The vertical facelift
If you have jowls that are easily visible and partially obscuring your jawline when you look in the mirror while standing or sitting, try looking with a hand mirror while lying on the bed or sofa. What happens? In many people, this results in the jowls moving upwards into the lower face and backward toward the ears, so that the jawline is magically restored to a youthful state.
Guess what position patients are in during facelift surgery? If you guessed flat (supine), you are correct. So in this position, the jowls are simply not visible in many cases. They have temporarily migrated up into the face where surgeons do not perform traditional liposuction. So what happens to the jowls? If you’re having a facelift procedure that doesn’t directly address the jowls, the jawline will generally look better right after surgery but over time, and often sooner than later, the jowls will become apparent again — even if the skin is relatively tight across the jawline.
This is why Dr. Holcomb keeps the patient positioned with the head up during this part of the radiofrequency assisted facelift — so that the jowls are visible. This is what is called a “vertical facelift”.