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About Facelift

by Ramtin Kassir, M.D., F.A.C.S. | Learn More About Dr. Kassir

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 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 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 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 (Superficial Musculoaponeurotic System) Facelift is the traditional facelift which pulls up the SMAS layer and is effective for those with jowls and skin laxity. Dr. Kassir's SMAS facelift works to lift and tighten the lower face and neck muscles as well as the skin to produce a more defined jawline and rejuvinated lower face

The Deep Plane Facelift is a modification of the traditonal facelift that works more effictively on the midface areas such as nasolabial folds. During surgery, Dr. Kassir lifts the fat pads and muscles of the cheeks to restore volume and youth in the midface region.

The Endscopic Facelift is a minimally invasive technique using small cameras to guide insturments and allows for lifting the midface and brow.  It is most effective for patients seeking to make moderate corrections of a downturned mouth, sagging cheeks, hollowing under eyes, or a drooping forehead. Incisions are only about one inch long and are typically made above the hairline and/or behind the ear, resulting in hidden sutures, a quick recovery time, and almost scarless incision sites.

The Midface Lift is a procudure to specifically targert the areas of aging in the midface; the areas between the cheekbones.Dr. Kassir's midface lift is performed endoscopically to reposition the malar fat pads in the cheek area to restore volume in the midface. 

The Mini Facelift is related to the traditional facelift but involves smaller incisions behind the ear and focuses on adjusting the skin.  The best candidates for a Mini Facelift are patients who are just starting to show signs of aging and seek to tighten their skin, reduce sagging, and reduce nasolabial through a minimally invasive procedure.

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 my jowls be best addressed?

For patients with jowls, the best option would probably be a comprehensively planned facelift. The Lifestyle Lift, to be frank, does not cut it when it comes to the jowl area especially when the surgery takes only an hour or so to do (it does not venture deep enough into the SMAS layer, etc.).

What's the closest thing to a full facelift?

The next best thing to a facelift would probably be a mini facelift which offers small-scale improvement to jowling and other “facelift”-related symptoms. However, non-surgical options like fillers or fat grafting do exist which, depending on the patient, can provide better results.

Is the facelift procedure different for a patient with sleep apnea?

Patients who have severe sleep apnea and require a CPAP machine should be monitored 24 hours in a hospital following the facelift to avoid a severe apnea episode.

What is the Y-Lift?

The Y-Lift, from my research, is a form of the liquid facelift in which a different instrument (blunt cannula) is used as opposed to sharp needles.

How long has the Endotine procedure been around?

This procedure has been around for a decade and is somewhat recent in terms of facial rejuvenation surgery. For this reason, it has not been proven to work as effectively as a facelift procedure and is continuously hounded by many doctors as a “fad”.

How are PSP facelifts categorized?

PSP Facelifts are considered regular facelifts because the procedure involves the tightening of the platysma and SMAS muscle and tissue layers.

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.

Can a 45 Year Old Get a Facelift?

Again, it is the patient’s physical facial state which determines the correct time for a facial procedure. Generally, patients looking to do facelifts early (in their 40s, etc.) will definitely need to come back after 10-15 years, meaning that doctors usually do not recommend facelifts at such a young age.

How does keloid scarring work post-facelift?

It is important for patients to recognize and be able to differentiate between keloids and hypertrophic scars. Both of these are very uncommon after surgery, but are found more on dark-skinned individuals and are best treated with cortisone injections.

Will swelling stretch the skin appreciably?

Generally, swelling within the first few weeks of surgery, though seeming like a lot, will not stretch the skin to any appreciable degree. The results of the facelift will largely remain intact.

Can I get a facelift at 43?

It is important to recognize that the timing of a facelift is again related mainly to the physical stage of a patient, rather than the patients themselves, and are controlled by genetics and environmental factors. Even though you may be young for a full facelift, you could easily qualify as an ideal candidate for a mid-facelift. This facelift is ideal for those who have lost definition in the eye area and who are beginning to show the signs of sagging.

What is the Arasys Perfector Facelift?

As a surgeon, I try to avoid facelift technique which are branded and have official names to them. For most patients, sticking with tradition is probably the best avenue for surgical success

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.

Can I correct a drooping lower face without touching the jaw or chin?

For patients with a good chin and neck area, facelifts are generally not necessary and symptoms can usually be resolved with the use of fillers or even a mini jowl and neck lift. If necessary, a mid-face lift can also be performed in conjunction with a cheek augmentation.

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.

When will my facial movement return to normal post-facelift?

Due to post-surgery tightness and local edema (not to mention swelling), facial movement is always impaired after surgery. However, as these issues begin to resolve themselves out, the range of facial movement tends to increase and weakness usually recovers smoothly. Again, though, it is best to consult with your plastic surgeon or even a neurologist if any concerns are there.

Is 40 Too Young for a Facelift?

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.

Should I revise my cheeks several months post-facelift?

Patients must be careful in deciding to undergo revision surgery, especially because the healing process is not yet finished after several months post-surgery. Consulting board-certified surgeons is probably the best option in addressing patient concerns.

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.

Why do I keep hearing snapping noises post-facelift?

Patients dealing with stiffness and hearing snapping sounds within their skin may be dealing with the snapping of internal sutures. Generally, even after 2 weeks post-op, patients have a good chance of full recovery and excellent results if they see their surgeon ASAP.

Does a facelift in the 40s require one in the 50s?

Generally, the earlier a facelift is done, the more better and long-lasting the results are. However, patients must be careful to only have a facelift if the signs are there (e.g. sagging skin, facial/skin laxity, etc.) and avoid having it too earlier.

What are some irregularities of the Endotine device?

It is common for people with thin skin to feel the endotine device under their skin, but the device does dissolve over a period of one year. Dimpling may occur during this point, but the endotine device should not be visible.

What procedures should I consider as a 20 year old?

Generally, patients with excess fat in the lower face at 20 years should not consider a facelift automatically, but should look into other options like buccal fat pad removal which can be done under local anesthesia and for which the results are visible in one month.

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.

Will sagging occur post-op?

Generally, the results of a brow and facelift are expected to last for about 5-10 years, but can vary due to the patient’s health and lifestyle (smoking, exercise, etc.). However, after the surgery, the patient will continue to age normally and should not have any distortions with the aging process.

Can Fraxel treatment damage facelift results?

It is difficult to believe that Fraxel treatment prior to surgery would do anything to contribute to the facelift. I would personally recommend having the procedure done concurrently with the surgery or several weeks post-op in order to hide any possible scars which may develop.

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.

Is there a benefit to having a facelift early?

The most important part of considering a facelift is deciding whether it is even necessary. Many patients who are younger often look at facelifts as the only option for facial structure issues and often skip over more effective solutions like fillers, etc. Again, consulting with your surgeon as to your particular facial problems is the best way to avoid looking “freakish” or unnatural following surgery.

How can I treat my asymmetric mouth?

Asymetric mouth can be treated with a lip lift, augmentation, upper lip lift, DAO muscle fiber division, etc.

Why should I have a facelift as opposed to less invasive procedures?

If patients are truly serious about long-term results, the facelift is probably the best option. Granted, some facelifts are more small-scale and less invasive than others, meaning less downtime and longevity, but, in general, facelift techniques which repair facial contours and rearrange muscles in the face are more long-lasting and provide for more satisfying results.

Are there non-invasive procedures for sagging cheeks?

Other non-invasive procedures for cheeks include endoscopy. A technique that is far less mainstream than traditional or minor surgical facelifts, an endoscopic lift is a minor facelift in which a small endoscope is inserted through the hairline through three or more small incisions that are less than one inch long. These cameras then transmit small video images to a larger TV screen, thus guiding the surgeon through the repositioning of surface tissues. This particular operation is usually done on an outpatient basis using local anesthesia or intravenous sedation.

Opinions on Threadlift vs facelift?

The consensus on threadlifts for most plastic surgeons is that the results look fantastic, but only last a week or two. Therefore, it is generally not worth the money to have it substitute a solid, long-lasting facelift.

Does losing weight help before having a Facelift?

On the contrary, losing weight may make things worse. People desire a facelift because of increase skin laxity and loss of facial volume. Losing weight means volume loss in the face, that may need to be replaced during a Facelift with Fat Transfers. However, if you are at an unhealthy weight losing weight may be a priority.

What are some non-invasive procedures for the chin and neck?

To be frank, there are very little procedures, besides the facelift, which can be done for patients demanding significant improvement in the neck area. Certain procedures like liposuction or laser/ultrasound treatment can be somewhat useful, but are very short-term and offer little when compared to a face/neck lift.

How can I deal with tightness and lumps almost a year post-facelift?

Tightness several months after a facelift is a hallmark of persistent edema or tissue swelling which cannot be resolved through medical means but only through time. Patients with these symptoms may want to cut down on sodium level or explore the options of manual lymphatic drainage or endermologie.

Can my facelift scars be excised to let my ears move into a better place?

Scars can be easily excised causing any lower pole on the ear to move into a better position. After this is done, soft tissue can be activated to fill the defect.

When will my facial nerves recover post-facelift?

Typically, numbness in the face, difficulty making facial expressions, and the drooping of facial features is caused by facial nerve injury. If temporary, this usually resolves itself within 6 months to a year, but may take longer for some patients.

Is 7 hours under general anesthesia for multiple procedures a stretch?

7 hours is not unusual for multiple facial procedures especially for rhinoplasty. Concerning general anesthesia, the most important thing to consider is the ability of the patient to tolerate it. Make sure to have your surgeon consult all this with you.

Can microcurrents address facial drooping?

Again, like many other methods of so-called “treatment”, I remain rather dubious of microcurrents. Granted, they give you some improvement, but major facial drooping can only be corrected with facelift surgery.

What do I do about swollen cheeks post-facelift?

It is difficult to recommend lines of treatment for various patients with asymmetrical faces following surgery without having pictures or a routine examination. Generally, the best option for such patients is to consult with surgeons specializing in revisional facelift surgery.

Can I get a facelift at 45?

Often, it is not the age of the patient but the symptoms which the surgeon considers when deciding on a facelift. At this age, is not unreasonable for you to believe that you need a facelift. Such a procedure could be beneficial, but fillers and fat augmentation could also give you similar results with less invasiveness. You must decide with your plastic surgeon which route you want to take, as I believe both will improve your overall facial structure.

Are Stem Cell Facelifts the new Trend or just another Fad?

Stem Cell Facelift take fat stem cells from the thigh, buttocks, and other lower body areas and transplant them into the face. The idea is that these stem cells will grow and fill in what has been lost with age. Some patients have noticed significant improvements, however so far research has not shown it to be better than other fat augmentation procedures This technique is new and it is probably best to proceed with caution.

What can I do about swelling and pulling around my earlobes post-facelift?

Patients should remember that swelling following facelift surgery is extremely common, but should also take care not to touch the areas around the earlobes too greatly because results may be altered tremendously. If pulled earlobes are a major concern, patients should talk with their surgeon immediately.

Why do I still have bruising several months post-op?

At this point, any residual bruising would most likely be caused by residual hemosiderin staining or a small hematoma. It generally is not a great issue, but should be consulted with the plastic surgeon.

How is aging affected post-facelift?

The extent to which aging increases/decreases post-facelift depends on the way the surgery was performed. Generally, if performed adequately, the surgery should not cause any changes in skin texture or blood supply to the skin, meaning that aging should not be affected generally. The point of a facelift is not to alter the aging clock, but simply to reverse it temporarily. A facelift, if done correctly, should be followed by normal aging without any facial distortion.

Will surgeons negotiate fees?

Even during a bad economy, surgeons will most likely NOT be inclined to “negotiate” especially because many of them reduce their fees in response to a declining economy. In general, patients should not let price be a guide in choosing their surgeon and should only go to the best surgeons available when they have the funds for it. I always say that redoing a bad job is much more expensive than doing it right the first time.

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 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.

Can fat transfer be accompanied by a facelift?

For patients experiencing midface hollowness with very little evidence of jowling, perhaps the best option would not even be surgery. Fat grafting often substitutes very effectively for surgery and is less invasive.

Why aren't composite facelifts common anymore?

It is strange to think that composite facelifting has sort of gone by the wayside, as they say, but I would have to disagree with people who state that there is only one way to address certain problems in a patient. Depending on the plastic surgeon and the patient’s preferences, there are many techniques which could be used to solve the same problem. Therefore, it is important for patients to find the best plastic surgeon for them and find the right procedure for their specific needs.

Can acne scarring be fixed during a facelift?

Generally, a facelift can be used to treat acne scarring in and around the cheeks and is usually best combined with fat augmentation in these areas. Yet, it is important to remember that a facelift is not geared SPECIFICALLY towards the treatment of surface features like scarring and should not be expected to fully resolve these issues.

Will healing after a midface lift be impacted by excessive facial movements (smiling, laughing, etc.)?

Patients worried about affecting the results of the facelift with excessive movement of the face (smiling, talking, etc.) should not be so concerned. Again, the elevated tissues modified in the facelift are fixed in place with sutures and/or Endotine devices and will be released in time.

Can I have a facelift at age 45?

At age 45 it is not an unusual for someone to have a facelift. Whether an individual is needs to have one 45 depends on their particular face. At age 45 volume loss, and particularly skin laxity may have begun to set in. At age 45 you may still be a candidate for less invasive procedures using fillers. Please consult with an experienced surgeon.

Can malar bags be addressed via a midface lift?

A midface lift is known for its role in addressing the cheek area and addresses sagginess. However, more often, surgeons will use fillers like Restylane or Juvederm to address problems in this area because of their low risk and, in general, greater effectiveness.

Is it normal to have hearing loss post-facelift?

Patients dealing with hearing loss should immediately consult an ear physician because it is usually caused by fluid or congestion in the ear, ear infections, or other temporary problems. It is important for the patient to have a full evaluation, however, to make sure that conditions are still fine within the ear itself and were not adversely affected by surgery.

What is the variation in facelifts?

Facelifts tend to vary greatly from doctor to doctor, with less invasive facelifts generally having less downtime and swelling than more invasive ones. Surgeons also have different draining techniques and other small things, so it is best to find the best one for you.

Can I do a facelift under one doctor and a blepharoplasty under another?

If patients want to do two surgeries concurrently with different doctors, it could be possible. However, this could be somewhat unnecessary as many board-certified plastic surgeons are fully capable of performing blepharoplasty incisions when doing facelifts anyway. Therefore, if the plastic surgeon is fully qualified, it may just be easier to have him/her do the surgery alone.

Is it normal for swelling and bruising to exist weeks post-op?

Swelling and bruising are extremely common for up to 4 weeks after surgery. Generally, some patients will experience lumps and bruising which are accumulations of blood under the skin which have acquired collagen buildup. Sometimes, in these cases, steroid injections can help along with pressure dressings.

Why don't I see any difference a year after my facelift?

It is important for patients to realize that a facelift will not induce dramatically facial contours/facial structures and that a totally rejuvenated look is wishful thinking. However, looking at before and after photos, patients should notice at least some difference if the facelift was suited for them. Again, some procedures like the Lifestyle Lift, etc. do very little, so expect few things from them, but generally, you should notice SOMETHING.

What should I be looking for in Before & After photos?

In before and after Photo’s you should focus on whether the person still has the same facial structure that defines them. Then look to see if the person looks like a more refreshed and youthful version of themselves.

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 is the Ribbon Lift?

The ribbon lift is a procedure similar to a thread lift but uses a different device, a collar with spikes of one side. The device is inserted into the platysma muscle and used to pull it back, a procedure which helps with neck lifts, but does nothing for jowls and cheeks. It is a good temporary procedure if done correctly.

What does a MACS facelift cost?

In general, facelift cost vary depending on location, surgeon’s skill, facility and anesthesia fees, etc. Generally speaking, the cost hovers around 15,000 to 18,000 dollars.

Why can't I smile 2 weeks post-facelift?

Damage to the buccal branches of the facial nerve is generally not a cause for major concern as cross innervation generally allows for full recovery. However, improvement should be seen after 2 weeks. Consult with the plastic surgeon or a neurologist to check for permanent damage.

Do Facial Microcurrents do the same thing as a facelift?

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

Can rosacea present a problem during a facelift?

Facelifts are generally not meant to address the skin, but rather for deeper muscle layers and tissues. Therefore, redness and pimples on surface skin should not present a problem during the procedure.

Does Acculift Work?

I remain quite distrustful of these gimmick procedures, especially when they claim to replace the need for fillers and face lifting procedures. Until scientific evidence is provided which shows that these procedures actually have a better effect, I would stick with tradition.

Do I need a deep plane facelift?

Often, when patients have ineffective surgeries done in the past, they feel the need to do more invasive procedures to achieve the results which they want. However, very often, the problem lies not in the procedure, but the surgeon. Find a good plastic surgeon with the credentials to perform the surgery which is right for you.

Does a facelift address the eyes and neck?

Facelifts generally do not include the eyes and neck and instead encompasses the reposition and tightening of facial tissue around the cheeks and the very upper neck. Necklifts and blepharoplasties (eyelid surgeries) are considered entirely separate procedures.

Is sagging around the cheeks and nose worthy of a facelift?

A saggy cheek and nasal region is usually not caused by typical aging and patients who have this symptom over the long-term may have problems with the tissue structure in the face. If this is true, facelifts are not the answer, but consultation with the plastic surgeon could provide several options for these patients.

Is Beverly Hills the only place to get quality plastic surgeons?

Though it may seem like all the best plastic surgeons are in the Beverly Hills area, there are plenty of other surgeons throughout the country who can probably do the same work for a cheaper price. Most board-certified plastic surgeons are perfectly capable, but patients must make sure to check credentials and certifications beforehand.

How can I alleviate concerns about how I'll look after my facelift?

The most important tool for a patient in finding the right plastic surgeon is to do their research. The way to find a good plastic surgeon is to look at their work (before and after photos), talk to former patients, and to evaluate them after consultations. Again, it is the patient’s face, meaning that the patient has a job in finding the right surgeon for them.

How do I find the best facelift surgeon?

Patients looking to find the best doctor to treat them should generally look for ones who are board certified in plastic surgery or facial plastic surgery. Evaluating before and after photos and evaluating if they are a good fit for you is another thing which a patient can do prior to undergoing surgery.

What differentiates a facelift from liposuction?

There remains an important difference between a facelift and a liposuction in terms of procedure. A liposuction is merely the removal of fat in the chin (submental area) and in the neck since facial fat is good for maintaining youth. A facelift, however, is much more involved and consists of removing fat above and below the platysma, tightening neck muscles, etc.

What is the Refresher Lift?

When it comes to plastic surgery, the most important thing to remember is that it must be specific for the patient’s needs. I would suggest researching the technique and deciding whether it is best for you. From the information which is available, it seems as if it has a shorter incision and preserves the hairline, but I would remain wary of these brand-name lifts.

Who do you recommend for facelifts?

Again, the decision for surgeons is generally up to you. When it comes to cost, don’t let it be your sole factor in decision-making, as plastic surgeries is usually on a “you get what you paid for” basis. Keep in mind that location, anesthesia, overhead costs, etc. all play a part, as does the skill and individual technique of the surgeon.

How long does a stem cell lift last?

There haven’t been enough studies about stem cell lifts to definitively prove they provide results as good and long lasting as a standard Fat Transfer/graft. For now we would recommend standard Fat Transfer/Grafting because Stem Cell lifts are still unpredictable.

What can I do about ptosis and lacrimal gland swelling?

It is probably best for patients dealing with these conditions to first see an ophthalmologist or even an oculoplastic surgeon to examine the lacrimal gland swelling. If ptosis surgery is needed afterwards, it can also be done.

When are surgical marks made?

Marks are usually made when the patient is upright or awake unless adjustments are called for when they are unconscious.

Are there any issues to expect post-facelift?

With sutures being used to tighten muscles in and around the face, it is normal to experience tightness especially where the incision was made. Itchiness should also be expected for a bout a year and swelling should be anticipated for up to 6 months post-op.

How long does Lifestyle Lift last?

For many of these branded techniques, it is difficult to estimate their longevity. After all, the Lifestyle Lift is not a particular type of facelift. Generally, results will last a very small amount of time: as little as one week or so before fading.

Will steroid injections cause weight gain or flare-ups for rosacea patients?

Dilute steroid solutions should not cause either.

How can I address nasolabial folding, jowling and festoons?

Though photos are usually a better tool for determining the nature of a recommended procedure, patients who are dealing with these symptoms will often require a neck and midface SMAS elevation in order to address muscle laxity in the lower jaw area and also have fat transfer to treat the nasolabial folds.

How can I treat a hematoma?

Generally, for any suspicious lumps and bumps, patients are expected to consult with their plastic surgeon post-op. They can also use their own techniques including massaging, but actual aspiration of the lump if necessary should fall to the surgeon.

What are my facial rejuvenation options as a 65 year old woman?

Generally, at the age of 65, jowling and significant fat deposits in the neck are the main problems and they can be corrected with a lower facelift under local anesthesia. Nasolabial folds can also be a problem and can be helped with the use of fat grafting and fillers. Be sure to consult with individual plastic surgeons about the best options, but these are generally the main ideas I would bring forth.

Can I have a facelift in spite of a past pulmonary embolism?

Most of the time, facelifts are done with the use of IV sedation anesthesia which carries little risk compared to general anesthesia. Patients with a pulmonary embolism in the past would probably prefer this option as breathing is entirely controlled by the patient.

What can I do about a disproportionately fat face?

Generally, patients who are too young for a facelift but demand facial contouring can achieve what they need through consultations with their plastic surgeons. Unless carefully examined, it is difficult to recommend specific treatments, but some include fat removal, tissue lifting and redraping, etc. Either way, consultation is probably the best option for these patients.

Can I have a rhinoplasty post-facelift?

If the patient is particularly ambitious, rhinoplasties can technically be done after 30 days of healing. However, to ensure the best results, it is probably best to wait for any residual swelling to go down which could take as long as 6-9 months.

What is the Laser Facelift?

Lasers are generally used for the elevation and tightening of the skin rather than the actual facelift procedure itself (which consists of repositioning the SMAS layer of the skin). This is a very new procedure which offers the benefits of less bleeding, less bruising, less swelling, and quick recovery.

How can I deal with perioral mounds?

Patients who have “mounds” when smiling usually have a problem with volume loss related to diminished subcutaneous fat. Fillers and perhaps Botox are the best lines of treatment for these conditions.

How can I address early jowling?

Patients who are in their early forties should not look for a particularly invasive procedure. Personal recommendations for correcting early signs of jowling would be procedures like the S-Lift or mini jowl lift which address the SMAS layer but not drastically.

Does the FeatherLift work?

A featherlift was a procedure used several years ago which worked similar to a thread lift. Barbed sutures were inserted under the skin to lift it up as a whole. The only problem was that, as tissue is tightened, it expands, thus defeating the purpose of the procedure in general.

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 is the longevity of Smart Lift results?

Again, due to the low invasiveness of this procedure, there is a much shorter longevity for these procedures when compared to other procedures. Often, a mini facelift can be substituted with fillers, Botox, and other skin care methods that would be less invasive and probably more effective.

Can Botox be done concurrently with a facelift?

This is probably a question needed to be asked for individual surgeons themselves. Botox being in place during a facelift should not be a problem; neither should fillers. However, in the case of fillers, have your doctor customize the surgical procedure for maximum results.

Why do I still have pulsing in my ears post-facelift?

Patients dealing with pain the ear after a long period of time may have injured the greater auricular nerve, causing it to form a neuroma (overgrowth of nerve endings). The best thing to do for patients is to consult with a neurologist.

When should I quit smoking prior to surgery?

Doctors recommend that patients quit smoking for at least 2 weeks before surgery. This is because nicotine in smoke constricts blood vessels which are needed for healing post-op. Failure to quit smoking can create devastating open wounds and the advent of dead skin

Can I lose weight pre-facelift?

It is important for young people to keep a healthy amount of fat in their face simply for the purposes of structure and support. For this reason, if weight is lost significantly, the skin may become lax due to lack of support. It is best for younger patients to wait until the weight becomes stable before addressing skin laxity, meaning that a facelift is probably not needed and can substituted with fat grafting or even with time (skin will naturally tighten).

How can I deal with a frozen eyebrow post-facelift?

Unfortunately, any nerve damage sustained over 18 months or longer is likely to be permanent. The best solution would be to have Botox placed on the other side to even out the distortions.

How can I correct facial asymmetry?

Patients dealing with asymmetry would most likely benefit from fillers or fat grafting.

Can I have a facelift at an outpatient center?

Generally, if outpatient surgery centers are located adjacent to a hospital, patients will want to look at the credentials of the outpatient center alone. Unless the outpatient center is hospital-owned, they are usually on their own, so having one that is AAAHC certified is probably the best option.

Can I resolve smile lines via facelifts?

Unfortunately, patients will not find any improvement with smile lines or nasolabial folds following a facelift. These are more likely resolved with fillers or fat grafting.

I have major swelling 2-3 weeks post-op. Is this normal?

Patients experiencing unusual swelling may be at risk for developing hematomas post-op. These growths need to be aspirated as soon as possible unless the body can naturally resolve on its own. IF these symptoms persist, it is important to consult your surgeon.

Can dissolvable sutures be used post-facelift?

The placement of sutures and the types of sutures used depend mainly on the surgeon’s preference. Generally speaking, though dissolvable sutures aid in the conspicuousness of the surgery, they are known for being absorbed too quickly before lending any support to the structure of the new face. If patients are particularly worried, they could use permanent sutures to ensure that the sutures hold long enough for the doctors to remove them if need be.

What are the recovery times for facelift, breastlift and armlifts?

All of these procedures will take as much as 2 weeks for recovery, but breast reduction tends to be longer and requires more anesthesia.

Where is scarring post-facelift?

Scarring can vary based on the experience and skill of the surgeon, so it is probably best to consult further with your surgeon or another trusted individual at the very least. However, facelifts will generally only require a scar behind the ear up to the earlobe which can be covered by the hairline for the most part.

Is it weird to have skin breakouts post-facelift?

Skin breaking out may be part of the healing process, but proper skin care may be in order. Check with a dermatologist to find your options.

Does a deep plane facelift have a longer downtime than a SMAS facelift?

Generally, because of the deeper invasiveness of the deep plane lift, the deep plane lift has a slightly greater recovery time (about a week longer than that of the SMAS Lift). However, each surgeon has different policies concerning surgery and recovery time, so it is best to consult with your doctor if you have specific questions.

How can I address rippling post-facelift?

It is unusual for patients to demonstrate ripples, especially months after a facelift. This may be caused by residual swelling, but more importantly, may be the result of underlying scar tissue. If the problem continues for about half a year, it is probably best to consult with the surgeon. Until then, patients are encouraged to massage the area.

Thoughts on Midface lift vs implants?

Facelifts are generally the option for patients who, rather than dealing with a lack of actual structure in the face (due to fat loss, etc.), are dealing with greater problems in skin laxity. This often presents itself in the form of saggy jowls as well. Patients, however, who are simply losing fat in the face due to age can be easily “cured” with the use of fillers and fat grafting.

What are these lines on my face post-facelift?

Patients dealing with lines on the face after the operation along the sides were subject to poor skin redraping. This can be resolved through massage, ultrasound, steroid injections, etc. but the condition should first be discuss with a plastic surgeon.

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.

Why do my ears feel blocked/stuffed after surgery?

The feeling of blocked ears is somewhat common as the incisions made in the ear area tend to swell. It is important for patients to check for wax, residual cotton from the surgery, or dried blood in the ears to avoid any complications in the future.

Can a facelift help with pores?

The main objective of a facelift is not to address surface skin (epidermal) issues, but rather to correct deeper layer issues and alter facial contours. Therefore, if patients are looking to correct acne scarring, pores, or other issues on the skin itself, the facelift option should be avoided and substituted with laser resurfacing or full face dermabrasion.

Can a facelift fix my neck?

The only case in which facelifts would be required to fix the neck area is if the patient demonstrates laxity in the skin, shown especially by the presence of jowls. Generally, patients who demonstrate this will often do the facelift concurrently with a neck lift for the best possible results.

Can I address my face without touching the neck?

Patients looking for a minimally invasive procedure which does little to alter the neck should look for the option of a mini facelift which has smaller incisions and is less obvious.

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.

Which facelifts have the least scarring?

Some of the least invasive facelifts include short scar or mini facelifts which, though providing less long term results than SMAS lifts, etc., have less scarring and downtime.

Can a facelift and liposuction be done concurrently?

Though it may appear to be a good and cost-effective idea to have both procedures done at the same time it is probably best for patients to avoid doing so, simply because of the risk of infection and thrombosis. However, again, it all depends on the health of the patient and their ability to recuperate after these procedures.

Can wrinkles be treated with laser resurfacing?

For superficial wrinkles on the face post-op (since facelifts actually do little to address wrinkling), laser resurfacing is definitely a good option.

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.

What do I do about residual jowling post-facelift?

It is strange for patients who have a lower facelift to still have problems with jowling, especially since this procedure is geared specifically for this problem. The most likely route, as of now, is further lifting, but keep in mind that bone structure, fat, chin shape, etc. may have played a role in creating these residual jowls.

Is a third revision rhinoplasty necessary?

Patients before considering themselves for a third revision must be sure that it is needed. Consulting with their surgeon and examining before and after photos is an ideal place to start.

What should I look for in a revision plastic surgeon?

Surgeons doing revision surgery generally should be more experienced in order to ensure a low complication rate. Make sure to examine before and after photos before deciding on a surgeon.

Are Skin Only facelifts still performed?

Skin Only facelifts, common in the 80s, are still performed. However, surgeons have discovered that the best results for a facelift often come when tissues underlying the skin are adjusted along with the skin. Otherwise, there is a chance for that characteristic windswept look of botched facelift surgeries.

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