A facelift is surgery that pulls and fixes loose skin together with the SMAS (fascia) layer beneath it, and is divided into deep plane, SMAS and mini lift depending on the extent of dissection.
A facelift is the surgery for the stage of face anti-aging where sagging is pronounced. Tissue that has descended to the cheeks, jawline and jowls is lifted and fixed not by the skin alone but together with the SMAS (fascia) layer beneath it. Pulling only the skin puts the tension on the skin, which looks unnatural and does not last; lifting the layer that supports the tissue means only the truly excess skin needs to be removed.
The standard for a facelift at Atelier Plastic Surgery is 'properly', not 'more'. How hard the tissue was pulled has no bearing on how natural the result looks. The goal is for sagging tissue to return in the direction it came from, while the shape of the ear and the hairline stay as they were. To achieve this, the extent of dissection and the direction of fixation are set according to the pattern of sagging.
Dr. Juyoung Go is a board-certified plastic surgeon who trained in both reconstructive and aesthetic surgery in the Department of Plastic Surgery at Samsung Medical Center, and plans surgery on the basis of facial anatomy. Only one surgery under general anesthesia is performed per day, and the director personally handles everything from consultation through surgery and follow-up. A board-certified anesthesiologist attends, and after surgery you recover in a private recovery room.
Dissection is carried out beneath the SMAS layer so the skin and SMAS are lifted as a single layer. The retaining ligaments that hold the face are released and the whole tissue is moved back in its original direction, so no tension is placed on the skin. Because the dissection is deep, it requires an understanding of the course of the facial nerve.
After the skin is dissected, the SMAS layer is folded up, partly excised and sutured, or raised as a SMAS flap and pulled into fixation. The dissection is more limited than deep plane, and the method is chosen among the three according to the degree of sagging and tissue thickness.
Through a short incision in front of the ear, a limited area of skin and SMAS is pulled and fixed. The small incision and dissection mean faster recovery, but the range that can be corrected is correspondingly limited.
A technique that lifts and fixes midface soft tissue that has descended toward the front of the cheek, under the eyes and above the nasolabial folds using a mesh suspension thread. A paper in the Journal of Cosmetic Dermatology (2016), on which Dr. Juyoung Go is a co-author, prospectively evaluated the outcomes of this technique. It is performed alone or used to reinforce the midface together with a facelift.
When neck sagging is present below the jawline, the incision behind the ear is extended to address the neck skin and platysma together. The jawline is where the face and neck meet, so correcting only one side can leave an awkward border. Details are covered on the double chin and neck wrinkles page.
These may vary depending on your condition; we will give you precise details at your consultation.
Whether sagging starts from the midface or is mainly along the jawline, and how much excess skin there is, determines the choice between deep plane, SMAS and mini lift. Wider dissection allows wider correction, but recovery and risk grow with it, so the principle is to dissect only as much as needed.
Facial tissue generally descends downward and forward. Pulling sideways alone easily produces a pulled look around the mouth. We confirm the direction of sagging, move the tissue in the opposite direction, and fix it so that the tension is carried by the SMAS layer, not the skin.
Incisions are placed inside the cartilage in front of the ear (tragus), in the crease behind the ear and along the hairline so that scars sit at natural borders. The amount of skin removed is set so that the earlobe is not stretched and the hairline is not pushed back.
Only one surgery under general anesthesia is performed per day. A board-certified anesthesiologist attends, the operating room has CCTV and a private recovery room is provided, and pre-operative consultation, surgery and follow-up are all carried out by Dr. Juyoung Go personally.
You recover in a private recovery room with a compression dressing in place. A drain may be placed to prevent hematoma, and you rest with your head elevated.
The dressing is changed and the drain removed. Swelling and bruising peak during this period, and there may be a feeling of tightness in the face and numbness.
Some sutures along the incisions are removed and you can begin washing your face. Swelling begins to subside and light outings are possible.
Suture removal is complete and most people return to daily life. Makeup is possible except over the incision lines.
Most of the swelling has subsided and light exercise can begin. The incision lines are still red, so avoid sun exposure.
Scars fade, sensation recovers and the result approaches its final form. You visit for follow-up.
A facelift involves dissection near the branches of the facial nerve, and although rare, facial nerve injury can cause weakness of the expression muscles. This mostly recovers with time, but recovery may be slow or some weakness may remain. Other possible complications include hematoma at the surgical site (most common within 24 hours after surgery and may require drainage), infection, skin necrosis (higher risk in smokers and patients with diabetes), reduced sensation around the ear and cheeks, altered sensation of the ear from injury to the great auricular nerve, scarring and hypertrophic scars along the incisions in front of and behind the ear, hair loss around the incisions, earlobe deformity, asymmetry, saliva collection from injury to the parotid (salivary) gland, anesthesia-related risks, and the possibility of revision surgery if the result is unsatisfactory. Smoking must be stopped for at least 4 weeks before and after surgery, and you must tell us in advance at consultation about any medications or supplements that affect blood clotting. Results and recovery time vary by individual, and risks and how they are managed are explained fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Double chin and neck lines approached by cause: submental fat, neck sagging or chin position
Learn more Related Thread liftA thread lift designed around direction and anchor points rather than the number of threads
Learn more Related UltheraFocused ultrasound lifting that tightens down to the SMAS layer, planned by area and depth
Learn more Related Face Anti-Aging GuideA face anti-aging guide staged by degree of sagging, not by age
Learn moreConsultations are conducted by the Director herself. Schedule one by phone or KakaoTalk, or leave an online consultation request.
