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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

What should I do about lumps and scarring months post-op?

Patients experiencing lumps in the face may be experienced small, localized hematomas which can be easily treated with massage and ultrasound. Tightness is somewhat normal after surgery and is a sign of sensation returning to the deep SMAS layers of the skin. Finally, thick scarring can be resolved with Kenalog injections unless the surgeon feels that they are unnecessary (in which case the patient would have to wait for them to heal).

Should I get liquid lift or midface lift in my 40s?

Personally, I would recommend that patients in their 40s stick with their nonsurgicals simply because the signs of aging necessary for a facelift are usually not there at this point. Liquid lift is probably the best option right now.

How should I time my facelift surgery?

For some patients who are not quite ready for a major, invasive procedure, fillers and Botox might be good as temporary solutions. Especially for younger patients in their early forties, liposuction could also help with jowling and presents a lower cost option when compared to surgery. Perhaps consulting with your surgeon is the best option for you at this point.

Is a revision necessary if my earlobes are elongated and scarred?

A revision facelift is not often necessary in these conditions as less invasive procedures like skin redraping or local tissue rearrangement can be done far more easily.

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.

How can I deal with anxiety post-facelift?

Patients experiencing post-op anxiety can usually be helped with anti-anxiety medications or a visit to their local therapist or plastic surgeon.

Is high blood pressure an issue before a facelift?

Among other things like general wellness and a healthy diet, maintaining a healthy, constant blood pressure is perhaps one of the most important things a patient can do prior to surgery. General anesthesia is probably the best option for high blood pressure receivers of a facelift.

Why do I have ropey fullness on my neck post-facelift?

Ropey fullness on the neck tends to be the mark of fluid collection which can easily be aspirated by a surgeon. Even untreated, the symptoms will eventually begin to heal on their own. Consult your surgeon to check it out.

What is an "experienced" surgeon?

Surgeons who are experienced are not qualified simply by numbers, but by their before and after photos, their technique, etc. Research is the key for patients.

Should I avoid Arnica cream if I have allergies?

Patients who have experienced allergies to arnica cream should probably avoid it altogether during surgery, as its effects are controversial and extremely limited.

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.

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.

Why can't younger patients get facelifts?

Younger patients who are serious about having a facelift should probably have a consultation with a qualified surgeon to see if that is the only option for them. Facelifts are most commonly used for facial aging due to the drooping of midfacial tissues or for patient who have very little volume in the face. However, younger patients are more encouraged to maintain proper nutrition and have less invasive procedures like cheek implants, etc.

When do people usually start having facelifts?

For most people, the first facelift usually occurs between the ages of forty and fifty because of the loss of facial volume from age-related fat loss and by the development of lax skin again due to age. Again, however, it is the physical state of the patient, as opposed to his/her age which actually determine the need for surgery, so consulting with surgeons is probably the best first step in deciding.

Should lupus and fibromyalgia impact my facelift results?

Especially with adverse conditions like lupus and fibromyalgia, it would be wise to discuss specific instructions and concerns with your surgeon. The disease should be maintained and under control before the surgery is performed.

Why did I not have the pins and needles sensation before regaining feeling post-facelift?

It is possible for some patients to bypass the pins and needles feeling in favor of immediate return of sensation. It just depends on the extent of nerve healing which can occur, with some patients healing faster and better than others.

How can younger patients look more youthful?

In today’s society, a youthful face mainly consists of having bright well shaped eyes and a defined jawline. Patients looking to achieve these features can generally find them with chin implants, mini neck lifts, and an upper eyelid lift, but facelifts should generally be avoided (especially if the patient is younger).

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.

How will smoking impact my facelift?

Again, because of the nature of chemicals in cigarettes in adjusting the vascular nature of the blood vessels of the face, smokers have a higher risk for post-operative complications. Smoking constricts blood vessel, reducing blood flow to the skin and increasing the risk of the development of dead skin, etc. It would be well advised for patients NOT to smoke for several weeks before and after surgery.

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.

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.

How much bandaging will be used after my facelift?

Bandages aren’t typically used after a facelift, but instead the head is wrapped over the ears and under the chin. The wrap is used for 1 or 2 days.

How can I prepare for the swelling after a Facelift?

You can expect that majority of the swelling will resolve in 2 to 3 weeks, and the remainder will slowly resolve over a 3 to 4 month period. To try to lessen the amount of swelling you should avoid salty food before and after the surgery, and sleep with your head elevated to help the fluid drain. These measures may have some minimal effect on the swelling, but giving the body time is the best method.

Why do I have this feeling of migrating tightness post-facelift?

It is not unusual to feel migrating tightness post-mini facelift. Normal post-operative scars will feel their tightest at around 6-12 weeks post-op, but can be easily treated with massage and hydrocortisone cream.

What is the difference between a full facelift and a lower facelift?

A traditional facelift IS a lower facelift in that it addresses mainly the lower 1/3 of the face and takes care of issues like jowling and sagging of the neck and lower jaw. The term “lower” facelift is used simply to differentiate a facelift from a “mid” facelift which addresses the cheek area and a “brow” lift which addresses the upper third of the face.

Can I get a facelift in my teens?

Patients in their teens should not be considering a facelift, period. Consulting with a surgeon as to your options and even with your primary care doctor may be the best option.

I have a weak smile years post-facelift. What's wrong?

This may not be the answer which you wish to hear, but, after five years post-op, I see very little changing in terms of facial structure. It is possible that, although rare, you may have had minor nerve damage, but, again, it is best to consult with a facial nerve expert to be absolutely sure.

Why do I still have jowling post neck and chin lift?

Generally, after a face and neck lift, one would expect any jowling before surgery to be gone. However, it all depends on the extensiveness of the facelift and whether the deeper SMAS tissues responsible for jowling were addressed at all. Again, though, patients must remain patient even months after the procedure before they start making judgment calls.

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.

How are facelift incisions done?

Generally, when doing a facelift, the incision made occurs behind the ear and curves along the shape of the ear to the earlobe, simply for the purpose of effectively redraping the skin and hiding as best as possible any evidence that a procedure has been done.

Is puffy loose skin normal post-facelift?

Generally, as I tell my patients, the first couple of weeks following surgery are the worst in terms of appearance as the swelling and bruising are beginning to come in full force. It is probably best to wait before considering options like volume injections or laser resurfacing around the mouth.

When can I use Radiesse?

Quite often, fillers rather than facelifts are the ideal procedure for solving certain facial problems. Fillers like Radiesse or fat grafting can be used to fill depression, while facelifts can be used in concurrence to treat jowl formation.

What should I do about jowling and platysmal retraction post-facelift?

Patients experiencing jowling post-op may definitely require a facelift in order to lift the SMAS and a liposuction of the neck to improve platysmal retraction.

Is chin swelling normal after a facelift?

One month post-op, it is extremely common for patients to have swelling in and around the chin. Unless symptoms persist for more than 10-12 weeks, patients should not worry.

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.

Did my doctor do the wrong surgery?

For patients who have legitimate proof that a doctor did an incorrect surgery, it is best to first check the consent form for surgery to see if the surgery was incorrect. Legal documentation is needed before accusations are made.

How does a Lazerlift procedure work?

The Lazerlift procedure is marked by its use of a Cynosure laser-tipped cannula which is used to undermine facial tissue and achieve skin tightening. The results of this are not nearly as invasive or effective as a facelift, but nerve damage may still be a risk.

When can I color my hair post-facelift?

The best option at this point would probably be to wait several weeks post-op until all the wounds have healed before coloring the hair. This point usually occurs within three to five weeks, so consult with your surgeon about your option.

Should I address aging at 30?

Many patients reaching big birthdays will often feel the need to have major surgeries done to combat aging especially if they have been ill for several months. I would not recommend invasive surgery right now, but instead advocate a healthy lifestyle, perhaps supplemented with non-invasive procedures like facials, light laser treatment, Botox, or fillers.

How do Ultrasound Facelifts compare to Fraxel Re:Pair Laser treatments?

Ultrasound Facelifts and Fraxel Re:Pair Laser cannot give the same result as true surgical Facelift, but they can give good results for the right people. Ultrasound Facelifts deliver energy into the skin to stimulate collagen to tighten and lift areas such as the brow, neck, and chin. Fraxel Re:Pair Laser can rejuvenate the skin surface to address fine lines. Neither Ultrasound Facelifts nor Fraxel Re:Pair Laser address volume loss or reposition the underlying muscle layers that structure the face.

When will post-facelift malar bags heal?

Generally, the development of malar bags under the skin is somewhat common and can be easily alleviated by massaging the cheeks in a circular motion while elevating them upwards. It will take time for these injuries to heal, usually about 8 weeks.

Did my doctor mess up my fat transfer?

Irregularity following a fat transfer, especially one done very poorly, can be common. Patients, however, should be wary of worrying too much and should let time go by a little before making any calls.

When can I fly home post-facelift?

Typically, surgeons will recommend that a patient ideally stays for about 2 weeks before flying in order to decrease blood pressure spikes and to ensure that all stitches are removed without possible infection.

How can I handle suture contraction post-MACs Lift?

Massaging the area of contraction could help in getting rid of the dimples, but so can a procedure known as needle subcision in which a scar is created that can then be broken up with further application of the needle.

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 I get a facelift after weight loss?

Generally, patients who have suffered weight loss tend to lose essential fat in the face, causing them to believe that they need a facelift. Usually, the method of treatment is much simple, with fat grafting or fillers being used to substitute for fat lost in the face.

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.

How can I address my concerns about general anesthesia?

It is perfectly normal for patients to have concerns about general anesthesia and, if this is the case, they should consult with their plastic surgeon about it prior to surgery. However, anesthesia is very safe and patients should not be concerned unless health problems present an issue.

How soon after a facelift can I engage in oral sex?

Strenuous physical activity or any activity that may raise your blood pressure, such as oral sex, should be a avoided for 2-4 weeks after a Facelift. A raised blood pressure, such as during oral sex may worsen swelling.

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.

Can a fractional laser substitute for a mini lift?

The main purpose of a fractional laser is to help improve fine lines and texture by stimulating the collagen layer of the skin. However, the question is whether it does its job. Scientific evidence saying this has been rather shallow and it’s difficult to prove whether this actually does anything significant. I would stay away from it and stick with tradition.

What's the difference between the SMAS facelift and a deep plane facelift?

The difference in a deep plane facelift as opposed to other surgeries is that the deep plane lift cuts below the SMAS layer before lifting and repositioning the muscle layers above it (the SMAS). This provides for more long-term results, but is usually reserved for patients with GREAT skin laxity (usually in their 70s or 80s). The regular facelift, while invasive, is less so and strictly limits itself to rearranging the SMAS layer.

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 do a facelift following a parotidectomy?

I would not recommend getting a facelift following a parotidectomy simply because of the increased risk of facial nerve injury. This is because, after a superficial parotidectomy, the position of the facial nerve changes and is unknown to the surgeon.

Why do Celebrities Have Such Bad Facial Surgeries?

The simple reason for this is that celebrity surgeons simply show very little technique and are often better at public relations than actual operations. As with “normal” people, celebrities who do their research and find the best plastic surgeons often look perfectly normal.

Will the procedure for anesthesia (breathing tube) disturb dental work?

Patients concerned about displacing or fracturing existing dental work with general anesthesia should not worry too much as anesthesiologists take care for these concerns. LMA or Combitube can also help for patients with concerns.

What does a fat transfer help with?

Patients must remember that a fat transfer is not at all equivalent to a facelift. Fat transfer helps with lost facial volume and involves the addition of fat to the cheek and temple areas.

How does skin reattachment work during a facelift?

During a facelift procedure, it is not truly the skin itself which is altered, but the SMAS layer under it. The SMAS layer is tightened and reattached to the underlying tissue by the use of sutures, after which the skin is trimmed and reattached using stitches. Soon after, the body produces new collagen which causes the skin to adhere better to the underlying tissue.

Can I get surgery abroad?

America is not the only country with top-dollar plastic surgeons. However, if patients are going overseas for surgery, they should definitely do their homework on their surgeons, making sure that they are achieving the best results they can for their ideal price. Patients should also plan to stay in the country for an extended period of time in case any problems may arise (since this could be a problem, I would not advise having surgery overseas).

Can a blepharoplasty and brow lift alter the hairline?

The extent of hairline alteration during surgery honestly depends with the surgeon. Generally, incisions made in front of the hairline will not change it, but those made within the scalp (performed in conjunction with skin removal) may cause the recession of the hairline slightly.

Can I do a revision Lifestyle Lift?

Lifestyle Lift, being a branded facelift, is probably not the best option for patients wishing to undergo revision surgery. It puts patients at a higher risk of being dissatisfied and requiring more procedures short-term, and is far less advanced than many surgeries of today.

Can loose skin be corrected non-surgically?

Unfortunately, skin laxity cannot be addressed by a non-surgical method, but only through a facelift.

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.

Can I do a facelift under an oculoplastic surgeon?

Especially for larger procedures like a SMAS or deep plane facelift, it is probably best advised that the patient exclusively sees a board certified plastic surgeon. Many oculoplastic surgeons are very skilled in procedures around the eyes, however, so they remain an option for these areas.

Why do I have recurrent swelling which comes and goes post-facelift?

Swelling which arrives and then disappears 18 months after a facelift is not indicative of a typical hematoma, but is more likely the result of a parotid leak. I would recommend a full exam with the surgeon followed by the application of Botox and antisialagogues to the area.

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.

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.

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.

Can I have bone grafting done during my facelift?

It is definitely possible for patients to have bone grafting procedures done concurrently with the facelift. Yet, I would not recommend having the bone grafts taken from the face itself as altering contours of the face can do some serious damage for the facelift as a whole. I would recommend places like the elbow or the hip for better bone harvesting.

Why do I have a depression of the zygomatic arch post-facelift?

A depression in the zygomatic arch could be attributed to the atrophy of the temporalis muscle. In this situation, fillers, fat grafting, or even Sculptra treatment could all help.

Are there problems associated with a facelift?

With the Acculift procedure, small fibers are used to deliver laser energy around the jowls, neck, and mouth. It is supposed to have little downtime and other benefits, but, to be honest, all it does is remove fat and slightly tighten the skin in areas where MORE fat is needed or where a traditional facelift would be better.

When will I look "normal" after a facelift?

Generally, patients should be looking at a healing time of 2 months or so following a facelift for results to begin to normalize.

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 facelifts cause hair loss?

Facelifts generally do not cause the loss of hair. However, if a facelift is performed concurrently with another upper-face procedure like a browlift, this may have been the cause for hair loss. General anesthesia used during surgery has also been known to cause hair loss.

How can I prepare for facelift surgery?

As soon as the date is set for surgery, it is important for patients to arrange for a ride home from surgery and also to clear their schedule for up to 2 weeks post-op. Smokers should quit several weeks before and continue not to smoke for several weeks after surgery and, unless approved by the doctor, any medications and herbal medicines should be avoided.

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Dr. Ramtin Kassir © 2018

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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.