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The Profiles Hybrid Lift – Step by Step

Step 1 – The Incisions

The Profiles Hybrid Lift starts with a minimally invasive mini-lift incision. Unlike traditional facelift incisions that extend into the hairline both in front of and behind the ears, our Hybrid Lift incision is limited to the skin creases around the ear itself (shown in blue in the photos). This presents several very meaningful advantages that have patients from around the world coming to Profiles for their facelifts. Incisions in the hairline can risk causing hair loss and upward pulling or even removal of the temporal hair tuft, the wispy tuft of short hairs in the sideburn area. Thinning, removal, or upward movement of this tuft is a clear giveaway of a facelift procedure and will often mean that women can’t wear their hair back. The same goes for incisions in the hairline behind the ear that can heal poorly and be seen when your hair is pulled back. Over many years, we’ve found that these extended incisions are completely unnecessary, as they don’t add any real benefit to the lift. Instead, our minimally invasive incisions ensure rapid healing and inconspicuous scars so you can enjoy your beautiful new face without fear of looking unnatural. And, even better, you can style your hair any way you please!

Step 2 – The Skin Dissection

Our Hybrid Lift uses mini-lift incisions that ensure a rapid recovery, but combines these with a lift that is extensive in its scope. This is a crucial aspect of the procedure as it allows us to accomplish maximal reversal of your sagging neck and jawline. The area of skin lifted over the side of the face is shown in green, extending from your cheekbone over the jowl area and all the way down into the neck. For those in need of a platysmaplasty (central neck tightening), the central neck skin is elevated (shown in yellow) from just under the chin down over your windpipe, extending over to join the area elevated on the side of the face. In this way, the facial skin is elevated in continuity over all of your problem areas to ensure a comprehensive and smooth, natural lift without areas of dimpling or undercorrection. In contrast, in a mini-lift, a much smaller area of skin is lifted just in front of and behind the ear, which translates to much less correction of sagging skin. While that might be fine for someone with very early jowling, someone needing more is going to be disappointed by what a mini-lift can accomplish as compared to our Hybrid Lift.

Step 3 – The SMAS Dissection

Once the skin has been widely elevated, our Hybrid Lift proceeds with the SMAS dissection, the heart and soul of our comprehensive, natural facelift. The SMAS (Superficial Musculo-Aponeurotic System) is an extensive layer of thin, but tough, fibrous tissue that covers the muscles and deeper tissues of the face and neck. Unlike many surgeons’ techniques that place most of the tension on the skin, it is this layer that does all the heavy lifting in the Hybrid Lift. Why is this important? Because your skin is stretchy, excessive tension placed on the skin will often lead to facelift problems such as the dreaded windswept look, stretching and widening of the incision, and pulling down of the ear lobe (Pixie ear deformity). These problems are prevented by placement of all tension on the SMAS layer. This also ensures longevity of the lift. Since the SMAS layer is much less elastic and stretchy than skin, tension placed on the SMAS will provide an enduring lift that won’t fail and fade over time. In our Hybrid Lift, a large crescent of SMAS tissue is actually removed (shown in purple) and the edges are brought together. In addition, the platysma muscle (shown in red) is widely exposed so that it too can be tightened to provide the ultimate in neck recontouring.

Step 4 – SMAS Tightening

Tightening of the SMAS and platysma layer has two key components that allow us to achieve a remarkable recontouring and definition of the neck, jawline, and lower face. First, splayed platysma edges are brought together in the midline under the chin. With age, the normal connection between the platysma muscles frays and widens, causing banding of muscle in the neck and allowing fat pockets to protrude (in yellow). In the Hybrid Lift, this muscle connection is repaired using a corset-type suture technique that tightly overlaps the edges in the midline, restoring a youthful neckline. Next, the crescent of SMAS tissue in the face is removed, and the leading edge is lifted and tightly secured to bring the edges back together. A critical aspect of the lift is the vector, the direction in which the tissues are pulled and tightened as noted by the arrows. The vector of lift should be about 45 degrees along the jawline, and from the corner of the mouth to the upper ear. Anything more horizontal or vertical in direction can cause unnatural distortion of the tissues and an operated appearance. Using the correct vector in our Hybrid Lift allows us to guarantee a completely natural, unoperated result. With the facelift experts at Profiles, you can be assured of the perfect lift every time.

Step 5 – SMAS Closure and Skin Excision

Here you see the edges of the platysma have been oversewn and the edges of the SMAS have been sutured back together (shown in purple). Placement of tension on these deep tissue repairs will ensure a smooth, extremely robust, and long-lasting improvement of contour for many years to come. At this point, there is a lot of extra skin to remove! Since all of the tension of the lift is placed on the deep tissues, the skin can be gently re-draped over the face and neck. The excess skin around the ear is carefully trimmed flush and removed without any pulling or distortion. We often remove as much as an inch or more of skin from each side! Without tension, the incisions heal quickly and smoothly, and are almost imperceptible within a short time after surgery. Patients often can’t believe how good their neck and jawlines look even the day after surgery! Now that the sagging tissues of the face and neck have been corrected, we turn our attention to dealing with the second major indicator of facial aging, loss of facial volume.

Step 6 – Facial Fat Transfer

Our famous Hybrid Lift would not be complete without facial fat transfer to your cheeks and folds. We love fat transfer at Profiles! There is nothing better for natural, volumetric enhancement of deflated cheeks, under eye hollows, and deep facial folds around the mouth and chin. And nothing makes you look younger and with more vitality than full, healthy-looking facial contours. That’s why every Hybrid Lift we perform includes comprehensive fat transfer to all areas that are in need (shown in blue). As we age, not only does our skin stretch but our tissues shrink. And not only do we lose volume in our fat pads but we lose bone density too. This leads to an appearance of deflation and loss of volume. So, any facial augmentation procedure should address volume loss to get the best possible result. Unlike temporary fillers, think of fat transfer as a fat transplant in which healthy living cells are transferred from your body to your face. Many wonder whether these transferred cells survive for very long or go away over time. The success of this procedure has a lot to do with using the right technique, and we can tell you that, in our hands, you should expect to have a fantastic result that will last for many, many years.

The Results With our Profiles Hybrid Lift, you too can look forward to a spectacular new you! Contact us today to see how we can help make your facelift fantasy come true.


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