How Do Facelift, Mini Facelift, and Thread Lift Differ?

Sagging Is Not Only a Skin Problem

When the face sags, it is not only the skin that sags. The layers beneath the skin also descend with it.

Nasolabial folds, a sagging jawline, and vertical neck lines are often seen together. In this case, simply cutting away and pulling the skin is not enough.

Beneath the skin of the face lies a layer called the SMAS (superficial musculoaponeurotic system, the facial fascia layer). Sagging occurs when this layer descends together with the skin. That is why the SMAS must be pulled along with the skin, rather than only cutting away skin. To pull the SMAS sufficiently, it is important to release the retaining ligaments (structures like cords that anchor tissue to the deeper layers). Once the retaining ligaments are released, the amount by which the fascia layer can be pulled increases, and the tension on the skin layer can be reduced. Depending on the condition of the face, other methods, such as folding and securing the SMAS, are also considered.

In plain terms In the face, it is not only the skin that descends but also the layer that supports the skin. So the supporting layer is pulled up together with it. That layer is held in place by cord-like structures at several points inside the face. Releasing those cords allows it to be pulled further, so no undue force is placed on the skin.

The Facelift Is the Most Traditional Method

The facelift is the oldest, most traditional of the lifting methods.

Excess sagging skin is removed and pulled, and the SMAS beneath it is also pulled and secured.

The incision is extensive. It starts inside the hairline on the scalp side of the temple, passes in front of the ear and around the earlobe, and continues behind the ear to the hairline at the back.

Compared with a thread lift or a mini facelift, the surgery is larger and takes longer. In return, it lasts longer.

Anesthesia, surgery time, and the recovery schedule are summarized in [Facelift surgery information](/lifting/facelift).

How Do the Three Methods Differ?

The thread lift and the mini facelift are simpler methods that came after the facelift. Their range of effect is limited accordingly.

Point of comparison	Thread Lift	Mini Facelift	Facelift
Incision	None	Inside the hairline only (does not extend toward the ear)	Inside the hairline on the scalp side of the temple – in front of the ear – earlobe – behind the ear – hairline at the back
Layer treated	Fat layer beneath the skin	Part of the SMAS layer	Down to beneath the SMAS layer
Time required	About 30 minutes	1 hour 30 minutes	4–5 hours (about 5–6 hours if combined with other surgery)
Hospital stay	Not required	Not required	Usually about one day
Range of effect	Limited	Narrower than a facelift	Widest
Duration	Short	Shorter than a facelift	Long

The numbers and incision ranges in the table are the same values as on the procedure pages. Details are in [Thread lift information](/lifting/thread) and [Mini facelift surgery information](/lifting/mini-facelift).

So Which Should You Choose?

The three methods are not substitutes for one another. The choice depends on the degree of sagging and the amount of remaining skin.

If a full-incision facelift feels like too much, a mini facelift or a thread lift is considered. Conversely, if the sagging has progressed over a wide area, a surgery with a wider range is needed.

Which one is right is decided through an examination and consultation. The criteria for choosing are summarized in [How to Choose a Lifting Treatment](/lifting).

We Look at Volume as Well as Sagging

When facial volume has decreased, pulling alone may not be enough.

When the cheeks become hollow, the contour of the face looks uneven. In this case, fat grafting may also be considered.

When we perform a facelift, we almost always combine it with facial fat grafting, facial liposuction, and double chin muscle tightening (platysmaplasty). Details are in [Fat grafting surgery information](/fat-graft).

Summary

Item	Guideline
What sagging is	The skin and the fascia layer beneath it descending together
Facelift	The incision is the most extensive, and it lasts longer
Mini Facelift	A surgery with a reduced incision and range
Thread Lift	No incision, and the range of effect is limited
What we look at together	We look at volume as well as sagging

Which method is right is decided by looking at the condition of your face.