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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

Is this a hypertrophic or keloid scar?

It is important for post-op patients to make the distinction between a hypertrophic scar and a keloid scar. A hypertrophic scar is a thickened scar which stays within the boundaries of the original incision whereas a keloid scar spreads out from the incision and have a mushroom-like appearance. Patients who have demonstrated keloid scarring should most likely see their surgeons.

Does a Serdev Suture Lift work for younger patients?

For younger patients, regardless of the marketing technique used, I would not recommend getting a facelift. Patients who are young are probably better off with injectables or even smaller scale techniques like threadlifting.

What arrangement need to be made If I am from out of state?

Arrangement will have to be made for you to stay in a hotel and have transportation to come into the office for a post op visit. This will require at least a one week stay, for your to get through the most intensive part of the recovery phase..

Why is my facial surface so uneven post-MACS facelift?

Uneven surface features following a MACS Lift can be attributed to an attached pursestring suture, tethered tissue underneath the skin, etc. Yet, many of these issues can be corrected with revision surgery and the same scars can be reopened.

Is bilateral numbness post-facelift normal?

Depending on where the initial incision was made, it is normal to experience numbness in the skin and to also have flaky, dry skin as well. Numbness around the ears is, to conclude, perfectly normal. However, numbness WITHIN the ear is a problem and usually indicates nerve damage which can be risky during any anticipated neck lift option.

Is canthopexy needed for eye deficiencies post-facelift?

Patients who feel that they have eye deficiencies post-op should probably wait for swelling to disappear before properly evaluating themselves.

Why do I have bruising and bunching of the skin post-MACS Lift?

Bruising following a MACS Lift may be completely normal, but could also be the result of hyperpigmentation which can be treated with hydroquinone or glycolic peels. Bunching of the skin, however, must be treated surgically with a redraping of the skin.

What is the downtime for a mini facelift?

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

Why are my facelift results so tight?

Patients are expected to feel a great deal of tightness post-op and swelling combined with blood clots are perfectly normal (they also exacerbate the tightness as well). It is probably best, if patients are worried about tightness, to wait for time to improve these conditions.

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.

How does a Lazerlift procedure work?

The Lazerlift procedure is marked by its use of a Cynosure laser-tipped cannula which is used to undermine facial tissue and achieve skin tightening. The results of this are not nearly as invasive or effective as a facelift, but nerve damage may still be a risk.

What is an "experienced" surgeon?

Surgeons who are experienced are not qualified simply by numbers, but by their before and after photos, their technique, etc. Research is the key for patients.

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.

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.

Should I address aging at 30?

Many patients reaching big birthdays will often feel the need to have major surgeries done to combat aging especially if they have been ill for several months. I would not recommend invasive surgery right now, but instead advocate a healthy lifestyle, perhaps supplemented with non-invasive procedures like facials, light laser treatment, Botox, or fillers.

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.

What is the Catio Lift?

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

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.

What is ROTEL?

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

What is the relationship between weight loss and a facelift?

Patients, when having a facelift procedure done, should attempt to keep their weight stable, meaning that any substantial weight loss/dieting should be done prior to surgery. However, patients who lose weight after a facelift will generally have the same benefits, as do patients who use standard fillers like Juvederm or Restylane.

Can neck sagging be treated with a facelift?

Often, patients dealing with neck sagging can have their issues addressed without a facelift procedure. Liposuction and neck skin resection may be all that is needed, but again consult with your plastic surgeon about your option.

How can I deal with post-facelift fat atrophy?

Patients dealing with post-op fat atrophy and dermal thinning should probably look to fat transfer as the most ideal option.

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 can I do about nasolabial folds post-facelift?

The procedure known as the mid facelift does not wholly target nasolabial folds and instead is reserved mainly for repositioning the malar fat pad and midface area. The best options to help with these folds are injectable fillers or fat grafting.

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 this swollen, hard mass I'm feeling?

Patients after having a face or neck lift may have to deal with fluid collections near the incision sites which have to be drained with aspirations. If salivary output is a concern (indication of parotid gland problems), Botox or antisialogogues may be needed.

Does Acculift Work?

I remain quite distrustful of these gimmick procedures, especially when they claim to replace the need for fillers and face lifting procedures. Until scientific evidence is provided which shows that these procedures actually have a better effect, I would stick with tradition.

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

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

What differentiates plastic surgeons from otolaryngologists?

Generally, plastic surgeons are trained in general surgery followed by more in-depth training of actual plastic surgery whereas ENT training starts with general surgery and is followed to be ENT training (which includes facial and neck reconstructive surgery). Again, it is best to find the reputation of the doctor in terms of facial surgery and examine before and after photos to evaluate their work.

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.

Is redness and scarring around the suture line normal post-facelift?

Redness and irritation around sutures post-op is normal as the body sees the suture as a potential agent of infection and attempts to expel it from the body. Inflammatory cells are called and attempt to break down the stitch. It is probably best to consult your surgeon about these problems.

Did I get unsatisfactory results from my MACS Lift?

What patients must remember is that MACS Facelift only yield good results on a certain handful of patients. It is a surgery which produces fullness in the cheek area, but may require a lower eyelid lift in order to reduce bunching from the underlying tissue. However, patients should wait several months before making any judgement calls.

How should I prepare for a Facelift?

To prepare for a Facelift, 2 weeks before surgery you should avoid taking prescription and OTC medications that increase bleeding risks such as aspirin, and advil. To decrease the amount of swelling after surgery, you should avoid salty foods which can increase water retention.

What certifications should you look for in a facelift surgeon?

When doing a plastic surgery, it is probably for the best that the surgeon be certified by the American Board of Plastic Surgery. Even for mini-lifts, which are not considered as invasive as facelifts, a great deal of experience and training is needed for good patient satisfaction.

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 procedures should I consider as a 20 year old?

Generally, patients with excess fat in the lower face at 20 years should not consider a facelift automatically, but should look into other options like buccal fat pad removal which can be done under local anesthesia and for which the results are visible in one month.

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

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

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.

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.

When should I get a browlift and when should I get a blepharoplasty?

Patients dealing with excess skin on the upper lid could probably just have a blepharoplasty done while a browlift can be performed for a droopy brow at the same time. Botox can also be used if the problem lies in the forehead itself.

What should I expect regarding bruising post-facelift?

Bruising, if hematomas are not present, usually fade within a 2 to 4 week period and can be treated with Arnica tablets as well.

Can I do a scar revision below the temple?

It is possible to fix scars in this location by re-excising them and closing it. Further healing can be done after 3-4 months when the scar is then lasered.

How can I correct facial asymmetry?

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

How does suturing work post-facelift?

It does not matter what type of sutures are used on a facelift. Where the incision is placed initially is important in the healing process. Also important is the tension placed on the skin. Wide scars are usually found when too much tension is placed on the skin. Finally, it is important that the sutures are removed very early to prevent railroad tracking on the incision.

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.

What is the general format of a facelift?

A traditional facelift is an extensive procedure which involves an incision near the hairline that extends behind the ear. During this procedure, excess skin is cut and the remaining skin is pulled and sutured. This surgery is more frequently used for those with excessive neck fat and it corrects skin laxity in the lower face.

Can I have bone grafting done during my facelift?

It is definitely possible for patients to have bone grafting procedures done concurrently with the facelift. Yet, I would not recommend having the bone grafts taken from the face itself as altering contours of the face can do some serious damage for the facelift as a whole. I would recommend places like the elbow or the hip for better bone harvesting.

Why should I have a facelift as opposed to less invasive procedures?

If patients are truly serious about long-term results, the facelift is probably the best option. Granted, some facelifts are more small-scale and less invasive than others, meaning less downtime and longevity, but, in general, facelift techniques which repair facial contours and rearrange muscles in the face are more long-lasting and provide for more satisfying results.

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.

How did my balding happen suddenly after my facelift?

When associated with surgery or stress, hair loss is usually caused by a condition known as alopecia areata which is completely reversible. Waiting a couple of months post-op is the best option for patients.

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

In general, minor defects in the bone structure which were not noticeable prior to the facelift should not be noticeable in the post-facelift results. Facelifts tend not to improve or worsen facial asymmetry.

Why is my face still tight a year after my facelift?

After a long period of time (e.g. a year), it is unusual for patients to deal with tightness in the face and numbness. Possible nerve damage could be a factor if these symptoms persist and it is best that patients see a neurologist as soon as possible.

Can I take medications for swelling post-facelift?

Patients should probably avoid NSAIDS after a facelift due to risk of bleeding. Consulting with the plastic surgeon, in this case, is probably the best option.

Does a deep plane facelift have a longer downtime than a SMAS facelift?

Generally, because of the deeper invasiveness of the deep plane lift, the deep plane lift has a slightly greater recovery time (about a week longer than that of the SMAS Lift). However, each surgeon has different policies concerning surgery and recovery time, so it is best to consult with your doctor if you have specific questions.

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

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

How can I deal with anxiety post-facelift?

Patients experiencing post-op anxiety can usually be helped with anti-anxiety medications or a visit to their local therapist or plastic surgeon.

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 a facelift fix an upside down smile?

Facelifts will generally do little to help with an upside down smile because the problem is more volume loss related as opposed to skin laxity-related. Volumizers like fillers or fat injections are the best solution in this case.

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

Patients having jowl problems post-surgery usually have their problems addressed quite fully with fat injections. Glandular problems and exposed glands can also be addressed by the excision of skin.

Why do I have red skin and scarring by my incision site so long post-facelift?

Patients dealing with extensive white scarring behind the ears following surgery usually have excess tension in the skin of this region and thus have a poor blood supply in this area. The scar must be excised and the skin adjusted to reduce the tension in the area.

Can I treat melasma with a facelift?

A facelift is not a prescribed treatment for melasma which is probably better treated with skin cares lines like Obagi or other agents like retin-A and hydroquinone.

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.

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).

How can I treat my asymmetric mouth?

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

What are the pros and cons of a facelift?

Pros: Removal of excess skin, lifting of drooping skin along face, jawline, and neck
Cons: Cost, undergoing surgery, recovery time, scars, swelling/bruising, and risks of surgery

When do people usually start having facelifts?

For most people, the first facelift usually occurs between the ages of forty and fifty because of the loss of facial volume from age-related fat loss and by the development of lax skin again due to age. Again, however, it is the physical state of the patient, as opposed to his/her age which actually determine the need for surgery, so consulting with surgeons is probably the best first step in deciding.

Can I get a facelift after cheek implants?

Patients who already have cheek implants in place generally do not require a subperiosteal midface lift. Either the cheek implants should go or the surgery should be avoided.

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.

What is recovery from a lower facelift like?

Recovery from a lower facelift is take about 2 to 3 weeks. The majority of the swelling goes down in the first 2 to 3 days, and the bruising takes about 2 to 3 weeks to resolve completely. When you first go home remember the “ it will get worse before it gets better”.

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.

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

Patients looking for deeper facelifts should make sure that they find someone who they can clearly trust to do good work with their face. It is important for patients considering a procedure to do their homework on it, looking at before and after photos, consulting with several surgeons, etc. to determine whether it is indeed the procedure for them.

What is QuickLift?

As I have said many times before, there is no marketing substitution for a facelift for which the recovery time is approximately 10-14 days. Any facial lift surgery performed by a non-certified surgeon is risky and probably should not be done for patients serious about the outcome.

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 I travel for a facelift?

If patients are more comfortable traveling for surgery, this can be done. However, they should arrange for a ride and a stay at a nearby hotel post-surgery.

Why can't I pucker post-facelift?

Inability to pucker post-facelift is usually caused by swelling and will most likely recover before long.

What are side effects of a facelift?

Side effects, though rare, include
• Infection
• Bleeding
• Scarring
• Numbness
• Hair loss along incision lines
• Facial nerve damage (very rare)

When should I see the final results of a facelift?

Generally, patients should not expect to see immediate results by a certain time, but rather a gradual improvement of facial features. But, 3 months is more or less the benchmark.

Is a revision necessary if my earlobes are elongated and scarred?

A revision facelift is not often necessary in these conditions as less invasive procedures like skin redraping or local tissue rearrangement can be done far more easily.

When can I get a second opinion on my facelift?

Patients should probably wait for a minimum of six months post-op before having a second opinion on their facelift simply because the skin needs time to heal and re-establish blood supply. Unless there are major problems (e.g. infection, major pain, etc.), this is probably the ideal time frame.

What is the Ribbon Lift?

The ribbon lift is a procedure similar to a thread lift but uses a different device, a collar with spikes of one side. The device is inserted into the platysma muscle and used to pull it back, a procedure which helps with neck lifts, but does nothing for jowls and cheeks. It is a good temporary procedure if done correctly.

When should I have a fat transfer/grafting in relation to a Facelift?

Ideally the best time to do a fat transfer/grafting is during a Facelift operation. A Fat Transfer/grafting along with a facelift allows the surgeon to have a good sense of the final look of your face.

Should I consider local anesthesia or sedation during a facelift?

To be frank, the purpose of anesthesia is strictly for patient comfort. Facelifts can use general anesthesia, local anesthesia, or IV sedation, but it is probably safer and more comfortable to use general anesthesia.

What are the side effects of Facetite?

The main side effects of this procedure are bleeding, scarring, and possible nerve injury. It would be best to find a board-certified plastic surgeon and have a consultation to decide whether this procedure is the best for you.

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.

I have banding almost a year 6 months post-op. Why?

Generally, by this time, the face should be relatively healed. Muscle tightness may persist for several months, but banding calls for an additional consultation.

What is your opinion on endotine periorbital lifts?

Endotine, for me, does not have a useful role in facial rejuvenation. It is a foreign body and creates unnecessary scarring and inflammation. The best option would be to consult with a plastic surgeon trained in problems of facial aesthetic surgery.

How can my jowls be best addressed?

For patients with jowls, the best option would probably be a comprehensively planned facelift. The Lifestyle Lift, to be frank, does not cut it when it comes to the jowl area especially when the surgery takes only an hour or so to do (it does not venture deep enough into the SMAS layer, etc.).

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.

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.

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.

Why do people go with vertical face lifts?

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

How are stitches hidden post-facelift?

Most surgeons hide the stitches in as inconspicuous of a place as possible. Often, the stitches are hidden in the hairline and along the curve of the earlobe, which is very helpful for women with long hair. Men, on the other hand, could extend their hair through sideburns, etc. in order to disguise the stitches.

Opinions on Acculift vs Fillers?

I remain quite distrustful of these gimmick procedures, especially when they claim to replace the need for fillers and face lifting procedures. Until scientific evidence is provided which shows that these procedures actually have a better effect, I would stick with tradition.

Can I get a facelift after weight loss?

Generally, patients who have suffered weight loss tend to lose essential fat in the face, causing them to believe that they need a facelift. Usually, the method of treatment is much simple, with fat grafting or fillers being used to substitute for fat lost in the face.

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

Generally, patients have to remember that the healing process takes a great deal of time when it comes to facelifts and that they must keep their expectations optimistic, but also realistic. If patients have concerns, they are probably best addressed by their doctors or surgeons and are best done with multiple consultations.

What is the best option for Marionette Lines and Jowls?

Without a doubt the best option for Marionette Lines and Jowls is a SMAS Facelift. Injectable fillers such as restylane, perlane, radiesse can provide temporary relief of Marionette lines, and a Mini Lift may improve jowls.

When will I truly recover post-facelift?

Swelling after a facelift should be resolved within four to six months and bruising should recover much earlier, within a matter of weeks. Again, recovery is rather variable from patient to patient and surgeons should be consulted.

Why do I have raised scarring in front of my ear?

Raised red scars after facelifts should probably be treated with steroid injections, but the surgeon should be careful with these in order to avoid skin vessel changes and the death of surface skin tissue. Laser treatments could also be an option.

Can I get a facelift in my teens?

Patients in their teens should not be considering a facelift, period. Consulting with a surgeon as to your options and even with your primary care doctor may be the best option.

When can I expect swelling to go away post-midface lift?

It does take some time for the swelling to settle down after a mid facelift and fat injections. Look for about three months before you start healing. By then, the swelling will have probably subsided greatly.

When can facelift sutures be removed?

Generally, sutures are removed very gradually, with some removed after one week in front of and behind the ears and others located behind and above the ears removed after two weeks.

What is undermining?

The technique of undermining is a technique which involves using scissors to cut through tissue underneath the skin in order to access deeper tissues like the SMAS or the platysma. It is usually a technique reserved from major invasive lifts like deep-plane, subperiosteal, and SMAS lifts.

Do I need to do facial prep (peels, etc.) before a facelift?

Patients looking to get a facelift should generally not require any pre-op work (peels, etc.) to be done, but , after 6 weeks to 3 months post-op, they can consider non surgical facial treatments.

What is a SOOF lift?

The procedure of a SOOF lift consists of combining fatty areas from the ocular areas and the sub-ocular areas and allowing this combined fat to elevate the orbicularis oculi muscle for a full cheek lift. This is very similar to a midface lift except that the incisions are made through the lower eyelids rather than through the temple region and the gums.

Is it normal to have hearing loss post-facelift?

Patients dealing with hearing loss should immediately consult an ear physician because it is usually caused by fluid or congestion in the ear, ear infections, or other temporary problems. It is important for the patient to have a full evaluation, however, to make sure that conditions are still fine within the ear itself and were not adversely affected by surgery.

Facelift or fat injections?

Younger patients who are simply looking to replace lost volume in the face should definitely choose fat injections or fillers over facelifts simply because of their cost-effectiveness and minimal downtime.

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.

Are Stem Cell Facelifts the new Trend or just another Fad?

Stem Cell Facelift take fat stem cells from the thigh, buttocks, and other lower body areas and transplant them into the face. The idea is that these stem cells will grow and fill in what has been lost with age. Some patients have noticed significant improvements, however so far research has not shown it to be better than other fat augmentation procedures This technique is new and it is probably best to proceed with caution.

My doctor is giving me a half-priced facelift. Should I do it?

As with most surgeries, it is probably best to remain wary of “discount” facelifts. Unless the doctor is a Board Certified Plastic Surgeon, it is not a good idea to undergo surgery.

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.

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 high blood pressure an issue before a facelift?

Among other things like general wellness and a healthy diet, maintaining a healthy, constant blood pressure is perhaps one of the most important things a patient can do prior to surgery. General anesthesia is probably the best option for high blood pressure receivers of a facelift.

What is the thread facelift?

A technique which caused quite a buzz in the plastic surgery world several years ago, the thread or feather lift is a minimally invasive technique used to replace open surgery in the lifting of sagging facial skin. A relatively simple procedure, it consists of using tiny suture barbs to act as a hook to gather skin layers upwards, thereby causing the skin to tighten. These barbs are connected to a thread which remains in place after the procedure and solely cooperate with the fibrous tissue to provide a lifting effect to the skin. Though not used quite frequently as a technique by itself, this procedure is often used in combination with other facelifts as a method of support, especially with younger people having facelift surgeries earlier and more frequently.

What can I do about fullness in the chin and neck post-facelift?

For patients several months post-op who are still seeing fullness and lumpiness in the neck and chin, it is probably safe to assume that most of this is composed of residual swelling and inflammation as well as limited platysmal banding. At this point, the only methods of treatment are massage and dilute steroid injections.

Will more facial work mean more swelling?

Patients who have major facial work done, meaning several major procedures done concurrently, should expect a great deal of downtime AND a longer period of swelling and bruising as they are dealing with internal and external healing. Optimal results may be in store if the patient is willing to wait up to several months.

How are PSP facelifts categorized?

PSP Facelifts are considered regular facelifts because the procedure involves the tightening of the platysma and SMAS muscle and tissue layers.

What should I do if I have facial spasms after a facelift?

You should consult your surgeon, but generally these facial spasms after a Facelift are nothing to worry about and are only temporary. Spasms after a facelift are a caused by swelling and bruising that temporarily pinches the nerves of the face.

How long does a stem cell lift last?

There haven’t been enough studies about stem cell lifts to definitively prove they provide results as good and long lasting as a standard Fat Transfer/graft. For now we would recommend standard Fat Transfer/Grafting because Stem Cell lifts are still unpredictable.

What is SmartLift?

It is important, once again, for patients to recognize the unfortunate marketing scams which are occurring in the plastic surgery industry. The Smart Lift technique is not particularly groundbreaking and relies mainly on a laser removing fat through small incisions, the results being limited tightening of the skin. The better and more long-lasting procedures are more highly recommended for the simple reason that they are proven to work for long periods of time.

Is an endotine mid-facelift corrective or preventative?

In general, it is a bad idea to perform surgery for “preventative” reasons. Surgery should be done only when an actual problem is present, not to prevent one from developing. It would probably be best for younger patients to use hyaluronic acid fillers, sometimes in and around the nasolabial folds.

How can I correct my jowls post-facelift?

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

Is 76 too old for an Acculift?

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

Does losing weight help before having a Facelift?

On the contrary, losing weight may make things worse. People desire a facelift because of increase skin laxity and loss of facial volume. Losing weight means volume loss in the face, that may need to be replaced during a Facelift with Fat Transfers. However, if you are at an unhealthy weight losing weight may be a priority.

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.

What is this hot lump on my face post-facelift?

Generally, patients dealing with major lumps post-surgery are dealing with hematomas where cells break up, releasing salts and drawing fluid to create more swelling. Needle aspiration of the area is usually required to test for infection.

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