Tired of looking older than you feel? Find out how to turn back the clock a decade or more with a signature Facelift by Dr. Kassir.
by Ramtin Kassir, M.D., F.A.C.S.
Want to look as young as you feel? Are you looking for a natural looking facial rejuvenation?
Facelift Surgery is designed to reverse the visible signs of facial aging, including the formation of jowls, which obscure the jaw line, the occurrence of a double chin and the appearance of vertical bands of the skin and muscle in the front of the neck. Dr. Kassir is a leading expert in facelifts in NYC and NJ. Patients travel from national and international destinations for Dr. Kassir's facelifts. Click here to see examples of patients who have had facelifts by Dr. Kassir and their stories.
What is a facelift?
Facelift surgery, also known as rhytidectomy, is a plastic surgery procedure performed to improve the neck laxity, jowls, and the midface. As a person ages, the midface begins to go downhill, producing the smile lines" or "laugh lines. The lower face then begins to show jowling, near the chin and the neck muscles sag, producing banding and redundancy. These three areas can be improved with the facelift procedure. The facelift does not improve the skin texture or quality.
Modern facelift techniques involve resuspending the deep connective tissues of the face and allow the face and neck skin to be elevated and produce a natural rejuvenation. These techniques avoid the "plastic" or stretched appearance so common with facelift surgeries in the past. The surgery is typically performed without the need for general anesthesia and a 1 to 3 week recovery period is usually necessary after the procedure.
What can Facelift Surgery do?
Facelifts, technically known as rhytidectomies, rejuvenate the mid- to lower face and neck. Facelifts are most effective for NJ and NYC patients who want to correct:
Are you a good Facelift surgery candidate?
The best candidates for facelift surgery are:
Recovery from Facelift Surgery
The most important thing to remember after a facelift is patience. The body takes time to heal, and your face will look worse before it looks better. Your face may feel tender and tight after the surgery, and there will be discomfort, swelling, and bruising. Dr. Kassir can prescribe painkillers to alleviate the pain, and antibiotics to fend off infection.You should be up and about in a few days, and be sure to walk around 3 to 4 times a day to increase circulation, and prevent blood clots. The bruising and swelling will subside and you should be fine in about 2 weeks. Full recovery however may take 1 to 4 months. Do not bend over or lift heavy objects until Dr. Kassir gives the all clear. Also stay away from saunas, steamrooms, alcohol, aspirin, and ibuprofen. If Incisions were made in the mouth consult Dr. Kassir on what to eat until your recovery is completed. Sleep with your head elevated for example on a pillow, and as still as possible. If you experience any extreme pain, excessive redness, or elevated temperature contact Dr. Kassir immediately.
After your rhytidectomy facelift surgery, Dr. Kassir will wrap the incisions in light bandages. On the next day your hair can be carefully washed and a week later the sutures will be removed.
At first, you may experience swelling, numbness, bruising, and a feeling of tightness or tension in the face and neck. Recovery will be noticed usually within 3-6 weeks, and sensation typically returns to normal within a few months. Scars become less red, raised, lumpy or itchy in time.
Many NJ and NYC facelift surgery patients return to work by the second week and some resume normal activities by day five.
What are the different types of Surgical Facelifts?
The SMAS Facelift is the traditional facelift which pulls up the SMAS layer and is effective for those with jowls and skin laxity.
The Deep Plane Facelift is a modification of the traditonal facelift that works more effictively on the midface areas such as nasolabial folds.
The Endscopic Facelift is a minimally invasive technique using small cameras to guide insturments and allows for lifting the midface and brow.
The Midface Lift is a procudure to specifically targert the areas of aging in the midface; the areas between the cheekbones.
The Mini Faceliift is related to the traditional facelift but involves smaller incisions behind the ear and focuses on adjusting the skin.
The Tissue-glue Facelift is a technique that uses fibrin, a safe biological agent, to close inscision as opposed to sutures.
More Facelift Information
One of the most common procedures in plastic surgery is the facelift. According to the American Society of Plastic Surgery 124,000 facelifts were perfomed in New Jersey in 2012, and in New York facelifts were up 42 percent from 2000 to 2011. Our skin is constantly changing, and the older we become the more our skin cells break down, and divide slower. The dermis, or lower layer of the skin, begins to grow thinner as well. The dermis is comprise of different types of tissue, including elastin and collagen. While the elastin provides elasticity for the skin, the collagen keeps the skin taut. Over time these proteins begin to break down, and results in the loss of elasticity in the skin and deeper tissue. The skin begins to sag as well as the muscle and tissue composition under the skin change, and leads to wrinkles. Although a facelift can lead to younger looking face with a better jawline, neck and midface, it cannot completely erase the signs of age, or fix all problems such as sagging eyelids, eyebrows, or skin discoloration. These problems can be fixed with other procedures for example, an eyelift, browlift, or chemical peel. The procedure of a facelift takes time for recovery, and has minimal risks.
Since every patient is different, the procedure will be different for everyone as well. Dr. Kassir will examine the skin, and explain the procedure to you. Smokers will be asked to stop smoking for a week or two before the surgery, and a few weeks after as well. Smoking is not advised since it inhibits blood flow to the skin, and can interfere with the healing process. Patients are also asked to avoid aspirin or other medications that increase bleeding.
The facelift surgery can be performed in Dr. Kassir's office or accredited surgical center. The patient is usually given a local anesthetic or sedative for the facelift procedure. An incision is made around the temple along the hairline, and goes down to the earlobe. An additional incision is made underneath the chin to tighten the skin of the neck. The skin is then separated from the muscle and fat, and the fat may be trimmed or sucked out via liposuction. Dr. Kassir then takes the SMAS (Superficial Musculoaponeurotic System) and repositions it at a higher, more youthful level. Tightening and reposition the SMAS in this manner gives the jawline a sleeker look, and firms the neck. The skin is then pulled back over the area of the incision and the excess skin is removed with a laser or knife. The incision is then closed with stitches, sultures, or tissue glue.The stitches are placed within the hairline so they are hidden. The surgery takes about 2 to 4 hours depending on the extent of muscle and tissue work. There are other methods to achieve a younger looking face, that require less time for recovery, such as the K-lift™ or liquid facelift with restylane, perlane, belotero, radiesse, juvederm, scultpra, artefill, or fat.
Many other types of facial lifts are favorable including the mini-lift due to its short recovery time, the S-lift and the K-lift™ which focuses on the lower part of the face (neck and chin), mid-facelift which includes small incisions in the hairline, above the ear, and inside the mouth, and the Tissue-glue facelift which uses tissue glue to seal the incisions made. Some non-surgical techniques are also available with lower costs and fewer risks. Thermage or thermacool uses radio frequency to activate the body's natural collagen, and causes the skin to tighten and contract. This technique is best used for slight wrinkles, and the results can last from six months to two years. Ultherapy uses sound waves to achieve facial and neck tightening. Another alternative is the ThreadLift or FeatherLift, which involves inserting a needle with a surgical thread (or a non-absorbable sulture) into the skin. The thread is then pulled tight, and the muscle and tissue tightens with it. This technique leaves no scars, and the thread remains in the body. Some risks of facelifts include infection, scarring, reaction to anesthesia, hematoma, damage to facial nerves, necrosis, and alopecia at the incision site. These risks are minimal, and the procedure results in a younger looking you
What Does a Facelift Cost?
The average cost of a rhytidectomy (facelift) can range from $7,000 to $25,000, depending on what's being done and the problems being addressed. The cost of revision and corrective facelifts are higher. This encompasses the anesthesia, the fee for the facility, and the remainder is the surgeon's fee. Having more than one procedure at the same time, such as a browlift or eyelid surgery, may also be cost saving since the cost for the anesthesia and facility are being paid.
Are Facelifts Safe?
Facelift surgery or rhytidectomy is a safe procedure if performed by experienced surgeons. Dr. Kassir performs many facelift surgeries per week and also corrects “botch” jobs. That's why it's so important to pick your surgeon carefully and be an informed consumer. Be sure to direct any questions towards Dr. Kassir. It is normal to feel anxious or nervous about your new look. Afterwards you will have some swelling and bruising, and in a few weeks you will enjoy a rejuvenated look! Be patient. If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. Be sure to follow Dr. Kassir's instructions on how to take care of yourself after surgery.
Do you Need a Facelift?
Signs of an aging face:
1. Wrinkly skin: Over time your skin's natural collagen and elastin begin to breakdown, which causes wrinkles, lines, folds, and a sagging look. A facelift can help with the sagging skin, but problems such as lines and wrinkles can be better addressed with injectable fillers, and good skin care.
2. Sunken eyes: As fat under the eyes starts to descend, your face develpoes a more sunken look. This looks like a loss of volume around the cheeks, and can be fixed most efficiently with a blepharoplasty, small amounts of fat grafts, or injectable fillers as a non-surgical option. Your blepharoplasty can be performed at the same time as your facelift.
3. A saggy jawline: When the jawbone loses density over time, there is less of a structure for the skin to hang on to, therefore the skin begins to sag. To correct this, the loose skin must be excised and the remaining skin must be tightened by a facelift.
4. Bone changes: With time then density of the bones in the face begin to reabsorb. This makes the eyes appear sunken, the jawline becomes less defned, and the cheeks appear flatter. A facelift can help with these changes.
5. Loss of volume: As your face begins to lose fat, the skin begins to droop. The more fat that is lost, the more pronounced folds and lines are. Fat can be taken from a different areas and added during your facelift to add more volume. Fillers can also be injected either before or after your surgery to gve your face more volume.
What to know before you have facelift surgery:
1. Your facelift expectations need to be realistic: A facelift is designed to make your face look refreshed, younger, and fix any laxity. A facelift can't always eliminate every wrinkle and line, and doesnt mean you will look 20 years old again. Dr. Kassir explains that the goal is to create a younger version of yourself that gives you a "rested" and "natural" look. Dr. Kassir fequently reverses and undo's the "windblown", "pulled", and "Hollywood" look.
2. You will have scars after a facelift: Although techniques have improved throughout the years, a facelift still leaves scars. Dr. Kassir makes incisions along the sidburn and ear so they are hidden by the hair, and inside the ear canal. With most patients, scars improve over time and blend in.
3. There is some downtime after a facelift: It may take 10 days to a couple of weeks until you are ready to resume daily activities, and a few months until all of the swelling goes down. With most patients bruising is slight, and pain is minimal. Most patients report that although they barely have pain, there is a bit of tightness involved that will go away the more you heal.
4. Know what can and cannot be fixed with a facelift: A facelift is meant to restore a youthful shape to your face, but it will not improve the look of brown spots, fine lines, or the position or shape of your eyelids and eyebrows.
You should pick facelift surgery if:
1. You want long-term results: Unlike other age-reversing treatments like lasers and injectables (which don't address lack skin), the results of a facelift are very long-lasting.
2. There is loose skin: Loose skin at the jawline and on the neck creates the look of a double chin or a "turkey waddle". Microliposuction can eliminate unwanted fatty areas, but loose extra skin needs to be excised.
3. There are lines and folds: Over time facial expressions cause the skin to crease and fold which causes lines. Although fillers can help eliminate these lines and folds, lax skin needs to be addressed with surgery.
4. You imagine how you would look with a facelift : If you pull your skin back and see how it would look tighter, a facelift is the only was to get long lasting, elevated results.
Are you a candidate for a facelift?
If your face is oval, you may benefit from a facelift. Hollowing in the temples and cheeks is common because of extra fat in the cheeks, which dissapates over time. Fillers and/or fat fill out hollowing; a mid-facelift helps with sagging.
If your face is round, you may benefit from a facelift. The cheeks and lower face may sag. A lower facelift, which targets the lower part of the face, is the best option. The cheeks can be resculpted by injecting fat and/or fillers.
If your face is rectangular or square, you may benefit from a facelift. loose skin and sagging jowls on the lower part of the face tend to be the biggest problems. A traditional facelift is likely the most effective solution as it addresses jowling and lax sking.
If your face is heart-shaped, you may benefit from a facelift. The forehead and upper eyes are most affected. Since the cheekbones are higer than square faces with flat cheekbones, hearts-shaped faces tend to ages slower.
Using a microcurrent on the facial structure involves sending a gentle electric stimulation to trigger a skin enhancement reaction from the body’s natural cells. This current mirrors the body’s current, making it extremely imperceptible at the gross level. Research shows that, after twenty days of treatment with microcurrent technology, collagen production increases by about 14%, elastin by 48%, and blood circulation by 38%.
Research has suggested that electrical stimulation of cells intensifies healing by the body and may, over time, contribute to a moderately youthful appearance. However, the best results can only be achieved with a full SMAS or deep plane facelift. These intensive surgeries alter the muscular contours of the face and offer MUCH more long-term enhancements than facial microcurrent stimulation. If you want serious results that will last several years a facelift is the best option
The total cost of a Facelift is made up of several components, including: surgeon’s fees anesthesia fees, facility fees, and other variable costs. Some of the average costs for these components are listed below:
· Upfront surgery cost – $6,000 to $25,000
· Anesthesia – $1,300 to $2,500
· Facility/hospital fees – $1000 to $3,000
· Surgeon’s fee – $7,000 to $25,000
The other variable costs include blood tests, X-rays, a physical exam, prescription medications, bandages/elastics, and many more costs.
In addition, the previously outlined costs range depending on several variables. One major variable is geographic location. For example, Urban areas like New York City or Los Angeles, have highly capable, experienced, and reputable plastic surgeons, and tend to have high overhead costs (money spent on maintenance, rent, wages, etc.). This often translates into higher surgery costs for patients. Another important variable is the type of facelift, since by their very nature some facelifts such as the SMAS facelift or the deep plane facelift are more expensive in comparison to their lesser counterparts like the K-lift® (nonsurgical face-lift). Below is a list of costs for several facelift types::
· Deep Plane Facelift
· SMAS Lift – $5,000-$12,000
· K-Lift® – $6,000-$10,000
· Endscopic Facelift
· Midface or Cheek Lift – $6,000-$10,000
· Stem Cell Facelift -$5,500 to $15,000
· Thread Lift (Feather/Aptos Lift) – $2,000 to $3,00
The healing time varies for each patient, but typically you will be able to resume most normal daily activities by the 2 week mark. Dr. Kassir usually removes any sutures at day 7, and some patients are able to resume exercise by day 10. You will be ready to show off your rejuvenated face at public events (weddings, reunions, birthdays, etc) by 2-3 weeks.
The first thing to remember is that people continue to age even after a facelift. How long the influence of the facelift last differs from from person to person, and varies based on which type of facelift was performed. SMAS and deep-plane facelifts, which adjust the underlying muscular contours of the face, lead to changes in the structure of the face and are thus longer-lasting than lesser examples like the S-Lift which only deal with the surface skin and surrounding tissues. SMAS and deep-plane facelifts last up to 10-12 years, whereas smaller scale surgeries last around 5 to 8 years. Also important is the patient. Typically, patients who can maintain higher bone densities and have a tendency to maintain taut skin have a higher chance of maintaining the results of their facelift for a longer period of time.
“One-stitch lift” may refer to a procedure where a surgeon uses one stitch to suspend the midface. This procedure should not be considered a true facelift. The term may also be a substitute name for a procedure called the Thread Lift. This procedure takes one to two hours under a local anesthetic (some patients opt for IV sedation for the sake of comfort) and its main purpose is to elevate and reposition loose skin on the brow, face, and neck with a less invasive type of surgery. This involves tiny threads being inserted under the skin which are then passed into the area of operation with a special needle. The threads grab onto the soft tissue/muscle of the area, allowing the entire structure to be lifted as a whole. Over time the thread becomes fixed in the skin, holding the results of the surgery in place. The benefit is that this procedure does not require a great deal of actual stitching, but the results are often very minimal and are certainly not worthy to be called an “facelift”.
These three procedures are considered true facelifts. The difference between them is the areas of the head and neck that they address.
Mini-Face lift: used more frequently in younger patients, and consists of a small incision behind the ear and only adjusts the skin, leaving the underlying muscular structures intact.
Mid-Face lift: addresses the mid-face (triangle formed on either side of the face from the corners of the eye to the corner of the mouth), specifically around the cheek area (saggy cheeks, etc). The incision is made in the hairline and the fatty layers of the skin are repositioned over the cheekbones.
Traditional facelift: most extensive and involves an incision near the hairline which extends behind the ear. The muscular layers are repositioned, tightened and excess skin is cut and the remaining skin is pulled and sutured. This surgery is more frequently used for those with excessive neck fat and it corrects skin laxity in the lower face.
Swelling and numbness are normal and expected post-procedure but they vary with the type of facelift procedure. Numbness may last for up to 1 year and will steadily dissipates month by month. Swelling may be extensive for the first three days but will steadily begins to disappear over a several week period. Some Tingling sensations are normal for up to 6 months. In the case of excessive swelling some oral steroids may help reduce swelling. Dr. Kassir avoids using drains or heavy bandages meaning that most patients tend to have minimal swelling,
The alternative options range from energy devices, to non-surgical procedures. Energy devices include radiofrequency (RF), and ultherapy or ultrasound therapy, devices which stimulate the skin to tighten up. Non surgical procedures include Dr. Kassir’s trademarked procedure known as the K-Lift® which involves using adjustable sutures under the skin to tighten up the neck and lower face.
One of the proven methods known to be very effective for firming the neck and chin is the SMAS facelift (traditional facelift). It is probably the best option for those with jowls and significant skin laxity. This surgical procedure pulls up the SMAS layer of muscles just under the skin.
To answer the question, No. There are different types of lifts and if under 40 you don’t need to have one of the major operation that is typically reserved for patients over the age of 60. These advanced procedures have deep incisions into the muscular structure of the face in order to adjust the outward look of the face. Even though you may be too young for a “Full” facelift, you may be ideal for a mid-facelift. This facelift is best suited for those who have lost definition in the eye area and whose cheeks are beginning to sag. This procedure works on the deeper layers in the middle of the face and places them over the cheekbones to create a fuller look in that area. The total effects are expected to last about 5 to 6 years.