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About Facelift

by Ramtin Kassir, M.D., F.A.C.S.

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

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

What is a facelift?

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

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

What can Facelift Surgery do?

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

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

Are you a good Facelift surgery candidate?

The best candidates for facelift surgery are:

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

Recovery from Facelift Surgery

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

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

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

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

What are the different types of Surgical Facelifts?

The SMAS Facelift is the traditional facelift which pulls up the SMAS layer and is effective for those with jowls and skin laxity.

The Deep Plane Facelift is a modification of the traditonal facelift that works more effictively on the midface areas such as nasolabial folds.

The Endscopic Facelift is a minimally invasive technique using small cameras to guide insturments and allows for lifting the midface and brow.

The Midface Lift is a procudure to specifically targert the areas of aging in the midface; the areas between the cheekbones.

The Mini Faceliift is related to the traditional facelift but involves smaller incisions behind the ear and focuses on adjusting the skin.

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

More Facelift Information

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

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

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

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

What Does a Facelift Cost?

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

Are Facelifts Safe? 

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

Do you Need a Facelift?

Signs of an aging face:

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

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

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

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

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

What to know before you have facelift surgery:

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

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

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

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

You should pick facelift surgery if:

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

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

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

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

Are you a candidate for a facelift?

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

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

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

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

Facelift: Questions & Answers

Why am I panicking about my looks post-facelift?

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.

What are my facial rejuvenation options as a 65 year old woman?

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.

Can a surgeon predict scarring?

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.

Does a facelift address the eyes and neck?

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.

What can I do about cheek asymmetry post-facelift?

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.

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.

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

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

Is getting a facelift early detrimental?

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.

How can I deal with a frozen eyebrow post-facelift?

Unfortunately, any nerve damage sustained over 18 months or longer is likely to be permanent. The best solution would be to have Botox placed on the other side to even out the distortions.

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.

Can fillers address jowling?

Patients often become confused with jowls and believe that the main issue with them is lack of structural fat within them. However, this is not the case, with the usual problem being skin laxity. Fillers, because of this, cannot really be used for addressing jowls because they merely add volume where volume is needed (cheeks, lips, etc.). Adding them to the jowls will not only do very little, but may worsen the symptoms.

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.

Should I concerned about scarring post-facelift?

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.

Can I use hirudoid cream on my lumps post-facelift?

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 does bruising subside post-facelift?

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.

How long do Acculift results last?

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.

What can I do about a previous “ugly” MACS surgery?

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.

Are cheek and neck lifts equivalent to the results of a facelift?

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.

Can I have a neck lift following a platysmaplasty?

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.

Can an S-Lift help with jowling?

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.

Is the age of a surgeon important for a facelift?

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.

Will surgeons negotiate fees?

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.

What is a deep plane facelift?

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.

Did my doctor mess up my fat transfer?

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

Does drinking liquid collagen help with facelifts?

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.

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

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

Can a MACS Lift be done with Fraxel repair?

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.

What is the Swelling and Numbness after a facelift like?

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

Can I resolve smile lines via facelifts?

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.

What is the best age to do a Facelift?

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

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.

Is the cheekbone moved during a MACS lift?

Though the cheekbone itself is not moved during a MACS lift, underlying tissue can be elevated.

What do I do about volume loss post-facelift?

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.

Can I take amino acid supplements 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.

What distinguishes board-certified surgeons from licensed surgeons?

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.

How can loose skin around the mouth be dealt with?

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

What 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.

What can be done about chin scarring post-facelift?

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.

Does an acupuncture lift work?

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

Are these dimples on my skin post-facelift normal?

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.

When will post-facelift malar bags heal?

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

How can I deal with lateral sweeps post-facelift?

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

Is tightness associated with nerve damage?

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

What are long-term results from a facelift?

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.

When can I have a chin and jowl lift?

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.

Can a fractional laser substitute for a mini lift?

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

What are these lumps on my neck post-facelift?

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

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.

Do I need a deep plane facelift?

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.

Can I get flattened cheeks from a facelift?

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.

Is paralysis of the eyebrows normal post-facelift?

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.

Can I have laser treatment post-facelift?

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.

Can I use Fat Augmentation to rejuvenate my face?

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.

What skin care regimens should I undertake prior to a facelift?

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.

How long will my face feel tight 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.

Can sagging be addressed via a lower facelift?

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.

Why do I have beads under my skin post-facelift?

Patients experiencing the sensations of beads under the skin are probably dealing with minor blood clots or sutures. The former problem can be dealt with by massage, but the latter should be taken care of by the surgeon.

Can an uneven face be corrected with a facelift?

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.

Can a 54 Year Old Get a Facelift?

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

Is bruising and discoloration normal within the first week post-facelift?

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.

Why are there jowls and double chins post-facelift?

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

Can I have surgery out of town?

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.

Can I have a lower lid retraction via a midface lift?

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.

Can spacer grafts be performed during a midface lift?

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

Is post-facelift mouth movement difficulty normal?

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

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.

When can I have a facelift after doing Lifestyle Lift?

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.

Can E-cigarettes cause damage before a facelift?

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.

Can I use cooling or support devices post-facelift?

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.

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.

Why do I still have a droopy face post-facelift?

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.

What should I be looking for in Before & After photos?

In before and after Photo’s you should focus on whether the person still has the same facial structure that defines them. Then look to see if the person looks like a more refreshed and youthful version of themselves.

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 chin sagging?

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.

Is the facelift procedure different for a patient with sleep apnea?

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.

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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.