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. SAMS Face Lift. SMAS is an acronym for Superficial Musculo-Aponeurotic System. It is a fibrous/muscular layer under the skin. Above it lays the cheek fat. Below it sit 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. We always incorporate fat suspension into our face lifts. Jaw Line Like the cheek, your plastic surgeon will evaluate your jaw line 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 facelift this tissue is re-suspended back into the cheek area where it belongs. Before After   Face lift - notice elimination of jowls and jaw line definition. Face Lift Incisions Typical facelift incision. Variations above the ear Hairline Incision. This incision does not cause hair parting complications plus allows for more upward skin pull. The incision is well hidden at the hairline. 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. This incision stays on top of the tragus. It is well hidden but does not go into ear canal. Variations Behind Ear No Posterior Ear Incision. We utilise this so that hair can be worn up and no incision can be seen at all behind the ear. Our Normal Incision We often utilise the above incision. Above the ear, the incision is within the hairline, it then goes retro-tragal. We are usually able to avoid a posterior ear incision so that hair can be worn up without any visible scar.