S Lift Surgery
Let’s first talk about an S Lift. An S Lift is a procedure where a small incision is created, a small amount of skin is elevated to access the SMAS layer and its most posterior aspect is then elevated. It has its limitations because we can’t remove a lot of skin, although we can pull on the SMAS, we are only pulling on the SMAS laterally, so quite far away from the jaw line and the jowl so there are some limitation related to that.
So who might be a candidate for that? Often it’s people in a younger age group so not necessarily under the age of 45, but that’s a general guideline. Someone who has very slight laxity of the jaw line and perhaps slight laxity in the mid face, or perhaps some slight laxity in the cheek tissues.
Someone who is not an S Lift candidate is someone who has significant jowls, a poor neck angle or significant laxity of the skin below the chin and significant laxity of the muscles in the neck that cause the sagging in the neck line. So those patients are unlikely to see substantial benefit from an S Lift.
How the S Lift is performed is through a fairly small incision you can see through the dotted line. Generally the incision runs in front of the hair line where it’s hidden the best. We want to keep the hair line where it is and move the skin up to that hair line. So this is the skin that is elevated, it’s just a small amount of skin. We can access the SMAS laterally and then pull that up in an upper direction and I think that’s helpful distance from the SMAS where we’re elevating it and the jowl or the platysma muscle in the neck is pretty far so it’s unlikely that pulling way up here is going to have a substantial effect here. So there are definitely limitation to that procedure.
The steps of an S Lift are pretty straight forward. We make an incision as we mentioned before just in front of the hair and just in front of the ear, and then the skin is elevated and the SMAS is identified and elevated upward with stitches and then any excess skin that is present is removed and the incision is then closed with dissolvable stitches.
What’s nice about elevating a very small skin flap is the recovery period is pretty quick. So most people can probably get back to work within a few days or something like that. So the term “Weekend Facelift” is sometimes applied to this, only of course if you have it done on the weekend, but there are a few days after the surgery where people kind of take it easy and lay low, but often they can get back to work with a little bit of camouflage.
What are the risks and recovery with S Lift surgery?
Bleeding and infection can occur but of course with a small skin flap like this the chances of bleeding are pretty small. Infection is a rare occurrence that we treat with antibiotics. Recover is fairly short. We ask that people do not do rigorous activities for about a week, but most people can return to work after a few days.
As with all these procedures, we want to talk about the Risk Reward Trade Off. In terms of S Lift surgeries, it’s probably the least invasive of surgeries we do given only that a small skin flap is elevated so risks are very low, recovery time is quite quick and most people can get back to work pretty quickly. So think in terms of tolerance, it’s a pretty easy procedure to tolerate.
I think as I mentioned earlier a small skin flap equals a short recovery and I think that’s the main pro of the S Lift is the recovery time is very quick.
The con of course is the improvements that can be made through such a small skin flap are limited and certainly can not expect to have substantial tightening of the jaw line and the neck through a small skin flap and small incision. The other cons of the S Lift technique was because we’re performing such a small skin flap, there’s limited access to the SMAS layer, although it can be tightened it can only be tightened in a small area.
The results are probably short lasting, much of the tension on the facial skin with an S Lift is on the skin itself. The skin tends to be fairly elastic and will probably stretch out with time more quickly then would be the case if the power of the elevation was done through the SMAS layer.
In terms of Risk Reward Trade Off, I think with an S Lift there’s a limited amount of improvement that you get but at the same time you still have a very similar incision that you would see with a short scar facelift.
I think the may benefit of course is the short recovery time, but given you have to have a small facelift scar in that area is not always worth it.