The minilift is a plastic surgery procedure designed to tighten loose skin in the lower third of the face and neck. The procedure can improve the appearance of jowls or heavy cheeks. Good candidates for the minilift include healthy patients who have jowling and either minimal or no neck laxity.
Dr. Moynihan performs the minilift in an outpatient surgical center using local anesthesia or sedation. The procedure takes two to three hours to complete. The incision for the minilift is completely hidden in the area around the ear. Once the incision is made, permanent sutures are used to tighten the underlying musculature and liposuction is used to remove excess fat in the neck.
Recovery after the minilift takes about one week. Patients may experience some bruising and swelling, and the skin may feel tight or numb. Any discomfort that patients experience usually fades quickly and can be controlled with medication. In one week, the stitches are removed and patients can return to work. Light exercise may also be resumed after one week, though more strenuous exercise will need to be postponed for about two weeks.
- What is the minilift?
The minilift is a plastic surgery procedure which tightens loose skin in the lower third of the face and neck, improving the appearance of jowls, or heavy cheeks.
- Who is a good candidate for a minilift?
Healthy men and women who have jowling and either minimal or no neck laxity may be good candidates for the minilift.
- What happens during the minilift consultation?
During the consultation, your face will examined, your medical history taken, and your goals discussed. The details of the minilift, including the technique, the anesthesia, the recovery, the risks and the costs, will all be explained.
- Where are minilift performed?
Dr. Moynihan performs minilifts in an outpatient surgical center.
There are many different terms used in the field of plastic surgery to indicate a procedure that is less complex and with less downtime then a formal rhytidectomy (facelift). The nomenclature can be as varied as safety lift, lunchtime facelift, S lift or cheek lift. Unfortunately, these phrases are often used for marketing purposes and do not accurately describe the procedure that will be performed; the outcomes to expect nor the risk involved in the procedure. Corporate entities participate in this marketing with promises of procedures performed awake with no downtime. With such varied terminology out in the public, the problem that arises for the plastic surgery consumer is the inability to compare and contrast the various procedures and decide which one is right for them.
I prefer to keep things simple in my life. With that in mind, I offer two procedures to rejuvenate the lower half of the face and neck: Facelift and Minilift.
In general, the term facelift refers to lifting the tissues of the cheek, jaw line and neck region, whereas the term mini-lift refers to lifting the tissues of the cheek and jaw line. Individuals with stand-alone cheek laxity and little to no neck laxity are candidates for a minilift. A minilift is not an option for individuals with neck laxity, as they will end up disappointed due to the simple fact that the neck is not addressed by the minilift procedure. In my practice, the difference between the two procedures is simply the extent of the incision but no difference in the extent of the muscle tightening.
The decision on which procedure is correct for the patient is determined during the consultation. The concerns of the patient are reviewed with the doctor along with relevant medical history and medications taken. Photographs are taken and imaging performed which allows demonstration of what possible outcomes are achievable with each procedure. It allows patients to confirm that the procedure decided upon will alleviate the highest priority concerns.
To assure all patients are healthy enough to undergo a minilift, their primary care physician performs a history and physical. Appropriate laboratory and diagnostic testing is performed on a case-by-case basis. A list of prohibited medicines are provided and should be stopped two weeks prior to the procedure under the guidance of the patient’s physician. It is recommended that a patient purchase Arnica Montana and Brome lain (found in pineapple/pineapple juice). Both of these homeopathic, natural supplements assist in the postoperative healing process by reducing swelling and bruising. The night before the procedure and the morning of, the patient will shower with an antibacterial soap and not to be followed by the application of lotion.
It will be necessary to have several prescriptions filled (pain medicine; antibiotic; nausea prevention medicine and sleep aid) as well as several postop care items (hydrogen peroxide; witch hazel; Vaseline; qtips and medical gloves). The use of these medicines and postop treatments will be discussed in a later section.
Anesthesia and Facility
Both the facelift and minilift are performed in an operating room for both the safety and sterility of the patient. The facility used is most often an outpatient surgical center that affords both convenience and privacy of the patient. The outpatient center is often more economical for the patient. I perform both facelifts and minilifts under Sedation (often referred to as Twilight or MAC anesthesia). Sedation refers to the use of medicines delivered intravenously which provides both relaxation and amnesia for the patient while allowing the patient to breathe on their own (no breathing tube necessary). An anesthesiologist or nurse anesthetist delivers the anesthesia. The clear advantage of sedation is in the recovery period. The sedated patient wakes up very quickly with little to no nausea while also avoiding the oft recounted ‘washed out’ feeling of general anesthesia, which can take several days to clear.
A ‘patient sitter’ (retired surgical assistant-who has worked with me in the operating room for several years) will accompany the patient from the recovery room to a hotel room across the street from my office. I will check up on the patient at the hotel room on the evening of the day of surgery. The sitter will bring the patient to my office the next morning to remove dressings and review postop wound care.
As mentioned above the actual difference between a facelift and a minilift is the length of the incision and the amount of surgery performed on the neck tissues. The minilift procedure requires an incision that is placed where the ear interfaces with the plane of the face and extends into the temple a few centimeters and behind into the post-auricular (hidden behind the ear) crease. There is no such thing as scar-less surgery but it is possible to hide the scars in areas of the face that the human eye expects to see a line, such as the interface between the front of the ear and the face.
Once the incision is made, the skin is carefully dissected off the underlying tissue. Following the dissection, the muscular layer is positioned into its natural anatomical position (slightly higher and further back towards the ear). The lift is created with tension on the muscle and not with tension on the skin. This is an important differentiation to highlight since this technique produces a natural result without the ‘pulled’ or ‘wind swept’ look. The neck region is typically not addressed when performing a minilift although if there is some mild laxity present some light liposuction is performed.
Incisions are closed with sutures and stainless steel clips in hair-bearing regions of the scalp to protect and preserve the hair follicles. There is a compressive dressing placed around the face and neck to prevent collections of blood. The dressing is removed the next morning when returning to the office with the sitter the next morning. Sutures and clips are removed one week after the procedure. A significant amount of the swelling and bruising resolves at the end of the first week and certainly by ten to fourteen days the patient is ready for re-entry into society.