Face Lift - The Three Most Common Face Lift Methods

Subcutaneous Face Lift

The skin is undermined to an appropriate level determined during the physical exam. The skin is then advanced laterally and slightly upward to put it back where it was during youth. This effectively tightens the skin and smoothes out the facial contour. Care is taken to put all the skin tension above and behind the ear so that there is minimal tension in front of the ear itself. This avoids an operated look.

Subcutaneous Face Lift with Fat Suspension

This is a Subcutaneous Face Lift but in addition, the descended fat is elevated back into position with sutures.

SMAS Face Lift

SMAS is an acronym for Superficial Musculo-Aponeurotic System. It is a fibrous/muscular layer under the skin. Above it lies the cheek fat. Below it sits the facial muscles that animate the face. A SMAS facelift will elevate the SMAS and thus, concomitantly, elevate the facial fat and muscles.

It has been shown that all three types of facelifts can achieve excellent results. Which is best for you depends on what needs to be corrected and what your plastic surgeon is most comfortable with. Joseph T Cruise, MD always incorporates fat suspension into his face lifts.


Like the cheek, your plastic surgeon will evaluate your jawline by pinching the soft tissue on top of it and elevating it to see what is the best treatment. Jowls are a combination of fat and SMAS that have descended with age. During a face lift, this tissue is re-suspended back into the cheek area where it belongs.

Types of Facelift Incisions

Typical face lift incision behind the ear

Typical Face Lift Incisions

Hairline incision for face lift

Variations above the ear
Hairline Incision. Does not cause hair parting complications and allows for more upward skin pull. Incision is well hidden at the hairline.

Retro-tragal incision for face lift

Variations in Front of the Ear
Retro-Tragal Incision. This incision goes into the ear canal and, therefore, part of it is not visible. Potential downside is tragal distortion.

Tragal edge incision used for face lift

Tragal Edge Incision. This incision stays on top of the tragus. It is well hidden but does not go into ear canal.

No posterior ear incision, used by Joseph T Cruise, MD, Newport Beach face lift specialist

Variations Behind Ear

No Posterior Ear Incision. Joseph T Cruise, MD utilizes this so that hair can be worn up and no incision can be seen at all behind the ear.

Incision above the ear used for face lift by Joseph T Cruise, MD

Joseph T Cruise, MD's Preferred Incision
 Above the ear, the incision is within the hairline, it then goes retro-tragal. Joseph T Cruise, MD is usually able to avoid a posterior ear incision so hair can be worn up without any visible scar.