What types of facelifts are there?

13 November 2015

By Plastic Surgeon Dr Dirk Kremer

FaceliftThere are so many different variations of facelifts available that it's understandably difficult to decide which one is best for you. Recently, people have been distancing themselves from facelift procedures that involve going under the knife, opting for less evasive procedures; it is these more natural facelifts that I’ll be discussing today.

Non-surgical facelifts

Thread facelifts

Known as a non-surgical, or lunchtime lift, the Thread Lift is said to be the most discreet facelift that cosmetic surgeons perform. The treatment only takes around 30 minutes as it involves the application of local anaesthetic rather than general anaesthetic, and people often have the surgery during their lunch break, hence the nickname. I personally don’t advise my patients to undergo this kind of facelift in their lunchbreak as promoted by many clinicians. Indeed, the amount of swelling and even bruising can’t be predicted so I prefer to tell my patients ‘to take it easy’ for the rest of the day.

The procedure involves the insertion of threads into the skin, which are then pulled taut in order to tighten the face, by pulling facial skin upwards. The threads are left in the skin and eventually biodegrade, meaning the results of this procedure last roughly 18 months, at which point, patients who wish to maintain their new youthful appearance are able to undergo another thread lift procedure. Threads like the ones of the Silhouette Lift, which I offer at Harley Street Aesthetics, don’t resorb and can be readjusted and pulled tight through the old incision scar so the desired lifted result is regained. The original procedure takes roughly one hour, and the adjustment, which is usually done after 2 years – although this differs from patient to patient and also depends on your individual expectations - just takes a few minutes and is again performed under local anaesthesia just in the area of the incision.

The Thread lifts are an option when minor sagging of skin and fat of the cheeks/midface and neck/jowls occurs, in people in their late thirties to mid/late forties.

Liquid facelifts

When you age, your facial skin thins and your muscles atrophy, meaning your face will begin to show signs of sagging. Liquid facelifts are perfect for people looking to restore vibrancy and youthfulness that is often lost when facial skin begins to sag.

A liquid facelift involves the injection of hyaluronic acid (the same substance used as dermal fillers) into the face at the temples and along the jaw; the filler is then sculpted by hand in order to create a high, arched eyebrow curve, and a more defined jawline.

Liquid facelifts can cause swelling or even bruising overnight, but this usually rectifies itself after a couple of days. The effects of a liquid facelift can last up to 2 years. 

Again, a facial rejuvenation purely by injection of fillers is limited to the amount of saggy skin and droopy facial fat. A good age group are patients in their mid-thirties when first signs of ageing (loss and drooping of facial fat) occur, up to patients in their late forties, depending on how advanced their ageing process is.

I think a liquid facelift is perfect for the ‘right patient’, but can’t replace a surgical facelift despite what many practitioners who are not able to perform a surgical facelift want to make patients believe. We shouldn’t forget that a filler shouldn’t be used to fill the face until its skin is stretched, plum and wrinkle-free. Over-injection can result in a very unnatural appearance and always changes the individual anatomy of the patient, which consequently changes the patient’s natural look. My advice is ‘less is more’. I personally like to add fillers where a surgical facelift couldn’t reach, especially the lines around the mouth. Also, sometimes after undergoing my vertical TBT-facelift it can happen that the fat that has been vertically lifted back to its original position over the midface is not enough, because with age we lose facial fat. In this case, after the swelling has settled I can discuss with my patients a slight enhancement of their cheeks with fillers.

Laser facelifts

Laser facelifts are yet another time-friendly way to give yourself younger looking skin! However, while all the other treatments mentioned cause minimal pain, a laser facelift can be a slightly more painful and intense experience.

The heat of the laser basically burns ‘tunnels’ into the dermis, therefore stimulating the formation of collagen which assists in the tightening of tissue. The sessions have to be repeated several times with a 4 weeks' time of recovery.

Even though you will see noticeable results within the week following the surgery, a common complaint with laser facelifts is that the best results don’t appear until around 6 months after the procedure, which is quite a long time to wait if you’re feeling uncomfortable with your appearance today! Laser facelifts may be effective but usually just fine lines are improved and only a slight skin tightening can be noticed. It doesn’t work on facial fat which is actually the great benefit of a real surgical facelift.

Stem cell facelifts

This is possibly the most unique type of facelift on this list. A stem cell facelift involves a plastic surgeon taking fatty tissue from your stomach or inner thigh and injecting it back into your face.

It’s an extremely contentious topic as to whether or not this procedure actually works. Stem cell treatment may become useful in aesthetic surgery one day, but right now, there is very little evidence to suggest that the stem cell facelift treatment is effective. While I cannot tell you which facelift to go for, I would strongly recommend that if you’re planning on a stem cell facelift, you do your research first. Stem cell facelifts can cost upwards of $20,000, which is a lot for something unproven!

Surgical facelifts

TBT Facelift

The Turn-Back-Turn Facelift is one of my signature procedures here at Harley Street Aesthetics. Most evasive facelifts, while consistently offering a line-free appearance, can leave the patient looking unnaturally taut. With the TBT facelift, I seek to give you a maximal rejuvenation with giving you none of the visible stigmas of a facelift. Your facial characteristics stay the same, they are just rejuvenated; my patients don’t look different but younger and rested.

I ask to see a picture of my patients when they were younger before I perform a TBT facelift, so that I have a clear goal to work towards. I can then subtly change the procedure so that the end results are more natural to what a younger you looked like.

The TBT-facelift basically Turns Back what Time did to our face (that’s what TBT stands for), as gravity pulls our facial fat and skin vertically down.

Rather than removing fatty deposits or pulling them to the side, I pull them strictly vertically up and reposition them over the cheekbones and midface in order to restore the face’s fullness. Skin and fat are pulled upwards, rather than laterally, which, along with giving cheeks fullness, has the benefits of reducing nose to mouth folds and creating a smooth jawline.

This procedure takes roughly 2.5-3 hours, but the results will make you believe that you’ve gone back in time.  

Here at Harley Street Aesthetics, I understand that it is important for my patients to feel happy and comfortable with the procedure(s) they are having, that is why I hold a personal consultation before agreeing to perform any cosmetic surgery; this is not only to ensure that the patient truly wants the surgery, but to make sure that we can agree on the perfect procedure for them. For enquires on facelifts, or any of the other cosmetic procedures that I perform at my London clinic on Harley Street, contact me today.


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