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About Facelift

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

Want to look as young as you feel? Are you looking for a natural looking facial rejuvenation?

Facelift Surgery is designed to reverse the visible signs of facial aging, including the formation of jowls, which obscure the jaw line, the occurrence of a double chin and the appearance of vertical bands of the skin and muscle in the front of the neck. Dr. Kassir is a leading expert in facelifts in NJ. Patients travel from national and international destinations for Dr. Kassir's facelifts. Click here to see examples of patients who have had facelifts by Dr. Kassir and their stories.

What is a facelift?

Facelift surgery, also known as rhytidectomy, is a plastic surgery procedure performed to improve the neck laxity, jowls, and the midface. As a person ages, the midface begins to go downhill, producing the smile lines" or "laugh lines. The lower face then begins to show jowling, near the chin and the neck muscles sag, producing banding and redundancy. These three areas can be improved with the facelift procedure. The facelift does not improve the skin texture or quality.

Modern facelift techniques involve resuspending the deep connective tissues of the face and allow the face and neck skin to be elevated and produce a natural rejuvenation. These techniques avoid the "plastic" or stretched appearance so common with facelift surgeries in the past. The surgery is typically performed without the need for general anesthesia and a 1 to 3 week recovery period is usually necessary after the procedure.

What can Facelift Surgery do?

Facelifts, technically known as rhytidectomies, rejuvenate the mid- to lower face and neck. Facelifts are most effective for NJ patients who want to correct:

  • Midface sagging
  • Deep creases under the eyes
  • Deep creases between the nose and mouth
  • Jowls due to loss of muscle tone
  • Sagging areas of fat
  • Loose skin and fat under the chin and jaw

Are you a good Facelift surgery candidate?

The best candidates for facelift surgery are:

  • Wish to improve one or more of the signs of aging indicated above
  • Are men or women whose faces have begun to sag, but whose skin still has some elasticity
  • Are generally healthy
  • Are considering a facelift for personal reasons to improve their image and appearance

Recovery from Facelift Surgery

The most important thing to remember after a facelift is patience. The body takes time to heal, and your face will look worse before it looks better. Your face may feel tender and tight after the surgery, and there will be discomfort, swelling, and bruising. Dr. Kassir can prescribe painkillers to alleviate the pain, and antibiotics to fend off infection.You should be up and about in a few days, and be sure to walk around 3 to 4 times a day to increase circulation, and prevent blood clots. The bruising and swelling will subside and you should be fine in about 2 weeks. Full recovery however may take 1 to 4 months. Do not bend over or lift heavy objects until Dr. Kassir gives the all clear. Also stay away from saunas, steamrooms, alcohol, aspirin, and ibuprofen. If Incisions were made in the mouth consult Dr. Kassir on what to eat until your recovery is completed. Sleep with your head elevated for example on a pillow, and as still as possible. If you experience any extreme pain, excessive redness, or elevated temperature contact Dr. Kassir immediately.

After your rhytidectomy facelift surgery, Dr. Kassir will wrap the incisions in light bandages. On the next day your hair can be carefully washed and a week later the sutures will be removed.

At first, you may experience swelling, numbness, bruising, and a feeling of tightness or tension in the face and neck. Recovery will be noticed usually within 3-6 weeks, and sensation typically returns to normal within a few months. Scars become less red, raised, lumpy or itchy in time.

Many NJ facelift surgery patients return to work by the second week and some resume normal activities by day five.

What are the different types of Surgical Facelifts?

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

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

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

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

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

The Tissue-glue Facelift is a technique that uses fibrin, a safe biological agent, to close inscision as opposed to sutures.

More Facelift Information

One of the most common procedures in plastic surgery is the facelift. According to the American Society of Plastic Surgery 124,000 facelifts were perfomed in New Jersey in 2012, and in New York facelifts were up 42 percent from 2000 to 2011. Our skin is constantly changing, and the older we become the more our skin cells break down, and divide slower. The dermis, or lower layer of the skin, begins to grow thinner as well. The dermis is comprise of different types of tissue, including elastin and collagen. While the elastin provides elasticity for the skin, the collagen keeps the skin taut. Over time these proteins begin to break down, and results in the loss of elasticity in the skin and deeper tissue. The skin begins to sag as well as the muscle and tissue composition under the skin change, and leads to wrinkles. Although a facelift can lead to younger looking face with a better jawline, neck and midface, it cannot completely erase the signs of age, or fix all problems such as sagging eyelids, eyebrows, or skin discoloration. These problems can be fixed with other procedures for example, an eyelift, browlift, or chemical peel. The procedure of a facelift takes time for recovery, and has minimal risks.

Since every patient is different, the procedure will be different for everyone as well. Dr. Kassir will examine the skin, and explain the procedure to you. Smokers will be asked to stop smoking for a week or two before the surgery, and a few weeks after as well. Smoking is not advised since it inhibits blood flow to the skin, and can interfere with the healing process. Patients are also asked to avoid aspirin or other medications that increase bleeding.

The facelift surgery can be performed in Dr. Kassir's office or accredited surgical center. The patient is usually given a local anesthetic or sedative for the facelift procedure. An incision is made around the temple along the hairline, and goes down to the earlobe. An additional incision is made underneath the chin to tighten the skin of the neck. The skin is then separated from the muscle and fat, and the fat may be trimmed or sucked out via liposuction. Dr. Kassir then takes the SMAS (Superficial Musculoaponeurotic System) and repositions it at a higher, more youthful level. Tightening and reposition the SMAS in this manner gives the jawline a sleeker look, and firms the neck. The skin is then pulled back over the area of the incision and the excess skin is removed with a laser or knife. The incision is then closed with stitches, sultures, or tissue glue.The stitches are placed within the hairline so they are hidden. The surgery takes about 2 to 4 hours depending on the extent of muscle and tissue work. There are other methods to achieve a younger looking face, that require less time for recovery, such as the K-lift™ or liquid facelift with restylane, perlane, belotero, radiesse, juvederm, scultpra, artefill, or fat.

Many other types of facial lifts are favorable including the mini-lift due to its short recovery time, the S-lift and the K-lift™ which focuses on the lower part of the face (neck and chin), mid-facelift which includes small incisions in the hairline, above the ear, and inside the mouth, and the Tissue-glue facelift which uses tissue glue to seal the incisions made. Some non-surgical techniques are also available with lower costs and fewer risks. Thermage or thermacool uses radio frequency to activate the body's natural collagen, and causes the skin to tighten and contract. This technique is best used for slight wrinkles, and the results can last from six months to two years. Ultherapy uses sound waves to achieve facial and neck tightening. Another alternative is the ThreadLift or FeatherLift, which involves inserting a needle with a surgical thread (or a non-absorbable sulture) into the skin. The thread is then pulled tight, and the muscle and tissue tightens with it. This technique leaves no scars, and the thread remains in the body. Some risks of facelifts include infection, scarring, reaction to anesthesia, hematoma, damage to facial nerves, necrosis, and alopecia at the incision site. These risks are minimal, and the procedure results in a younger looking you

What Does a Facelift Cost?

The average cost of a rhytidectomy (facelift) can range from $7,000 to $25,000, depending on what's being done and the problems being addressed. The cost of revision and corrective facelifts are higher. This encompasses the anesthesia, the fee for the facility, and the remainder is the surgeon's fee. Having more than one procedure at the same time, such as a browlift or eyelid surgery, may also be cost saving since the cost for the anesthesia and facility are being paid.

Are Facelifts Safe? 

Facelift surgery or rhytidectomy is a safe procedure if performed by experienced surgeons. Dr. Kassir performs many facelift surgeries per week and also corrects “botch” jobs.  That's why it's so important to pick your surgeon carefully and be an informed consumer. Be sure to direct any questions towards Dr. Kassir. It is normal to feel anxious or nervous about your new look. Afterwards you will have some swelling and bruising, and in a few weeks you will enjoy a rejuvenated look! Be patient. If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. Be sure to follow Dr. Kassir's instructions on how to take care of yourself after surgery.

Do you Need a Facelift?

Signs of an aging face:

1. Wrinkly skin: Over time your skin's natural collagen and elastin begin to breakdown, which causes wrinkles, lines, folds, and a sagging look. A facelift can help with the sagging skin, but problems such as lines and wrinkles can be better addressed with injectable fillers, and good skin care.

2. Sunken eyes: As fat under the eyes starts to descend, your face develpoes a more sunken look. This looks like a loss of volume around the cheeks, and can be fixed most efficiently with a blepharoplasty, small amounts of fat grafts, or injectable fillers as a non-surgical option. Your blepharoplasty can be performed at the same time as your facelift.

3. A saggy jawline: When the jawbone loses density over time, there is less of a structure for the skin to hang on to, therefore the skin begins to sag. To correct this, the loose skin must be excised and the remaining skin must be tightened by a facelift.

4. Bone changes: With time then density of the bones in the face begin to reabsorb. This makes the eyes appear sunken, the jawline becomes less defned, and the cheeks appear flatter. A facelift can help with these changes.

5. Loss of volume: As your face begins to lose fat, the skin begins to droop. The more fat that is lost, the more pronounced folds and lines are. Fat can be taken from a different areas and added during your facelift to add more volume. Fillers can also be injected either before or after your surgery to gve your face more volume.

What to know before you have facelift surgery:

1. Your facelift expectations need to be realistic: A facelift is designed to make your face look refreshed, younger, and fix any laxity. A facelift can't always eliminate every wrinkle and line, and doesnt mean you will look 20 years old again. Dr. Kassir explains that the goal is to create a younger version of yourself that gives you a "rested" and "natural" look. Dr. Kassir fequently reverses and undo's the "windblown", "pulled", and "Hollywood" look.

2. You will have scars after a facelift: Although techniques have improved throughout the years, a facelift still leaves scars. Dr. Kassir makes incisions along the sidburn and ear so they are hidden by the hair, and inside the ear canal. With most patients, scars improve over time and blend in.

3. There is some downtime after a facelift: It may take 10 days to a couple of weeks until you are ready to resume daily activities, and a few months until all of the swelling goes down. With most patients bruising is slight, and pain is minimal. Most patients report that although they barely have pain, there is a bit of tightness involved that will go away the more you heal.

4. Know what can and cannot be fixed with a facelift: A facelift is meant to restore a youthful shape to your face, but it will not improve the look of brown spots, fine lines, or the position or shape of your eyelids and eyebrows.

You should pick facelift surgery if:

1. You want long-term results: Unlike other age-reversing treatments like lasers and injectables (which don't address lack skin), the results of a facelift are very long-lasting.

2. There is loose skin: Loose skin  at the jawline and on the neck creates the look of a double chin or a "turkey waddle". Microliposuction can eliminate unwanted fatty areas, but loose extra skin needs to be excised.

3. There are lines and folds: Over time facial expressions cause the skin to crease and fold which causes lines. Although fillers can help eliminate these lines and folds, lax skin needs to be addressed with surgery.

4. You imagine how you would look with a facelift : If you pull your skin back and see how it would look tighter, a facelift is the only was to get long lasting, elevated results.

Are you a candidate for a facelift?

If your face is oval, you may benefit from a facelift. Hollowing in the temples and cheeks is common because of extra fat in the cheeks, which dissapates over time. Fillers and/or fat fill out hollowing; a mid-facelift helps with sagging.

If your face is round, you may benefit from a facelift. The cheeks and lower face may sag. A lower facelift, which targets the lower part of the face, is the best option. The cheeks can be resculpted by injecting fat and/or fillers.

If your face is rectangular or square, you may benefit from a facelift. loose skin and sagging jowls on the lower part of the face tend to be the biggest problems. A traditional facelift is likely the most effective solution as it addresses jowling and lax sking.

If your face is heart-shaped, you may benefit from a facelift. The forehead and upper eyes are most affected. Since the cheekbones are higer than square faces with flat cheekbones, hearts-shaped faces tend to ages slower.

Facelift: Questions & Answers

What is the SMAS layer?

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.

How does bandaging work post-facelift?

Bandages are generally not used in a facelift. Rather, garments are wrapped around the head for up to a day before being removed.

How can I address my red suture lines post-facelift?

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.

Does swelling require drainage?

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.

Is blood work required pre-facelift?

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.

What is the longevity of Smart Lift results?

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

Can eyebags be caused by fat injections?

No.Fat injections should generally be added along the tear trough, which is the deep grove along the bone of the lower eyelid.

When will my facelift scars heal?

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.

Why do I have irregularities in my face post-facelift?

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.

How much will facial feminization surgery cost?

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.

What do I do about divots in my cheek post-facelift?

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.

How do midface lift revisions work?

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.

Can facial exercises help with an Asymmetrical face after a prior facelift?

Unfortunately with significant facial asymmetry you may need reconstructive surgery to undo the botched work of the prior surgeries.

Are raised sideburns a concern post-facelift?

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.

What does it mean If I have blinking difficulties after a Facelift?

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.

Are drains always used post-facelift?

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

What is the maximum number of facelifts I can undergo?

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

Is asymmetrical swelling post-facelift normal?

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.

What does bulging several months post-facelift indicate?

Bulging after a facelift may be the result of several symptoms which require a more comprehensive face-to-face exam.

What are staples used for in a facelift?

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).

Can skin creams give me surgical results?

Nothing can replace a true, well-done surgery. I would distrust many of these skin cream options which are available out there.

When does healing take place after a facelift?

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.

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

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

Can a Mid-face Lift help with sagging eyes?

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.

How long does a deep plane facelift last?

The usual longevity of this particular surgery varies with genetics and environmental factors, etc, but usually goes for about 10-15 years.

What do I do about swollen cheeks post-facelift?

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

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

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

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

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

Why is there still problems with my chin post-facelift?

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.

Will staple removal combat tightness in the skin?

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

What can I do about nasolabial folds post-facelift?

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.

How is tumescent fluid used during a facelift?

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

How can I address jowling without scarring?

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.

Are there volumizers that are non-surgical and don't use needles?

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.

Can a fractional laser substitute for a mini lift?

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

How can pixie ears be corrected post-facelift?

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

When can I see the earliest results from a deep plane facelift?

Typically, improvement from a facelift should be seen after 1-2 weeks when examining before and after photos.

Why did my skin slough post-facelift?

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.

What does nicotine do during a facelift?

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

How is swelling after a deep plane facelift?

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

Will my sideburns be permanently affected by my procedure?

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

How long is lumpiness, etc. following a facelift?

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.

Do I need General Anesthesia for my facelift?

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.

How should sun exposure go post-facelift?

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).

Can I use the same plastic surgeon for a facelift and other different procedures?

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.

What are the pros and cons of a facelift?

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

What do I do about fat dissipation post-facelift?

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

Am I ready for a facelift in my 40s?

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

Can rosacea present a problem during a facelift?

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

Can nerve damage occur from a facelift?

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.

When are sutures and staples removed after a facelift?

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.

When can I use Radiesse?

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

Does a lumpy post-op neck require revision?

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.

Will minor skeletal defects be noticeable post-facelift as opposed to before?

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.

What is the “One-Stitch Lift”?

“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”.

Can patients prone to keloid scarring undergo a facelift?

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.

What are these lines on my face post-facelift?

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

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

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

Is scarring visible post-facelift?

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.

What can I do about sagging skin in my 40s?

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.

Are there alternatives to lidocaine post-facelift?

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.

What is the downtime post-facelift?

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).

How can permanent nerve damage be repaired post-facelift?

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.

Is there an advantage to stem cell facelifts?

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.

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

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

What is an endoscopic facelift?

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.

When will I look "normal" after a facelift?

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

How do I minimize bruising after a facelift? Should I be worried that I’m swollen and it’s been only 3 days?

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.

What's the risk of scarring post-facelift?

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

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

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

How do I discuss options with my surgeon?

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.

Can fillers be done in conjunction with a facelift?

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

What does a Midface Lift address?

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

What non surgical options can are available for jowling?

Energy devices such as ultrasound (Ultherapy) and radiofrequency (RF) can improve jowling. Injectable fillers can also camouflage jowling by creating a straighter jawline.

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

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

What is the treatment for saggy eyes?

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.

What can be done about my lower facial issues?

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.

Are there minor procedures for people in their 40s?

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.

Was my tongue and palate injured during my facelift?

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.

Why do I still have hematomas post-facelift?

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.

Can you differentiate between a mini facelift and a full facelift?

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.

What is the burning sensation I feel post-facelift?

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

What is the Biltmore facelift?

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.

Why are my ears protruding so much post-facelift?

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.

When can I fly home post-facelift?

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

Can dermal fillers be put in before the surgery?

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.

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

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

What can younger patients do about droopy faces?

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.

How long should I wear a Face Tensor after a Facelift?

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.

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

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

Can jowling occur in younger patients?

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

What can be done about my post-facelift parotid gland swelling?

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.

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

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

What is ROTEL?

The reinforced orbitotemporal lift (ROTEL) is probably one of the more aggressive surgeries out there and one I would definitely advocate against using as a technique. In the procedure, an incision is made in the lower eyelid below the eyelashes and surgical dissection is carried out under the lower eyelid muscle, a technique which puts the lower eyelid at risk for nerve damage and pulverizes temple fat.

What type of surgeon is best for facial surgery?

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.

I have ear canal issues post-facelift. What can I do?

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.

Where will the scars for my Facelift be?

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.

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

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

Why do I have indentations in my face post-facelift?

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.

Can Fraxel treatment damage facelift results?

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

Can deep plane facelifts fix the cheek area?

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

What can I do if I'm dissatisfied post-facelift?

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.

What does a MACS facelift/PSP facelift cost?

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.

Can Botox be done concurrently with a facelift?

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

Can I get black eyes post-facelift?

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.

Should I avoid Arnica cream if I have allergies?

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

What can I expect in my facelift results?

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.

Facelift Costs

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).

How can pain be controlled post-facelift?

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.

Can a facelift treat midface sagging?

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

How can I find a good surgeon for a deep facelift?

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.

Is there a risk of nerve damage in deep plane lifts as opposed to others?

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.

Can I get a facelift at 76?

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.

How can I address a leaking parotid gland post-facelift?

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.

Should I look for an MD or DO in my facelift surgeon?

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.

How long can edemas last post-facelift?

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.

Can a 21 Year Old Get a Facelift?

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.

How much bandaging will be used after my facelift?

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

What are alternative to fibrant sealants post-facelift?

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.

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

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

What can I do about a sagging mouth and wrinkles on my forehead?

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.

What can I do about a protruding suture post-facelift?

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.

Can I treat melasma with a facelift?

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.

How can I address anxiety prior to surgery?

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.

Will the MACS facelift make my cheeks bumpier?

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.

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