Facelift

Tired of looking older than you feel? Find out how to turn back the clock a decade or more with a signature Facelift by Dr. Kassir.

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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

If I'm dealing with skin laxity post-facelift, is a revision necessary?

Patients who are still dealing with skin laxity post-op especially after a period of many weeks are usually in need of a revision facelift surgery. Excess fluid present in the neck could also be a problem and could be easily drained and the skin could be redraped behind the ears.

Why do I have numbness and tingling after a deep plane lift?

Generally, numbness and tingling is caused by the disruption of nerves and changes in nerve activity following the procedure. It usually takes up to 3-6 months for the face to feel normal again

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).

What is the difference between the SMAS vs Deep Tissue Suture Lift?

Generally, the SMAS Lift which manipulates and repositions the inner contours of the face will yield a much more long-lasting result than the deep tissue suture lift which generally just elevates the tissue without doing much repositioning.

What is the cost of a ribbon lift?

Again, over the years, the ribbon facelift has gone down in popularity simply based on the overwhelmingly high cost to benefit ratio. I personally would not recommend this procedure, but, if dead set on this particular technique, average costs hover $3500 to $5,000.

Can I get Botox done post-facelift?

Botox can usually be done concurrently with facelifts as long as they do not include the brow or forehead area. However, if said areas are affected, it is best to wait 2-4 weeks after browlift surgery to consider Botox.

What are these sensations and aching that I am having Years after a facelift?

These sensations and aches are likely an uncommon complication of any type of surgery where skin is cut, and is the result of the way you body healed and scarred over the skin nerves that were cut. You should consult your surgeon since the possible use of permanent sutures may be another cause.

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

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

What is the Swelling and Numbness after a facelift like?

Swelling and numbness are normal and expected post-procedure but they vary with the type of facelift procedure. Numbness may last for up to 1 year and will steadily dissipates month by month. Swelling may be extensive for the first three days but will steadily begins to disappear over a several week period. Some Tingling sensations are normal for up to 6 months. In the case of excessive swelling some oral steroids may help reduce swelling. Dr. Kassir avoids using drains or heavy bandages meaning that most patients tend to have minimal swelling,

Any recommendations for facelift surgeons in South Florida?

The ASPS website has a physician locator feature that will provide a list of qualified surgeons. It is probably best to consult with several surgeons in order to find the one that best meets your needs.

Do laser treatments cause neck issues?

Laser treatments, unfortunately, tend to aggravate neck folding and are often better substituted with a complete revision neck lift consisting of redraping the skin, a platysmaplasty through an incision under the chin and other steps. Consulting with a plastic surgeon may be the best way to find other options as well.

What is a dissolvable implant?

The “dissolvable” implant which surgeons refer to during this procedure is probably an endotine anchor which holds the results of the facelift together until the tissues have healed.

Why is my facial surface so uneven post-MACS facelift?

Uneven surface features following a MACS Lift can be attributed to an attached pursestring suture, tethered tissue underneath the skin, etc. Yet, many of these issues can be corrected with revision surgery and the same scars can be reopened.

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 a facelift be done at age 24?

Again, young patients are not recommended to use a facelift as a first line of treatment. Often, patients who demonstrate pre-mature aging have genetic deficiencies in facial structure and are probably in more need of good fillers/fat grafting techniques. Surgery is definitely not a good option.

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.

Is it common to have spotty bleeding post-facelift?

Weeks after surgery, it is not unusual to see post-operative bleeding on certain scars. Patients, if this occurs, should take care when cleaning the area and make sure to consult with their surgeon (or even send him/her photos) about the bleeding just to make sure everything is fine.

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.

Are there any procedures with minimal scarring?

The amount of scarring which a patient will undergo depends on the genetics of the individual, the surgeon’s placement of incisions and his/her skill, and the tension placed on the skin. There is no definite procedure which provides the least scarring, yet smaller, less invasive procedures (in accordance with popular belief) often have less scarring than other more invasive ones (deep plane, SMAS, etc.).

Why do my nasolabial folds look bigger post-Endotine lift?

Unfortunately, patients looking to correct nasolabial folds and other problems in this area, the endotine lift is probably not the best option. Revision surgery can certainly be done, but only by a board-certified plastic surgeon (if the patient wants the best results).

Are there non-surgical facelifts?

Truly, there is no such thing as a non-surgical facelift. Non-surgical options exist for facial rejuvenation techniques like injectable fillers, fat grafting, etc, but these are typically reserved for younger patients who are just beginning to show the signs of facial aging.

Can loose skin be corrected non-surgically?

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

How should I choose a surgeon and procedure?

Without photographic evidence, it is difficult for doctors with no connection to a patient to determine their need for a facelift, especially with the many variations of the procedure. What patients want to look for is a surgeon who is fully capable and has a good reputation and consult with them as to the best possible options.

Why am I bleeding several months post-facelift?

Generally, bleeding after a facelift is caused by tension of the wound, a minor infection, or suture problems all of which usually resolve themselves quickly. However, it is important to discuss these results with your surgeon to rule out the possibility of a hematoma.

Why is my forehead bulging post-facelift?

A bulging forehead muscle post-op may be the result of an internal fixation device which slipped, but also could be an endotine device placed during an upper blepharoplasty which will eventually dissolve over time.

I have platysmal banding post-facelift. What can I do?

Platysmal bands, usually the results of aging, shortening, and fibrosing of the neck muscles, can usually only be treated with revision platysmaplasty.

Will more facial work mean more swelling?

Patients who have major facial work done, meaning several major procedures done concurrently, should expect a great deal of downtime AND a longer period of swelling and bruising as they are dealing with internal and external healing. Optimal results may be in store if the patient is willing to wait up to several months.

What distinguishes a mini facelift vs a modified facelift?

With all the names out there for various facelifts, it is difficult to understand what is what at some points. A minifacelift generally will remove excessive skin and pull the remaining skin to the side for a more youthful look, whereas a modified facelift may orient itself towards the neck more for greater and more long-lasting results.

Will my sideburns be permanently affected by my procedure?

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

Should I be worried about having orbital rim implants done with a facelift?

Following the use of midface lift and orbital facelifts, patients may need to remain wary of Ectropions, which is the pulling down of the lower eyelid following the implantation of these devices. It should be treated as soon as possible to avoid any further damage to the eyes.

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.

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.

Does an Endotine facelift cause nerve damage?

If done properly, the long-lasting (10 year) Endotine procedure should not produce any facial nerve damage.

Are drains always used post-facelift?

Drains in general are often put in place to aid with bruising, but are not always used and not always required by surgeons.

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.

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.

How can I improve my eye and cheek area?

Patients looking to improve the periorbital and cheek area should look into the cheek augmentation option via fat grafting. Jowling can also be fixed temporarily with chin implantations.

How effective is a Ultrasound facelift?

Ultrasound facelifts send energy through the skin to stimulate cells to produce collagen. This adds some amount of volume to the skin and tightens. Ultrasound facelifts such as Ultherapy are not as effective as traditional Facelift. With multiple sessions Ultrasound facelifts can yield some decent results in areas such as the brow, neck, and chin.

Why are there jowls and double chins post-facelift?

For patients who have jowls remaining after a facelift, it is probably best to realize that the deeper layers of the face and neck (SMAS, etc.) were left relatively unaffected causing the development and the remaining of saggy jowls. Microliposuction or fractional resurfacing could be used to treat these symptoms.

How can I determine if a clinic is up to standard for a facelift?

Patients should check if offices have some sort of safety standards, preferably AAAHC or JCAHC (or even Medicare facilities) which hold surgeons, RNs, etc. responsible. Patients can also avoid general anesthesia if they are especially anxious.

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.

Should I have fillers before or after a lower Facelift?

As we age we first lose volume in the face, and then the skin starts to become lax. If you are at the stage where you have loose skin in the form of jowls, bags and neck folds, then you should be thinking about having a facelift. Facelifts address laxity, and fillers address volume loss. We address both problems simultaneously by doing some sort of volume replacement (Fat Transfer, Restylane, Perlane, Radiesse) before, during, or after a facelift.

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.

How can I restore volume to my face post-facelift?

Generally, shadowy areas and depressions in the face can usually be corrected with fat or filler injections and other volumizing treatments.

How can I address nasolabial folding?

For nasolabial fold problems, probably the best procedure to perform is the injection of fillers performed in conjunction with a mild pre-auricular facelift OR, if the patient is up to it, a cheek lift and a midface lift.

What is the cost of a facelift vs a Lifestyle Lift?

In plastic surgery, it is probably the best idea NOT to let price be the sole guide for going through with certain surgeries and to remember that you often get what you pay for. The Lifestyle Lift is generally a modified version of the S-Lift which offers very little benefits for its rather high cost. A facelift, on the other hand, costing from anywhere between $5,000 to $25,000, is a procedure proven to yield significant results and is the one I would advocate to many of my patients (depending on need, of course).

What are these lumps on my neck post-facelift?

The most likely reason for the existence of lumps post-operation is usually residual sutures which hold the platysma and other muscles in place or minor collections of blood.

Why do I have bruising 6 months post-op?

Bruising in the face 6 months post-op is somewhat unusual and is something which should be consulted with your doctor ASAP. Time may be needed for healing, but problems could lie with pigmentation issues.

My lips aren't working well after a midface lift. Why?

Generally, any procedures done in the middle part of the face involve work around the infra-orbital nerve. Usually, as this nerve is numbed, its ability to move certain parts of the face is hampered, but this should not be a major concern as long as the patient can process sensory information from the lips.

Can buccal fat pad suspension help with jowling?

The buccal fat pad is located in an area superior to the fat around the jowls and thus will have very little impact on jowling if suspended. The true method to treating jowls consists of an SMAS Lift possibly combined with fat resection.

Did my bilateral swelling post- op come from the facelift?

Patients when trying to diagnose glandular swelling post-op must try to make sure that it is not in fact swelling from the facelift procedure itself. During a facelift, it is unlikely for the parotid gland to be disturbed in any way.

Is post-facelift mouth movement difficulty normal?

Patients who are weak in the lips and mouth post-surgery may have experienced damage to the buccal branches of the facial nerve caused by dissection during Mid facelift surgery. Recovery is generally possible, however, but a professional evaluation by a neurologist may be needed to determine the extent of damage.

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.

Why am I having difficulties post-Acculift?

Patients having difficulty with their face post-Acculift may be experiencing difficulties with the injectables and fillers used during the procedure. Consult with the surgeon to find what problems you are having.

What is this swollen, hard mass I'm feeling?

Patients after having a face or neck lift may have to deal with fluid collections near the incision sites which have to be drained with aspirations. If salivary output is a concern (indication of parotid gland problems), Botox or antisialogogues may be needed.

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

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

Is it normal for jowling to return post-SMAS facelift?

Generally, for such invasive procedures, it may be too early to make a truly accurate call as to the effectiveness of the surgery. For now, try looking at before and after photos, trying to maintain clear, rational expectations for yourself. However, SMAS lifts specifically target the jowls, meaning that you may need revision surgery.

What is the Segmental Stepwise facelift?

I would remain wary of such “gimmick” procedures which promise much but actually provide little.

Can Sculptra be done post-facelift?

For patients willing to plump their cheeks and rid themselves of tear troughs, a Sculptra procedure can be done post-surgery once the swelling has disappeared (6 months or so post-procedure). This is in order for the patient to have more symmetry in the face prior to Sculptra procedure.

What are these ridges on my cheeks several months post-facelift?

Several months post-op, it is unusual to have swelling around the incision site. Such symptoms could be the mark of an edema or possible fluid, but may be an underpulled skin flap. Again, a more face-to-face exam is probably necessary.

How can pixie ears be corrected post-facelift?

Generally, pixie ears can be easily corrected by elevating the remaining lobe and closing off the scar area.

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 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.

Is the neck area cut during a facelift?

Generally, it is the neck lift procedure which relies on the incision around the neck to tighten and remove excess skin in the area. Doctors may cut there during a facelift as well if they deem it necessary.

Are lumps common post-facelift?

For most procedures, it is extremely common to have lumps several weeks after surgeries which are mainly composed of blood collections under the skin. However, if they remain for a long time after surgery, they may develop into hematomas (blood clots) and will require frequent massage for healing.

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.

Can I travel for a facelift?

If patients are more comfortable traveling for surgery, this can be done. However, they should arrange for a ride and a stay at a nearby hotel post-surgery.

Is asymmetrical tightness post-facelift normal?

It is normal for patients to feel tightness more sharply on one side of the face than the other, yet massage and time usually helps even things out.

Is there a risk of having nylon sutures post-facelift?

Nylon sutures which are left in post-procedure are generally not toxic and do little internal harm. The problem is that they tend to work themselves out of the skin, meaning that they must be removed when they are near the skin.

Is blinking difficult after a facelift?

It shouldn’t be. Patients having trouble with the eyelids or lips following surgery may have sustained temporary damage to the facial nerve. It is important that, for the time being, the patient makes a sustained effort to keep the eye lubricated and consult with a specialized neurologist in order to pinpoint the extent of possible nerve damage.

How is swelling after a deep plane facelift?

Particularly for the more invasive facelifts, swelling and dry skin weeks after surgery is to be expected as skin, when swelling occurs, become less pliable and more rigid. Certain creams like Acquaphor may help but discuss their options with your surgeon.

Do younger patients need a facelift to combat vigorous rubbing of the face?

Even for patients who have a bad habit of rubbing their face, facelift is probably not needed. The best options for these patients would be to stop rubbing the face vigorously and maintain a good system of skin care protection.

How can I choose between a Mini Facelift and Full Facelift?

A Mini facelift is for a patient who have minimal jowling and skin laxity. A full facelift such as the SMAS facelift is for patients with more significant jowls and skin laxity. Mini Facelift patients tend have younger faces than full facelift patients

Will staple removal combat tightness in the skin?

Generally, tightness in the face is more related to returning nerve sensation and tension on the skin post-op. Therefore, removing staples would probably do very little in terms of alleviating tightness in the face.

Can I fix my earlobes post-facelift?

If patient find their post-op earlobe shape unsatisfactory, it can easily be repaired under local anesthesia. However, it should be done after the facelift has healed when the skin and supporting tissues are more fixed in place.

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.

Can a facelift address asymmetrical faces?

Again, I would not recommend opting for a facelift surgery at your age even with the symptoms you are describe (marionette lines, etc.). For people with disproportionate faces, the problem often lies in the underlying fat structure of the face for which a facelift and a liposuction can do greater damage. I would consult with your plastic surgeon about your individual options.

Any good tips for patients undergoing facelifts?

The best way to avoid complications during and post-surgery is by making sure that all questions are answered. Be frank and open with your surgeon and ask anything which could be troubling. Also, quitting smoking and following other orders by your surgeon is also important.

What is the Laser Scalpel procedure?

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.

Can a facelift treat under-eye hollowness?

Unfortunately, under eye hollowness is not one of the many symptoms which a facelift treats. Patients looking to treat this symptom should look a route centered on blepharoplasty with fat transfer (the fat usually is harvested from the thigh). Fillers may also work in this case, but usually fat transfer is the best option.

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.

What should I do about loose skin following a lower facelift?

Patients with loose skin following a lower facelift would probably best be comforted by a platysmaplasty performed under local anesthesia.

What are less expensive options than a facelift?

Facelifts come in a variety of forms depending on the desire for invasiveness and results on the part of the patient. Generally, however, younger patients are not recommended to get a facelift and should instead rely on other, non-surgical methods like fractional laser resurfacing, fillers, and Botox to aid in the youthful rejuvenation of their face.

Why do I have uneven cheeks after my facelift?

Uneven checks may be the result of the procedure itself or from the effectiveness of the fat grafting. Please consult your surgeon. If your uneven cheeks become apparent shortly after surgery it is likely due to postoperative swelling or scarring. If the uneven cheeks begin later down the road it is likely due to failed fat grafting, which would require additional fat transfers.

When can I get a second opinion on my facelift?

Patients should probably wait for a minimum of six months post-op before having a second opinion on their facelift simply because the skin needs time to heal and re-establish blood supply. Unless there are major problems (e.g. infection, major pain, etc.), this is probably the ideal time frame.

Why are my facelift results so tight?

Patients are expected to feel a great deal of tightness post-op and swelling combined with blood clots are perfectly normal (they also exacerbate the tightness as well). It is probably best, if patients are worried about tightness, to wait for time to improve these conditions.

Why is my healing post-MACs facelift asymmetrical?

It is normal, in a facelift, to experience asymmetrical healing. This is usually caused by ingrown hair or sutures and should not be that great of a concern. Besides, one month after surgery is probably the worst that a patient will ever look post-surgery, so hang in there and be patient.

What is the minimum amount of experience necessary for a proper facelift?

It is important for patients to seek out an adequate surgeon with plenty of experience in facial surgery and check out his/her before-and-after work. If I had to put it into numbers, which can be misleading (by the way), I would recommend a surgeon who is accustomed to doing around 1-2 facelifts a week for about 10+ years.

Why will my plastic surgeon not answer my questions?

This is unusual. The point of plastic surgery is, ultimately, patient satisfaction. However, if the patient has questions, it is his/her duty as the receiver of medical care to address them with the plastic surgeon without embarrassment. It is our job as doctors to provide for every need, within reason, for the patient during surgery.

What is the difference between a Deep Plane Facelift and a SMAS Lift?

The two procedures start out the same by working on the SMAS layer (superficial musculoaponeurotic system), but the Deep Plane Facelift goes even deeper than that. The Deep Plane Facelift leads to longer lasting results and works more effectively on the midface.

Can a 54 Year Old Get a Facelift?

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

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 is the best age to do a Facelift?

There isn’t really any best age to do a facelift, but it is recommended that the earliest a patient should have a facelift is early 40’s. After age 40 jowls and neck sagging start to become problem, at which point only a Facelift can give effective long lasting results.

How is tumescent fluid used during a facelift?

Tumescent fluid is a combination of local numbing medicine (lidocaine,etc.) coupled with adrenaline (epinephrine) used in order to constrict blood vessels and reduce bleeding. Generally, it is not used as the sole source of anesthesia but is used in conjunction with sedation or other forms of local anesthesia.

What is the burning sensation I feel post-facelift?

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

What can I do about my face in my 30s?

For patients in their early 30s, doctors will tend to recommend lesser, non-invasive routines than a facelift. Such solutions include implants particularly for the jaw areas (e.g. chin-jowl implant) which helps stretch the jaw and reduce jowling as well as submental liposuction to allow for a decrease in neck fat.

Can a facelift treat midface sagging?

Generally, midface sagging is better resolved with filler treatment as opposed to a facelift simply because it is usually a problem of volume loss rather than skin laxity.

Is there an issue with bald patients having a facelift?

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

How do I treat my parotid fistula post-facelift?

The best treatment for this would probably be the use of a Scopalamine patch and having a patient keep a very bland diet until saliva output decreases. Again, however, this problem is usually very temporary and the patient should remain calm.

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

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

How can I address my lower cheek fat loss?

Lower cheek fat loss is probably best addressed without the use of invasive procedures especially if recovery time is a concern. Fat grafting could be an option, but again there is the possibility of major downtime and more procedures needed to be done in the future. Probably the best option would be to fill the cheeks with Perlane or other fillers to address volume problems.

Is a facelift covered by insurance?

Unfortunately, as the facelift is a cosmetic procedure, it is very unlikely that it will be paid for by the insurance company.

Any inexpensive, but good, surgeons you would recommend?

In the world of plastic surgery, it is important to remember that price is relative. You can probably find a surgeon that will do a great job that fits your budget. It all depends on what you think is inexpensive. However, the patient should remember that often, you get what you paid for, so it is important NOT to let price be a guiding factor.

What is the cost of a rhinoplasty?

The costs of a rhinoplasty is driven by three main factors: operating room time, the surgeon’s individual fee for the operation, and the anaesthesia/individual equipment used. First time rhinoplasties will typically hover around $6,000-$7,000, while revisions may be several thousand higher. However, financing options will probably exist in your surgeon’s office that will make the surgery more affordable.

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

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

How can I deal with post-facelift fat atrophy?

Patients dealing with post-op fat atrophy and dermal thinning should probably look to fat transfer as the most ideal option.

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.

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.

How can loose skin around the mouth be dealt with?

Loose skin around the mouth area, especially for younger patients, is usually best addressed with the use of fillers or fat grafting.

What arrangement need to be made If I am from out of state?

Arrangement will have to be made for you to stay in a hotel and have transportation to come into the office for a post op visit. This will require at least a one week stay, for your to get through the most intensive part of the recovery phase..

Can facelifts give me a more defined jawline?

Patients dealing with jowling early on may want to consider a facelift as a way of tightening the SMAS layer and removing excess skin. Thermage treatments may also help in defining the jawline more.

Can fillers be done in conjunction with a facelift?

Volume augmentation with fat grafts can definitely be performed at the same time as a facelift to restore the volume that the face has lost.

Does an acupuncture lift work?

Like many other non-traditional procedures, it is doubtful whether the acupuncture face lift actually does its job in terms of promoting a more youthful appearance. I would advocate avoiding new-fangled therapies and sticking with tradition.

Is tightness associated with nerve damage?

Generally, tightness around the ears several months post-op should not worry patients as it is not associated with permanent nerve damage but rather with inflammation associated with healing. Here, nerves are just beginning to recuperate after the trauma of surgery but may take a while to adjust themselves.

Is facial hair growth impaired post-facelift?

Normally, surgeons will ask that men shave as much as possible before surgery. Generally, as hair growth returns, beard growth should remain relatively normal.

Are neck bands post-facelift normal?

The presence of neck bands following a particularly invasive facial surgery is generally not good and probably indicates a neck placation or a platysmal band which was not treated fully. Revision surgery may be needed, but, until then, vigorous massage and warm packs can also be utilized as methods of treatment.

Can a facelift correct asymmetrical eyes?

Asymmetry in the eyes can generally be corrected not by a plastic surgeon, but by a maxillofacial surgeon who is more specialized in these issues.

What are my facial rejuvenation options at age 37?

Various options exist depending on what areas need to be addressed. Mini facelifts address the mouth, lower cheek, and the jowl area, whereas soft tissue fillers are more used for the cheeks and nasal labial folds.

How will smoking affect my Facelift?

Anyone who is actively smoking a few weeks before their Facelift or smokes with several month of their Facelift, increases their risk for permanent scarring and noticeably dead skin. Smokers should quit 1 month before undergoing a Facelift. The chemicals in smoke alter the blood vessels of the face (and the rest of the body), and result in constriction.

Am I ready for a facelift in my 40s?

Generally, younger patients should look for more skin-tightening procedures rather than facial contouring ones. I would recommend Ulthera therapy or having minor procedures like fillers or even a blepharoplasty as a way to reduce a tired look.

What should I consider when choosing to undergo a facelift?

Generally, the best way to determine where to undergo a facelift is to evaluate the surgeon’s experience, training, and their before and after photos. Patients should choose the doctor who they are most comfortable with.

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.

I have nerve damage on my upper lip more than a year post-op. Is it permanent?

If numbness and other evidence of nerve damage is present 15 months post-op, it is unfortunately indicative of permanent damage to the buccal branch of the facial nerve. Nothing much can be done, sadly, at this point.

How long do PSP Facelift and MACS facelifts last?

The effects of these surgeries can last up to 10 years. As with any facelift the results don’t last indefinitely because skin continues to sag, and muscle continues to get weaker. Exactly how much sagging occurs depends upon your genetics and facial structure.

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.

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