all different types of facelifting techniques including the SMAS Facelift, the Mini Facelift and more. After years of education, training and experience in facelifts, Dr. Jones has synthesized the best and the safest techniques from the many facelift approaches he has mastered and coined his own approach to facelift: The Natural Uplift (NU) facelift. Using this advanced and innovative facelifting technique, he is able to achieve elegant and natural results for his valued patients.
To understand how Dr. Jones is able to accomplish such a natural facelifting outcome, it helps to understand some key choices a surgeon makes as he or she performs facelift surgery. Where and how the surgeon makes the incisions and where and how he lifts the skin determines how it will look and feel, and for how long it will look good.
While Dr. Jones was a Fulbright scholar in Paris, France, in the 1980s, he was privileged to train under the innovators of facelift techniques and has since studied their approaches. Having trained with the best in the field, Dr. Jones has gained a unique perspective and insight into refining these techniques from his repertoire of knowledge.
Dr. Jones categorizes the facelift techniques generationally, as each progressive generation adds something new to the previous advances. These approaches can be summarized as follows, with the common terminology used today:
• 1st generation, or the mini-lift
• 2nd generation, or the subcutaneous facelift
• 3rd generation, or the superficial muscular and aponeurotic system (SMAS) facelift
• 4th generation, or the deep plane facelift
• 5th generation, or the thread lifting facelift procedures
• 6th generation, or the minimal access cranial suspension (MACS) facelift
• Dr. Jones’s approach, or the natural uplift (NU) facelift
Georgia MACS Facelift
Georgia plastic surgeon, Dr. Mark Mitchell Jones, is highly knowledgeable and experienced in all the different types of facelifting procedures including the MACS Facelift, Mini Facelift, Natural Uplift Facelift (NU) and more. Please read below to get additional information about each of the different types of face-lifting procedures.
The mini-lift is the original facelift made popular in Paris, France, by Dr. Noel in the 1920’s. Mini-lift, as the name implies, refers to techniques with limited, small incisions. It (Figure 1.) effects an elliptical excision of skin in front of the ear to remove the extra, sagging skin. Mini-lift does little for other areas of the face; however, it is quick and easy to accomplish under local anesthesia in the office.
The Subcutaneous Facelift
The subcutaneous facelift (Figure 2.) is a two-fold extension of the mini-lift. First, the incision around the ear is lengthened to reach above and behind the ear. Second, the undermining of (or cutting under) the skin is more extensive, sometimes extending completely over the neck and face. In undermining the skin, the surgeon temporarily releases the fascia and muscles holding the skin so he can pull the skin into an improved position. The surgeon uses his judgment to determine the extent of undermining needed in each case. Still, the subcutaneous facelift addresses only excess skin, not the deeper structures such as fat pads, connective tissues, and muscles. Since only skin is being pulled, this ‘skin-only’ facelift often results in a ‘pulled’ look that many want to avoid. It is no longer commonly used.
In addition to excising extra skin, as in the subcutaneous facelift, the SMAS facelift (Figure 3.) addresses the deeper SMAS layer under the skin. The SMAS layer, or superficial muscular and aponeurotic system, is a sheet of muscle and connective tissue (fascia) joined together in the cheek area. The SMAS layer contributes to facial expression. As facial skin ages, there is a gradual loss of elasticity in the top layer of the skin as well as in the SMAS membrane. As the skin loses its elasticity, gravity causes the cheek skin area to sag along the jaw bone, creating fleshy jowls and sometimes a double chin. In turn, this drooping down of the lax area of the cheek pushes the cheek fat pads to sag forward, thus deepening of the nasolabial folds. The result is a common look in an aging face.
To conclude, the SMAS facelift addresses both the upper skin and the deeper SMAS layer around the cheek unit with deeper undermining. Compared to the mini-lift and the subcutaneous lift, the result lasts longer and is more extensive. It also accomplishes a less ‘pulled’ look.
Deep Plane Facelift
Deep Plane Facelift
The deep plane facelift technique was developed to address the shortcomings of the previous generation facelift methods. It was accomplished by cutting deeper, even down to the bone, to reposition thicker planes of the face, including the upper cheeks and mid-face (Figure 4.). Naturally, there is more swelling and the risks of complications are higher with this method. Dr. Jones does not believe the benefits are worth the risks.
The Thread Lifting Procedures
Since 1st generation facelifts, surgeons have attempted facelift improvements by inserting wire or various sutures under the skin to pull the relaxed skin into a tighter position. A patented approach using a blue barbed nylon suture was developed in Russia in the late 1990s. Since then variations of threading these permanent sutures under the skin abound.
In the thread lifting procedures, 4-12 sutures with a long needle are threaded into the deeper, soft tissue structures (Figure 5). Once the suture is in place, it is pulled, anchoring the barbs into the soft tissue and lifting it. The ends of the exposed sutures are snipped, leaving the suture buried beneath the skin. No skin is removed nor incision made.
Dr. Jones does not favor thread lifting procedures for their many disadvantages. Bruising, swelling, and tenderness of the area often accompany these procedures. Complications include uneven puckering of the face and recurrence of sagging if the wire is not properly placed or does not hold. Furthermore, the non-slip wires do not allow for a natural movement of the tissues and affect facial expressions.
MACS is one of latest innovations in facelift techniques. As the name—minimal access cranial suspension—implies, this technique allows correcting the sagging facial features through a short, minimal incision and by elevating the skin vertically by suspending it from above (Figure 6).
The incision is reduced to the fold in front of the ear and follows the hairline above the ear in a zig-zag pattern, making the scar blend with the hairline. In the end, the scar becomes virtually invisible. Once the incision is made, the surgeon elevates the highlighted area of the skin (Figure 6.) to gain access to the deeper tissues. The surgeon weaves in 2-3 sutures from the firm positions on the top, down and up again suspending the facial structures upward as if pulling on purse strings. Each suture is positioned to restore a specific area of the face. The accomplishments include re-establishing the support of the lower eyelid or the descended cheek, smoothing the nasolabial fold, and tightening the upper and middle neck. (See Figure 6, purse string sutures from left to right)
MACS facelift is safer than the earlier generation lifts because less skin is raised, decreasing risks of bleeding and nerve and other damage. Not undermining so deep under the skin also shortens recovery time. Finally, patients appreciate the short scar and the more natural, rather than the ‘windswept’ look. Dr. Jones is experienced in performing MACS facelift and considers it one of the better approaches.
If you would like to learn more about facelift procedures and Dr. Jones’s Natural Uplift (NU) face-lifting technique, please contact Atlanta SMAS Facelift Surgeon today to schedule a consultation.