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.
I don’t think I have ever used the word ABSOLUTELY DELIGHTFUL to describe the first encounter with any doctor in my life but that is exactly how I would describe the first time I met Dr.Kassir. He is energizing, confident, encouraging, personable and completely present. He couldn’t have been a better listener or more enthusiastic in discussing the changes I wanted to make to my early aging face. As he explained the minor, non-invasive procedures he could do to make MAJOR improvements, I found myself feeling hopeful that I could once again look like I did 10 years ago.
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:
Are you a good Facelift surgery candidate?
The best candidates for facelift surgery are:
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.
Using a microcurrent on the facial structure involves sending a gentle electric stimulation to trigger a skin enhancement reaction from the body’s natural cells. This current mirrors the body’s current, making it extremely imperceptible at the gross level. Research shows that, after twenty days of treatment with microcurrent technology, collagen production increases by about 14%, elastin by 48%, and blood circulation by 38%.
Research has suggested that electrical stimulation of cells intensifies healing by the body and may, over time, contribute to a moderately youthful appearance. However, the best results can only be achieved with a full SMAS or deep plane facelift. These intensive surgeries alter the muscular contours of the face and offer MUCH more long-term enhancements than facial microcurrent stimulation. If you want serious results that will last several years a facelift is the best option
The total cost of a Facelift is made up of several components, including: surgeon’s fees anesthesia fees, facility fees, and other variable costs. Some of the average costs for these components are listed below:
· Upfront surgery cost – $6,000 to $25,000
· Anesthesia – $1,300 to $3,600
· Facility/hospital fees – $1200 to $5,000
· Surgeon’s fee – $7,000 to $25,000
The other variable costs include blood tests, X-rays, a physical exam, prescription medications, bandages/elastics, and many more costs.
In addition, the previously outlined costs range depending on several variables. One major variable is geographic location. For example, Urban areas like New York City or Los Angeles, have highly capable, experienced, and reputable plastic surgeons, and tend to have high overhead costs (money spent on maintenance, rent, wages, etc.). This often translates into higher surgery costs for patients. Another important variable is the type of facelift, since by their very nature some facelifts such as the SMAS facelift or the deep plane facelift are more expensive in comparison to their lesser counterparts like the K-lift® (nonsurgical face-lift).
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.
The first thing to remember is that people continue to age even after a facelift. How long the influence of the facelift last differs from from person to person, and varies based on which type of facelift was performed. SMAS and deep-plane facelifts, which adjust the underlying muscular contours of the face, lead to changes in the structure of the face and are thus longer-lasting than lesser examples like the S-Lift which only deal with the surface skin and surrounding tissues. SMAS and deep-plane facelifts last up to 10-12 years, whereas smaller scale surgeries last around 5 to 8 years. Also important is the patient. Typically, patients who can maintain higher bone densities and have a tendency to maintain taut skin have a higher chance of maintaining the results of their facelift for a longer period of time.
“One-stitch lift” may refer to a procedure where a surgeon uses one stitch to suspend the midface. This procedure should not be considered a true facelift. The term may also be a substitute name for a procedure called the Thread Lift. This procedure takes one to two hours under a local anesthetic (some patients opt for IV sedation for the sake of comfort) and its main purpose is to elevate and reposition loose skin on the brow, face, and neck with a less invasive type of surgery. This involves tiny threads being inserted under the skin which are then passed into the area of operation with a special needle. The threads grab onto the soft tissue/muscle of the area, allowing the entire structure to be lifted as a whole. Over time the thread becomes fixed in the skin, holding the results of the surgery in place. The benefit is that this procedure does not require a great deal of actual stitching, but the results are often very minimal and are certainly not worthy to be called an “facelift”.
These three procedures are considered true facelifts. The difference between them is the areas of the head and neck that they address.
Mini-Face lift: used more frequently in younger patients, and consists of a small incision behind the ear and only adjusts the skin, leaving the underlying muscular structures intact.
Mid-Face lift: addresses the mid-face (triangle formed on either side of the face from the corners of the eye to the corner of the mouth), specifically around the cheek area (saggy cheeks, etc). The incision is made in the hairline and the fatty layers of the skin are repositioned over the cheekbones.
Traditional facelift: most extensive and involves an incision near the hairline which extends behind the ear. The muscular layers are repositioned, tightened and excess skin is cut and the remaining skin is pulled and sutured. This surgery is more frequently used for those with excessive neck fat and it corrects skin laxity in the lower face.
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,
The alternative options range from energy devices, to non-surgical procedures. Energy devices include radiofrequency (RF), and ultherapy or ultrasound therapy, devices which stimulate the skin to tighten up. Non surgical procedures include Dr. Kassir’s trademarked procedure known as the K-Lift® which involves using adjustable sutures under the skin to tighten up the neck and lower face.
One of the proven methods known to be very effective for firming the neck and chin is the SMAS facelift (traditional facelift). It is probably the best option for those with jowls and significant skin laxity. This surgical procedure pulls up the SMAS layer of muscles just under the skin.
To answer the question, No. There are different types of lifts and if under 40 you don’t need to have one of the major operation that is typically reserved for patients over the age of 60. These advanced procedures have deep incisions into the muscular structure of the face in order to adjust the outward look of the face. Even though you may be too young for a “Full” facelift, you may be ideal for a mid-facelift. This facelift is best suited for those who have lost definition in the eye area and whose cheeks are beginning to sag. This procedure works on the deeper layers in the middle of the face and places them over the cheekbones to create a fuller look in that area. The total effects are expected to last about 5 to 6 years.
Bruising after a facelift can be an unsettling problem for some patients. There a ways to significantly preemptively reduce bruising and swelling which include proper surgical technique and the use of fibrin sealants or fibrin glue or tissue glue. It can be expected that the worst of the bruising will be seen around 3 days post-operation and will gradually disappear over a six week period. Therefore, patients should not be alarmed if they have still have some bruising apparent after the three week mark. If you have a hematoma (small pocket of slowly resorbed blood in the tissues) then it may contribute to your bruising and may extended the normal healing process.
Typically bruising is at its peak 3 days after surgery, and will gradually disappear over a 6 week period. If you develop a hematoma it may extend the normal healing process a little bit, but in the end you will look great. Keep in mind that you will look worse before you look better.
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.
The most common best way to lift jowls is to use a traditional facelift. Another great way to lift sagging jowls is a Minimal Access Cranial Suspension (MACS) Lift. The MACS lift is minimally invasive and works by lifting skin vertically directed to a point in front of the ear.
Stem Cell Facelift take fat stem cells from the thigh, buttocks, and other lower body areas and transplant them into the face. The idea is that these stem cells will grow and fill in what has been lost with age. Some patients have noticed significant improvements, however so far research has not shown it to be better than other fat augmentation procedures This technique is new and it is probably best to proceed with caution.
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.
These are a group of less invasive procedures that have much shorter recovery time, which allows most people to recover over 1 weekend. One example is the mini lift where incisions are made behind ear and only skin is pulled to adjust the contours of the face. These quick procedures are categorically less effective than the more traditional facelifts, such as the SMAS which adjusts muscle layers, and are thus not appropriate for every face.
A Deep Plane Facelift is a more intensive version of the classic SMAS Facelift. The Deep Plane Facelift involves cutting and repositioning skin and removing parts of the SMAS layer. The way in which the SMAS layer is manipulated leads to more significant changes in the midface than a SMAS Facelift. The Deep Plane Facelift also last longer, and tends to require less revision surgeries years down the road.
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
How do I know if I need liposuction of the neck and jowls after a Facelift?
The distinction must be made whether the neck folds and jowls are caused by having excess fat or just loose skin. Jowls and neck folds caused by skin laxity can be made worse by using liposuction.
An incision is made along the hairline, that extends around and behind the earlobe. Skin and muscle are pulled towards the incision, trimmed appropriately, and are sutured/clipped/glued closed. The various /procedures can take from 2 to 5 hours, with a minimum recovery of 2-3 weeks.
Energy devices such as ultrasound (Ultherapy) and radiofrequency (RF) can improve jowling. Injectable fillers can also camouflage jowling by creating a straighter jawline.
This is nonsurgical procedure where large amounts of injectable fillers such as (restylane, perlane, radiesse) are used to fill in sagging areas of the face. It is comparable to fat injections in the sense that it not nearly as long lasting as more traditional facelifts
Bandages aren’t typically used after a facelift, but instead the head is wrapped over the ears and under the chin. The wrap is used for 1 or 2 days.
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..
The difficulty with MACS procedures is that since it is performed with vertical suspension, the surgeon must be very experienced for the results to be correct. You should come into the office for a consultation to see what type of revision surgery would work best for you.
Using injectable fillers such as restylane, perlane, and radiesse can help to enhance the look of your face, however nothing is as effective and long lasting as facelift. Using fillers does not come without risks, such as infection, and in the end repeated injections over the years add up in terms of cost.
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.
The concept of Facelift cream is that it attracts water into the tissues of the face to add volume and thus fill in wrinkles. and creases. This is similar to using injectable fillers, except the effectiveness is variable and much less predictable. Anyone looking for a long lasting and significant change should consider injectable fillers and if necessary a standard Facelift.
A Mini Facelift is done by first creating an incision behind the earlobe and then pulling the skin of the face towards that point. A Mini Facelift does not address underlying muscle issues such as the SMAS group. A Mini Facelift recovery time is about 2 weeks, and the results last for about 1 year.
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.
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.
Without a doubt the best option for Marionette Lines and Jowls is a SMAS Facelift. Injectable fillers such as restylane, perlane, radiesse can provide temporary relief of Marionette lines, and a Mini Lift may improve jowls.
A Laser Facelift is a bit of a misnomer since, the procedure does little to actually adjust the contours of the face. A Laser Facelift works by sending the right amount of energy to predictably burn certain layers of skin. These layers grow back in an environment of increase collagen and thus give a more youthful appearance. Laser Facelifts should be used in adjunct to traditional facelifts to resurface or rejuvenate the skin’s appearance.
Recovery from a lower facelift is take about 2 to 3 weeks. The majority of the swelling goes down in the first 2 to 3 days, and the bruising takes about 2 to 3 weeks to resolve completely. When you first go home remember the “ it will get worse before it gets better”.
Non-surgical facelifts are not truly facelifts in the traditional sense of the term. They are generally less effective alternative to undergoing a surgical procedure, which depending on the patient may be sufficient to address the problem. These include the Thermage procedure, laser resurfacing, and volume replacements such as fillers and fat. It is important to remember the Non-surgical facelifts are only temporary measures.
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.
For a surgeon the results of results of the surgery are not affected by the type of sedation used. IV sedation is used for the sake of the patients comfort, since some patients may be very nervous with someone operating over them. Local sedation is just as effective for blocking all the pain, and only leaves patients feeling pulling and pushing sensations.. Local sedation has the added benefit of not requiring an anesthesiologist.
The Thread Facelift may at best get somewhat inferior results to the Traditional Facelift, however these results typically only last a few weeks. If a patient wants more long lasting results, a more Traditional facelift is required.
It is certainly possible and safe to have another facelift only 7 years later, however it may not be necessary to go that far. You may only need to have a Mini Facelift or use injectable fillers (perlane, restylane, radiesse) to supplement the Facelift as you continue to age.
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.
At age 32 you are more likely dealing with a loss of volume in the face as opposed to those over 40 who are dealing with increased skin laxity. To correct purely volume loss, and to give a more youthful appearance you should consider using injectable fillers or fat grafts; for example to the cheeks.
The fact is that Thread Facelifts only yield temporary results, and tend to be overpriced for the results they give. Clinically there shouldn’t be any reason why a patient can’t have Traditional Facelift (SMAS, deep plane, etc) after a Thread Facelift.
It is recommended that patients do not wear any kind of facial jewelry for at least 4 weeks after undergoing a Facelift. The tension from earrings may worsen the scarring and stretch out the earlobes
Patients can expect that a Traditional Facelift will typically hold good results for up to 10 years. Exactly how long a Facelift lasts depends partially on the patient in terms of health, smoking status and genetics.
A good surgeon practices placing their incisions in the least visible places, and at the same time allows for the right amount of tension to have smooth scar formation. Most Facelifts have scars behind the ears, but the MACS Facelift has them directly in front of the ear.
Fat Augmentation or Fat Transfer, cannot replace a Facelift in the appropriately aged face, however it can be used as supplement. Fat Augmentation is used to add volume to the face in areas that are naturally fatty in the young.
Firstly patients should consult their surgeon so that they can make a clinical judgment about the swelling and lumps. To help the reduce lumps and swelling, it may be helpful to soak with warm water and massage the area, however this will not help resolve hematomas. Hematomas that appear soon after surgery should be drained. The most effective tool to reduce swelling and lumps is allowing time for the body to heal on its own.
Statiscally general anesthesia is for the majority of Facelift procedures done in America, however it has no direct bearing on the results of the Facelift. General anesthesia primary functions to eliminate of patient anxiety during a procedure so that they can tolerate the operation. Surgeons using Local anesthesia take just as many precautions to minimize the risk of surgery, and can achieve the same results. We prefer twilight anesthesia, referred to as IV sedation, which is much like the anesthesia for colonoscopies.
Fat transfers and many other minimally invasive procedures tend not to address the issue of skin laxity. Fat transfers can correct volume loss issues seen in younger patients. To address skin laxity problems patients need to consider undergoing a Facelift procedure
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.
You can expect that majority of the swelling will resolve in 2 to 3 weeks, and the remainder will slowly resolve over a 3 to 4 month period. To try to lessen the amount of swelling you should avoid salty food before and after the surgery, and sleep with your head elevated to help the fluid drain. These measures may have some minimal effect on the swelling, but giving the body time is the best method.
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.
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.
The amount and duration of tightness you feel will depend on the type of facelift procedure and the surgeon’s style. More invasive Facelifts that suture muscle layers will feel more tight than others. The first 2 weeks are the tightest, and by 2 to 3 months the feeling of tightness will be virtually gone.
Patients should expect the most swelling the first few days after a Facelift and a significant decrease over the first 2 weeks. Ice can help reduce the swelling, but using it too much can damage the skin.
Yes. The lower Facelift scar under your chin can be used as an entry point to place the chin implant.
A lower Facelift/Necklift is a procedure that does well for tightening the neck and only minimally addresses jowls. A full Facelift is superior in that it addresses the neck, jowls, and face by pulling the contiguous muscle layer upwards.
This may an indication that some damage has happened to a part of the Facial Nerve during your Facelift. You should consult an experienced plastic surgeon who can assess and treat you with surgery if necessary.
On the contrary, losing weight may make things worse. People desire a facelift because of increase skin laxity and loss of facial volume. Losing weight means volume loss in the face, that may need to be replaced during a Facelift with Fat Transfers. However, if you are at an unhealthy weight losing weight may be a priority.
Droopy eyes are caused by sagging eyelids, not by facial skin laxity. Skin laxity is treated using facelift that tighten the skin and muscles underneath; sagging eyes are treated with eyelid surgery or browlift to adjust the anatomy.
At age 45 it is not an unusual for someone to have a facelift. Whether an individual is needs to have one 45 depends on their particular face. At age 45 volume loss, and particularly skin laxity may have begun to set in. At age 45 you may still be a candidate for less invasive procedures using fillers. Please consult with an experienced surgeon.
To prepare for a Facelift, 2 weeks before surgery you should avoid taking prescription and OTC medications that increase bleeding risks such as aspirin, and advil. To decrease the amount of swelling after surgery, you should avoid salty foods which can increase water retention.
You should advise and consult the surgeon who will do your facelift for a definite answer, but generally speaking you should wait at least 2 months after fillers before doing anything to the face. The time frame your surgeon gives you will depend on where the fillers were placed.
Ideally the best time to do a fat transfer/grafting is during a Facelift operation. A Fat Transfer/grafting along with a facelift allows the surgeon to have a good sense of the final look of your face.
There haven’t been enough studies about stem cell lifts to definitively prove they provide results as good and long lasting as a standard Fat Transfer/graft. For now we would recommend standard Fat Transfer/Grafting because Stem Cell lifts are still unpredictable.
A lower facelift can cost anywhere between $7,500 and $15,000, depending on on the location, surgeon and other fees such as anesthesia. You should focus on finding a good surgeon with proven results and ignore any minor differences in prices.
Facelifts for men are typically more challenging than for women. Men tend to have more vascular and more supported skin, as well as larger faces than women. This means Facelifts for men take more time, and that men bleed more than women.
Ultrasound Facelifts and Fraxel Re:Pair Laser cannot give the same result as true surgical Facelift, but they can give good results for the right people. Ultrasound Facelifts deliver energy into the skin to stimulate collagen to tighten and lift areas such as the brow, neck, and chin. Fraxel Re:Pair Laser can rejuvenate the skin surface to address fine lines. Neither Ultrasound Facelifts nor Fraxel Re:Pair Laser address volume loss or reposition the underlying muscle layers that structure the face.
We usually take the sutures out about 1 week after the Facelift procedure.
Downtime of a Mini Facelift is around 7-10 days, but we recommend that you plan for 2 weeks to be comfortable.
Strenuous physical activity or any activity that may raise your blood pressure, such as oral sex, should be a avoided for 2-4 weeks after a Facelift. A raised blood pressure, such as during oral sex may worsen swelling.
Two good options to address laxity under the eyes while avoiding changing eye lid shape are the Lower Lid Lift, and Cheek Lift. The Lower Lid lift is a procedure that removes excess skin, and the Cheek Lift actually lifts cheek tissue. You can also address it with injectable fillers (Perlane, Restylane, Radiesse), energy devices (Ulthera, Thermage, Radiofrequency) and lasers (CO2 laser resurfacing like Fraxel).
A Face Tensor can be put on after the sterile bandages have been taken off, and can be worn for 2 to 3 days. The tensor provides support to the face and helps reduce swelling.
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.
Yes, you can have a Mini Facelift done concurrently with a blepharoplasty. Having a Mini Facelift done with a blepharoplasty means total recovery time will be less, and you will only have to undergo anesthesia once.
You should consult your surgeon, but generally these facial spasms after a Facelift are nothing to worry about and are only temporary. Spasms after a facelift are a caused by swelling and bruising that temporarily pinches the nerves of the face.
A Facelift does not alter the rate of aging, it simply reverts your face back to an earlier time. After a Facelift aging will continue, meaning that 20 years later you will look older, and may desire another facelift.
Deep Plane Facelifts have an increased risk of damaging motor and sensory nerves, a risk which is very rare for a well trained and experienced surgeon. Other risk for Deep Plane Facelifts include hematoms and infections.
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.
Unfortunately with significant facial asymmetry you may need reconstructive surgery to undo the botched work of the prior surgeries.
The average age of a Deep plane Facelift in NJ and NY is 52-55. Depending on your need you may only require a SMAS lift, or you may even get away with the patented K-Lift™ procedure. You can undergo a Facelift under local anesthesia preferably, or alternatively IV sedation or general anesthesia. If you have any medical problem you should discuss them with your surgeon.
It is highly irregular for a patient of your age having a facelift. A facelift is only necessary for patients looking to address the sagging of skin and muscles due to laxity of these constituents and, for young patients, this is rare except in the case of a tumor, extreme weight loss (causing the loss of structure in the face, etc.). I would not recommend it for you empirically based on your testimony.
Scarring can vary based on the experience and skill of the surgeon, so it is probably best to consult further with your surgeon or another trusted individual at the very least. However, facelifts will generally only require a scar behind the ear up to the earlobe which can be covered by the hairline for the most part.
Generally, midface lifts are NOT done endoscopically and are usually quite open. Open technique allows for easier removal of skin and the strengthening of the underlying SMAS layer. There are procedures which conduct midface lifts endoscopically, but they are not as effective as open technique.
Again, the decision for surgeons is generally up to you. When it comes to cost, don’t let it be your sole factor in decision-making, as plastic surgeries is usually on a “you get what you paid for” basis. Keep in mind that location, anesthesia, overhead costs, etc. all play a part, as does the skill and individual technique of the surgeon.
Before applying any topical ointment to the skin following a facelift, especially so soon, I would consult with my doctor. There is usually no benefit in applying things blindly.
When doing a plastic surgery, it is probably for the best that the surgeon be certified by the American Board of Plastic Surgery. Even for mini-lifts, which are not considered as invasive as facelifts, a great deal of experience and training is needed for good patient satisfaction.
At age 19, there should be no reason to be thinking about a facelift of any kind. Many nonsurgical treatments (e.g. fillers, fat augmentation, implants, etc.) are available and should be used more frequently as potential first lines of treatment.
Temple wounds are somewhat uncommon following a facial procedure. The best option at this point would probably be to wait it out and see how the wounds scar/develop and, as always, consult with the surgeon.
It is important to recognize that the timing of a facelift is again related mainly to the physical stage of a patient, rather than the patients themselves, and are controlled by genetics and environmental factors. Even though you may be young for a full facelift, you could easily qualify as an ideal candidate for a mid-facelift. This facelift is ideal for those who have lost definition in the eye area and who are beginning to show the signs of sagging.
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.
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.
Again, it does not truly matter what sort of degree the doctor has. If he is adequately trained and has a good reputation combined with the experience which you are looking for, the surgery should go smoothly regardless.
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.
Typically, an SMAS facelift will reposition the cheek muscles in a more youthful position and will usually elevate the cheek fat to augment the area. Therefore, it is advisable not to be worried about “cheek damage” in this case.
To be honest, any experienced and capable surgeon should not be afraid of doing nerve damage, etc. simply because of their knowledge in the field. However, the problem with you may be that fat grafting or augmentation is needed to plump various areas without the use of a facelift.
Usually, for younger patients, it is not advisable to have a facelift especially given the drastic consequences which it could have. Also, it does not seem that skin laxity in the face is a problem (photo evidence would be needed to prove this though). The best option for you would probably be less invasive technique like laser surfacing or Botox.
At your age, it is probably inadvisable to look at surgery as the first line of treatment especially because skin laxity is usually not a great problem in the late 30s and early 40s. Other non-invasive options exist such as neuromodulators, fillers, laser-based procedures, and soft tissue tighteners.
The problem with ultrasound facelift is that it has been given far too much hype in the media. Granted, its role in stimulating collagen cells may cause the skin to tighten somewhat but it does not address volume loss and skin laxity, two of the most common symptoms of aging. Again, better to not let price be your guide when it comes to facial procedures.
Usually, different surgeons will choose different incision techniques based on experience and the need to hide incisions in the natural crease lines. Again, the key is to make the surgery less obvious and the surgeon will usually best know how to do that.
Though the midface lift does help address sagginess in the cheeks, it can help tighten skin under the eyelid. However, for true results, removing the lower eye skin in a skin pinch procedure under local anesthesia might be more advantageous.
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.
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.
Generally, when doing a facelift, the incision made occurs behind the ear and curves along the shape of the ear to the earlobe, simply for the purpose of effectively redraping the skin and hiding as best as possible any evidence that a procedure has been done.
This may not be the answer which you wish to hear, but, after five years post-op, I see very little changing in terms of facial structure. It is possible that, although rare, you may have had minor nerve damage, but, again, it is best to consult with a facial nerve expert to be absolutely sure.
Again, because of the nature of chemicals in cigarettes in adjusting the vascular nature of the blood vessels of the face, smokers have a higher risk for post-operative complications. Smoking constricts blood vessel, reducing blood flow to the skin and increasing the risk of the development of dead skin, etc. It would be well advised for patients NOT to smoke for several weeks before and after surgery.
For some patients who are not quite ready for a major, invasive procedure, fillers and Botox might be good as temporary solutions. Especially for younger patients in their early forties, liposuction could also help with jowling and presents a lower cost option when compared to surgery. Perhaps consulting with your surgeon is the best option for you at this point.
Before a facelift, some of the best options could be to use Retin-A before and after surgery. Examples include using Obagi.
A midface lift can be performed through the mouth as a way of providing support and increasing the volume of the hollow cheek area. This can most often be done through an upper lid incision.
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.
If the doctor with whom you are doing the surgery is competent and has a good reputation, there is little to worry about in terms of the “windswept” look. In the SMAS lift especially, it is important that the SMAS layer and the skin are concurrently pulled in the same general proportion, thus enhancing the natural look of the surgery.
For patients dealing with drooping mouths (specifically at the corners of the mouth), probably the best procedure would be to use fillers like Restylane and Juvederm Ultra. For greater marionettes lines, however, fillers would not work well and a full facelift would probably the best option.
Depending on where the initial incision was made, it is normal to experience numbness in the skin and to also have flaky, dry skin as well. Numbness around the ears is, to conclude, perfectly normal. However, numbness WITHIN the ear is a problem and usually indicates nerve damage which can be risky during any anticipated neck lift option.
Usually, after a traditional SMAS lift, 40-50 stitches are used to cover the residual scars located close to the incision site at the hairline, in front and behind the ears. These stitches are removed at the fourth day after the surgery to avoid railroad track scars along the incision line.
For many patients, the two to three week mark indicates the worst effects of the surgery. At this point, patients can expect to be quite swollen and have lumps which probably indicate minor blood collections that will heal over time. Massaging these lumps can help, but overall, time is the best cure.
A technique that is far less mainstream than traditional or minor surgical facelifts, an endoscopic lift is a minor facelift in which a small endoscope is inserted through the hairline through three or more small incisions that are less than one inch long. These cameras then transmit small video images to a larger TV screen, thus guiding the surgeon through the repositioning of surface tissues. This particular operation is usually done on an outpatient basis using local anesthesia or intravenous sedation.
The ribbon lift is a procedure similar to a thread lift but uses a different device, a collar with spikes of one side. The device is inserted into the platysma muscle and used to pull it back, a procedure which helps with neck lifts, but does nothing for jowls and cheeks. It is a good temporary procedure if done correctly.
A midface lift is known for its role in addressing the cheek area and addresses sagginess. However, more often, surgeons will use fillers like Restylane or Juvederm to address problems in this area because of their low risk and, in general, greater effectiveness.
A featherlift was a procedure used several years ago which worked similar to a thread lift. Barbed sutures were inserted under the skin to lift it up as a whole. The only problem was that, as tissue is tightened, it expands, thus defeating the purpose of the procedure in general.
Unfortunately, bruising after a facelift is something which is greatly inevitable. However, medicines taken to reduce blood pressure and help with the bruising, using drains, preoperative care, etc. can all be used to at least minimize the bruising present.
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.
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.
Healing after a surgery, especially after 2 to 3 weeks, is always tough and numbness and swelling are to be expected. Usually, however, after this nightmare period is over, nerves gradually begin to recover and feeling begins to return to the face soon after. Lumpiness could be from minor blood collections which are again very normal and can be massaged if the patient is particularly anxious. As I have stated many times before, time is the greatest healer when it comes to plastic surgery procedures.
For patients with jowls, the best option would probably be a comprehensively planned facelift. The Lifestyle Lift, to be frank, does not cut it when it comes to the jowl area especially when the surgery takes only an hour or so to do (it does not venture deep enough into the SMAS layer, etc.).
The most important part of a facelift procedure is planning on what the patient wants. Choosing the best surgeon is often the best idea for not only finding the best option, but also of understand what to expect from surgery. Doing your research is the only way to become truly happy with your results.
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.
Usually, swelling after facelifts are at their worst for about 2 to 3 weeks post-procedure and gradually dissipate through the period of a year. It is unusual to have great swelling after a year, something which might be helped with lymphatic massage.
For most people, the first facelift usually occurs between the ages of forty and fifty because of the loss of facial volume from age-related fat loss and by the development of lax skin again due to age. Again, however, it is the physical state of the patient, as opposed to his/her age which actually determine the need for surgery, so consulting with surgeons is probably the best first step in deciding.
Nothing can replace a true, well-done surgery. I would distrust many of these skin cream options which are available out there.
Often, it is not the age of the patient but the symptoms which the surgeon considers when deciding on a facelift. At this age, is not unreasonable for you to believe that you need a facelift. Such a procedure could be beneficial, but fillers and fat augmentation could also give you similar results with less invasiveness. You must decide with your plastic surgeon which route you want to take, as I believe both will improve your overall facial structure.
In general, when a surgery is done, the surgeon should try as best as possible to avoid having the patient look like they have had surgery. When a good lift is done, the deeper tissues are pulled slightly and little skin is excised, meaning very thin lines are often needed if done properly. Again, finding a good surgeon who is reliable is probably the best option for you at this point.
It does take some time for the swelling to settle down after a mid facelift and fat injections. Look for about three months before you start healing. By then, the swelling will have probably subsided greatly.
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.
Short scar lift/mini facelifts, like many facelifts, are done under local anesthesia and are performed by creating an incision in the back of the ear towards the earlobe. They, however, merely address the skin, rather than the underlying muscle tissue (SMAS layer of the skin), meaning that the results typically last for a maximum of about a year (the usual recovery time is about 2 weeks).
Pros: Removal of excess skin, lifting of drooping skin along face, jawline, and neck
Cons: Cost, undergoing surgery, recovery time, scars, swelling/bruising, and risks of surgery
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.
Side effects, though rare, include
• Hair loss along incision lines
• Facial nerve damage (very rare)
Often, patients will find that oozing behind the ears can happen followed by the movement of thread through the skin. These threads are prolene sutures which can easily be removed at the surgeon’s office.
The problem in your case could be dysesthesia which occurs when nerve pains do not go away shortly after surgery with massage, etc. Some potential methods of treatment could be massage. However, if nerve pain persists, patients may want to consult neurologists or pain specialists.
Bandages are generally not used in a facelift. Rather, garments are wrapped around the head for up to a day before being removed.
Though surgeons are generally trained to minimize scars as much as possible, scars will be present. Surgeons will usually attempt to place incisions in areas that are hidden or in areas where it may look like natural wrinkles (ex. Hairline, behind the ear), but, particularly in Hispanic or African-American patients, there is an increased risk of “hypertrophic” or “keloid” scars.
A traditional facelift is an extensive procedure which involves an incision near the hairline that extends behind the ear. During this procedure, excess skin is cut and the remaining skin is pulled and sutured. This surgery is more frequently used for those with excessive neck fat and it corrects skin laxity in the lower face.
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.
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.
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.
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.
This is probably a question needed to be asked for individual surgeons themselves. Botox being in place during a facelift should not be a problem; neither should fillers. However, in the case of fillers, have your doctor customize the surgical procedure for maximum results.
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.
Especially with adverse conditions like lupus and fibromyalgia, it would be wise to discuss specific instructions and concerns with your surgeon. The disease should be maintained and under control before the surgery is performed.
Endotine, for me, does not have a useful role in facial rejuvenation. It is a foreign body and creates unnecessary scarring and inflammation. The best option would be to consult with a plastic surgeon trained in problems of facial aesthetic surgery.
The choice of a facelift depends on the patient’s skin laxity and submental fat present. A minilift allows for minimal jowl addressing and the tightening of the neckline, but smart lipo may not be as long-lasting as a minilift.
As soon as movement is possible, try to walk frequently (3-4 times per day) in an effort to boost circulation and avoid the development of deep venous thrombosis (potentially fatal blood clots in the veins of the leg). It is also important to avoid lifting heavy objects until approved by your surgeon and avoid steam rooms and saunas as well as niacin-containing medicines (and possibly foods) for a while due to their tendency to cause facial flushing. Also avoid consuming alcohol or aspirin-like products (e.g. Ibuprofen) without the surgeon’s approval.
Also, expect to return to work within two weeks. Any major events should be within one to four months of surgery.
In an effort to avoid swelling, it is advisable for patients to sleep with their heads elevated, either by sleeping on two pillows or using a wedge-shaped foam pillow. Keeping the head still during sleep is important as well so as not to pull on delicate sutures on the face. Sleeping on a recliner would most likely be the best option to avoid patients rolling over and disrupting facial changes.
Steroid injections can be useful in areas of excess incisional inflammation, but should only be used when acute and subacute inflammation have subsided. Steroid injections while helping to break down swelled tissue have no control and often break down normal tissue as well, further complicating the situation.
Possible procedures include:
• Suction of the neck and jaw line to remove your submental fat pocket and define your neck/face junction
• A short scar face lift with neck liposuction
All three of these procedures are considered true facelifts. The only variance between them, however, is the scale on which they are performed and the areas they specifically address. A mini-face lift, more frequently used for younger patients, consists of a small incision made behind the ear and only adjusts the skin, leaving the underlying muscular structures intact. This procedure is more frequently used for younger patients and is generally less invasive. In an attempt to avoid the windswept look (AKA the windtunnel face) which is a potential side effect of normal facelift, the MACS lift relies on the vertical lifting of the skin, creating a more natural, less apparent look. Surgeons often describe it as a variation of a normal “short-scar” or “S” Lift because of this. The operation of the MACS lift involves the creation of a small incision within the hairline in front of the ear. The traditional facelift, however, is more extensive and involves an incision near the hairline which extends behind the ear. During this procedure, excess skin is cut and the remaining skin is pulled and sutured. This surgery is more frequently used for those with excessive neck fat and it corrects skin laxity in the lower face.
The usual longevity of this particular surgery varies with genetics and environmental factors, etc, but usually goes for about 10-15 years.
Asymetric mouth can be treated with a lip lift, augmentation, upper lip lift, DAO muscle fiber division, etc.
Bruising, if hematomas are not present, usually fade within a 2 to 4 week period and can be treated with Arnica tablets as well.
The best option at this point would probably be to wait several weeks post-op until all the wounds have healed before coloring the hair. This point usually occurs within three to five weeks, so consult with your surgeon about your option.
It is somewhat unusual for patients to have black eyes after 2 months, even with genetics, medications, and all other factors considered. Problems with drainage post-procedure may be to blame, but exercise and massaging (warmth as well) could also be used to help treat these various conditions.
The most common alternative to lidocaine in many practices is Marcaine, but general anesthesia accompanied with epinephrine to deal with bleeding control could be a potentially good option in general.
In general, it is a bad idea to perform surgery for “preventative” reasons. Surgery should be done only when an actual problem is present, not to prevent one from developing. It would probably be best for younger patients to use hyaluronic acid fillers, sometimes in and around the nasolabial folds.
For younger patients, it is inadvisable usually for them to get mid facial lift unless absolutely necessary. A better option to address volume loss around the nasolabial folds would be to use facial fillers.
Facelifts, depending on the time, have a maximum recovery time for anywhere from 2 to 4 weeks during which bruising and swelling are at their worst.
With sutures being used to tighten muscles in and around the face, it is normal to experience tightness especially where the incision was made. Itchiness should also be expected for a bout a year and swelling should be anticipated for up to 6 months post-op.
Other non-invasive procedures for cheeks include endoscopy. A technique that is far less mainstream than traditional or minor surgical facelifts, an endoscopic lift is a minor facelift in which a small endoscope is inserted through the hairline through three or more small incisions that are less than one inch long. These cameras then transmit small video images to a larger TV screen, thus guiding the surgeon through the repositioning of surface tissues. This particular operation is usually done on an outpatient basis using local anesthesia or intravenous sedation.
There are no OTC medicinese available to treat scars, but several treatments including laser and Neosporin application have been shown to.
Endoscopic facelifts, though not being as mainstream as open surgery, are minimally invasive procedures which presents many advantages to younger people who are not in need of a major surgery. 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. Therefore, for people who are in need of a facelift but do not require or want the invasiveness of open surgery, endoscopic surgery is a good option.
Again, like many other methods of so-called “treatment”, I remain rather dubious of microcurrents. Granted, they give you some improvement, but major facial drooping can only be corrected with facelift surgery.
Swelling after a facelift should be resolved within four to six months and bruising should recover much earlier, within a matter of weeks. Again, recovery is rather variable from patient to patient and surgeons should be consulted.
Changes in earlobe position (known as Pixie or Spock Ear) can be caused when the skin around the ear becomes overtrimmed after which the tension in the skin pulls down the earlobe. Usually, a revision facelift may be needed.
The surgery of achieving a balanced, feminine face usually involves a facelift, forehead/brow lift, and lip augmentation using Restylane and other features. Again, like other procedures, the cost is highly variable but usually lingers at around $50,000.
The main purpose of a fractional laser is to help improve fine lines and texture by stimulating the collagen layer of the skin. However, the question is whether it does its job. Scientific evidence saying this has been rather shallow and it’s difficult to prove whether this actually does anything significant. I would stay away from it and stick with tradition.
It is difficult to say exactly which procedures of the jowl area should done when the problems are not well known by the patient. It is often necessary to consult with a facial plastic surgeon, especially when concerning problems with the salivary duct and other vital parts of that area.
The procedure for a deep plane facelift is very much like the procedure for a SMAS Lift, yet carries the steps of the SMAS Lift much further. In this surgical operation, small incisions are made along the hairline in an effort to reposition facial muscles and upper fatty tissue layers. These incisions are then extended downward along natural creases along the face and proceed along the edges of the ears ending behind the earlobes. After this is done, the skin is separated, leaving the SMAS layer behind. Going further, the surgeon then ventures underneath the SMAS layer (into the “deep plane” layer), cutting attachments and repositioning certain areas in order to create a more tension-free, vibrant look in the face. Finally, after the necessary SMAS portions are appropriately repositioned, excess skin is removed and the edges are sutured. Again, this procedure is a much more invasive version of the SMAS Facelift and is known to be more effective in correcting nasolabial folds (“laugh lines”).
Generally, patients who have very limited bruising can return to work in two weeks, three weeks if they are in the public eye. Make-up can be worn after this time, even if eyelid/brow surgery has been performed. Swelling may take a while to subside (few weeks or so).
Unfortunately, patients who wish to improve the look of their eyes along with their facial contours should consider an Extended MACS facelift in which the lower eyelid skin is trimmed as the cheek tissue is uplifted. The regular MACS lift, unfortunately, will do very little for the under eye area.
Generally, because of the deeper invasiveness of the deep plane lift, the deep plane lift has a slightly greater recovery time (about a week longer than that of the SMAS Lift). However, each surgeon has different policies concerning surgery and recovery time, so it is best to consult with your doctor if you have specific questions.
Tingling in the cheeks is quite common after a facelift and will usually last for about 2-3 years as the nerves try to reattach and supply the skin with sensory information. Usually, it is not too great of an issue and the symptoms tend to dissipate over time.
When it comes to facelift scars, the initial redness of these wounds will begin to heal after about 3 months or so, and wound appearance continues to improve for 6-12 months. Again, it is usually the surgeon’s duty to assure that the scars are as inconspicuous as possible and the patient can also apply makeup after 1 week to help with the camouflage.
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.
For younger patients wishing to change their inherent facial structure, the facelift would probably not be the option to go for. Instead, non-invasive methods, like fillers, would be a far superior first line of treatment. Consulting with their specific plastic surgeons and obtaining a detailed exam and treatment plan would be the best option at this point.
Facelifts generally do not cause the loss of hair. However, if a facelift is performed concurrently with another upper-face procedure like a browlift, this may have been the cause for hair loss. General anesthesia used during surgery has also been known to cause hair loss.
The Serdev Suture style has been acknowledged for having minimal invasiveness to the face, lack of scars, and a quick recovery time. However, Dr. Serdev has been known for using unique sutures and instruments which are not widely available in the United States such as specially designed needles and sutures. Before patients fly over to Bulgaria, however, they must recognize that the procedure is a very short-term solution as the sutures dissolve over a short number of years, but that the procedure is good for people who do not want an invasive procedure.
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.
Again, as I have told my patients several times, it is the physical state of the patient’s face, rather than the age of the patient, which determines the timing of a facelift. If the patient has problems with jowling, marionette lines, deepening nasolabial folds, and excess neck skin (all issues related to skin laxity), a facelift may be the best option.
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.
In the world of plastic surgery, there exists many forms of facelifts, many of them branded for specific causes. This technique is not one that is well known in plastic surgery and would probably be better investigated with several consultations.
The main objective of a facelift is not to address surface skin (epidermal) issues, but rather to correct deeper layer issues and alter facial contours. Therefore, if patients are looking to correct acne scarring, pores, or other issues on the skin itself, the facelift option should be avoided and substituted with laser resurfacing or full face dermabrasion.
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.
Generally, sutures are removed very gradually, with some removed after one week in front of and behind the ears and others located behind and above the ears removed after two weeks.
For patients wishing to improve mouth shape/orientation and sagging around the lower face, a facelift would probably not be an ideal first line of treatment. Fillers would probably be a better option, and further consultations can be done with the plastic surgeon if the patient is unsatisfied.
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.).
Generally, facial asymmetry is best corrected with the use of fillers and fat grafting. Yet, consulting with the plastic surgeon may provide a more specific and personal method of treatment for individual cases.
Chin scarring is generally the hardest and most irritating scar and usually takes up to three months to heal. Usually, in order to speed up this process of healing, pressure is put on the incision using a foam pad secured with a bandage which is worn for 6 hours a day.
Depending on the surgeon, geography, overhead costs, etc., the price for facility and anesthesia fees will vary. Patients should spend significant time researching their surgeons in order to provide a rough estimate of the costs. Generally, urban areas will have higher facility costs and more extensive anesthesia (general) will be more expensive than local or IV sedation.
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.
Again, it is the patient’s physical facial state which determines the correct time for a facial procedure. Generally, patients looking to do facelifts early (in their 40s, etc.) will definitely need to come back after 10-15 years, meaning that doctors usually do not recommend facelifts at such a young age.
Compression or injury to the greater auricular nerve during a face lift or neck lift will result in numbness to the ear lobe and a small area of the neck just below the earlobe. To be frank, this nerve is purely sensory and cannot be treated if damaged, except naturally. Usually, it will heal after 12 months.
Especially for patients who have had jaw reduction surgery, poorly attached skin can be a problem especially as the plastyma muscle and the submental fat pad under the chin are moved down. To correct this, a procedure will be needed to reduce submental fat pads near the platysma (liposuction, etc.) and tighten the platysma muscle.
With the Acculift procedure, small fibers are used to deliver laser energy around the jowls, neck, and mouth. It is supposed to have little downtime and other benefits, but, to be honest, all it does is remove fat and slightly tighten the skin in areas where MORE fat is needed or where a traditional facelift would be better.
In cases of darkening of the skin following surgery, the usual causes lie with laser treatment. To alleviate these symptoms, hydroquinone products could be used carefully or Restylane filler could be used in the dark circles.
Usualy, if the scars are thin and flat, but have a red, rather fleshy color, they are still maturing and will continue to mature for up to 90 days. People in the short-term recovery phase of the surgery should be patient and allow the scars to heal naturally. However, if the red lines become raised or thick, they could be hypertrophic scars and one should see their surgeon if this occurs.
The ClearLift procedure makes use of a Q-switched laser which mainly treats loose skin at the surface after a series of treatments and is usually best reserved for patients with thick skin. Yet, usually, this procedure is best used for skin wrinkling rather than facial structure issues, especially for older patients. For addressing the issue of severe jowling and fat below the neckline, there is again no substitute for a comprehensive neck lift.
Typically, surgeons will recommend that a patient ideally stays for about 2 weeks before flying in order to decrease blood pressure spikes and to ensure that all stitches are removed without possible infection.
Generally, it is unusual for patients to experience deep scarring after three weeks of surgery. What patients believe are “scars” may actually be small fluid collections or old blood under the skin. While ultrasound may be useful for bumps post-op, it is probably best to consult with a plastic surgeon as to using it for facelift scarring.
At 20 years old, it is difficult to imagine that a patient would be an ideal candidate for a facelift and cheek implants. However, they could be easily eligible for nonsurgical options like fillers or skin care treatments and even lifestyle changes like exercise and dietary restrictions. Consulting with plastic surgeons and dermatologists will probably be the best, most conservative approach.
Patients desiring a more “baby face” look following a Facelift will probably want to use volume fillers like Scuptra Esthetic or perhaps utilize fat grafting and fillers depending on what is desired. Consult with the plastic surgeon to find the best options for your individual case.
Facelifts generally do not include the eyes and neck and instead encompasses the reposition and tightening of facial tissue around the cheeks and the very upper neck. Necklifts and blepharoplasties (eyelid surgeries) are considered entirely separate procedures.
The only issue with age and timing for facelift is whether the patient is healthy. It is perfectly normal to have a facelift at that age, yet the surgeon must make sure to understand that the skin and deeper facial tissues may be thinner at this age compared to patients in their 50s and 60s.
Generally, patients who are too young for a facelift but demand facial contouring can achieve what they need through consultations with their plastic surgeons. Unless carefully examined, it is difficult to recommend specific treatments, but some include fat removal, tissue lifting and redraping, etc. Either way, consultation is probably the best option for these patients.
It is important for young people to keep a healthy amount of fat in their face simply for the purposes of structure and support. For this reason, if weight is lost significantly, the skin may become lax due to lack of support. It is best for younger patients to wait until the weight becomes stable before addressing skin laxity, meaning that a facelift is probably not needed and can substituted with fat grafting or even with time (skin will naturally tighten).
It is common for sutures to protrude after facelift, but it is important for them to be removed as soon as possible. Depending on the type of suture, it may be necessary to make incisions in order to remove the suture and avoid the possibility of infection.
It is strange to think that composite facelifting has sort of gone by the wayside, as they say, but I would have to disagree with people who state that there is only one way to address certain problems in a patient. Depending on the plastic surgeon and the patient’s preferences, there are many techniques which could be used to solve the same problem. Therefore, it is important for patients to find the best plastic surgeon for them and find the right procedure for their specific needs.
Again, it is important, when considering revision surgery, for patients to display before and after photos and have the surgeon examine them. Consultation, if the patient is dissatisfied, is the best option.
Patients who are in their early forties should not look for a particularly invasive procedure. Personal recommendations for correcting early signs of jowling would be procedures like the S-Lift or mini jowl lift which address the SMAS layer but not drastically.
Generally, jowling is best corrected with a full facelift. However, the scars, depending on the skill of the surgeon to make them inconspicuous, are usually not as noticeable as patients may believe and can be hidden by the earlobe and hairline.
At age 24, except in special cases, facelifts are usually out of the question and are far too invasive. Some options for addressing these problems could be through the use of filler and fat injections to add volume to the face and laser treatment for facial resurfacing.
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.
The procedure known as the mid facelift does not wholly target nasolabial folds and instead is reserved mainly for repositioning the malar fat pad and midface area. The best options to help with these folds are injectable fillers or fat grafting.
To be frank, the purpose of anesthesia is strictly for patient comfort. Facelifts can use general anesthesia, local anesthesia, or IV sedation, but it is probably safer and more comfortable to use general anesthesia.
The placement of sutures and the types of sutures used depend mainly on the surgeon’s preference. Generally speaking, though dissolvable sutures aid in the conspicuousness of the surgery, they are known for being absorbed too quickly before lending any support to the structure of the new face. If patients are particularly worried, they could use permanent sutures to ensure that the sutures hold long enough for the doctors to remove them if need be.
As long as patients are not suffering from a hematoma (consulting with surgeons is especially important), major swelling should not last longer than around a week. After this point, it gradually dissipates.
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.
Generally, after 9 weeks, much of the swelling has begun to subside and skin on the neck begins to loosen. However, patients should generally not worry as the collagen and scar tissue tends to then contract once more over the course of 6 months to a year. As in many cases, patients who are anxious should schedule a consultation.
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.
The problem with the extended MACS facelift is that, though it is a vertical facelift and the results look more natural than most others, it does not address lax skin on the neck and definitely does not target fat and banding around the platysma muscle.
It is important for patients to recognize and be able to differentiate between keloids and hypertrophic scars. Both of these are very uncommon after surgery, but are found more on dark-skinned individuals and are best treated with cortisone injections.
Unfortunately, facelifts have their share of risks associated with them, among them the chance that nerves may be damaged. Consulting with a neurologist is probably the best option to understand the extent of the damage. Following this, weak areas (eyes, etc.) can be supported and electrical stimulation could also be an option, but generally, there is very little that can be done.
To be frank, there are very little procedures, besides the facelift, which can be done for patients demanding significant improvement in the neck area. Certain procedures like liposuction or laser/ultrasound treatment can be somewhat useful, but are very short-term and offer little when compared to a face/neck lift.
Generally, after a period of several weeks, facial tightening begins to fade unless sutures were placed poorly in which case the surgeon must be found as soon as possible to avoid infection.
Patients prone to keloid scarring should have no problem undergoing a facelift as what most patients see as keloids are simply hypertrophic scars (thick, itchy raised scars) which can easily treated by the surgeon. However, the surgeon which whom you are working may want to consider alternative incisions methods to combat the possibility of major scarring.
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.
Patients should remember that swelling following facelift surgery is extremely common, but should also take care not to touch the areas around the earlobes too greatly because results may be altered tremendously. If pulled earlobes are a major concern, patients should talk with their surgeon immediately.
Generally, in the hands of an experienced facial surgeon, the need for revision is relatively low (about 1 to 6 percent), but the risk for revision increases if the patient is overweight, has a generally heavy neck, smokes, etc. Talk with your surgeon to best understand the options which you have.
It is strange for patients who have a lower facelift to still have problems with jowling, especially since this procedure is geared specifically for this problem. The most likely route, as of now, is further lifting, but keep in mind that bone structure, fat, chin shape, etc. may have played a role in creating these residual jowls.
Bruising is generally very common for the first two weeks following surgery, but some patients may develop hemosiderin staining which is similar to bruising and may last for about a year. Again, for bruising, time is often the best factor for healing, but makeup can be worn for camouflage purposes.
When addressing cheek asymmetry, it is important to understand that time must be taken for the face to heal fully (several months or so) before a decision can be made. Infections, hematomas, and seromas can all cause fat on the cheeks to dissipate unevenly, yet, early on, the only good options are to consult with your surgeon.
As a surgeon, I try to avoid facelift technique which are branded and have official names to them. For most patients, sticking with tradition is probably the best avenue for surgical success
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.
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).
As soon as the date is set for surgery, it is important for patients to arrange for a ride home from surgery and also to clear their schedule for up to 2 weeks post-op. Smokers should quit several weeks before and continue not to smoke for several weeks after surgery and, unless approved by the doctor, any medications and herbal medicines should be avoided.
This is somewhat difficult considering that the thin skin closest to the nose is very difficult to incise without creating an obvious scar. If this is a particularly bothersome issue, consult with your surgeon about your options.
Patients must remain patient when it comes to swelling. Though the worst of the swelling generally subsides after 2 weeks, patients should expect moderate swelling for 4 to 12 weeks and even later post-op. The best thing to do is to avoid strenuous activity and bending excessively.
For many patients, simple Botox and Dysport treatments can be used to treat swollen glands, but the surgeon should be consulted prior to deciding upon this option. Removal of the gland is generally not recommended and a conservative approach is advocated.
Though it is a concern if a patient is having trouble smiling post-surgery, it is usually not a sign of permanent nerve damage, but rather a sign of stretching and swelling of the nerves. Generally, though it takes a while, muscle movement should begin to increase as the nerves begin to reorganize and reattach.
The conservative approach to dealing with a leaking parotid gland would be pressure dressing, the avoidance of spicy and sour foods (which promote excessive salivation), and anti-cholinergic medications.
The purpose of a facelift is to reverse a patient’s biological clock by elevating and repositioning muscles and tissues in their face. Sagging skin should be greatly resolved due to trimming and repositioning and general volume deficiencies can be fixed with fat injections or fillers. In general, the patient should not expect overwhelming changes in their facial structure.
Generally, at the age of 65, jowling and significant fat deposits in the neck are the main problems and they can be corrected with a lower facelift under local anesthesia. Nasolabial folds can also be a problem and can be helped with the use of fat grafting and fillers. Be sure to consult with individual plastic surgeons about the best options, but these are generally the main ideas I would bring forth.
Determining whether a surgeon is still capable of good surgical technique often lies with examining recent before and after photos of patients and seeing whether he or she demonstrates the technique which they once did. Again, a facelift is a very challenging procedure and should be taken seriously.
The Face Tite procedure involves radiofrequency treatments for the tightening of facial skin and is a procedure which has only recently become available. These types of treatments are useful in tightening surface skin as opposed to making any significant changes in the deeper tissues, but are noted for their minimal downtime and short procedure time.
Generally, a facelift can be used to treat acne scarring in and around the cheeks and is usually best combined with fat augmentation in these areas. Yet, it is important to remember that a facelift is not geared SPECIFICALLY towards the treatment of surface features like scarring and should not be expected to fully resolve these issues.
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.
It does not matter what type of sutures are used on a facelift. Where the incision is placed initially is important in the healing process. Also important is the tension placed on the skin. Wide scars are usually found when too much tension is placed on the skin. Finally, it is important that the sutures are removed very early to prevent railroad tracking on the incision.
Good candidates for facelifts are those with sagging cheeks, jowl formation, and severe skin laxity. Volume loss, which is the problem that many people in their forties have as opposed to skin laxity, is best addressed by injectable fillers or fat grafting. Consult with your surgeon about the best option for you.
Again, like many surgical procedures, the costs of facelift vary depending on the surgeon’s skill and training, location of the procedure (urban areas have higher overhead costs), and other factors. It is important to research which procedures are the best for you, but generally expect to spend between $5,000 and around $15,000, depending on the invasiveness and effectiveness of the procedure.
Generally, patients have to remember that the healing process takes a great deal of time when it comes to facelifts and that they must keep their expectations optimistic, but also realistic. If patients have concerns, they are probably best addressed by their doctors or surgeons and are best done with multiple consultations.
Liposuction should only be used when skin laxity is not a problem and only fat is the issue. However, liposuction used when jowls and lax skin are the problem is not ideal and could cause nerve injury to the areas around the mouth. Consulting with a surgeon is probably the best option for people concerned about this problem.
Generally, younger patients are discouraged from pursuing a full-on, invasive facelift surgery. Many patients who have malar bags are discouraged to get facelifts and should instead opt for small cheek implants to enhance the fullness of these areas and give structure (thus fixing the problem of the sagging skin).
There has been no conclusive study to prove that caci treatment is significantly linked to releasing a great amount of mercury from dental amalgams in the teeth. Often, patients will describe a metallic taste in the mouth which is caused by the electronic current of the treatment. Any concerns, however, should be voiced with the dentist of the patient.
The main areas for men to hide facelift scars would be in front of the ear and behind the ear. Sideburns could be especially helpful in hiding more prominent scars and the hairline should help with the less conspicuous ones. Makeup can also be used to hide the redness of the incisions after about one week.
It is unusual for patients to demonstrate ripples, especially months after a facelift. This may be caused by residual swelling, but more importantly, may be the result of underlying scar tissue. If the problem continues for about half a year, it is probably best to consult with the surgeon. Until then, patients are encouraged to massage the area.
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.
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.
Most surgeons hide the stitches in as inconspicuous of a place as possible. Often, the stitches are hidden in the hairline and along the curve of the earlobe, which is very helpful for women with long hair. Men, on the other hand, could extend their hair through sideburns, etc. in order to disguise the stitches.
Patients, after a couple of weeks since the surgery, should not be concerned too greatly with any “irregularities” they may see as lumps, bumps, etc are usually pretty common after a facelift. Again, patience is the key for many people.
Again, for patients, it is never age, but the physical nature and state of the face which determine the timing for a facelift. As long as the patient is healthy and is able to undergo surgery, any time is perfectly fine for a facelift.
For patients in their 40s, the facelift option is usually one that should not be considered as a first line of treatment. Generally, characteristic issues like under eye circles or puffiness under the eyes can be addressed with minor procedures like a blepharoplasty or the trimming of excess skin.
Generally, patients who are in need of playsmaplasty are those who have platysmal banding. If such symptoms are not present, the procedure is simply not worth the swelling and recovery time unless an extremely tight neck is desired.
Generally, incisions, if done by a skilled plastic surgeon, should be virtually hidden by the hairline, but patients should remember that, often, it is the surgery itself which should matter rather than the incisions. If the outcome is satisfactory, patients will simply have to remain calm and understand that the healing process takes time.
Again, for patients, it is never age, but the physical nature and state of the face which determine the timing for a facelift. As long as the patient is healthy and is able to undergo surgery, any time is perfectly fine for a facelift.
It is important, once again, for patients to recognize the unfortunate marketing scams which are occurring in the plastic surgery industry. The Smart Lift technique is not particularly groundbreaking and relies mainly on a laser removing fat through small incisions, the results being limited tightening of the skin. The better and more long-lasting procedures are more highly recommended for the simple reason that they are proven to work for long periods of time.
Licensed surgeons are simply those with an MD degree, whereas board-certified plastic surgeons have been specifically trained in plastic surgery and have passed rigorous exams by the American Board of Plastic Surgery. These are the surgeons who many people rely on for true results and who have the greatest patient satisfaction in plastic surgery.
For patients looking to do liposuction and facelifts, surgeons must remember that doing them concurrently could increase the risk of blood clots and other medical problems. Generally, though they can be combined, liposuctions should be done first with the facelift done much later.
It is difficult to recommend lines of treatment for various patients with asymmetrical faces following surgery without having pictures or a routine examination. Generally, the best option for such patients is to consult with surgeons specializing in revisional facelift surgery.
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.
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.
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.
Generally, patients who have suffered weight loss tend to lose essential fat in the face, causing them to believe that they need a facelift. Usually, the method of treatment is much simple, with fat grafting or fillers being used to substitute for fat lost in the face.
Usually, a mini face lift encompasses about 7-10 days (ideally 2 weeks if possible).
Contrary to popular belief, younger patients who have had facelifts can easily consult surrounding surgeons for a revision. Sometimes, it is as simple as cutting internal stitches and loosening/trimming more excess skin.
Generally, for patients who have asymmetrical faces, it is often a major concern and one which seems to require major invasive procedures. However, a facelift is probably not recommended for younger patients, and can instead be substituted with less invasive procedures like fat grafting or fillers.
The technique of undermining is a technique which involves using scissors to cut through tissue underneath the skin in order to access deeper tissues like the SMAS or the platysma. It is usually a technique reserved from major invasive lifts like deep-plane, subperiosteal, and SMAS lifts.
For most patients, some pain is normal after surgery for which pain medications are designed to lessen the pain. Generally, however, pain should be rather low as swelling usually dies down after two weeks or so and bruising fades. Pain medications should generally not be needed until a few days after surgery is done as the skin is pretty numb at that point.
For an invasive surgery like a deep-plane procedure, the swelling will usually last for several weeks to several months. Patients should expect to out of work for at least 2 weeks and should plan on having someone take care of strenuous activities and tasks where bending is needed.
For many of these branded techniques, it is difficult to estimate their longevity. After all, the Lifestyle Lift is not a particular type of facelift. Generally, results will last a very small amount of time: as little as one week or so before fading.
Patients who have hypetrophic scars should probably have them removed ASAP by their surgeon with steroid injections used concurrently to help.
Generally, the development of malar bags under the skin is somewhat common and can be easily alleviated by massaging the cheeks in a circular motion while elevating them upwards. It will take time for these injuries to heal, usually about 8 weeks.
Generally, for younger patients, a facelift is not a recommended option, especially for those looking to alleviate nasolabial folding. The best option for these patients includes the use of fillers as a temporary method of treatment.
During a facelift, incisions are made behind and often in front of the ears. Patients are encouraged not to worry about swelling which may occur and are encouraged to remain calm in the face of “Dumbo-like” ears.
Generally, for younger patients, fillers are probably the best option for softening the initial signs of aging as opposed to face lifts which are reserved for people who show greater signs of aging. However, patients must remember that fillers are more addressed for volume loss whereas facelifts are addressed mainly for skin laxity.
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.
Cheekpad fat refers to malar fat which is a superficial, upside down triangle which is often elevated in a midface lift to restore fullness in the upper cheek. Buccal fat is deeper, more herniated and lower and is sometimes removed to reduce roundness in the face.
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.
The only case in which facelifts would be required to fix the neck area is if the patient demonstrates laxity in the skin, shown especially by the presence of jowls. Generally, patients who demonstrate this will often do the facelift concurrently with a neck lift for the best possible results.
For people having problems in these areas, the best option would probably be a traditional SMAS facelift combined with a neck lift and a forehead lift. Deep plane facelifts will also be useful and may be more effective for the jowl areas. The eyes could also be corrected with blepharoplasty.
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.
The effect of the E-Cigarette is virtually the same as smoking due to the presence of nicotine. 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.
Generally, lumps following a facelift indicate the presence of minor collections of blood or hematomas under the skin. Patients could do well to massage these areas and spread out the blood or can go to their surgeon to have these areas aspirated, if absolutely needed.
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.
Some products which are recommended to patients prior to facelift in order to promote collagen growth are Retin-A and a mild glycolic acid. However, before any skin care product is taken, patients should notify their surgeon.
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.
I would not recommend a full facelift and a full facial laser peel for the simple reason that there is a higher risk of skin loss from this procedure.
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.
Usually, for skin puckers, cortisone lines can be used to help alleviate any problems which may results. If this option is unsuccessful, surgical correction can be done after six months.
Again, like many brand-name surgical improvements, I remain apprehensive about the Silhouette Lift. The procedure is a variant of the thread lift which uses barbed sutures to lift and hold the skin in a suspended position. Unfortunately, with its expense, it provides very minimal improvement and I would not recommend it.
Patients dealing with hearing loss should immediately consult an ear physician because it is usually caused by fluid or congestion in the ear, ear infections, or other temporary problems. It is important for the patient to have a full evaluation, however, to make sure that conditions are still fine within the ear itself and were not adversely affected by surgery.
Though it may seem like a convenient idea to have ultrasound gadgets handy for hematomas and other possible complications, it is probably for the best that a patient avoids using them without authorization by the surgeon. However, if permission is given, it should be used rather frequently (2-3 times a week), with patients seeing a change within 10-14 days.
The most important tool for a patient in finding the right plastic surgeon is to do their research. The way to find a good plastic surgeon is to look at their work (before and after photos), talk to former patients, and to evaluate them after consultations. Again, it is the patient’s face, meaning that the patient has a job in finding the right surgeon for them.
A technique which caused quite a buzz in the plastic surgery world several years ago, the thread or feather lift is a minimally invasive technique used to replace open surgery in the lifting of sagging facial skin. A relatively simple procedure, it consists of using tiny suture barbs to act as a hook to gather skin layers upwards, thereby causing the skin to tighten. These barbs are connected to a thread which remains in place after the procedure and solely cooperate with the fibrous tissue to provide a lifting effect to the skin. Though not used quite frequently as a technique by itself, this procedure is often used in combination with other facelifts as a method of support, especially with younger people having facelift surgeries earlier and more frequently.
When it comes to plastic surgery, the most important thing to remember is that it must be specific for the patient’s needs. I would suggest researching the technique and deciding whether it is best for you. From the information which is available, it seems as if it has a shorter incision and preserves the hairline, but I would remain wary of these brand-name lifts.
Again, it is very normal to have anxiety for surgery. Ask the doctor, if necessary, for Xanax, ativan, and certain other medications which he could recommend (be careful which medications are taken though) and which can be taken the night before surgery.
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.
Pain medications are often helpful in treating pain, but for great swelling and burning pain, other medicines like Neurontin or Lyrica may be needed. Consult with your doctor before taking any potentially harmful medications.
Often, the reason for sagging lies not in skin laxity on the various facial structures, but rather with the absence of facial structure itself. Usually, patients who do not wish to have surgery will find that fillers like Juvederm and Radiesse or even fat injections harvested from the upper thigh are often useful in helping to treat various symptoms, including sagging.
With an experienced surgeon, it is very unlikely that injury to the facial nerve will occur during surgery. Again, many surgeons are certified by the American Board of Plastic Surgery and are often trained to avoid such complications. Therefore, the risk is relatively low (around 1% or so), even if a small cyst is removed. However, if doctors are removing large objects like a tumor, the chance for nerve injury increases, so take care to select a surgeon with great medical skill.
This treatment procedure seems like another variant of the long abandoned threadlift and is probably not worth the time or the effort (not to mention the cost) of going through with surgery. If patients are serious about creating facial changes, it probably cannot be done with procedures that seem “to good to be true”.
Sometimes, scars are best left alone in order for the healing process to increase in speed, particularly weeks out from a procedure. Consult with your physician about the best possible options.
Patients looking to reduce facial scars should definitely not look into facelifts as a primary method of treatment, particularly if they are young. Fat grafting, neck liposuction, even fillers, etc. may be better methods of treatment.
Oral sedation works with good local anesthesia of the area being operated on. IV sedation does increase the risk slightly but will improve your overall comfort during the procedure.
What is generally found with a lower facelift is that it addresses the lower two thirds of the face, causing the jawline to become sharper and the angle of the jaw to become more acute. Sagging chins, on the other hand, are more caused by a lack of projection (AKA loose skin and fat), or, in other words, the absence of structure. The best method of treatment, in this case, is to do a chin implant since the problem is not skin laxity.
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.
Especially for larger procedures like a SMAS or deep plane facelift, it is probably best advised that the patient exclusively sees a board certified plastic surgeon. Many oculoplastic surgeons are very skilled in procedures around the eyes, however, so they remain an option for these areas.
The key saying with post-facelift patients is that “You look worse before you look better”. Patients will often find themselves questioning when the swelling and bruising will end and will usually look for immediate gratification post-surgery. The important part post-procedure is simply patience.
Generally, ears that have been pulled forward have had an incision made within the part of the ear known as the tragus. Usually, this is done to hide the obviousness of facelift scarring, but can pull the entire tragus forward.
Often, when discussing surgeries, different surgeons will recommend different procedures for the same problems. The best way for patients to find the best options for them would be to look at many before and after photos for each procedure to find what they want.
Patients, when having a facelift procedure done, should attempt to keep their weight stable, meaning that any substantial weight loss/dieting should be done prior to surgery. However, patients who lose weight after a facelift will generally have the same benefits, as do patients who use standard fillers like Juvederm or Restylane.
Patients who are looking to keep the results of a facelift intact are generally not advised to lose a significant amount of weight as loss of fat in the face can reduce facial structure and may cause the return of skin laxity post-facelift. If weight loss is desired, patients should go about it slowly, evaluating themselves after every 10 lbs or so lost.
Patients who have under eye surgery are generally not expected to have a facelift done to simply “even” out the face. Of course, it can be done with fantastic results, yet it is not always necessary.
The consensus on threadlifts for most plastic surgeons is that the results look fantastic, but only last a week or two. Therefore, it is generally not worth the money to have it substitute a solid, long-lasting facelift.
Patients may, after having a facelift surgery, experience swelling of the parotid gland which must be reduced. Generally, the use of Botox or the scopolamine patch can be used to improve the area, but must be done in the hands of an experienced surgeon to negate the possibility of infection.
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.
Ptosis of the eye is usually related to complications with the facial nerve after surgery. Generally, this heals strongly without long term issues, but the patient should take care to keep the eye moist and possibly tape it.
Facelift procedures generally do not require an overnight stay unless there are complications with the anesthesia post-surgery.
The cost of a facelift can vary depending on the surgeon’s skill and especially location. Generally, patients will find the money through credit or will have credit from before, but it is best that , if your finances are not up to it, facial surgery may not be the option for you.
Generally, the concern with double procedures is the question of making the anesthesia last without complications for the patient. Patients willing to undergo a breast lift in conjunction with a face lift can generally have it done with additional cost benefits.
The MACS Lift, a treatment used for sagging facial tissues, muscles, and jowls, can indeed be done with the Fraxel treatment, which repairs aging skin. Both procedures are relatively non-invasive and can be done in conjunction.
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.
Marks are usually made when the patient is upright or awake unless adjustments are called for when they are unconscious.
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.
Often, patients will experience a suture granuloma which is an attempt by the body to rid itself of undissolved sutures through the dissemination of pus. This is a very normal bodily reaction post-surgery, but the surgeon should take a look at it in an effort to avoid an infection.
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.
Procedures like the mini facelift or marketed facelifts generally do not interfere with the muscle layers of the skin known as the SMAS (where cheek fat is generally centered), so repositioning of malar fat pads is not a concern here. For deeper procedures, surgeons may reposition them entirely or may trim it, depending on the surgeon.
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.
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.
Especially for patients who are several weeks post-surgery, it is unlikely that hematomas could form. If they do, however, aggressive massage is not recommended as it may increase the risk of inflammation. Gentle fingertip massage and simple patience may be the best option.
Patients looking for a minimally invasive procedure which does little to alter the neck should look for the option of a mini facelift which has smaller incisions and is less obvious.
Again, for surgeries like the mini face lift, there is less invasiveness and, therefore, less risk. The trade-off, however, is the lack of long-lasting results which one would find in a facelift. However, the procedure varies from surgeon to surgeon so patients should consult with their individual surgeons.
Surgeons who are experienced in facelift surgery will try to place scars in the least conspicuous spaces possible while also avoiding skin tension. Patients looking to have an additional facelift can easily have the old scars removed in conjunction with the procedure.
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.
The best option, generally, for facelift surgery is to have it done by a board certified plastic surgeon or, even better, a board certified facial plastic surgeon.
Generally, plastic surgeons are trained in general surgery followed by more in-depth training of actual plastic surgery whereas ENT training starts with general surgery and is followed to be ENT training (which includes facial and neck reconstructive surgery). Again, it is best to find the reputation of the doctor in terms of facial surgery and examine before and after photos to evaluate their work.
Short term swelling can easily be treated with a cool compress or cooling mask, but could be easily substituted with ice, frozen peas, etc.
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.
Fish oil and other medications should probably be avoided weeks before and after surgery. The surgeon will provide an indication as to which medicines should be avoided.
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.
Surgeons and patients should make sure, prior to surgery, that they are both comfortable with the performance of various incisions near the hairline. For most full facelift procedures, the incision is made around the back surface of the ear and is hidden by the auricle of the ear and the hairline itself.
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.
Again, many of the marketed facelift procedures generally consist of mini facelifts which do very little for the money paid for them. Patients who are serious about facelift procedures would probably benefit the most from a full facelift.
Like many facial surgeries, the midface lift varies from surgeon to surgeon in terms of technique. Some surgeons prescribe endoscopic lift marked by the use of a camera used to lift tissue, whereas others may prescribe thread-lifting with the use of small barbed sutures. However, others will recommend a lower eyelid incision which, though carrying the risk of possible temporary ptosis, yields longer lasting results.
Unlike facelifts of the past, facelifts today generally rely more on addressing lost volume than actually pulling the skin. Furthermore, patients who have had facelifts generally have better skin due to the use of skin care systems, microdermabrasions, weight control, exercise, etc. Again, however, it depends on the surgeon and the type of facelift performed.
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.
Generally, patients dealing with major lumps post-surgery are dealing with hematomas where cells break up, releasing salts and drawing fluid to create more swelling. Needle aspiration of the area is usually required to test for infection.
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.
Patients looking to remove fat under the chin and the neck area should look into the option of microliposuction to the face and neck as a short-term option. Long-term, after several months or so, a minimal incision facelift can be performed, but generally, extensive surgery should not be used as a first line of treatment.
Generally, patients, following a facelift procedure, should experience a degree of tightness in the face. However, it should not be long term and follow-up care with the surgeon should be taken at ALL costs if symptoms persist for a great deal of time.
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.
For patients several weeks post-op, it is perfectly normal to experience swelling. Consultation with the surgeon and looking out for infections are probably the best routes for these patients.
Generally, patients who are finding malar bags on their cheekbones should not look for implants as a source of treatment. Usually, malar bags were probably present before surgery and cannot be treated easily.
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.
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.
Generally, without pictures, it is difficult to prescribe treatment to patients. Younger patients who have “droopy” faces can probably benefit with fillers or voluminizers, but consultation with the surgeon is probably the best option.
Procedures like the Acculift and other branded facelifts should not expect great change, as the procedures consists of opening the skin and allowing the laser to minimally tighten skin. Again, this procedures can only last for approximately 6-12 months before results wear off.
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.
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.
Lifestyle Lift, being a branded facelift, is probably not the best option for patients wishing to undergo revision surgery. It puts patients at a higher risk of being dissatisfied and requiring more procedures short-term, and is far less advanced than many surgeries of today.
Post-op, many patients will find that sagging can be asymmetrical. However, this is not due to the skin laxity which required the facelift, but more so because of fat/volume loss in the cheeks. This can easily be corrected with fat grafting or fillers.
Patients who have underwent facial fat grafting should keep their head elevated for 2-3 weeks post-op and should generally avoid movement and pressure around the area affected.
Patients experiencing lumps in the face may be experienced small, localized hematomas which can be easily treated with massage and ultrasound. Tightness is somewhat normal after surgery and is a sign of sensation returning to the deep SMAS layers of the skin. Finally, thick scarring can be resolved with Kenalog injections unless the surgeon feels that they are unnecessary (in which case the patient would have to wait for them to heal).
Young adults are somewhat limited in facial rejuvenation options. The best options at that age would probably be maintaining good hydration, no sun tanning of the face, and good medical skin care.
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.
In today’s society, a youthful face mainly consists of having bright well shaped eyes and a defined jawline. Patients looking to achieve these features can generally find them with chin implants, mini neck lifts, and an upper eyelid lift, but facelifts should generally be avoided (especially if the patient is younger).
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.
Swelling post-facelift lasts for as long as 6 months (sometimes longer), but usually begins to dissipate after three months. Up to this point, patients should not worry about asymmetrical swelling, but should take care not to sleep on their sides as this could have long-term consequences for this swelling.
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.
Though it may appear to be a good and cost-effective idea to have both procedures done at the same time it is probably best for patients to avoid doing so, simply because of the risk of infection and thrombosis. However, again, it all depends on the health of the patient and their ability to recuperate after these procedures.
The main area affected during a facelift is the SMAS layer which is a layer of fascia under the skin which is tightened during the procedure as a way of avoiding direct tension of the overlying fat and skin.
Younger patients who are serious about having a facelift should probably have a consultation with a qualified surgeon to see if that is the only option for them. Facelifts are most commonly used for facial aging due to the drooping of midfacial tissues or for patient who have very little volume in the face. However, younger patients are more encouraged to maintain proper nutrition and have less invasive procedures like cheek implants, etc.
The extent to which aging increases/decreases post-facelift depends on the way the surgery was performed. Generally, if performed adequately, the surgery should not cause any changes in skin texture or blood supply to the skin, meaning that aging should not be affected generally. The point of a facelift is not to alter the aging clock, but simply to reverse it temporarily. A facelift, if done correctly, should be followed by normal aging without any facial distortion.
Patients post-surgery will often deal with swelling which could progress into the development of fluid collections and even hematomas. If lumps develop, it is probably best for the surgeon to examine the patient to determine the nature of these lumps.
Numbness following trauma to the skin is a very normal part of healing and should normally heal after a year, but complete feeling is not guaranteed. Again, it depends on the actual extent of the incision, with superficial incisions having a higher chance of full recovery.
Generally, facelifts, though associated with tightness in the skin and possible swelling and bruising of the skin, are relatively pain-free compared to many other procedures. Patients will often benefit from facelifts combined with other procedures like blepharoplasties or filler/fat injections.
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.
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.
Often, patients who desire surgery can often find the answers to their facial structure problems through less invasive methods like fillers or laser treatment or even simple procedures like liposuction to reduce jowling. Again, consulting with the surgeon is probably the best option.
Patients who have very little success with fillers and fat grafting generally experience better results with a lower and mid-face or cheek lift in a way that would help the tissue falling over the corners of the mouth to be elevated. Botox in the mouth could also help with the “frown” look.
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.
PSP Facelifts are considered regular facelifts because the procedure involves the tightening of the platysma and SMAS muscle and tissue layers.
Again, like many brand-name surgical improvements, I remain apprehensive about the Silhouette Lift. The procedure is a variant of the thread lift which uses barbed sutures to lift and hold the skin in a suspended position. Unfortunately, with its expense, it provides very minimal improvement and I would not recommend it.
Especially for deeper procedures like a SMAS or deep-plane facelift, one can definitely expect a more youthful appearance when all is said or done. However, the face at this point is not set in stone, but will continue to age normally, meaning that additional follow-up surgeries may be needed.
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.
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.
The only issue with age and timing for facelift is whether the patient is healthy. It is fine to have a facelift at that age, yet the surgeon must make sure to understand that the skin and deeper facial tissues may be thinner at this age compared to patients in their 50s and 60s. Patients who have pacemakers must have them demagnetized though and must make sure that their blood pressure is healthy prior to surgery.
It is normal to have raised scars in and around the tragus area, but it is probably best to consult with the surgeon in order to avoid any possible infection especially since red scars are more common around the earlobe and behind the ear. Cortisone shots can be used in addition to treat scarring.
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.
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.
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.
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.
Swelling for up to a month after surgery is extremely common and is probably the worst stage of swelling post-op. Patients at this stage should definitely be patient about swelling and should follow-up with their surgeon if there are any potential concerns.
Raised red scars after facelifts should probably be treated with steroid injections, but the surgeon should be careful with these in order to avoid skin vessel changes and the death of surface skin tissue. Laser treatments could also be an option.
Normally, surgeons will ask that men shave as much as possible before surgery. Generally, as hair growth returns, beard growth should remain relatively normal.
Patients looking to get a facelift should generally not require any pre-op work (peels, etc.) to be done, but , after 6 weeks to 3 months post-op, they can consider non surgical facial treatments.
The treatment for saggy eyes can generally consist of a combination of browlift combined with blepharoplasty, fat/filler injections, fat grafting, and possibly ultherapy. Keeping a good skin care regimen is also quite useful.
Patients looking for deeper facelifts should make sure that they find someone who they can clearly trust to do good work with their face. It is important for patients considering a procedure to do their homework on it, looking at before and after photos, consulting with several surgeons, etc. to determine whether it is indeed the procedure for them.
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.
In my opinion, anything is possible in the hands of an experienced plastic surgeon, especially concerning fillers and facelifts. A physician who is experienced and has a good reputation in his/her field and whose before and after patient photos are stellar is probably the best way for patients to achieve a “natural” result without the look of plastic surgery.
Patients experiencing unusual swelling may be at risk for developing hematomas post-op. These growths need to be aspirated as soon as possible unless the body can naturally resolve on its own. IF these symptoms persist, it is important to consult your surgeon.
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.
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.
A facelift is not a prescribed treatment for melasma which is probably better treated with skin cares lines like Obagi or other agents like retin-A and hydroquinone.
Patients who have had a midface lift may have problems with Endotine devices irritating sensory nerves, thereby causing itching. Usually, these are dissolvable within a year or so, but patients are often annoyed with the device because of the symptoms which you describe.
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.
For patients having early signs of aging, a range of options exist. Some of these are non-invasive like Ultherapy or Thermage which tighten facial tissues and others are more invasive like fat grafting and redistribution. Facelifts are definitely not an option. Consulting with the plastic surgeon is a good start for these patients.
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.
Certainly, patients are not required to have any treatments prior to their facelift, but many have found that treatments with Retin-A or Obagi have been helpful in allowing them to maintain the results of surgery. This treatment is very cost-effective, so patients looking for the best results with little cost should probably consider it.
Many patients reaching big birthdays will often feel the need to have major surgeries done to combat aging especially if they have been ill for several months. I would not recommend invasive surgery right now, but instead advocate a healthy lifestyle, perhaps supplemented with non-invasive procedures like facials, light laser treatment, Botox, or fillers.
Certainly, patients in their late 40s should not be considering a facelift as a first line of treatment. Generally, a good start would be to have a “mini” necklift done and avoid a facelift due to the possibility of making the jaw too feminine (not to mention the scars which develop). Facial skin resurfacing and Botox could also be good, non-invasive options as well.
Even during a bad economy, surgeons will most likely NOT be inclined to “negotiate” especially because many of them reduce their fees in response to a declining economy. In general, patients should not let price be a guide in choosing their surgeon and should only go to the best surgeons available when they have the funds for it. I always say that redoing a bad job is much more expensive than doing it right the first time.
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.
Tightness several months after a facelift is a hallmark of persistent edema or tissue swelling which cannot be resolved through medical means but only through time. Patients with these symptoms may want to cut down on sodium level or explore the options of manual lymphatic drainage or endermologie.
Any issues with the ear canal are probably be resolved with an appointment with the plastic surgeon. Swelling and bruising around the ear is perfectly normal in these situations and should not be a major issue for the patients.
No.Fat injections should generally be added along the tear trough, which is the deep grove along the bone of the lower eyelid.
Generally, as I tell my patients, the first couple of weeks following surgery are the worst in terms of appearance as the swelling and bruising are beginning to come in full force. It is probably best to wait before considering options like volume injections or laser resurfacing around the mouth.
Generally, surgeons will need to include drains after performing a major facelift as a way of speeding up healing by preventing fluid accumulation. Drains are usually left in for a day post-op and are carefully removed by the surgeon.
Banding in the neck can generally be treated quite adequately with a facelift. Most likely, patients would require a lower facelift designed to tighten the neck muscles and to redrape the skin.
Prior to a surgery, a surgeon must be positive that their patient is healthy enough for an operation. If he/she feels that a patient’s past health problems deem a blood test necessary, then a blood test will usually be recommended.
If patients wish to have fillers added prior to surgery, the best initial option would be to first consult with their surgeon. However, inserting fillers prior to surgery will distort the anatomy of the face and will probably not address areas which could be hollowed-out post-op. Generally, it makes more sense to have fat/filler injections done during or after surgery.
During a facelift procedure, it is not truly the skin itself which is altered, but the SMAS layer under it. The SMAS layer is tightened and reattached to the underlying tissue by the use of sutures, after which the skin is trimmed and reattached using stitches. Soon after, the body produces new collagen which causes the skin to adhere better to the underlying tissue.
When associated with surgery or stress, hair loss is usually caused by a condition known as alopecia areata which is completely reversible. Waiting a couple of months post-op is the best option for patients.
Generally, the results of a brow and facelift are expected to last for about 5-10 years, but can vary due to the patient’s health and lifestyle (smoking, exercise, etc.). However, after the surgery, the patient will continue to age normally and should not have any distortions with the aging process.
Generally, edemas and other swelling lasts for approximately 6 months post-op, but, if it is a concern for patient, it is probably best to have a consultation with the plastic surgeon.
Many patients with minimal jowling and slight neck skin excess will do great with a mini facelift provided that the procedure takes care of the SMAS. If patients have excess jowling and neck skin then a traditional facelift is probably in order. Again, price should probably not be the guide and patients should do their research when selecting a surgeon and procedure.
Indentation following a facelift may be the result of fluid or residual laxity but it is difficult to truly pinpoint without the benefit of a full surgical exam. If the issue remains unresolved for months, fat grafting may be the best option to correct any deficiencies.
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.
For patients having issues in these areas, time is probably the best factor for healing and for determining if additional treatment is necessary. Especially for the sagging submandibular glands, I would wait about 9 months or so before making any major decisions.
Again, after having a facelift, it is very uncommon for patients to sustain nerve damage. Generally, nerve damage recovers over a long period of time, but may be contributed to synkinesis which can be treated through Botox injections.
It is probably best for surgeons to avoid taking any unnecessary risks when doing surgery. People with coronary heart disease are probably not good candidates for full facelift procedures but may, depending on cardiologist-led examinations, be eligible for cosmetic surgery.
Generally, because having Sculptura treatments can distort the face, it is difficult for surgeons to have a true vision of the patient’s face after they have had these treatments. Therefore, though there should not be a health-related issue, I would not recommend having a facelift until Sculptura treatments are stopped.
Though collagen does help with addressing skin elasticity and does form an essential part of the skin’s framework, it would probably be digested by enzymes in the stomach and would not help greatly with wrinkles.
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.
Patients who have thyroid issues should probably consider talking to their doctors (ENT/head and neck surgeon) about this first about having a biopsy, since these lesions can be cancerous. However, consulting with a surgeon and further evaluation after this would be needed to determine if a facelift is safe.
Most of the time, facelifts are done with the use of IV sedation anesthesia which carries little risk compared to general anesthesia. Patients with a pulmonary embolism in the past would probably prefer this option as breathing is entirely controlled by the patient.
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.
Patients who have lumps post-op may be experiencing a localized blood collection or a hanging salivary gland, simply based on empirical observation. These patients are probably best recommended to consult with their surgeon.
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.
As with most surgeries, it is probably best to remain wary of “discount” facelifts. Unless the doctor is a Board Certified Plastic Surgeon, it is not a good idea to undergo surgery.
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.
Generally, by this time, the face should be relatively healed. Muscle tightness may persist for several months, but banding calls for an additional consultation.
Lasers are generally used for the elevation and tightening of the skin rather than the actual facelift procedure itself (which consists of repositioning the SMAS layer of the skin). This is a very new procedure which offers the benefits of less bleeding, less bruising, less swelling, and quick recovery.
Compression garments are generally composed of natural cotton combined with synthetic compression wrap. Gauze like Kerlix can be inserted to help with any irritations, but is usually not necessary. You can ask your surgeon to have a “test” run on the garment prior to surgery.
Generally, any medications which are taken normally should be stopped prior to surgery due to their unknown effects on the body. Usually, amino acids should be excreted in urine if in excess but again, discuss your options with your plastic surgeon if necessary.
Generally speaking, thermage and filler treatments work very well with facelift and skin resurfacing procedures. As long as the patient waits for the Sculptra injection site to be become soft, a facelift will simply enhance the look which fillers, etc. gave the patient.
Massaging the area of contraction could help in getting rid of the dimples, but so can a procedure known as needle subcision in which a scar is created that can then be broken up with further application of the needle.
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.
Patients with loose skin following a lower facelift would probably best be comforted by a platysmaplasty performed under local anesthesia.
Jowls, composed of lax tissues beneath the skin, can only truly be lifted with a facelift (preferably an SMAS Lift) not laser treatment (which, at most, can only tighten the skin to a small degree).
Patients with sagging problems may require a face and neck lift, especially if loose skin, hanging muscles, and fat is an issue. The jowls can also be addressed through these methods as well without the windswept look.
Generally, if outpatient surgery centers are located adjacent to a hospital, patients will want to look at the credentials of the outpatient center alone. Unless the outpatient center is hospital-owned, they are usually on their own, so having one that is AAAHC certified is probably the best option.
7 hours is not unusual for multiple facial procedures especially for rhinoplasty. Concerning general anesthesia, the most important thing to consider is the ability of the patient to tolerate it. Make sure to have your surgeon consult all this with you.
As I have said many times before, there is no marketing substitution for a facelift for which the recovery time is approximately 10-14 days. Any facial lift surgery performed by a non-certified surgeon is risky and probably should not be done for patients serious about the outcome.
Patients having “dog ear” style scars under their chin post-op may be treated with steroid injections if the scar is hard, thick, and red, but if it is white or puffy, surgery may be needed to avoid infection. Patients dealing with the latter should wait at least 6 months before considering revision surgery.
Patients dealing with nerve issues following a facelift surgery, especially around the facial muscles, should expect the feeling to come back in the lip after surgery. Much of the midface lift is conducted around the infraorbital nerve around the lip. However, if the lower eyelids are being pulled, revision surgery may be needed.
Patients dealing with pain the ear after a long period of time may have injured the greater auricular nerve, causing it to form a neuroma (overgrowth of nerve endings). The best thing to do for patients is to consult with a neurologist.
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.
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.
Though patients should not get facelifts until they are truly ready, there is no harm in having one early under the hands of an experienced and capable surgeon. Especially if early signs of aging are present, treating them earlier may help create more long-lasting results. But consult with your plastic surgeon about this.
Surgeons often have a problem with patients and facelifts in that the patients often expect too much from their surgery. Again, the object of a facelift is not to change the face entirely, but to create a younger, more natural looking version of the patient. So, it is best for patients to consult with their doctor in order to create the best possible results.
If performed properly, the deep plane injury should have a relatively low risk of nerve injury as the facial nerve branches are generally exposed as much as during a SMAS lift. Again, it all depends on the skill of the surgeon.
During strain, contraction of the platysma muscle could expose banding areas, especially if the patient loses weight due to frequent work outs.
Generally, patients should not expect to see immediate results by a certain time, but rather a gradual improvement of facial features. But, 3 months is more or less the benchmark.
Following a fat transfer, patients should wait until any firmness, edema, etc. is healed completely before doing a facelift. This usually occurs after 3 months.
Uneven cheeks post-op is most likely caused by typical facial scarring which can usually be treated with dilute steroid injection, fat transfers, and/or re-draping the skin. Consult with your plastic surgeon about your options.
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.
Consulting with the plastic surgeon may be the best idea when dealing with vitamin supplements. However, a proper intake of Vitamins A, C, E, etc. may be required.
Patients dealing with asymmetry would most likely benefit from fillers or fat grafting.
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.
In order to prepare for a facelift, patients need to do very little. Generally, avoiding aspirin, motrin, and other medicines which prolong bleeding and fish oil, herbal meds, etc. is probably the only actual work which the patient has to do.
Patients should probably avoid NSAIDS after a facelift due to risk of bleeding. Consulting with the plastic surgeon, in this case, is probably the best option.
Patients, even if they have protein S deficiency (involved with thrombosis), should not worry about undergoing surgery if they have been cleared by their hematologists.
Patients dealing with excess skin on the upper lid could probably just have a blepharoplasty done while a browlift can be performed for a droopy brow at the same time. Botox can also be used if the problem lies in the forehead itself.
This is probably better discussed with your surgeon as he/she will have a better idea of what areas need to be addressed. Again, it is more these important areas that need to be addressed, rather than the actual terminology, which matters.
Generally, the greater auricular nerve is not damaged during mini-facelift surgery because the incisions are made after the earlobe is cut free. Therefore, there is usually not a great deal of permanent numbness but again, consulting with a neurologist may be necessary for anxious patients.
The degree of complications following surgery usually has a direct correlation with the skill of the surgeon. Again, most complications are minor and relate to fluid present in the skin or small irregularities, but they can be major if they include nerve damage, etc. Asking these questions with the plastic surgeon is probably the best option.
Personally, I would not recommend having liposuction procedures done on the face especially for younger patients as they are difficult to repair if done incorrectly.
Facelifts tend to vary greatly from doctor to doctor, with less invasive facelifts generally having less downtime and swelling than more invasive ones. Surgeons also have different draining techniques and other small things, so it is best to find the best one for you.
The main side effects of this procedure are bleeding, scarring, and possible nerve injury. It would be best to find a board-certified plastic surgeon and have a consultation to decide whether this procedure is the best for you.
Typically, improvement from a facelift should be seen after 1-2 weeks when examining before and after photos.
Though fellowship doctors have a lower cost, it is important that they be monitored by the Fellowship director for quality control and teaching purposes.
Marionette lines are typically caused by loss of facial volume and skin laxity, both of which must be addressed through fat grafting or facelifts before the marionette lines are excised.
Unfortunately, patients will not find any improvement with smile lines or nasolabial folds following a facelift. These are more likely resolved with fillers or fat grafting.
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.
Patients must be careful in deciding to undergo revision surgery, especially because the healing process is not yet finished after several months post-surgery. Consulting board-certified surgeons is probably the best option in addressing patient concerns.
Post-facelift, patients are recommended to sleep with the head elevated and perfectly straight (not on their side where they could put pressure on various parts of the face).
It is not uncommon to see patients undergoing these procedures in their early 40s if they present the need for one, the need normally being problems with skin laxity. Again, if you feel that you need the surgery and your consultations with the plastic surgeons have been any indication, I would go ahead with the surgery.
Generally, fat grafting is done during a facelift causing the face to appear thinner. Also, because the muscles and skin are being tightened, the cheeks often have to be reshaped causing thinning of the face.
People who are out in the sun a great deal often find themselves dealing with premature signs of aging. However, facelifts are often not necessary and can easily be replaced with eyelid lifts and modified facelifts. Consult with your plastic surgeon about your options.
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.
The double chin is probably best corrected with liposuction and the facelift can be done later for further improvement.
It is perfectly normal for patients to have concerns about general anesthesia and, if this is the case, they should consult with their plastic surgeon about it prior to surgery. However, anesthesia is very safe and patients should not be concerned unless health problems present an issue.
In general, both the deep plane and midface lift technique are done extensively by many surgeon and are both formidable techniques in their own right that can varied from patient to patient. In selecting a surgeon, it is best to evaluate before and after photos in addition to making sure he/she is board-certified.
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.
If patients are truly serious about long-term results, the facelift is probably the best option. Granted, some facelifts are more small-scale and less invasive than others, meaning less downtime and longevity, but, in general, facelift techniques which repair facial contours and rearrange muscles in the face are more long-lasting and provide for more satisfying results.
Generally speaking, fat remaining along the nasolabial folds all the way down through the jowls can only be corrected with a facelift. Excess fat below the chin, however, can be corrected with chin implants and additional cheek reshaping can be done with a filler.
Unfortunately, given the nature of a facelift to tighten the SMAS layer and redrape the skin, it is virtually impossible to do a full facelift endoscopically.
I would not recommend getting a facelift following a parotidectomy simply because of the increased risk of facial nerve injury. This is because, after a superficial parotidectomy, the position of the facial nerve changes and is unknown to the surgeon.
Generally, patients experiencing swelling in the malar regions are those who have a great amount of excess tissue prior to surgery. Liposuction can usually be done on these pouches, but results may vary and it may take up to 12 months for the area to heal (if it even does).
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.
It is possible to fix scars in this location by re-excising them and closing it. Further healing can be done after 3-4 months when the scar is then lasered.
This is a question which probably requires special examination by a plastic surgeon. Find an experienced surgeon with the credentials for this job and do not let price be the sole guide of your choices.
Post-surgery, it is extremely uncommon to find blood blisters on the face. Consulting with a plastic surgeon who performed the procedure is probably the best option at this point.
Generally, surgeons reserve staples for anything in the scalp area especially for incisions along the hairline because they provide excellent eversion and do not compromise blood supply (thereby reducing hair loss).
Platysmal bands, usually the results of aging, shortening, and fibrosing of the neck muscles, can usually only be treated with revision platysmaplasty.
Experiencing tightness, a sign of returning nerve activity, is extremely common after a facelift. However, after 7 months, it is possible that the tightness is caused by a permanent suture which can be removed.
Facelifts will generally do little to help with an upside down smile because the problem is more volume loss related as opposed to skin laxity-related. Volumizers like fillers or fat injections are the best solution in this case.
Dimpling of the chin can generally be improved greatly with Botox and the nose can easily be fixed with a bulbous tip reduction. Furthermore mentalis bunching can be corrected with the use of a chin implant.
The best treatment for jowling post-facelift is probably a mini jowl lift which has minimal incisions and will probably provide the desired results for many patients.
This gene mutation which is noted for creating an increased risk of blood clots and other vascular complications may present problems during surgery. It is important for patients with this condition to be cleared by the hematologist prior to undergoing surgery in order to avoid hematomas.
Most patients even at this age do not require a full facelift, but are often more eligible for procedures like a mini facelift or laser and chemical peel simply to treat skin laxity around the jawline. These procedures all performed under local anesthesia can give long-term results.
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.
Just because the use of fillers was unsuccessful does not automatically mean that a patient requires a facelift. Flat cheekbones can corrected with fat injections and other areas can easily be corrected with microliposuction.
For patients who have problems with stitches popping post-surgery, it is probably to see the surgeon in order to determine if they were necessary in the first place. It depends on how wide the existing scar is and whether the patient is comfortable with that.
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
In general, drainage should not last more than a day or two after surgery. If drainage is persistent, it is probably best to notify your surgeon immediately to examine for hematomas.
It is unusual for surgeons to cut through the eyelid when doing the surgery. What the surgeon most likely wants to do is to make a skin incision below the lower eyelid lashes and dissect the orbicularis oculi muscle below the eyelid. Usually, this incision will be relatively unnoticeable.
It is important for patients post-op to take it easy on the face and neck area especially in an effort to avoid platysmal banding and the stretching or straining of delicate post-op facial structures.
The difference in a deep plane facelift as opposed to other surgeries is that the deep plane lift cuts below the SMAS layer before lifting and repositioning the muscle layers above it (the SMAS). This provides for more long-term results, but is usually reserved for patients with GREAT skin laxity (usually in their 70s or 80s). The regular facelift, while invasive, is less so and strictly limits itself to rearranging the SMAS layer.
Patients who are not comfortable with facelift surgery may consider fillers as a way to simply restore volume without actually lifting the face. This may be best discussed with your plastic surgeon.
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.
Most hospitals in which facelift surgery is performed usually have an associated ASC so the chance for infection in either location is usually low as long as they have good certifications/credentials (preferably AAAHC). If the surgery is performed in an ASC, it is probably best to ensure that the surgeon has hospital clearance so that, if complications arise, he/she can have you admitted into the hospital.
All of these procedures can generally be performed concurrently as long as an MD anesthesiologist is available and is fully consulted with prior to surgery.
Without photographic evidence, it is difficult to actually prescribe a line of treatment for patients. However, for droopy cheeks, I would say that the best method of treatment would be a cheek lift. Consult with a plastic surgeon about this and patients who have had this done.
Some of the least invasive facelifts include short scar or mini facelifts which, though providing less long term results than SMAS lifts, etc., have less scarring and downtime.
If patients want to do two surgeries concurrently with different doctors, it could be possible. However, this could be somewhat unnecessary as many board-certified plastic surgeons are fully capable of performing blepharoplasty incisions when doing facelifts anyway. Therefore, if the plastic surgeon is fully qualified, it may just be easier to have him/her do the surgery alone.
Generally speaking, the S-Lift is not a fully adequate procedure to use when patients want to address jowling. The S-Lift is more of a procedure which lifts the skin and does not frequently touch the deeper SMAS layers of muscle and fascia which control jowling. Perhaps a more invasive facelift is needed to address jowling.
For people dealing with infections prior to surgery, it is probably best to completely resolve these issues before undergoing surgery.
Typically, after a failed MACS Lift, revision surgery is not suggested until a year later. Yet, photographs and formal examinations are in order for patients who seek revision surgery.
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.
When trying to find a good surgeon for a facelift, it is best to find one with a good reputation and to also consult with them to find the best possible surgery for you. Looking at before and after photos can also be helpful.
Generally, pixie ears can be easily corrected by elevating the remaining lobe and closing off the scar area.
Following a surgery, scarring is often a problem for many patients. However, the extent can vary from patient to patient, meaning that consultation are often necessary.
A week post-surgery is usually too early for patients to adequately examine the effectiveness of the procedure.
People have been questioning recently whether the advent of Botox and other procedures have negated the need or have at least driven down the costs of a facelift. To be honest, I feel that this is not the case and that, in fact, a facelift may cost less in the long run due to the repeating nature of Botox treatments. Also, given the minimal margin of error, it is difficult to see facelifts becoming less expensive.
Facelifts are generally not meant to address the skin, but rather for deeper muscle layers and tissues. Therefore, redness and pimples on surface skin should not present a problem during the procedure.
Generally, people around the age of 26 rarely require a facelift surgery because skin laxity is usually not a problem at this age. Though fillers may be unsuccessful at addressing volume loss, other methods like implants, fat grafting, etc. may help where fillers have failed.
Patients must remember that a facelift is only a temporary measure which, rather than stopping the time clock entirely, sets it back about 10 years. Because of this, aging often initiates the necessity for a second facelift particularly when volume loss and skin laxity continue to be a problem.
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.
Among other things like general wellness and a healthy diet, maintaining a healthy, constant blood pressure is perhaps one of the most important things a patient can do prior to surgery. General anesthesia is probably the best option for high blood pressure receivers of a facelift.
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).
For younger patients, regardless of the marketing technique used, I would not recommend getting a facelift. Patients who are young are probably better off with injectables or even smaller scale techniques like threadlifting.
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.
Unfortunately, skin laxity cannot be addressed by a non-surgical method, but only through a facelift.
Patients before evaluating themselves for “unsatisfactory” results must make sure to have a consultation with a plastic surgeon to determine whether these results are not normal. Taking before and after photos would be a good place to start.
Patients undergoing a subperiosteal midface lift combined with orbital rim implants may have a problem in that the eyes, if small in the beginning, may look even smaller. In this case, the incision for the facelift is made through the eyelid which changes the angle of the corner of the eye and the apparent height and width of the eye.
Patient who have a neck lift surgery may find that, over time, the skin in the submental region has become attached to the underlying muscle, causing a lumpy appearance under the neck. If this occurs, revision surgery is needed in which the original facelift incisions are opened up and the skin is redraped.
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.
People who have severe concavities in their lower eyelid can often find that procedure designed to lift and tighten the lower lid will help. Midface lifts are usually not needed in this case.
Generally, the earlier a facelift is done, the more better and long-lasting the results are. However, patients must be careful to only have a facelift if the signs are there (e.g. sagging skin, facial/skin laxity, etc.) and avoid having it too earlier.
In their early 20s, patients can easily substitute a temple lift surgery with Botox for the lateral brow area. Other options include lasers, light peels, and skin care treatments.
After a long period of time (e.g. a year), it is unusual for patients to deal with tightness in the face and numbness. Possible nerve damage could be a factor if these symptoms persist and it is best that patients see a neurologist as soon as possible.
Bags under eyes post-op is likely caused by either herniated fat or by fluids brought about by swelling. Having a second opinion is probably the option for concerned patients.
Patients who have “mounds” when smiling usually have a problem with volume loss related to diminished subcutaneous fat. Fillers and perhaps Botox are the best lines of treatment for these conditions.
Procedures like endoscopic browlift, mini facelift, cheek implants and eyelid surgery can all definitely be performed under local anesthesia, but IV sedation would probably be more recommended.
Board-certified plastic surgeons must undergo rigorous training and must be extremely familiar with the anatomy of the face to earn this high level of certification. Therefore, if you selected a capable surgeon, you are probably in good hands and need not worry about nerve damage.
Unfortunately, without surgery and without fillers and fat grafts, it is impossible to add volume to the face where it is needed. Facial exercises may exacerbate volume loss, but again the best treatments are fillers.
Patients should not worry about weight during facelift if they are able to keep their weight relatively stable. Patients who lose weight post-op, however, may have a problem with volume loss.
Ridges on the cheek post-op could be a variety of things including fluid, residual sutures, or fat necrosis. Consulting a plastic surgeon and having an exam is probably the best option for patients dealing with this problem.
It is unusual to hear of patients dealing with mental problems as a direct result of facelift surgery and is probably not true. Surgery can take its toll psychologically, particularly if the results are not satisfactory to the patient. Such patients should seek psychiatric help if symptoms persist.
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.
In general, it does not matter what type of plastic surgeon your doctor is, as long as he/she is experienced and has the necessary medical training and certifications to take on the surgery. One would hope that he/she has the experience necessary, regardless of where the surgeries are conducted, to repeat successes and do it consistently.
Patients dealing with lines on the face after the operation along the sides were subject to poor skin redraping. This can be resolved through massage, ultrasound, steroid injections, etc. but the condition should first be discuss with a plastic surgeon.
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.
Especially on patients with thin skin, the MACS Lift which involves pursestring sutures that elevate deeper tissues can often create noticeable lumps on a patient’s face post-op. For these patients, a limited traditional SMAS Lift may be the better option.
Drains are mainly used as a way of reducing the risk of hematomas post-op, but these devices are often clogged by the fluid which they try to drain, making them almost unneeded after a day or two post-op. Generally, this will not be an issue.
Patients dealing with platysmal banding after surgery, usually the results of aging, shortening, and fibrosing of the neck muscles, can usually only be treated with revision platysmaplasty. This procedure consists of a small incision made under the chin through which the platysmal muscle is tightened.
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.
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).
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.
Spasms are usually very common in most post-surgery patients. They usually heal themselves as time goes on.
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.
One month post-op, it is extremely common for patients to have swelling in and around the chin. Unless symptoms persist for more than 10-12 weeks, patients should not worry.
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.
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
Though suture line ruptures can happen in healthy people, it is not common. More likely, ruptured suture lines are caused by skin necrosis due to poor blood supply. As the part of the facelift which is under the most tension, low blood supply to this region is common and is even more exacerbated when the person smokes as nicotine constricts blood vessels.
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.
Fillers can be used on patients who are having droopy corners on their mouths when they smile.
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.
If major damage like paralysis occurs to the facial nerve, it may take quite a while before full recovery of the nerve (if full recovery even occurs). Generally, for these types of cases, patients should expect to wait 6 months before recovery ensues.
Patients concerned about displacing or fracturing existing dental work with general anesthesia should not worry too much as anesthesiologists take care for these concerns. LMA or Combitube can also help for patients with concerns.
Patients experiencing this symptom could be experiencing a laundry list of symptoms from a deep hematoma to a hardening of surrounding tissue caused by tightening due to a MACS Lift Suture.
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.
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.
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.
Patients dealing with extra skin (not to mention skin laxity) around the chin/neck area may require a lower facelift in addition to a chin lift. Platysmaplasty may also be required to deal with post-op neck banding following the surgery. In addition, though patients may be concerned about hitting the thyroid gland during surgery, these procedures rarely touch it.
Generally, though male patients constitute only about 10% of cosmetic surgery patients, doctors trained to handle female patients should be equally trained to handle male patients as well. The dissections and anatomy of the faces may be different, but, as long as these are attended to with skill, most of the surgeries remain relatively the same.
To be honest, I see no real benefit OR harm in having microcurrent procedures done because they only affect muscle rather than the fibrous tissue layer (SMAS) which was affected during the facelift. I have always been wary of these microcurrent treatments as stimulating muscle repeatedly could cause further wrinkling of the skin.
The problem with the stem cell facelift is that it is not really a facelift in the true sense, but rather a modified method of fat grafting. Studies have shown that it really does not do more for the patient than simple fat transfer which can last for several years.
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.
Drains in general are often put in place to aid with bruising, but are not always used and not always required by surgeons.
Surgeons doing revision surgery generally should be more experienced in order to ensure a low complication rate. Make sure to examine before and after photos before deciding on a surgeon.
The procedure of a SOOF lift consists of combining fatty areas from the ocular areas and the sub-ocular areas and allowing this combined fat to elevate the orbicularis oculi muscle for a full cheek lift. This is very similar to a midface lift except that the incisions are made through the lower eyelids rather than through the temple region and the gums.
In general, forehead wrinkling and other skin-related issues can be easily resolved with Botox injections repeated every 4 to 6 months. Fillers can also be used for the saggy mouth areas especially on the corners, but surgery may be required for more long-term results.
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.
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.
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.
Facelifts should improve quite subtly over a course of 6-12 months.
Generally, patients being unable to blink can anticipate that some sort of nerve damage has been done. Waiting a little for potential recovery, however, is the best option, but patients at this time must take care to keep their eyes moist to avoid corneal damage.
Without photographic evidence or a comprehensive exam, it is hard for doctors to diagnose skin laxity in the face. The best option for patients with “droopy” faces is to bring before and after photos to be evaluated by their plastic surgeon.
The amount of bruising for patient is dependent on the surgeon’s skill, potential drains, the patient’s history of bruising, etc. Patients tend to heal after about 2 weeks, but it may take as long as 3.
Tingling and numbness post-op is fairly common after surgery as nerve endings are attempting to regenerate themselves. This should continue for about a year until the conditions subside.
Often, for patients with excess skin, surgeons will make the mistake of trying to keep the incision short, causing excess skin to bunch up around the incision site. The best solution for this is probably the use of Kenalog injections and a possible re-draping of the skin.
Facelift scars generally fall behind the outline of the ear along the edge of the hairline. Blepharoplasty scars fall in the natural crease above the eye and just below the eyelashes on the lower lid. Finally, the subnasal lip lift is marked by an incision under the nostrils.
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.
Examining the results of a facelift consists of carefully inspecting the before and after photos taken with the same facial expression to check for any differences. Take care to look for aging features in both photos and examine them from different angles. Ultimately, the surgeon’s job is to create a younger looking more natural version of the patient.
Patients, after a midface lift, should generally not look to adjust the height of the cheek as it could distort the lower face as well. Cheek asymmetry, however, can be fixed by soft tissue fillers (Juvederm, Restylane, etc.) and fat transfer. Consulting with your plastic surgeon remains the best option.
What patients must remember is that MACS Facelift only yield good results on a certain handful of patients. It is a surgery which produces fullness in the cheek area, but may require a lower eyelid lift in order to reduce bunching from the underlying tissue. However, patients should wait several months before making any judgement calls.
The mini facelift procedure should be used for younger patients who are dealing with minimal jowling and looseness in the neck.
Younger patients who are simply looking to replace lost volume in the face should definitely choose fat injections or fillers over facelifts simply because of their cost-effectiveness and minimal downtime.
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.
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.
It is probably best for patients considering a deep plane procedure to have several consultations with different plastic surgeons before making a judgment call. Go with the surgeon who makes you feel the most comfortable.
Generally, it is not a good idea to create a facelift in which only the skin is pulled as this was a technique used in the 80s which most resulted in the “wind tunnel” look characteristic of poorly performed facelifts. In addition, these facelifts often had a long scar which was worse than those of today’s more invasive ones.
It is somewhat rare for patients to have a thin layer of subcutaneous fat (this is probably based on the structure of their faces). Though fat grafting may seem like a good option here, it can create several surface irregularities.
Though damage to the facial nerve can occur post-op, it is extremely rare and patients should wait and allow existing nerves to heal before diagnosing themselves.
Numbness around the ears is definitely a normal symptom, with sensation returning around 4-6 weeks after surgery. If sensation does not return after 6-12 weeks, damage could have been done to the greater auricular nerve.
A good place to start in finding plastic surgeons is on the website for the American Society for Aesthetic Plastic Surgery where readers can do a search (surgery.com).
Patients must remember that a fat transfer is not at all equivalent to a facelift. Fat transfer helps with lost facial volume and involves the addition of fat to the cheek and temple areas.
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.
Surgeons who are experienced are not qualified simply by numbers, but by their before and after photos, their technique, etc. Research is the key for patients.
Generally, for patients in their early 40s, it is best to address jowling and sagging with a mini facelift with touch-ups repeated every 7-10 years.
For patients several months post-op who are still seeing fullness and lumpiness in the neck and chin, it is probably safe to assume that most of this is composed of residual swelling and inflammation as well as limited platysmal banding. At this point, the only methods of treatment are massage and dilute steroid injections.
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.
The best place to start when assisting facelift patients would be to follow every post-op instruction given by the surgeon. Have the patient sit upright whenever possible and avoid putting pressure on any one side of the face.
Generally, patients should be looking at a healing time of 2 months or so following a facelift for results to begin to normalize.
Patients who have severe sleep apnea and require a CPAP machine should be monitored 24 hours in a hospital following the facelift to avoid a severe apnea episode.
Patients should not expect a great deal of change in volume when using a filler. Major changes should probably be done with implants which can put in with local anesthesia.
It is uncommon for patients to experience a great degree of pain 6 months post-op or swelling in a great amount. Consulting with the plastic surgeon is probably the best option at this point.
Generally, patients with excess fat in the lower face at 20 years should not consider a facelift automatically, but should look into other options like buccal fat pad removal which can be done under local anesthesia and for which the results are visible in one month.
Patients dealing with a hollow tear trough area should consider fillers like Restylane as a first line of treatment.
A mini facelift, as suggested by the name, is less invasive than a full facelift and relies mainly on lifting the jowl area and providing minimal tightening of the skin. A full facelift, however, goes deeper affecting the SMAS layer under the skin, repositioning facial contours, tightening the neck muscles, etc.
Patients experiencing post-op anxiety can usually be helped with anti-anxiety medications or a visit to their local therapist or plastic surgeon.
Redness near the incision site is most likely the mark of a suture which should be removed as soon as possible. After this, the wound should be treated with vinegar washes or topical antibiotics.
In general, if patients are concerned about facial aging, the best way to address their concerns is through a full facelift. The mid facelift, while providing temporary relief in the cheek areas, does very little for the aging process.
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.
It is probably best for patients post-surgery to refrain from repeated facial movements (chewing gum , etc.) for about 3 weeks.
Theoretically, there is no limit as to the number of facelifts which a patient could have. Therefore, if patients feel the need to have a revision done, it can be done successfully if the surgeon is fully competent and understands the context of their work fully. Again, I would look into other options before undergoing ANOTHER (maybe unnecessary) surgery.
I would remain wary of such “gimmick” procedures which promise much but actually provide little. The Quick Lift, from what I’ve heard, is simply a variation of the short scar or mini lift which lasts for about 5-10 years (varies greatly though). Again, for patients serious about facial rejuvenation surgery, there is no substitute for a true facelift.
Generally, marionette lines are not really the target area for a facelift and are much better suited for treatment by fillers or fat injections.
Sutures can be removed from incisions in front of the ear about 7 days post-op while staples and sutures behind the ear or in the scalp can be taken care of after about 2 weeks.
Hardness, swelling, and bruising are all extremely normal responses of the body to incision post-surgery. Patients, however, should monitor these sites over a period of weeks to check for possible hematomas.
Patients who have excess fat above and below the platysma post-maxillofacial surgery could have many of their problems with a neck lift combined with a platysmaplasty designed to remove this fat and sew the platysmal muscle next to the hyoid bone.
I would definitely beware of many of the marketed facelifts especially because they tend to promise much but often end up yielding very little. For patients serious about facial rejuvenation surgery, there is no substitute for a true facelift.
Patients deciding between doing either one of these procedures before the other can do any of these first, as long as the two procedures are separated by a period of 6 months. Laser treatment should probably be done later though as a way of combating the wrinkles which may appear after the facelift.
A revision facelift is not often necessary in these conditions as less invasive procedures like skin redraping or local tissue rearrangement can be done far more easily.
Though it may seem like all the best plastic surgeons are in the Beverly Hills area, there are plenty of other surgeons throughout the country who can probably do the same work for a cheaper price. Most board-certified plastic surgeons are perfectly capable, but patients must make sure to check credentials and certifications beforehand.
Otolaryngologists are highly trained in facial plastic surgery so they are certainly capable, but the question ultimately remains as to the actual experience of the surgeon. Patients, whenever choosing a surgeon, should do their homework and check for the necessary credentials and certifications before undergoing surgery.
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.
Patients must remember that a facelift is not the ideal solution for addressing volume loss in the face, but is rather more suited for addressing skin sagging and laxity. Patients having problems with fillers should consider fat grafting.
Irritation of the palate area post-op is most likely the result of intubation during surgery or an oral airway. Usually, irritation tends to resolve itself out within a few weeks, but a surgeon should consult with you.
Patients should not look at ultrasound facelifts and expect the same results as a traditional facelift.
If done properly, the long-lasting (10 year) Endotine procedure should not produce any facial nerve damage.
Generally, patients who are still dealing with nerve problems years after their surgery must accept the fact that such feelings are most likely permanent. Again, though, if deemed absolutely necessary, a consultation can be done with a neurologist.
The best treatment for chin definition would probably be the lower facelift which improves sagging jowls and removes excess skin from the lower areas, repositioning tissues along the way. Areas from the mouth, neck, and ears remain relatively unaffected.
Unfortunately, many marketed procedures are ineffective, but revision surgery can usually be done 6-12 months after the failed procedure during which scars can be removed and/or repositioned.
Two different types of fixation during a facelift are imbrication and plication. Imbrication consists of dissection underneath the SMAS and the suturing of the SMAS flap to the fascial layers (under tension) to achieve a lift. Plication involves folding over the SMAS.
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.
Patients having jowl problems post-surgery usually have their problems addressed quite fully with fat injections. Glandular problems and exposed glands can also be addressed by the excision of skin.
It is certainly possible that surgical trauma could activate granuloma, nodules, and biofilm, especially if the filler used was semi-permanent like Sculptra or ArteFill.
Asymmetry in the lips due to a neurological issue can be easily corrected with Botox, fillers, and additional revision surgery.
Patients who already have cheek implants in place generally do not require a subperiosteal midface lift. Either the cheek implants should go or the surgery should be avoided.
Personally, it is strange to see facial fillers AGING the skin. I would not recommend surgery as a first line of treatment, but would instead look at other options like full facial laser resurfacing or Sculptra.
Patients who wear dentures normally should definitely wear them during the operation as they add additional volume to the face and allow the surgeon to get a better idea of how you present yourself to the world. Again, it is best for the surgeon to have a good picture of the patient’s normal daily face in order to best address their normal concerns.
Patients exposed to secondhand smoke should probably not worry about how it will affect their surgery. Again, it is mostly the nicotine within the cigarette itself which constricts blood vessels, so secondhand smoke shouldn’t be a problem.
Redness and irritation around sutures post-op is normal as the body sees the suture as a potential agent of infection and attempts to expel it from the body. Inflammatory cells are called and attempt to break down the stitch. It is probably best to consult your surgeon about these problems.
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.
Generally, most facelift operations are made to have scars that look as inconspicuous as possible. Scars, in an effort to avoid raised sideburns, may be placed horizontally along the top of the ear.
Generally speaking, using glue versus using sutures should not affect the overall regeneration of sensation which should return fully after about 2 years.
Generally, people should wait a minimum of two weeks before resuming daily activities.
Patients who feel that they have eye deficiencies post-op should probably wait for swelling to disappear before properly evaluating themselves.
Generally speaking , this should do very little in the eye area besides removing excess skin, so it should not be a concern to patients.
Generally speaking, younger patients tend to be somewhat critical of themselves and tend to see signs of aging where there actually are none. Surgery is probably not the best option for these patients and can be better substituted by liposuction or Excilis treatments.
Prior to doing a revision surgery, it is often helpful for revision surgeons to have the notes from the previous surgery. Physicians are legally bound to release these records upon patient request as many patients have varying positions of vital structures on their face.
As tissues and sutures gradually relax, slanty eyes following a facelift usually tend to resolve themselves quickly. However, if they do not resolve themselves after 6 months, see your doctor quickly.
It is probably best for patients dealing with these conditions to first see an ophthalmologist or even an oculoplastic surgeon to examine the lacrimal gland swelling. If ptosis surgery is needed afterwards, it can also be done.
Personally, I would recommend that patients in their 40s stick with their nonsurgicals simply because the signs of aging necessary for a facelift are usually not there at this point. Liquid lift is probably the best option right now.
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.
It is possible for some patients to bypass the pins and needles feeling in favor of immediate return of sensation. It just depends on the extent of nerve healing which can occur, with some patients healing faster and better than others.
In general, fat grafting is a technique used for effectively addressing volume loss and is usually best combined with a facelift for maximum results. In general, I would recommend that patients trying to choose between these two options see their surgeon and decide for themselves.
I would be careful of having an aggressive subperiosteal midface lift so soon after a facelift and would instead look to substitute it with fillers or fat injections which fulfill the same task and are less invasive.
Generally, if deficiencies are not present immediately after the surgery and appear a while post-op, they are usually not related to the results of the surgery. It is more likely the result of a parotid gland problem which can be resolved by seeing an ENT.
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.
If done in the hands of a qualified plastic surgeon, fat grafting on the temples, under the eyes, and the cheekbones can be used. However, the surgeon must be qualified.
The Y-Lift, from my research, is a form of the liquid facelift in which a different instrument (blunt cannula) is used as opposed to sharp needles.
For patients experiencing midface hollowness with very little evidence of jowling, perhaps the best option would not even be surgery. Fat grafting often substitutes very effectively for surgery and is less invasive.
Bulging after a facelift may be the result of several symptoms which require a more comprehensive face-to-face exam.
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).
Scars can be easily excised causing any lower pole on the ear to move into a better position. After this is done, soft tissue can be activated to fill the defect.
Patients with cancerous tumors are at higher risks of developing deep vein thrombosis and pulmonary embolism post-op so it is imperative that these risks be addressed with the plastic surgeon. If possible, any tumors that can be removed should be prior to surgery.
A mini facelift is a procedure in which incisions are placed around the ears and the skin is pulled up to these incisions and trimmed at the suture line. A midface lift, however, is usually performed through an extended lower eyelid incision, a preauricular (in front of ear) incision or a combination of both.
Generally, patients should wait about 6 weeks or so (consult with your surgeon on the specifics about this) before any Obagi or facial rejuvenation treatment is considered. The Blue Peel treatment tends not to be that deep, but still caution is the best course.
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.
Yes. Patients before performing a fat grafting procedure should attempt to keep their weight as stable as possible prior to and after the surgery in order to keep the results stable. In addition, the grafted fat should come from a stable part of the body.
Post-surgery acoustic neuroma is best dealt with by a specialized facial nerve center comfortable with the procedures of static slings, dynamic slings, nerve grafts including cross facial nerve grafts, and free innervated muscle grafts.
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.
After a facelift, it is probably best for patients to wait at least a year before making any judgement calls. Facial exercise at this point are useless.
Patients looking to have a secondary facelift should first obtain medical and cardiac clearance and also make sure to discuss the consumption of bloodthinners (and when it should be stopped) with their surgeon.
A mini facelift, as suggested by the name, is less invasive than a full facelift and relies mainly on lifting the jowl area and providing minimal tightening of the skin. A full facelift, however, goes deeper affecting the SMAS layer under the skin, repositioning facial contours, tightening the neck muscles, etc.
Patients dealing with sloughing of the skin could attribute it to a variety of causes such as smoking, history of diabetes, cardiovascular issues, the use of blood thinners, or the over-tightening of skin flaps during surgery. Consultation is necessary.
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.
It is common for sutures to be placed in this location because it allows for trimming of neck tissue to be easily hidden within the hairline.
Usually, muscle spasms are not attributed to the breaking of sutures or disruption of tissues post-op. Yet, it is not a common problem and should be dealt with at your next follow-up appointment.
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.
For patients having surgery out of town, I would recommend staying in a recovery facility overnight to avoid any complications and staying within the same area for up to 2 weeks post-op.
Irregular depressions in the skin post-op may be the result of the swelling. However, if after 6 months, these depressions still remain, fat injections can be made into the hollows and steroids can be injected into the lumps and bumps to help smooth out the facial structure.
Numbness following a facelift is generally to be expected in the lateral cheek and neck area, yet weakness with smiling and other lower facial muscle-oriented movement may indicate facial or trigeminal nerve injury. It is important for patients to keep close contact with their surgeons in order to be prepared for such a situation.
It is definitely possible for patients to have bone grafting procedures done concurrently with the facelift. Yet, I would not recommend having the bone grafts taken from the face itself as altering contours of the face can do some serious damage for the facelift as a whole. I would recommend places like the elbow or the hip for better bone harvesting.
For superficial wrinkles on the face post-op (since facelifts actually do little to address wrinkling), laser resurfacing is definitely a good option.
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.
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.
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.
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.
Patients who wish to wear a certain hair style after surgery should discuss this with their surgeon before the surgery in order to ensure that the scars made from the incisions are as inconspicuous as possible.
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.
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.
The discoloration of the skin is caused by the release of melanin caused by the thermal injury of the skin cells during a laser skin resurfacing procedure. Yet, patients should not confuse laser skin resurfacing with a facelift. Laser skin resurfacing can cause some tightening of the skin, meaning it affects mainly the surface features of the face.
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.
Patients dealing with post-op fat atrophy and dermal thinning should probably look to fat transfer as the most ideal option.
I would remain wary of such “gimmick” procedures which promise much but actually provide little.
Depending on the relative pigmentation of the skin, ablative or non-ablative laser resurfacing techniques may be in order if the patient wishes to correct small depressions (pores) on the skin. For larger depressions, fat injections or fillers may also be effective.
Other options throughout the years have been fibrin glue and Jackson-Pratt drains, both of which have been used with excellent results. Again, it is mostly a matter of choice with the patient.
Generally, after a face and neck lift, one would expect any jowling before surgery to be gone. However, it all depends on the extensiveness of the facelift and whether the deeper SMAS tissues responsible for jowling were addressed at all. Again, though, patients must remain patient even months after the procedure before they start making judgment calls.
If the patient is particularly ambitious, rhinoplasties can technically be done after 30 days of healing. However, to ensure the best results, it is probably best to wait for any residual swelling to go down which could take as long as 6-9 months.
The stereotypical windswept look of a celebrity facelift can usually be attributed to simple inexperience and lack of technique on the part of the surgeon. Just because a surgeon works in Hollywood does not mean he/she is at the top of their field and the results often show this.
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).
Irritated or elevated scar tissue can be easily taken care of with cortisone injections, but other than that, very little can be done.
Temple wounds may be attributed to thermal wounds leading to a longer, more prominent scar. However, further consultation with a surgeon and a full exam may be needed.
To be honest, there is no set procedure for a secondary facelift. It all depends on the surgeon’s skill, knowledge of facial anatomy, experience, the patient’s facial structure, and several other factors. Generally, if you find an experienced surgeon, he/she will be able to yield the desired results.
The reinforced orbitotemporal lift (ROTEL) is probably one of the more aggressive surgeries out there and one I would definitely advocate against using as a technique. In the procedure, an incision is made in the lower eyelid below the eyelashes and surgical dissection is carried out under the lower eyelid muscle, a technique which puts the lower eyelid at risk for nerve damage and pulverizes temple fat.
Loose skin around the mouth area, especially for younger patients, is usually best addressed with the use of fillers or fat grafting.
Unfortunately, little can be done surgically, other than static or dynamic slings/muscle grafts, to repair long-term nerve damage. Patients can attempt to strengthen weak muscles through nerve stimulation and therapy, and asymmetry could be disguised with the use of fillers or Botox.
Generally, shadowy areas and depressions in the face can usually be corrected with fat or filler injections and other volumizing treatments.
Patients experiencing the sensations of beads under the skin are probably dealing with minor blood clots or sutures. The former problem can be dealt with by massage, but the latter should be taken care of by the surgeon.
Again, the best results often come from surgeons with the most experience. The best thing to do for patients unsure of a doctor’s expertise is to examine before and after photos to evaluate their work.
Skin Only facelifts, common in the 80s, are still performed. However, surgeons have discovered that the best results for a facelift often come when tissues underlying the skin are adjusted along with the skin. Otherwise, there is a chance for that characteristic windswept look of botched facelift surgeries.
There remains an important difference between a facelift and a liposuction in terms of procedure. A liposuction is merely the removal of fat in the chin (submental area) and in the neck since facial fat is good for maintaining youth. A facelift, however, is much more involved and consists of removing fat above and below the platysma, tightening neck muscles, etc.
Depending on the patient, a MACS/PSP Lift is expected to fix the jowl line and trim excess skin in the submental region. Yet, nasolabial folds are generally not fixed with this procedure and must be treated with the use of fillers.
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.
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.
Over the long term, there is virtually no way to ensure the constant maintenance of dermal toughness. However, in the short term, patients could look into the options of ultherapy and/or laser resurfacing treatments.
The best route, in my opinion, would be to do the latter surgery before the facelift.
In general, minor defects in the bone structure which were not noticeable prior to the facelift should not be noticeable in the post-facelift results. Facelifts tend not to improve or worsen facial asymmetry.
Sunscreen in the post-op days, when the skin loses its normal ability to respond to sun exposure and damage, is especially important. Patients should stay out of the sun for about 3 weeks, after which sunscreen can be applied (I recommend a zinc-based sunscreen for minimal chemical absorption).
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.
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.
Unfortunately, patients who are unsatisfied with their jowling post-MACS Lift have fallen victim to a common problem in facelift surgery. The MACS Lift, while being effective for some, is totally ineffective for those who want penetration into the deeper tissues, for which there is no cure but the SMAS Facelift.
Patients with an endoscopic lift may have issues with elevated cheekbones, issues which usually resolve themselves over time.
Dilute steroid solutions should not cause either.
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.
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.
Inability to pucker post-facelift is usually caused by swelling and will most likely recover before long.
Patients at the age of 32 are well below the normal age of a facelift. Many other options exist, some of which are not nearly as invasive, like fillers, Botox, fat grafting, photofacial, laser treatments, etc. Either way, a facelift is usually out of the question.
Patients looking to have a revision neck lift following a platysmaplasty may have lost significant elasticity in the first procedure, but can still have the neck lift done in a relatively short period of time.
Patients worried about affecting the results of the facelift with excessive movement of the face (smiling, talking, etc.) should not be so concerned. Again, the elevated tissues modified in the facelift are fixed in place with sutures and/or Endotine devices and will be released in time.
Facelifts and fillers tend to work hand-in-hand very well. Though many people would opt to have facelift procedures done BEFORE fillers are added, doing the reverse is perfectly acceptable.
Ropey fullness on the neck tends to be the mark of fluid collection which can easily be aspirated by a surgeon. Even untreated, the symptoms will eventually begin to heal on their own. Consult your surgeon to check it out.
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.
Patients who have experienced allergies to arnica cream should probably avoid it altogether during surgery, as its effects are controversial and extremely limited.
Generally speaking, the Acculift procedure, in the grand scheme of things, does very little for patients who are serious about facelift surgery, particularly those in their later years. Residual neck bands and poor facial definition are just some of the post-op complications which can occur.
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.
A saggy cheek and nasal region is usually not caused by typical aging and patients who have this symptom over the long-term may have problems with the tissue structure in the face. If this is true, facelifts are not the answer, but consultation with the plastic surgeon could provide several options for these patients.
After 3 years, many patients do experience recurring skin laxity following a facelift. Again, the extent of the loosening depends on many factors including sun exposure, smoking, genetics, etc.
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.
Patients who wish to use sunscreen post-op should probably go with a simple zinc oxide or titanium oxide formula or even non-oily coppertone SPF 30 or 50.
Unfortunately, any nerve damage sustained over 18 months or longer is likely to be permanent. The best solution would be to have Botox placed on the other side to even out the distortions.
This procedure has been around for a decade and is somewhat recent in terms of facial rejuvenation surgery. For this reason, it has not been proven to work as effectively as a facelift procedure and is continuously hounded by many doctors as a “fad”.
Swelling which arrives and then disappears 18 months after a facelift is not indicative of a typical hematoma, but is more likely the result of a parotid leak. I would recommend a full exam with the surgeon followed by the application of Botox and antisialagogues to the area.
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.
Generally, swelling within the first few weeks of surgery, though seeming like a lot, will not stretch the skin to any appreciable degree. The results of the facelift will largely remain intact.
Patients dealing with extensive white scarring behind the ears following surgery usually have excess tension in the skin of this region and thus have a poor blood supply in this area. The scar must be excised and the skin adjusted to reduce the tension in the area.
Often, when patients have ineffective surgeries done in the past, they feel the need to do more invasive procedures to achieve the results which they want. However, very often, the problem lies not in the procedure, but the surgeon. Find a good plastic surgeon with the credentials to perform the surgery which is right for you.
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.
These symptoms tend to resolve themselves over time, but, if persistent, can definitely be treated with Botox treatments. However, patients should be wary that a possible side effect of this treatment could be weakness at the site of injection.
Patients experiencing jowling post-op may definitely require a facelift in order to lift the SMAS and a liposuction of the neck to improve platysmal retraction.
A golf-ball sized lump present after the procedure is likely a hematoma. Drainage of this area is probably the best way to avoid facial contour damage.
The next best thing to a facelift would probably be a mini facelift which offers small-scale improvement to jowling and other “facelift”-related symptoms. However, non-surgical options like fillers or fat grafting do exist which, depending on the patient, can provide better results.
I would advise patients who have a support device to wear it continuously for up to 10 days post-op in order to control swelling. A cooling device can also be used in the first 48 hours after surgery to also control swelling.
It is important for post-op patients to make the distinction between a hypertrophic scar and a keloid scar. A hypertrophic scar is a thickened scar which stays within the boundaries of the original incision whereas a keloid scar spreads out from the incision and have a mushroom-like appearance. Patients who have demonstrated keloid scarring should most likely see their surgeons.
Both ABPS (requires the longest training) and ABFPRS are solid credentials for a plastic surgeon to have. However, the best results are often the ones in the hands of experience. Find a surgeon who has the capability and technical skill to adequately perform facelift procedures.
Though the cheekbone itself is not moved during a MACS lift, underlying tissue can be elevated.
Unfortunately, as the facelift is a cosmetic procedure, it is very unlikely that it will be paid for by the insurance company.
It may seem like a better idea to have different specialist treat different aspects of the face, but patients must remember that surgeons can often specialize in several different things, meaning that different procedures can be done all at once. Again, consultation is probably key, so see which surgeons you feel comfortable with.
Skin breaking out may be part of the healing process, but proper skin care may be in order. Check with a dermatologist to find your options.
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.
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.
This symptom may be attributed to an ectropion resulting from the excess removal of skin during the bleph procedure. Again, it is probably best for the surgeon to examine these problems, but volume fillers may be helpful.
A depression in the zygomatic arch could be attributed to the atrophy of the temporalis muscle. In this situation, fillers, fat grafting, or even Sculptra treatment could all help.
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.
Most facelifts frequently used today, whether they be SMAS, deep-plane, or even mini facelift, have at least some interaction with the SMAS layer beneath the skin. Tightening of the muscle layers underneath the skin usually always happens with any of these procedures.
Try all you want, but, unfortunately, facial exercises have not been proven to have any effect on improving facial asymmetry.
All of these procedures will take as much as 2 weeks for recovery, but breast reduction tends to be longer and requires more anesthesia.
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.
Unfortunately, as I have stated before, the MACS Lift is a surgery which works well for some patients and not so well for others. Patients in the latter category, because of the rather limited nature of the MACS Lift, may need to undergo secondary facelift or mini-lift surgery to achieve optimum results.
Bruising following a MACS Lift may be completely normal, but could also be the result of hyperpigmentation which can be treated with hydroquinone or glycolic peels. Bunching of the skin, however, must be treated surgically with a redraping of the skin.
Ringing in the ears could be attributed to residual blood from the surgery resting on the eardrum, but further consultation with an ENT may be necessary.
Like any procedure which separates the skin from underlying tissues, a facelift does come with its share of risk, namely of damage to the skin. However, because the face is so vascular, such risk is relatively minimal.
The PDS is a reabsorbable monofilament suture which is slowly broken down in the body and retains tensile strength for months after a surgery. It is commonly used as a method of fixating repositioned deep tissues.
It is probably best to have facial surgery when the respiratory system is clear and breathing isn’t affected. If the body is generally stabilized at this point, the facelift should be fine.
Often, patients dealing with neck sagging can have their issues addressed without a facelift procedure. Liposuction and neck skin resection may be all that is needed, but again consult with your plastic surgeon about your option.
Valium is an anti-anxiety medication which allows the patient to rest for the immediate post-op period. It is good for patients looking to avoid hematomas which are usually attributed to strenuous activity in this post-op period (rise in heart rate and blood pressure). Consult with your surgeon, however, for long-term use.
Patients using peroxide should probably stop using it as an anti-microbial agent as it is known to slow wound healing and cause a drying of the skin edges. Skin sloughing at this point could also be a problem due to excess tension on the skin.
Decadron is a steroid which works on the cellular level to decrease swelling and nausea in the patient. Even patients taking hydrocortisone for adrenal insufficiency are able to take this medication.
Generally, it is important for doctors after a cheek implant to fix it in place with a screw which may require surgical incision. A simpler method of treatment could be to inject fat into the area to hold up the implant in place.
HRT treatments during surgery may increase the risk of blood clotting so it is advisable to stop this treatment before surgery if possible.
Sculptra is generally used as a deeper volumizer primarily used within the cheeks and the temples and may require multiple treatment sessions for the desired effect. Acid fillers are probably better for under eye filling, as are fat transfer options.
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.
Generally, muscle weakness, if temporary, takes within 3-6 months to fully recover.
Personally, I do not approve of unproven, “gimmick” procedures like facelift acupuncture especially because they offer no elevation of the face.
Patients are recommended to be in their best nutritional state before surgery, but they must make sure that their weight is fully stable before undergoing elective cosmetic surgery.
A traditional facelift IS a lower facelift in that it addresses mainly the lower 1/3 of the face and takes care of issues like jowling and sagging of the neck and lower jaw. The term “lower” facelift is used simply to differentiate a facelift from a “mid” facelift which addresses the cheek area and a “brow” lift which addresses the upper third of the face.
After a post-op period of several years, it is unusual for patients to be experiencing tightness. The probable cause of this tightness is most likely a permanent suture which may need to be removed.
Full healing does not take place until about 6-12 months, but patients will generally be ready for public events after around 3 weeks. Again, it is important for the sake of the patient that he/she quit smoking and other habits which could inhibit or, at least, prolong healing.
Patients should wait for at least 4-6 months post-op before considering hair growth procedures, as surgery may have “shocked” hair follicles for a long, but temporary, period of time. However, if re-growth does not occur, the best option could be follicular unit grafting.
A facelift is not done based on age, but rather based on the symptoms of a patient. Generally speaking, skin laxity is the number one issue for which a facelift is necessary, an issue which is rarely present in younger patients (who more often have problems relating to volume loss).
Though changes after a facelift vary from patient to patient, some basic results of a standard lift include a better defined jawline, tightening of the skin under the chin, and elimination of muscle banding in front of the neck. As healing progresses, fluid collection and swelling should decrease dramatically and tissue should begin to soften.
This problem could be attributed to several things, namely an organized blood clot, scar tissue, cyst, retained fat, etc. A full exam is definitely in order to determine the nature of the lump.
It is common for people with thin skin to feel the endotine device under their skin, but the device does dissolve over a period of one year. Dimpling may occur during this point, but the endotine device should not be visible.
For patients who have legitimate proof that a doctor did an incorrect surgery, it is best to first check the consent form for surgery to see if the surgery was incorrect. Legal documentation is needed before accusations are made.
A fat pocket left over from surgery can easily be removed with direct skin excision or even through direct removal.
It is strange to hear of patients who have problems with their dental bite after facelift surgery, especially because the facelift merely involves the re-draping of surface skin and the repositioning of soft tissues. It is difficult to imagine that the minimal force required for a facelift surgery could alter something as large as a dental bite.
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.
Dr. Ramtin Kassir © 2017
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Disclaimer: This site only provides information about cosmetic surgery and this information is not meant to be taken as medical advice. For more information about plastic surgery, contact Dr. Kassir.