Numerous techniques exist for performing facelifts. Traditionally, facelifts involved cutting away skin from the forehead and in front of the ears, pulling the facial skin layer toward the back of the head, removing excess skin and then stitching the tissue back in place. Although this was an effective method for removing wrinkles, results from these “skin-based lifts” were short-lived.
The next major advance came with “deep-plane lifts,” which involve resituating the deep layers of the face (i.e., muscle and connective tissue) to produce longer-lasting facelift results. Today, the deep-plane lift is one of the most commonly used facelift techniques. One of its key drawbacks, however, it that it often produces a “pulled” appearance in facial skin post-operatively because the skin and muscle layers are pulled as a unit. Unfortunately, in the aging process, these layers sag and stretch in different directions.
The solution for managing layers of tissue that stretch in different directions came with the development of the bi-vector facelift. In the bi-vector facelift, the deep facial muscles are pulled up vertically to reverse gravity’s effects; then the facial skin is “redraped” to its natural orientation. This relatively new technique allows for facial rejuvenation characterized by a natural post-operative appearance.