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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

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

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

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

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

What 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.

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 defines an experienced facelift surgeon?

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

Is jowling normal post-op?

Patients dealing with saggy jowls post-op are probably best inclined to have a revision, double lift procedure especially if they have severe skin laxity or have wide, heavy faces (usually the case with males). A second, revision surgery will help to alleviate many of the symptoms of aging characteristic found after the first lift.

Can I get a facelift at a residency program?

Granted, experience may not be top-notch at many residency programs. However, one must remember that even the greatest surgeons started off as residents and fellows and that many of these young doctors-in-training are more capable than people give them credit for. Even so, I would make sure that the surgery is monitored.

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.

Can Fraxel treatment damage facelift results?

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

Is 76 too old for an Acculift?

To be honest, if a patient is serious about a facelift procedure especially at the age of 76, it is probably best to go for the more long-lasting, more invasive procedures. The Acculift procedure does very little actually tightening the skin and has been shown to reduce volume and fat, making it almost useless for MANY patients.

Why do I still have tightness several months post-facelift?

Generally, tightness can be seen as a good sign, indicating that nerve activity in formerly numb areas is beginning to recover. It is usually caused by the removal of skin during surgery but also by the contraction of scarring, all of which are good signs.

What is the downtime for a mini facelift?

Usually, a mini face lift encompasses about 7-10 days (ideally 2 weeks if possible).

How soon after a Facelift do the sutures come out?

We usually take the sutures out about 1 week after the Facelift procedure.

Opinions on Acculift vs Fillers?

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.

Why do I still have swelling/sagging weeks post-facelift?

It is unusual for swelling to be present after six weeks and it may be caused by a slight clotting of the blood, usually associated with bruising. Jowling may also be caused by swelling that could subside.

What's the risk of scarring post-facelift?

Generally, scars tend to heal quite nicely across most demographics and age groups, yet younger patients tend to scar more noticeably than older patients (better inflammatory responses, etc.). Again, genetics also plays a huge role in determining the outcome of scarring as does racial demographics in some cases (African-Americans, for example, tend to develop very noticeable pink scars).

How can I treat heavy brows and nasolabial folding post-facelift?

Low brows can generally be treated with neuromodulators like Botox and nasolabial folds with fillers like Juvederm. Yet, partial MACS Lift surgery could also be an option. Consult with your plastic surgeon about your options.

What is the maximum number of facelifts I can undergo?

Technically a patient can undergo as many facelifts as they want until they are happy, however at some point one more facelift will throw off the natural contours of the face, making it a “bad” facelift. This point differs based on genetics and age.

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.

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.

How can I deal with transition lines post-facelift?

Transition lines can often be dealt with quite effectively with a variety of options including surgical revision (major or minor), Juvederm fillers, or subcision of scar lines (in order to smooth out the bands by relieving adherence to the deeper tissues).

I think my doctor made a mistake during my facelift. What can I do?

Generally, patients following facelifts will have certain areas of concern like scars and nerve weakness. These issues tend to resolve themselves over time, but patients must remain calm and remember that the healing process is gradual.

What is the Recovery like after a facelift?

The healing time varies for each patient, but typically you will be able to resume most normal daily activities by the 2 week mark. Dr. Kassir usually removes any sutures at day 7, and some patients are able to resume exercise by day 10. You will be ready to show off your rejuvenated face at public events (weddings, reunions, birthdays, etc) by 2-3 weeks.

I have a lot of issues with my jaw post-facelift. Why?

Jaw problems, especially those that are not present immediately after surgery, are probably unrelated to the results of the operation itself. It is probably best for patients dealing with these problems to be seen by an ENT and possibly even have an MRI done to check for problems.

My lower Face is droopy after a Facelift?

Contact your surgeon immediately. It is not common for the Facial nerve to be damaged during the modern facelift, but if it is cut it needs to be addressed surgically as quickly as possible. The more likely scenario that causes a droopy face is that the nerve is stretched or swelling around it is pinching it, which may necessitate steroids to calm the area down.

Why do people go with vertical face lifts?

Most facelifts today are conducted in a vertical manner in order to enhance the “natural” look of the patient and avoid the windswept look of past surgeries gone wrong. Some surgeries like the MACS Lift or the SMAS are much more vertical, but the patient should discuss options with their doctor.

What can be done about loose facial skin for younger patients?

For younger patients, I would recommend having deep layer fat compartment augmentation simply as a method of restoring structure and weight to the face, mainly because skin laxity is usually not a problem for people in their 20s and 30s. If skin laxity is a problem, however, further facelift options may be needed.

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

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

How can I treat seroma scars post-facelift?

Seroma scars can be treated with cortisone injections, but may need to be properly aspirated to avoid any long-term damage. It is probably best to consult with the surgeon and avoid making hasty decisions.

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.

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.

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 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.

What can I do if I have allergies to lidocaine?

Generally, for patients who have allergies to lidocaine, the best option would be to switch from local to general anesthesia. This offers the additional benefit of better results without the risk of allergic reactions.

How can I avoid facelift mishaps?

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

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.

How can I correct my jowls post-facelift?

Again, patients who have jowls post-facelift should definitely reconsider their choice of surgeon, especially because the whole purpose of a facelift largely is to improve the appearance of jowls. Consulting 2 or 3 other surgeons and waiting at least 6 months is probably the best option for such patients.

What is LazerLift?

Again, laser treatments are usually brought in to tighten skin not actually adjust the skin in a great way. I would remain wary of such “gimmick” procedures.

How can I deal with lateral sweeps post-facelift?

Patients dealing with lateral sweeps across their face should definitely wait for time to hopefully heal things. It is probably not the best option to select fillers and patients should instead look for other methods like massage which do not interfere with lift.

Can spacer grafts be performed during a midface lift?

For facelift patients who happen to have severe lower eyelid retraction, it is often necessary to perform a spacer graft procedure in concurrence with the facelift surgery.

What is better: A Deep Plane Facelift or a Suture Suspension?

To be honest, there is not one set procedure which offers the best results; preferable procedures vary from patient to patient. Only by getting to know your surgeon and having him/her examine you thoroughly will give him/her the best idea of how to approach the surgery.

How effective is an endoscopic lift?

Endscopic facelifts are a minimally invasive procedure and the results generally show this. It has a very limited effect on the neck and jowl region, but allows patients to have a lower risk of potential nerve damage and is very effective in dealing with minor facial deformities such as cheek sagging. It cannot, however, be used to perform neck lifts or major operations which would normally require a facelift procedure.

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.

Are facelifts harder in thinner patients?

Ironically, healthy patients present problems in surgery due to their lack of major facial issues. In addressing the problems of these people, the best approach is to address the problems of volume loss (fillers, etc.) , skin laxity (facelifts), and change in facial shape. I would recommend a more holistic approach in addressing these problems, meaning a consultation is needed.

What does a Midface Lift address?

The Midface lift is a good procedure designed to elevate the midface triangle/cheekbone area and the lateral brow area. This will help combat skin laxity around this area.

Is it okay to have a full body massage post-facelift?

Contrary to popular belief, having a full body massage is not only OK after surgery, but is probably encouraged. A full body massage can be easily done 4-6 weeks post-op to help dealing with swelling and other lingering problems.

Can I have buccal fat removal in my 20s?

Generally, patients who are younger will not require major procedures like buccal fat removal or facelifts and should instead, if serious about having a procedure done, consult with their surgeon about more minor procedures.

Can I have a facelift after adding fillers?

Generally, having a facelift is not a problem after fillers are added so long as it is placed in a convenient position which will not interfere with the procedure.

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.

Are cysts prior to a MACS lift a problem?

Generally, the presence of cysts prior to surgery is problematic in that it could increase the risk of post-op infection. However, if found early, cysts can be easily removed or avoided during surgery.

What are the surgeon's incision techniques for facelifts?

The reason why surgeon use different incision techniques mainly boils down to training and experience. The best surgeons, as implied, will attempt to create the shortest scars possible while being able to manipulate the skin and deeper tissues.

What do I do about fat dissipation post-facelift?

Patients who undergo skin depression and hollow cheeks may need to undergo facial surgery if said symptoms last for several weeks or months. However, such conditions can also be alleviated by fat or filler injections or the release of a possible suture. Discuss options with your surgeon.

How can I address post-op hyperpigmentation and residual fat?

Patients dealing with post-op fat under the chin may be dealing with excess fat (easily reduced with lipocontouring techniques) or residual scar tissue (could be treated with cortisone or other steroid injections). Hyperpigmentation can be addressed with laser resurfacing techniques.

What does nicotine do during a facelift?

Doctors will recommend that a patient quit smoking prior to and after the surgery because nicotine causes the constriction of blood vessels which can result in scarring and dead skin cells.

Is there any merit to the Face Bra or Face Lift Compression Garment?

There are many so-called “miracle” products on the market right now which claim to be able to substitute for facelifts and other surgical procedures. However, again, I would remain wary of these devices and would stick with traditional methods that have been proven to work.

Why do I keep hearing snapping noises post-facelift?

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

Why is my face partially paralyzed post-facelift?

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

How can I correct facial asymmetry?

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

Do I need a revision facelift if I see asymmetry post-op?

Generally, what patients see as asymmetry is usually not, meaning that full examination of a patient is needed to determine if treatment is needed (usually by a Board Certified Plastic Surgeon). Waiting 9 to 12 months before considering surgery is probably best. In the meantime, I would consider volume replacement with fillers or fat grafting.

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.

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.

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 can I treat my asymmetric mouth?

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

Can deep plane facelifts fix the cheek area?

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

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.

Why do I look windswept a week post-facelift?

Though patients worry about having an obvious, windswept look after surgery, seven days is WAY too early to call the results of the procedure. Again, it is probably better for patients experiencing anxieties around this time to wait until results begin to improve.

Why are my internal sutures escaping?

Internal stitches should generally not escape from a post-surgery scar, but such a thing is possible with the presence of a suture granuloma. This occurs when the suture does not dissolve properly and the body has an inflammatory response to it, causing the suture to make its way to the surface and create minimal training. Consult with your plastic surgeon to avoid any infections and perhaps suggest steroid injections as a possible line of treatment.

I'm dissatisfied with my facelift. What can I do?

After the operation, it is important for patients to give themselves times to heal. Swelling and bruising will be rampant for the first couple of weeks and the patient should expect to look worse before things begin improving. If any concerns are present, consulting with their plastic surgeon could help, but is usually unnecessary.

Can jowling occur in younger patients?

Younger patients generally do not have a problem with excessive jowling, but can take good skin care regimens and maintain a healthy lifestyle in order to keep themselves looking young.

Is tingling cheeks and jowling permanent post-facelift?

For many patients, tingling in the cheeks post-op is a very common thing. As nerves reattach themselves to the skin, tingling, burning, and sharp pain sensations may happen, but do not last for a great deal of time. Jowling, however, could be a potential problem, but is usually caused by swelling and should not be a concern until 6 months post-op.

Why do young people not need facelifts?

Generally, facelifts are reserved for patients who have problems with skin laxity, not with volume loss. Rarely does a young person have premature signs of aging such as jowling and neck laxity in which it would be appropriate to offer the patient a face and neck lift.

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.

What is the Catio Lift?

The Catio Lift is a relatively new procedure and there haven’t been any studies confirming its effectiveness. Therefore, it is probably best for patients, especially younger ones, to look for skin care options and ultherapy procedures for better results.

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

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

I have bulging and itching of the eyeball post-facelift. Is this a problem?

Problems with the eyelid post-op can be serious and usually call for additional consultations with the surgeon. Itching in the eyes is normal, but bulging of the eyeball can be related to internal bleeding or excessive scar formation.

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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.