Facelift, Lower Facelift, Necklift – What is What and Which is Better?

Facelift, lower facelift, neck lift; what does it all mean? To understand, the most important thing is to be clear about the different areas of the face. When looking at the face surgically, it’s best to break it into four parts. This would be the upper face, mid-face, lower face (or more specifically jawline), and neck. The upper face is generally from the eyes up and includes crow’s feet and forehead. The mid-face is the area roughly between the upper cheek and mouth. The lower face, or as I prefer to say, jawline, is just that: the area along your jawline. And lastly, the neck is everything below the jaw. Each of these areas has a specific surgical treatment to improve the appearance and rejuvenate.

Upper Face

There are three common procedures addressing the upper face: brow lift, upper lid blepharoplasty and lower lid blepharoplasty.

The brow lift smooths out the forehead and crow’s feet. There are several different types of brow lifts including lateral brow lifts, endoscopic brow lifts, forehead reducing (pretrichal or hairline) brow lifts, and the older traditional coronal brow lift. The best procedure for you would be decided by your surgeon.

An upper lid blepharoplasty removes excess skin from the upper lids.  It also redistributes or removes fat depending on each individual patient.

The lower lid blepharoplasty removes excess skin and can also remove or redistribute the fat in the lower lid as needed. Once again, the correct procedure would be decided by your surgeon as there are multiple ways to approach these areas.

Before and after photos of a patient who had an eyelid lift.

Mid-Face and Lower Face

These areas are addressed by the traditional facelift. The incisions are placed along the ear. From there, the deeper structures of the face can be addressed and pulled tight. The skin is then re-draped, and if done properly, gives a very natural rejuvenation to the nasolabial folds, elevates the mid cheek, defines the cheekbones, reduces the marionette lines, and tightens the jawline. The facelift can be confusing as there are multiple variations. It takes time to educate on which is the best procedure for each individual patient whether they are looking for a “mini lift” or a more sophisticated full SMAS multi-vectored facelift.

A mid facelift addresses the cheek and what is called the “malar fat pad” which lies just below the bone of the orbit. This procedure improves the cheekbones and particularly reduces the prominence of your nasolabial folds. It is generally performed through the lower lid of the eye. This procedure is for patients with very little aging along the jawline.

Try this at home: Place your fingers at the top of your cheekbones and push your skin upward and back. This will help you mimic the look you’ll get from a facelift.

Before and after photos of a facelift patient.


The neck is obviously treated by a neck lift and addresses loose neck skin (turkey waddle), excess fat below the chin (double chin), and vertical neck bands (platysmal bands). This procedure usually entails incisions behind the ear and along the hairline behind the ear. From these incisions the deeper structures can be addressed, the skin elevated, and the neck rejuvenated. Just like a facelift, there are multiple ways to tighten the neck. For many patients another procedure is also needed called an anterior platysmaplasty. This procedure helps define the neck line by improving the neck and jaw angle. In some patients this area is blunted. This procedure rearranges the anatomy to provide a very crisp neck line.

Try this at home: Place your forefingers below the jawline, outside your jaw and push upward and back. Doing so can give you an idea about what a neck lift can do for you.

Before and after photos of a patient who had a neck lift.

Which is Best?

As you can see, no one procedure is better than the other, they just address different areas. However, Dr. Dorner almost always prefers to do a facelift with a neck lift as they do work together. The rare patient may not require one or the other, but from a technical standpoint, being able to elevate the cheeks through the facelift and then pull the neck tight gives a more thorough rejuvenation than doing them separately. This is essentially the basis for why a multi-vectored SMAS based facelift gives the best, longest lasting results.

Face and neck lifting are one of Dr. Dorner’s favorite procedures. He spent a year being specially trained to perform these surgeries. Because of this, he can offer the most advanced techniques available today. Each patient’s surgical plan is tailored based on their desires, available downtime, and comfort level. Not everyone wants the full face and neck lift, so he works with them devise a plan that fits their individual needs.

Combination Procedures

Aging doesn’t just happen to one area of our body at a time. Most patients will benefit from multiple procedures.  Combining them cuts down on facility fee costs as well as recovery time. At the time of your in-person consultation, Dr. Dorner will help create an individualized treatment plan to meet your aesthetic goals.

Take the Next Step

Ready to learn more about how Dr. Dorner can help you look and feel your best? Schedule a consultation at Dorner Plastic Surgery by calling us at (614) 336-9000 or by simply filling out the form on this page today.

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