Deciding to have a traditional facelift is hard enough: After all, it's expensive, invasive surgery on the most noticeable part of your body. Now the decision may become even more difficult. Some plastic surgeons are promoting a controversial procedure called the "mid-facelift," which can be done by itself or can be done along with a traditional facelift.
The incisions made in the mid-facelift are just the same as those made in the traditional facelift, but the surgeon cuts much more deeply into the muscle tissue of the face in the newer procedure. This allows the surgeon to pull the muscles around the nose and in the cheeks up. The surgeon then stitches these tissues into the structures below the eye sockets.
By adding this extra step to the facelift, the midportion of the face, which normally isn't much changed by the facelift, is moved and secured higher in the face. Some say this gives a more natural appearance. Others say it is an added step that offers little long-term change to the patient's face.
"There are a number of doctors doing the mid-facelift, but it is a technically delicate operation. And since you have to be very aware of the anatomy and be prepared to deal with things that may go wrong, some doctors are criticizing the procedure," says Elliot Jacobs, MD, a plastic surgeon at Beth Israel Hospital in New York. "Some say it's too prone to complications, but it's not, if you know what you're doing."
Many people considering a facelift might find that to be too big an "if." Nonetheless, the procedure is growing in popularity, as facelift patients and cosmetic surgeons alike look for ways to make traditional facelifts look more natural.
"The mid-facelift is a very new treatment," says Jacobs. "It is totally revolutionary; and it allows me to do things that I would never be able to do with any other procedure. Many of my mid facelift patients are younger -- in their 30s and 40s -- and they don't want a full lift, just a younger look."
Most surgeons would rank a facelift as a major operative procedure, says H. George Brennan, MD, a cosmetic surgeon in Newport Beach, Calif., and a spokesman for the American Academy of Cosmetic Surgeons.
"This is a complex surgery," says Brennan. "Not only do you want to consult with a board-certified plastic surgeon, but you have to get a doctor who has extensive experience in this mid-facelift itself. People sometimes get the idea that a facelift is not real surgery, but it is very real surgery. It comes with its own risks, and the best way to approach those risks is to go with highly qualified experts in this particular procedure."