I just talked to a plastic surgeon.
Older methods of facelifts pulled the actual skin and restitched it in hidden locations like along the hair line. The problem with this method is it pulls on the skin too much and looks unnatural Also, over time, the skin stretches again.
Modern facelifts actually take the underlying muscle and pull it tight. She showed me how — they fold it over itself in in the middle and stitch it together. Then, they lay the skin back like a flap and cut it to fit. This allows the muscle to support the load so the skin is not pulled so tight. It increases the longevity and reduces the windswept look.
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