There are a number of variables that go into how long a facelift will last. While it is true some peoples’ tissues may give way sooner than others, on the other hand, the biggest factor in facelift recurrence seems to be the technique utilized by the surgeon. Dr. Core in Birmingham, Alabama has classified all facelifts into two basic categories. The first one being what he calls a “plication lift” and the other one being a “tissue transposition” lift. Dr. Core states that no matter what type of technique is utilized and what type of name is associated with it such as MACS lift, a C-lift, S-lift, mini-lift, and so on, that all lifts can be classified into one of these two categories based on how the anatomy is rearranged by the surgeon. Dr. Core goes on to state that a plication lift, which is the most common type of lift performed today and is a rapid and easy facelift with a quick recovery, also tends to give way much quicker than the tissue transposition lift. The reason is that with plication lifts, the sutures are placed into the tissue in a shoestring type fashion with a back and forth running suture, which is then pulled tight and draws the tissues together. This type of repair causes tissues, which have not been released from underlying attachments to be under tension. This has been demonstrated by Dr. Knutti from Europe with several radiographic studies demonstrating earlier failure of these types of lifts. The other type of lift, the tissue transposition lift, involves actual release of tissues from their attachments to the face, which are then lifted and transposed (hence the term tissue transposition) to a new position and then sutured into place. Due to the release of these tissues, the undersurface, which is advanced has a new point of attachment and reforms adherent bonds in this new position. This type of lift relies not only on the sutures, but also on the new tissue attachments formed after release and transposition of the lifted layers of tissue. Dr. Core states that within this category are lifts such as the deep-plane facelift, extended sub-SMAS facelift, and all other types of lifts, which reduce tension on the lift by the release and transposition of the tissue. Dr. Core routinely utilizes tissue transposition lifts in his practice, even in mini lifts, in order to help extend the longevity of the result.
by Dr. Grady Core