Signs of ageing are more evident in the face than elsewhere in the body. As a person ages, tissues are subjected to the effects of gravity, there is loss of elasticity, volume depletion or fat deposition. changes are also aggravated by lifestyle and habits, such as obesity, smoking, etc. In the face, ageing is evident by sagging of cheek tissues, the appearance of jowls, platysma bands, loss of volume in the zygomatic and cheek areas, fat deposits in the chin and neck area. Ageing is also evident by the descent of the brow, sagging of upper and lower eyelids. Loss of elasticity in the skin causes wrinkling and sagging. A facelift is a surgical procedure that helps rejuvenate the mid and lower face. Most of the times facelift is complemented by additional procedures to get a youthful appearance to the face as a whole.

These procedures include a neck lift, liposuction of submandibular area, chin augmentation, platysmaplasty, browlift, blepharoplasty, fat grafting to the molar area, etc. results are also augmented using fillers, laser skin resurfacing, etc.

The decisions to combine one or more procedures are taken at the time of consultation and examination. The goal of a facelift procedure is to reposition the sagging tissue components to their original position to achieve a youthful appearance. This procedure cannot replace lost volume, elasticity or correct asymmetries in the face. Additional procedures are employed to achieve the same. The goal of repositioning the facial tissue can be achieved through a myriad of techniques. The common steps of the procedure are described below.

1. The procedure is performed under sedation and local anesthetic or under general anesthesia.

2. The incision starts in the periauricular region, going around the lobule, postauricular sulcus and along the posterior hairline. The length of the incision varies with the procedure.

3. The skin is undermined, the degree of undermining varies with the procedure.

4. SMAS is excised or plicated and repositioned.

5. Via a submental incision, the platysma is exposed and placated.

6. Subplatysmal fat is excised if necessary.

7. The total procedure takes 2-3 hours to complete. There is a variation with the techniques used.

8. Recovery is completed in 4-6weeks time.

9. Newer techniques like mini facelift, suture lift take significantly lesser time.

Different techniques of Facelift

1. Facelift Proper involves extensive undermining of face and neck skin. Combined with platysmaplasty. Corrects a greater degree of sagging.

2. Mini facelift - the extent of skin undermining is limited. The postauricular scar is shorter. It is combined with platysma plication.

3. Macs lift- is another variant of facelift requiring less degree of dissection.

4. Subperiosteal facelift- less frequently performed procedure.

5. Suture facelift- it is a minimally invasive procedure which does not require an incision to be given. This new-age procedure uses bidirectional barbed sutures to lift facial tissues in different vectors. Procedure is done under local anesthetic and requires minimal recovery time.