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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 this lump on my neck/chin post-op?

Patients who have lumps post-op may be experiencing a localized blood collection or a hanging salivary gland, simply based on empirical observation. These patients are probably best recommended to consult with their surgeon.

How does a Thread facelift compare to a Traditional Facelift?

The Thread Facelift may at best get somewhat inferior results to the Traditional Facelift, however these results typically only last a few weeks. If a patient wants more long lasting results, a more Traditional facelift is required.

When is the minimum age for a facelift?

A facelift is not done based on age, but rather based on the symptoms of a patient. Generally speaking, skin laxity is the number one issue for which a facelift is necessary, an issue which is rarely present in younger patients (who more often have problems relating to volume loss).

Can steroid injections help with swelling post-facelift?

Steroid injections can be useful in areas of excess incisional inflammation, but should only be used when acute and subacute inflammation have subsided. Steroid injections while helping to break down swelled tissue have no control and often break down normal tissue as well, further complicating the situation.

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.

What distinguishes a mini facelift vs a modified facelift?

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

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.

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

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

When can I do a hair transplant post-facelift?

Patients should wait for at least 4-6 months post-op before considering hair growth procedures, as surgery may have “shocked” hair follicles for a long, but temporary, period of time. However, if re-growth does not occur, the best option could be follicular unit grafting.

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.

How effective is an endoscopic lift vs. midface lift?

Endoscopic facelifts, though not being as mainstream as open surgery, are minimally invasive procedures which presents many advantages to younger people who are not in need of a major surgery. It has a very limited effect on the neck and jowl region, but allows patients to have a lower risk of potential nerve damage and is very effective in dealing with minor facial deformities such as cheek sagging. It cannot, however, be used to perform neck lifts or major operations which would normally require a facelift procedure. Therefore, for people who are in need of a facelift but do not require or want the invasiveness of open surgery, endoscopic surgery is a good option.

How can I address early jowling?

Patients who are in their early forties should not look for a particularly invasive procedure. Personal recommendations for correcting early signs of jowling would be procedures like the S-Lift or mini jowl lift which address the SMAS layer but not drastically.

Can I have a facelift with a tumor?

Patients with cancerous tumors are at higher risks of developing deep vein thrombosis and pulmonary embolism post-op so it is imperative that these risks be addressed with the plastic surgeon. If possible, any tumors that can be removed should be prior to surgery.

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.

Can my muscle spasms affect my facelift results?

Usually, muscle spasms are not attributed to the breaking of sutures or disruption of tissues post-op. Yet, it is not a common problem and should be dealt with at your next follow-up appointment.

Are there non-surgical facelifts?

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

What is the difference between SMAS Facelift under local sedation vs IV sedation?

For a surgeon the results of results of the surgery are not affected by the type of sedation used. IV sedation is used for the sake of the patients comfort, since some patients may be very nervous with someone operating over them. Local sedation is just as effective for blocking all the pain, and only leaves patients feeling pulling and pushing sensations.. Local sedation has the added benefit of not requiring an anesthesiologist.

Why am I still tight years post-facelift?

After a post-op period of several years, it is unusual for patients to be experiencing tightness. The probable cause of this tightness is most likely a permanent suture which may need to be removed.

Is swelling post-endotine face lift normal?

For patients several weeks post-op, it is perfectly normal to experience swelling. Consultation with the surgeon and looking out for infections are probably the best routes for these patients.

Is there a benefit to having a facelift early?

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

Can I have a facelift in spite of a past pulmonary embolism?

Most of the time, facelifts are done with the use of IV sedation anesthesia which carries little risk compared to general anesthesia. Patients with a pulmonary embolism in the past would probably prefer this option as breathing is entirely controlled by the patient.

What are procedures for sagging at age 24?

At age 24, except in special cases, facelifts are usually out of the question and are far too invasive. Some options for addressing these problems could be through the use of filler and fat injections to add volume to the face and laser treatment for facial resurfacing.

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 do Ultrasound Facelifts compare to Fraxel Re:Pair Laser treatments?

Ultrasound Facelifts and Fraxel Re:Pair Laser cannot give the same result as true surgical Facelift, but they can give good results for the right people. Ultrasound Facelifts deliver energy into the skin to stimulate collagen to tighten and lift areas such as the brow, neck, and chin. Fraxel Re:Pair Laser can rejuvenate the skin surface to address fine lines. Neither Ultrasound Facelifts nor Fraxel Re:Pair Laser address volume loss or reposition the underlying muscle layers that structure the face.

Why are my stitches popping post-facelift?

For patients who have problems with stitches popping post-surgery, it is probably to see the surgeon in order to determine if they were necessary in the first place. It depends on how wide the existing scar is and whether the patient is comfortable with that.

How can younger patients look more youthful?

In today’s society, a youthful face mainly consists of having bright well shaped eyes and a defined jawline. Patients looking to achieve these features can generally find them with chin implants, mini neck lifts, and an upper eyelid lift, but facelifts should generally be avoided (especially if the patient is younger).

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.

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.

What is the Arasys Perfector Facelift?

As a surgeon, I try to avoid facelift technique which are branded and have official names to them. For most patients, sticking with tradition is probably the best avenue for surgical success

How are facelift incisions done?

Generally, when doing a facelift, the incision made occurs behind the ear and curves along the shape of the ear to the earlobe, simply for the purpose of effectively redraping the skin and hiding as best as possible any evidence that a procedure has been done.

How can men cover facelift scars?

The main areas for men to hide facelift scars would be in front of the ear and behind the ear. Sideburns could be especially helpful in hiding more prominent scars and the hairline should help with the less conspicuous ones. Makeup can also be used to hide the redness of the incisions after about one week.

Why are my cheeks asymmetrical post-facelift?

When addressing cheek asymmetry, it is important to understand that time must be taken for the face to heal fully (several months or so) before a decision can be made. Infections, hematomas, and seromas can all cause fat on the cheeks to dissipate unevenly, yet, early on, the only good options are to consult with your surgeon.

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

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

Can I change my hair style post-facelift?

Patients who wish to wear a certain hair style after surgery should discuss this with their surgeon before the surgery in order to ensure that the scars made from the incisions are as inconspicuous as possible.

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.

Where is scarring post-facelift?

Scarring can vary based on the experience and skill of the surgeon, so it is probably best to consult further with your surgeon or another trusted individual at the very least. However, facelifts will generally only require a scar behind the ear up to the earlobe which can be covered by the hairline for the most part.

What can I do about ptosis and lacrimal gland swelling?

It is probably best for patients dealing with these conditions to first see an ophthalmologist or even an oculoplastic surgeon to examine the lacrimal gland swelling. If ptosis surgery is needed afterwards, it can also be done.

Why do I have numbness and weaknesses post-facelift?

Numbness following a facelift is generally to be expected in the lateral cheek and neck area, yet weakness with smiling and other lower facial muscle-oriented movement may indicate facial or trigeminal nerve injury. It is important for patients to keep close contact with their surgeons in order to be prepared for such a situation.

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

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

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 are the risks of Deep Plane Facelifts?

Deep Plane Facelifts have an increased risk of damaging motor and sensory nerves, a risk which is very rare for a well trained and experienced surgeon. Other risk for Deep Plane Facelifts include hematoms and infections.

Are facelifts harder in thinner patients?

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

Do I need to wait to do a facelift following thermage and filler treatments?

Generally speaking, thermage and filler treatments work very well with facelift and skin resurfacing procedures. As long as the patient waits for the Sculptra injection site to be become soft, a facelift will simply enhance the look which fillers, etc. gave the patient.

When can I get another facelift?

Patients must remember that a facelift is only a temporary measure which, rather than stopping the time clock entirely, sets it back about 10 years. Because of this, aging often initiates the necessity for a second facelift particularly when volume loss and skin laxity continue to be a problem.

Can a patient on bloodthinners have a facelift?

Patients looking to have a secondary facelift should first obtain medical and cardiac clearance and also make sure to discuss the consumption of bloodthinners (and when it should be stopped) with their surgeon.

What can I do about post-facelift dog ear scars?

Patients having “dog ear” style scars under their chin post-op may be treated with steroid injections if the scar is hard, thick, and red, but if it is white or puffy, surgery may be needed to avoid infection. Patients dealing with the latter should wait at least 6 months before considering revision surgery.

Is it common to have spotty bleeding post-facelift?

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

Do I need a facelift to address just the eyes?

Patients who have under eye surgery are generally not expected to have a facelift done to simply “even” out the face. Of course, it can be done with fantastic results, yet it is not always necessary.

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 a breast lift be done in concert with a facelift?

Generally, the concern with double procedures is the question of making the anesthesia last without complications for the patient. Patients willing to undergo a breast lift in conjunction with a face lift can generally have it done with additional cost benefits.

Why is my skin discolored post-laser facelift?

The discoloration of the skin is caused by the release of melanin caused by the thermal injury of the skin cells during a laser skin resurfacing procedure. Yet, patients should not confuse laser skin resurfacing with a facelift. Laser skin resurfacing can cause some tightening of the skin, meaning it affects mainly the surface features of the face.

Are there any issues to expect post-facelift?

With sutures being used to tighten muscles in and around the face, it is normal to experience tightness especially where the incision was made. Itchiness should also be expected for a bout a year and swelling should be anticipated for up to 6 months post-op.

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.

How is tumescent fluid used during a facelift?

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

What is the burning sensation I feel post-facelift?

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

Can I have a facelift at 80 years old?

The only issue with age and timing for facelift is whether the patient is healthy. It is fine to have a facelift at that age, yet the surgeon must make sure to understand that the skin and deeper facial tissues may be thinner at this age compared to patients in their 50s and 60s. Patients who have pacemakers must have them demagnetized though and must make sure that their blood pressure is healthy prior to surgery.

Are slanty eyes post-facelift a permanent problem?

As tissues and sutures gradually relax, slanty eyes following a facelift usually tend to resolve themselves quickly. However, if they do not resolve themselves after 6 months, see your doctor quickly.

Should I do fractional laser resurfacing before or after a facelift?

Patients deciding between doing either one of these procedures before the other can do any of these first, as long as the two procedures are separated by a period of 6 months. Laser treatment should probably be done later though as a way of combating the wrinkles which may appear after the facelift.

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.

Why do young people not need facelifts?

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

When will my facial nerves recover post-facelift?

Typically, numbness in the face, difficulty making facial expressions, and the drooping of facial features is caused by facial nerve injury. If temporary, this usually resolves itself within 6 months to a year, but may take longer for some patients.

Is a facelift covered by insurance?

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

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.

Are there problems associated with a facelift?

With the Acculift procedure, small fibers are used to deliver laser energy around the jowls, neck, and mouth. It is supposed to have little downtime and other benefits, but, to be honest, all it does is remove fat and slightly tighten the skin in areas where MORE fat is needed or where a traditional facelift would be better.

Is there a way to avoid bruising post-facelift?

Unfortunately, bruising after a facelift is something which is greatly inevitable. However, medicines taken to reduce blood pressure and help with the bruising, using drains, preoperative care, etc. can all be used to at least minimize the bruising present.

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.

How can I fix my droopy cheeks?

Without photographic evidence, it is difficult to actually prescribe a line of treatment for patients. However, for droopy cheeks, I would say that the best method of treatment would be a cheek lift. Consult with a plastic surgeon about this and patients who have had this done.

Can weight fluctuation impact fat grafting?

Yes. Patients before performing a fat grafting procedure should attempt to keep their weight as stable as possible prior to and after the surgery in order to keep the results stable. In addition, the grafted fat should come from a stable part of the body.

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.

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

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

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.

Why do I still have pulsing in my ears post-facelift?

Patients dealing with pain the ear after a long period of time may have injured the greater auricular nerve, causing it to form a neuroma (overgrowth of nerve endings). The best thing to do for patients is to consult with a neurologist.

What can I do about uneven cheeks post-facelift?

Uneven cheeks post-op is most likely caused by typical facial scarring which can usually be treated with dilute steroid injection, fat transfers, and/or re-draping the skin. Consult with your plastic surgeon about your options.

Can I have a rhinoplasty post-facelift?

If the patient is particularly ambitious, rhinoplasties can technically be done after 30 days of healing. However, to ensure the best results, it is probably best to wait for any residual swelling to go down which could take as long as 6-9 months.

Why is my skin loosening 3 years post-facelift?

After 3 years, many patients do experience recurring skin laxity following a facelift. Again, the extent of the loosening depends on many factors including sun exposure, smoking, genetics, etc.

It's been a week post-op. Why are my eyes crooked?

A week post-surgery is usually too early for patients to adequately examine the effectiveness of the procedure.

Is there any specific diet needed prior to a facelift?

In order to prepare for a facelift, patients need to do very little. Generally, avoiding aspirin, motrin, and other medicines which prolong bleeding and fish oil, herbal meds, etc. is probably the only actual work which the patient has to do.

Why was there changes in my dental bite post-facelift?

It is strange to hear of patients who have problems with their dental bite after facelift surgery, especially because the facelift merely involves the re-draping of surface skin and the repositioning of soft tissues. It is difficult to imagine that the minimal force required for a facelift surgery could alter something as large as a dental bite.

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.

Can I do a blepharoplasty at the same time as a Mini Facelift?

Yes, you can have a Mini Facelift done concurrently with a blepharoplasty. Having a Mini Facelift done with a blepharoplasty means total recovery time will be less, and you will only have to undergo anesthesia once.

Can I address my face without touching the neck?

Patients looking for a minimally invasive procedure which does little to alter the neck should look for the option of a mini facelift which has smaller incisions and is less obvious.

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.

Can I do a facelift under one doctor and a blepharoplasty under another?

If patients want to do two surgeries concurrently with different doctors, it could be possible. However, this could be somewhat unnecessary as many board-certified plastic surgeons are fully capable of performing blepharoplasty incisions when doing facelifts anyway. Therefore, if the plastic surgeon is fully qualified, it may just be easier to have him/her do the surgery alone.

When can I do Obagi treatment post-facelift?

Generally, patients should wait about 6 weeks or so (consult with your surgeon on the specifics about this) before any Obagi or facial rejuvenation treatment is considered. The Blue Peel treatment tends not to be that deep, but still caution is the best course.

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.

When can I get a chin and jowl lift?

It is not uncommon to see patients undergoing these procedures in their early 40s if they present the need for one, the need normally being problems with skin laxity. Again, if you feel that you need the surgery and your consultations with the plastic surgeons have been any indication, I would go ahead with the surgery.

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.

Will a post-facelift ridge on my face turn into a scar?

Ridges on the cheek post-op could be a variety of things including fluid, residual sutures, or fat necrosis. Consulting a plastic surgeon and having an exam is probably the best option for patients dealing with this problem.

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.

How can I address nasolabial folding?

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

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 there a link between caci treatment and mercury leakage from dental amalgams?

There has been no conclusive study to prove that caci treatment is significantly linked to releasing a great amount of mercury from dental amalgams in the teeth. Often, patients will describe a metallic taste in the mouth which is caused by the electronic current of the treatment. Any concerns, however, should be voiced with the dentist of the patient.

Can I fix my earlobes post-facelift?

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

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.

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 I do laser resurfacing with a facelift?

I would not recommend a full facelift and a full facial laser peel for the simple reason that there is a higher risk of skin loss from this procedure.

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.

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 is a Mini facelift and what is the recovery like?

A Mini Facelift is done by first creating an incision behind the earlobe and then pulling the skin of the face towards that point. A Mini Facelift does not address underlying muscle issues such as the SMAS group. A Mini Facelift recovery time is about 2 weeks, and the results last for about 1 year.

Are incisions apparent post-facelift?

Generally, incisions, if done by a skilled plastic surgeon, should be virtually hidden by the hairline, but patients should remember that, often, it is the surgery itself which should matter rather than the incisions. If the outcome is satisfactory, patients will simply have to remain calm and understand that the healing process takes time.

Why aren't composite facelifts common anymore?

It is strange to think that composite facelifting has sort of gone by the wayside, as they say, but I would have to disagree with people who state that there is only one way to address certain problems in a patient. Depending on the plastic surgeon and the patient’s preferences, there are many techniques which could be used to solve the same problem. Therefore, it is important for patients to find the best plastic surgeon for them and find the right procedure for their specific needs.

Why was my earlobe repositioned after my facelift?

Changes in earlobe position (known as Pixie or Spock Ear) can be caused when the skin around the ear becomes overtrimmed after which the tension in the skin pulls down the earlobe. Usually, a revision facelift may be needed.

How much does anesthesia and facility fees cost during a facelift?

Depending on the surgeon, geography, overhead costs, etc., the price for facility and anesthesia fees will vary. Patients should spend significant time researching their surgeons in order to provide a rough estimate of the costs. Generally, urban areas will have higher facility costs and more extensive anesthesia (general) will be more expensive than local or IV sedation.

What can I do about lip asymmetry post-facelift?

Asymmetry in the lips due to a neurological issue can be easily corrected with Botox, fillers, and additional revision surgery.

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.

What are the best facelift options for a woman in her 50s?

The most important part of a facelift procedure is planning on what the patient wants. Choosing the best surgeon is often the best idea for not only finding the best option, but also of understand what to expect from surgery. Doing your research is the only way to become truly happy with your results.

How long is the downtime for a Mini Facelift ?

Downtime of a Mini Facelift is around 7-10 days, but we recommend that you plan for 2 weeks to be comfortable.

What are the surgeon's incision techniques for facelifts?

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

What does a MACS facelift cost?

In general, facelift cost vary depending on location, surgeon’s skill, facility and anesthesia fees, etc. Generally speaking, the cost hovers around 15,000 to 18,000 dollars.

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 will I look "normal" after a facelift?

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

Can a younger patient address cheek issues via a midface lift?

For younger patients, it is inadvisable usually for them to get mid facial lift unless absolutely necessary. A better option to address volume loss around the nasolabial folds would be to use facial fillers.

Do Facial Microcurrents do the same thing as a facelift?

Using a microcurrent on the facial structure involves sending a gentle electric stimulation to trigger a skin enhancement reaction from the body’s natural cells. This current mirrors the body’s current, making it extremely imperceptible at the gross level. Research shows that, after twenty days of treatment with microcurrent technology, collagen production increases by about 14%, elastin by 48%, and blood circulation by 38%.
Research has suggested that electrical stimulation of cells intensifies healing by the body and may, over time, contribute to a moderately youthful appearance. However, the best results can only be achieved with a full SMAS or deep plane facelift. These intensive surgeries alter the muscular contours of the face and offer MUCH more long-term enhancements than facial microcurrent stimulation. If you want serious results that will last several years a facelift is the best option

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

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

What is the variation in facelifts?

Facelifts tend to vary greatly from doctor to doctor, with less invasive facelifts generally having less downtime and swelling than more invasive ones. Surgeons also have different draining techniques and other small things, so it is best to find the best one for you.

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.

Is jowling normal post-op?

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

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 is the cost of a lower facelift?

A lower facelift can cost anywhere between $7,500 and $15,000, depending on on the location, surgeon and other fees such as anesthesia. You should focus on finding a good surgeon with proven results and ignore any minor differences in prices.

What can be done about jowling post-facelift?

The best treatment for jowling post-facelift is probably a mini jowl lift which has minimal incisions and will probably provide the desired results for many patients.

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.

Can I get surgery abroad?

America is not the only country with top-dollar plastic surgeons. However, if patients are going overseas for surgery, they should definitely do their homework on their surgeons, making sure that they are achieving the best results they can for their ideal price. Patients should also plan to stay in the country for an extended period of time in case any problems may arise (since this could be a problem, I would not advise having surgery overseas).

What is the California Lite Lift?

I would definitely beware of many of the marketed facelifts especially because they tend to promise much but often end up yielding very little. For patients serious about facial rejuvenation surgery, there is no substitute for a true facelift.

How can I treat swollen glands post-facelift?

For many patients, simple Botox and Dysport treatments can be used to treat swollen glands, but the surgeon should be consulted prior to deciding upon this option. Removal of the gland is generally not recommended and a conservative approach is advocated.

Why do I have facial and scalp itching post-Endotine lift?

Patients who have had a midface lift may have problems with Endotine devices irritating sensory nerves, thereby causing itching. Usually, these are dissolvable within a year or so, but patients are often annoyed with the device because of the symptoms which you describe.

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