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Lower Facelift


Lower facelift surgery rejuvenates the bottom third of the face by tightening the face’s underlying structures that slacken with age, forming jowls and a fleshy neck. The procedure also trims excess skin, smoothing it down to eliminate facial creases and giving a visual lift to the bottom third of the face. Read more about the lower facelift cost you can expect to pay, the techniques available, and other aspects of the procedure.

Candidates for Lower Facelift Surgery

A lower facelift is what often comes to mind when people think of a facelift. Lower facelift eliminates jowls, targets lax skin on the neck and jawline, addresses deep wrinkles, and raises the corners of the mouth. The “full facelift,” in contrast, is actually a combination of a lower facelift, mid facelift, and brow lift (forehead lift). The full facelift rejuvenates the face from forehead to neck, while the lower facelift rejuvenates the lower third of the face — an area quick to show signs of aging.

For these reasons, candidates for lower facelift surgery are patients in relatively good health who have reasonably elastic skin and are showing aging in the bottom third of their face as well as the neck. Those with lax skin around the jawline and/or drooping corners of the mouth as well as a neck with excess skin, thick bands, or excess fat, are ideal candidates for lower facelift surgery.

Lower Facelift Procedure

Lower facelift can be performed through a small incision that begins in front of the ear and extends down and behind the ear; or, it can be performed using an endoscopic face lift technique, in which small cameras (endoscopes) are inserted through a few short incisions. If a neck lift is performed at the same time as lower facelift, a small incision will be made under the chin.

Working through the small or hidden incisions, the surgeon carefully separates the skin from the tissue below. Excess fat is removed, facial muscles are tightened and restored to youthful positions, and skin is smoothed before the excess is trimmed away. The surgeon completes the lower facelift by closing the incisions with sutures.

For patients interested in both cheek elevation and tightening of the neck and jowls, a standard face lift may be more appropriate. The standard face lift offers more comprehensive facial rejuvenation. This technique requires incisions to be made near the ear and along the hairline or sideburn.

Lower Facelift Techniques

The facelift procedures of the past were performed by simply tightening the skin, ignoring muscle laxity and the face’s underlying structures and producing a taut, pulled, or windblown look. Newer facelift techniques, however, avoid this unnatural look because surgeons now carefully tighten the underlying structures of the face that, along with the superficial layer of skin, sag with age.

The lower facelift, for example, not only trims excess skin but tightens the structures that underlie the jawline and neck and move downward and become lax with age. Often combined with fat removal in the neck (facial liposuction), the lower facelift is able to restore a youthful, smooth look to the neck and lower third of the face.

There are several lower facelift techniques. A surgeon will choose the approach based on the patient’s anatomy and patterns of aging.

The S lift facelift is named after the small, S-shaped incision the surgeon makes in front of the patient’s ear. Working through this incision, the surgeon will tighten the underlying structures of the lower face, smooth down the skin, and trim excess. This procedure is generally ideal for patients 30-50 years old and can be performed under local anesthesia.

The SMAS facelift is named after the SMAS layer of the face: the underlying layer of muscle and connective and fatty tissue, which are tightened during the procedure along with the skin. The SMAS facelift requires a slightly longer incision than the S lift. This incision begins in the temples and extends down to loop around the ear. Hiding the incision in the hairline and in the face’s natural creases helps ensure minimal scarring.

Though both the S lift facelift and the SMAS facelift improve the appearance of an aging neck, they can both be combined with a neck lift — performed through a small incision under the chin — for a more dramatic rejuvenation of the neck.

Visit the DocShop gallery to view face lift before and after photos.

Photo credit: James P. Wire, MD

Lower Facelift Cost

Though lower facelift cost will vary depending on the locale and skills of the surgeon, prices for the procedure generally range from $4,000 to $10,000, with an average cost of about $7,000.

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