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About Facelift

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:

  • Midface sagging
  • Deep creases under the eyes
  • Deep creases between the nose and mouth
  • Jowls due to loss of muscle tone
  • Sagging areas of fat
  • Loose skin and fat under the chin and jaw

Are you a good Facelift surgery candidate?

The best candidates for facelift surgery are:

  • Wish to improve one or more of the signs of aging indicated above
  • Are men or women whose faces have begun to sag, but whose skin still has some elasticity
  • Are generally healthy
  • Are considering a facelift for personal reasons to improve their image and appearance

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.

Facelift: Questions & Answers

How can I address a leaking parotid gland post-facelift?

The conservative approach to dealing with a leaking parotid gland would be pressure dressing, the avoidance of spicy and sour foods (which promote excessive salivation), and anti-cholinergic medications.

What are my options for the midface lift?

Like many facial surgeries, the midface lift varies from surgeon to surgeon in terms of technique. Some surgeons prescribe endoscopic lift marked by the use of a camera used to lift tissue, whereas others may prescribe thread-lifting with the use of small barbed sutures. However, others will recommend a lower eyelid incision which, though carrying the risk of possible temporary ptosis, yields longer lasting results.

What can be done about jowling in the 20s?

For patients having early signs of aging, a range of options exist. Some of these are non-invasive like Ultherapy or Thermage which tighten facial tissues and others are more invasive like fat grafting and redistribution. Facelifts are definitely not an option. Consulting with the plastic surgeon is a good start for these patients.

How long can edemas last post-facelift?

Generally, edemas and other swelling lasts for approximately 6 months post-op, but, if it is a concern for patient, it is probably best to have a consultation with the plastic surgeon.

Are the cheek pads repositioned during a facelift?

Procedures like the mini facelift or marketed facelifts generally do not interfere with the muscle layers of the skin known as the SMAS (where cheek fat is generally centered), so repositioning of malar fat pads is not a concern here. For deeper procedures, surgeons may reposition them entirely or may trim it, depending on the surgeon.

Can I have a chin implant after already having a lower facelift?

Yes. The lower Facelift scar under your chin can be used as an entry point to place the chin implant.

Why do I have hardness and swelling 9 months post-facelift?

Hardness and swelling 9 months post-op is usually indicative of a maturing scar. However, it could also be attributed to fat necrosis or a small, unresolved hematoma.

Why do Hollywood stars have such bad facelifts?

The stereotypical windswept look of a celebrity facelift can usually be attributed to simple inexperience and lack of technique on the part of the surgeon. Just because a surgeon works in Hollywood does not mean he/she is at the top of their field and the results often show this.

Can fillers address jowling?

Patients often become confused with jowls and believe that the main issue with them is lack of structural fat within them. However, this is not the case, with the usual problem being skin laxity. Fillers, because of this, cannot really be used for addressing jowls because they merely add volume where volume is needed (cheeks, lips, etc.). Adding them to the jowls will not only do very little, but may worsen the symptoms.

Can I have the look of a Facelift without having surgery?

Using injectable fillers such as restylane, perlane, and radiesse can help to enhance the look of your face, however nothing is as effective and long lasting as facelift. Using fillers does not come without risks, such as infection, and in the end repeated injections over the years add up in terms of cost.

What defines an experienced facelift surgeon?

Often, it is better to not get bogged down with numbers when it comes to surgeries. Examining before and after photos and deciding whether you are completely satisfied (COMPLETE is emphasized here) is probably the best option when it comes to opting for surgery.

When can I do a hair transplant post-facelift?

Patients should wait for at least 4-6 months post-op before considering hair growth procedures, as surgery may have “shocked” hair follicles for a long, but temporary, period of time. However, if re-growth does not occur, the best option could be follicular unit grafting.

Why do I still have jowling post-MACS lift?

Unfortunately, patients who are unsatisfied with their jowling post-MACS Lift have fallen victim to a common problem in facelift surgery. The MACS Lift, while being effective for some, is totally ineffective for those who want penetration into the deeper tissues, for which there is no cure but the SMAS Facelift.

Why are my cheeks asymmetrical post-facelift?

When addressing cheek asymmetry, it is important to understand that time must be taken for the face to heal fully (several months or so) before a decision can be made. Infections, hematomas, and seromas can all cause fat on the cheeks to dissipate unevenly, yet, early on, the only good options are to consult with your surgeon.

Can I have fish oil post-facelift?

Fish oil and other medications should probably be avoided weeks before and after surgery. The surgeon will provide an indication as to which medicines should be avoided.

When can facelift sutures be removed?

Generally, sutures are removed very gradually, with some removed after one week in front of and behind the ears and others located behind and above the ears removed after two weeks.

Why do I have beads under my skin post-facelift?

Patients experiencing the sensations of beads under the skin are probably dealing with minor blood clots or sutures. The former problem can be dealt with by massage, but the latter should be taken care of by the surgeon.

Is the cheek fat pad repositioned/removed during a facelift?

Again, not all facelifts are the same. Some procedures including the SMAS facelift involve the repositioning of the cheek (buccal) fat pad and often involve the partial removal of it as well.

Fillers haven't helped me. Do I need a facelift?

Just because the use of fillers was unsuccessful does not automatically mean that a patient requires a facelift. Flat cheekbones can corrected with fat injections and other areas can easily be corrected with microliposuction.

What is a Laser Facelift?

A Laser Facelift is a bit of a misnomer since, the procedure does little to actually adjust the contours of the face. A Laser Facelift works by sending the right amount of energy to predictably burn certain layers of skin. These layers grow back in an environment of increase collagen and thus give a more youthful appearance. Laser Facelifts should be used in adjunct to traditional facelifts to resurface or rejuvenate the skin’s appearance.

Can I have a facelift after Sculptra treatment?

Generally, because having Sculptura treatments can distort the face, it is difficult for surgeons to have a true vision of the patient’s face after they have had these treatments. Therefore, though there should not be a health-related issue, I would not recommend having a facelift until Sculptura treatments are stopped.

When does muscle weakness recover post-facelift?

Generally, muscle weakness, if temporary, takes within 3-6 months to fully recover.

What are some basic improvements I can hope to see post-facelift?

Though changes after a facelift vary from patient to patient, some basic results of a standard lift include a better defined jawline, tightening of the skin under the chin, and elimination of muscle banding in front of the neck. As healing progresses, fluid collection and swelling should decrease dramatically and tissue should begin to soften.

Should I be concerned about nerve damage after doing multiple facelifts?

To be honest, any experienced and capable surgeon should not be afraid of doing nerve damage, etc. simply because of their knowledge in the field. However, the problem with you may be that fat grafting or augmentation is needed to plump various areas without the use of a facelift.

What facelift best improves chin definition?

The best treatment for chin definition would probably be the lower facelift which improves sagging jowls and removes excess skin from the lower areas, repositioning tissues along the way. Areas from the mouth, neck, and ears remain relatively unaffected.

What do you think of the skin trimming facelift?

Generally, it is not a good idea to create a facelift in which only the skin is pulled as this was a technique used in the 80s which most resulted in the “wind tunnel” look characteristic of poorly performed facelifts. In addition, these facelifts often had a long scar which was worse than those of today’s more invasive ones.

What procedures can be done under local anesthesia?

Procedures like endoscopic browlift, mini facelift, cheek implants and eyelid surgery can all definitely be performed under local anesthesia, but IV sedation would probably be more recommended.

Can deep plane facelifts fix the cheek area?

Generally, deep plane facelifts are good procedures for fixing the cheek and jawline areas as the cheek is usually elevated, creating a higher cheekbone and a well-developed facial structure.

Do I have loose skin from weight fluctuations?

Generally speaking, younger patients tend to be somewhat critical of themselves and tend to see signs of aging where there actually are none. Surgery is probably not the best option for these patients and can be better substituted by liposuction or Excilis treatments.

Why is my face partially paralyzed post-facelift?

Patients dealing with facial paralysis usually have their symptoms subside within 9 months to a year. However, this is an unusual symptoms and consultation with a neurologist may be necessary.

Is nerve damage post-facelift permanent?

Again, after having a facelift, it is very uncommon for patients to sustain nerve damage. Generally, nerve damage recovers over a long period of time, but may be contributed to synkinesis which can be treated through Botox injections.

What is the MTHFR gene mutation?

This gene mutation which is noted for creating an increased risk of blood clots and other vascular complications may present problems during surgery. It is important for patients with this condition to be cleared by the hematologist prior to undergoing surgery in order to avoid hematomas.

When will I feel my lips following a midface lift?

Patients dealing with nerve issues following a facelift surgery, especially around the facial muscles, should expect the feeling to come back in the lip after surgery. Much of the midface lift is conducted around the infraorbital nerve around the lip. However, if the lower eyelids are being pulled, revision surgery may be needed.

Can hyperpigmentation be corrected post-facelift?

In cases of darkening of the skin following surgery, the usual causes lie with laser treatment. To alleviate these symptoms, hydroquinone products could be used carefully or Restylane filler could be used in the dark circles.

What is facelift acupuncture?

Personally, I do not approve of unproven, “gimmick” procedures like facelift acupuncture especially because they offer no elevation of the face.

What is ROTEL?

The reinforced orbitotemporal lift (ROTEL) is probably one of the more aggressive surgeries out there and one I would definitely advocate against using as a technique. In the procedure, an incision is made in the lower eyelid below the eyelashes and surgical dissection is carried out under the lower eyelid muscle, a technique which puts the lower eyelid at risk for nerve damage and pulverizes temple fat.

When can I have dental work done post-facelift?

I personally recommend patients to avoid dental work for the first month or so after a facelift. However, even at seven weeks or so, patients should inform their dentists about their surgery and advise caution.

Are these dimples on my skin post-facelift normal?

Patients post-surgery will often deal with swelling which could progress into the development of fluid collections and even hematomas. If lumps develop, it is probably best for the surgeon to examine the patient to determine the nature of these lumps.

Why was my earlobe repositioned after my facelift?

Changes in earlobe position (known as Pixie or Spock Ear) can be caused when the skin around the ear becomes overtrimmed after which the tension in the skin pulls down the earlobe. Usually, a revision facelift may be needed.

Why do I have irregularities in my face post-facelift?

Irregular depressions in the skin post-op may be the result of the swelling. However, if after 6 months, these depressions still remain, fat injections can be made into the hollows and steroids can be injected into the lumps and bumps to help smooth out the facial structure.

Is weak smiling post-facelift permanent?

Though it is a concern if a patient is having trouble smiling post-surgery, it is usually not a sign of permanent nerve damage, but rather a sign of stretching and swelling of the nerves. Generally, though it takes a while, muscle movement should begin to increase as the nerves begin to reorganize and reattach.

What are the side effects of Facetite?

The main side effects of this procedure are bleeding, scarring, and possible nerve injury. It would be best to find a board-certified plastic surgeon and have a consultation to decide whether this procedure is the best for you.

Can facelifts be done post-fillers?

Facelifts and fillers tend to work hand-in-hand very well. Though many people would opt to have facelift procedures done BEFORE fillers are added, doing the reverse is perfectly acceptable.

What is the nature of the post-facelift compression garment?

Compression garments are generally composed of natural cotton combined with synthetic compression wrap. Gauze like Kerlix can be inserted to help with any irritations, but is usually not necessary. You can ask your surgeon to have a “test” run on the garment prior to surgery.

Why do I have bruising and bunching of the skin post-MACS Lift?

Bruising following a MACS Lift may be completely normal, but could also be the result of hyperpigmentation which can be treated with hydroquinone or glycolic peels. Bunching of the skin, however, must be treated surgically with a redraping of the skin.

Will sensation be impacted differently depending on if glue or sutures are used?

Generally speaking, using glue versus using sutures should not affect the overall regeneration of sensation which should return fully after about 2 years.

How do I deal with residual fat pockets after a lower facelift?

A fat pocket left over from surgery can easily be removed with direct skin excision or even through direct removal.

What can I do about post-facelift dog ear scars?

Patients having “dog ear” style scars under their chin post-op may be treated with steroid injections if the scar is hard, thick, and red, but if it is white or puffy, surgery may be needed to avoid infection. Patients dealing with the latter should wait at least 6 months before considering revision surgery.

What skin care regimens should I undertake prior to a facelift?

Some products which are recommended to patients prior to facelift in order to promote collagen growth are Retin-A and a mild glycolic acid. However, before any skin care product is taken, patients should notify their surgeon.

What is the Silhouette Lift?

Again, like many brand-name surgical improvements, I remain apprehensive about the Silhouette Lift. The procedure is a variant of the thread lift which uses barbed sutures to lift and hold the skin in a suspended position. Unfortunately, with its expense, it provides very minimal improvement and I would not recommend it.

Is the cheekbone moved during a MACS lift?

Though the cheekbone itself is not moved during a MACS lift, underlying tissue can be elevated.

Why am I panicking about my looks post-facelift?

The key saying with post-facelift patients is that “You look worse before you look better”. Patients will often find themselves questioning when the swelling and bruising will end and will usually look for immediate gratification post-surgery. The important part post-procedure is simply patience.

What can I do if I have uneven scarring after a facelift?

You should be examined by a certified facial plastic surgeon who will be able to perform a scar revision surgery for you. There are suturing techniques that can be used to help prevent this from happening.

Can patients prone to keloid scarring undergo a facelift?

Patients prone to keloid scarring should have no problem undergoing a facelift as what most patients see as keloids are simply hypertrophic scars (thick, itchy raised scars) which can easily treated by the surgeon. However, the surgeon which whom you are working may want to consider alternative incisions methods to combat the possibility of major scarring.

Am I too young for a temple lift?

In their early 20s, patients can easily substitute a temple lift surgery with Botox for the lateral brow area. Other options include lasers, light peels, and skin care treatments.

Should I get a surgeon of MY specific ethnic background?

Surgeons who are educated in plastic surgery will often be quite in tune to the various ethnic backgrounds of their patients and will recommend the best options they can for all patients. Therefore, finding a good surgeon, regardless of their background, is probably the best option for any patient.

It's been a week post-op. Why are my eyes crooked?

A week post-surgery is usually too early for patients to adequately examine the effectiveness of the procedure.

What is the difference between SMAS Facelift under local sedation vs IV sedation?

For a surgeon the results of results of the surgery are not affected by the type of sedation used. IV sedation is used for the sake of the patients comfort, since some patients may be very nervous with someone operating over them. Local sedation is just as effective for blocking all the pain, and only leaves patients feeling pulling and pushing sensations.. Local sedation has the added benefit of not requiring an anesthesiologist.

How can a 40-year old patient address sagging?

Generally, for patients in their early 40s, it is best to address jowling and sagging with a mini facelift with touch-ups repeated every 7-10 years.

What are good solutions to correct bottom-heavy faces?

Possible procedures include:
• Suction of the neck and jaw line to remove your submental fat pocket and define your neck/face junction
• A short scar face lift with neck liposuction

What is the burning sensation I feel post-facelift?

Burning sensations typically follow numbness in the cheek area as nerve endings attempt to regenerate. Usually, these sensations go away with time, but anti-inflammatory medications, taken with the surgeon’s approval, may help.

Can a 54 Year Old Get a Facelift?

Generally, patients at this age are dealing with excess jowling for which the best procedure is a facelift due to the tightening of the SMAS layer (longer lasting effects). However, patients looking for less invasive procedures can also benefit from a mini facelift complimented with injections of fat/fillers.

What is your opinion on the ultrasound facelift?

The problem with ultrasound facelift is that it has been given far too much hype in the media. Granted, its role in stimulating collagen cells may cause the skin to tighten somewhat but it does not address volume loss and skin laxity, two of the most common symptoms of aging. Again, better to not let price be your guide when it comes to facial procedures.

What are Non-surgical facelifts?

Non-surgical facelifts are not truly facelifts in the traditional sense of the term. They are generally less effective alternative to undergoing a surgical procedure, which depending on the patient may be sufficient to address the problem. These include the Thermage procedure, laser resurfacing, and volume replacements such as fillers and fat. It is important to remember the Non-surgical facelifts are only temporary measures.

Can a patient on bloodthinners have a facelift?

Patients looking to have a secondary facelift should first obtain medical and cardiac clearance and also make sure to discuss the consumption of bloodthinners (and when it should be stopped) with their surgeon.

What can I do about scleral show?

People who have severe concavities in their lower eyelid can often find that procedure designed to lift and tighten the lower lid will help. Midface lifts are usually not needed in this case.

Does a Serdev Suture Lift work for younger patients?

For younger patients, regardless of the marketing technique used, I would not recommend getting a facelift. Patients who are young are probably better off with injectables or even smaller scale techniques like threadlifting.

What should I do about the muscle spasms post-facelift?

Patients who are experiencing muscle spasms, but still retain feeling in the area around which the spasm is occurring, should likely not worry as this is usually indicative of minor nerve irritation. Again, consultation with the plastic surgeon may be necessary, but usually this is not a serious problem.

Will my sideburns be permanently affected by my procedure?

Patients dealing with scarring along the sideburns can easily have their issues resolved as this may be caused by tension on the suture line or by infection/healing issues on the incision site. Usually, traumatized follicles take about 6-9 months before they start regrowing.

Is there an issue with bald patients having a facelift?

Again, there is no real issue with bald patients having facelift surgeries. The problem lies in placing the incisions where it is least conspicuous. In many cases, the incisions are placed normally (behind the ear and around the structure of the ear) and will usually be noticeable for about 3-4 months as they turn from red to a natural fleshy color. Patients can help the process along by using makeup 1 week post-op.

Will the MACS facelift impact my eyes?

Generally speaking , this should do very little in the eye area besides removing excess skin, so it should not be a concern to patients.

Can I have a facelift after an EGC diet?

Patients are recommended to be in their best nutritional state before surgery, but they must make sure that their weight is fully stable before undergoing elective cosmetic surgery.

What should I do about the blood blisters on my face post-facelift?

Post-surgery, it is extremely uncommon to find blood blisters on the face. Consulting with a plastic surgeon who performed the procedure is probably the best option at this point.

When can I get a chin and jowl lift?

It is not uncommon to see patients undergoing these procedures in their early 40s if they present the need for one, the need normally being problems with skin laxity. Again, if you feel that you need the surgery and your consultations with the plastic surgeons have been any indication, I would go ahead with the surgery.

What is the Recovery like after a facelift?

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.

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Dr. Ramtin Kassir © 2017

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Disclaimer: This site only provides information about cosmetic surgery and this information is not meant to be taken as medical advice. For more information about plastic surgery, contact Dr. Kassir.