- Facelift/Neck Lift
A 42-year-old female presented to Dr. Harbison seeking facial rejuvenation to address early midface descent, deepening smile lines (nasolabial folds), jowling, and loss of definition along her lower jawline and neck. While patients often associate facelifts with later decades of life, this case highlights a fundamental surgical principle: anatomical facial laxity and structural descent—not chronological age—are the true indicators for facelift candidacy and success. Non-surgical modalities cannot reposition descended deep structural fat, making targeted surgery the most effective and natural solution.
Surgical Approach:
Demonstrating how impactful this surgery is as a standalone procedure, Dr. Harbison performed a comprehensive deep plane facelift and deep plane neck lift without additional adjunctive interventions:
Midface Elevation & Softening of Smile Lines: Traditional or superficial SMAS techniques pull laterally and rarely improve the center of the face. By entering the sub-SMAS deep plane and releasing the key retaining ligaments, Dr. Harbison directly mobilized the descended malar fat pad. Repositioning this volume vertically restores fullness to the upper cheek and naturally softens deep smile lines (nasolabial folds) from within, eliminating the need for synthetic fillers.
Jawline & Neck Sculpting: The deep cervical fascia and platysma muscle were mobilized and suspended to clear jowl overhang, recreate a crisp, sharp mandibular border, and sharply define the cervicomental angle under the chin.
Tension-Free Closure: All structural lifting forces were placed strictly on the deep muscular layers, allowing the overlying skin to redrape smoothly and heal without any tension or "windblown" appearance.
Results & Recovery:
Shown at 3 months post-operative. The patient exhibits a dramatically rejuvenated, contoured jawline, a crisp cervicomental angle, and a noticeable, natural softening of her smile lines. Repositioning the midface tissues restored an inverted "triangle of youth," creating a soft, natural, heart-shaped facial silhouette. The result underscores how addressing deep structural laxity in a patient's 40s produces long-lasting, youthful harmony while preserving native facial expressions and leaving virtually undetectable incisions.
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