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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

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.

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.

What differentiates buccal fat from cheekpad fat?

Cheekpad fat refers to malar fat which is a superficial, upside down triangle which is often elevated in a midface lift to restore fullness in the upper cheek. Buccal fat is deeper, more herniated and lower and is sometimes removed to reduce roundness in the face.

Any inexpensive, but good, surgeons you would recommend?

In the world of plastic surgery, it is important to remember that price is relative. You can probably find a surgeon that will do a great job that fits your budget. It all depends on what you think is inexpensive. However, the patient should remember that often, you get what you paid for, so it is important NOT to let price be a guiding factor.

Why do my ears feel blocked/stuffed after surgery?

The feeling of blocked ears is somewhat common as the incisions made in the ear area tend to swell. It is important for patients to check for wax, residual cotton from the surgery, or dried blood in the ears to avoid any complications in the future.

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.

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.

What can I do about my face in my 30s?

For patients in their early 30s, doctors will tend to recommend lesser, non-invasive routines than a facelift. Such solutions include implants particularly for the jaw areas (e.g. chin-jowl implant) which helps stretch the jaw and reduce jowling as well as submental liposuction to allow for a decrease in neck fat.

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.

When should I have a facelift?

Again, as I have told my patients several times, it is the physical state of the patient’s face, rather than the age of the patient, which determines the timing of a facelift. If the patient has problems with jowling, marionette lines, deepening nasolabial folds, and excess neck skin (all issues related to skin laxity), a facelift may be the best option.

What do I do about residual jowling post-facelift?

It is strange for patients who have a lower facelift to still have problems with jowling, especially since this procedure is geared specifically for this problem. The most likely route, as of now, is further lifting, but keep in mind that bone structure, fat, chin shape, etc. may have played a role in creating these residual jowls.

Why am I panicking about my looks post-facelift?

The key saying with post-facelift patients is that “You look worse before you look better”. Patients will often find themselves questioning when the swelling and bruising will end and will usually look for immediate gratification post-surgery. The important part post-procedure is simply patience.

Can paralysis occur one week post-facelift?

Though damage to the facial nerve can occur post-op, it is extremely rare and patients should wait and allow existing nerves to heal before diagnosing themselves.

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.

I have bulging and itching of the eyeball post-facelift. Is this a problem?

Problems with the eyelid post-op can be serious and usually call for additional consultations with the surgeon. Itching in the eyes is normal, but bulging of the eyeball can be related to internal bleeding or excessive scar formation.

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

Unfortunately, without surgery and without fillers and fat grafts, it is impossible to add volume to the face where it is needed. Facial exercises may exacerbate volume loss, but again the best treatments are fillers.

Can jowling occur in younger patients?

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

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.

Does an Endotine facelift cause nerve damage?

If done properly, the long-lasting (10 year) Endotine procedure should not produce any facial nerve damage.

Can you tighten collagen to preserve the results of a facelift?

Over the long term, there is virtually no way to ensure the constant maintenance of dermal toughness. However, in the short term, patients could look into the options of ultherapy and/or laser resurfacing treatments.

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).

When can I go out in public post-facelift?

Generally, people should wait a minimum of two weeks before resuming daily activities.

Can I lose weight pre-facelift?

It is important for young people to keep a healthy amount of fat in their face simply for the purposes of structure and support. For this reason, if weight is lost significantly, the skin may become lax due to lack of support. It is best for younger patients to wait until the weight becomes stable before addressing skin laxity, meaning that a facelift is probably not needed and can substituted with fat grafting or even with time (skin will naturally tighten).

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.

Will the Silhouette Lift help?

Again, like many brand-name surgical improvements, I remain apprehensive about the Silhouette Lift. The procedure is a variant of the thread lift which uses barbed sutures to lift and hold the skin in a suspended position. Unfortunately, with its expense, it provides very minimal improvement and I would not recommend it.

Can a facelift treat under-eye hollowness?

Unfortunately, under eye hollowness is not one of the many symptoms which a facelift treats. Patients looking to treat this symptom should look a route centered on blepharoplasty with fat transfer (the fat usually is harvested from the thigh). Fillers may also work in this case, but usually fat transfer is the best option.

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.

How should I handle myself post-op?

As soon as movement is possible, try to walk frequently (3-4 times per day) in an effort to boost circulation and avoid the development of deep venous thrombosis (potentially fatal blood clots in the veins of the leg). It is also important to avoid lifting heavy objects until approved by your surgeon and avoid steam rooms and saunas as well as niacin-containing medicines (and possibly foods) for a while due to their tendency to cause facial flushing. Also avoid consuming alcohol or aspirin-like products (e.g. Ibuprofen) without the surgeon’s approval.
Also, expect to return to work within two weeks. Any major events should be within one to four months of surgery.
In an effort to avoid swelling, it is advisable for patients to sleep with their heads elevated, either by sleeping on two pillows or using a wedge-shaped foam pillow. Keeping the head still during sleep is important as well so as not to pull on delicate sutures on the face. Sleeping on a recliner would most likely be the best option to avoid patients rolling over and disrupting facial changes.

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.

Does a facelift in the 40s require one in the 50s?

Generally, the earlier a facelift is done, the more better and long-lasting the results are. However, patients must be careful to only have a facelift if the signs are there (e.g. sagging skin, facial/skin laxity, etc.) and avoid having it too earlier.

Why is there tingling in my cheeks post-facelift?

Tingling in the cheeks is quite common after a facelift and will usually last for about 2-3 years as the nerves try to reattach and supply the skin with sensory information. Usually, it is not too great of an issue and the symptoms tend to dissipate over time.

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.

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

The difficulty with MACS procedures is that since it is performed with vertical suspension, the surgeon must be very experienced for the results to be correct. You should come into the office for a consultation to see what type of revision surgery would work best for you.

Do laser treatments cause neck issues?

Laser treatments, unfortunately, tend to aggravate neck folding and are often better substituted with a complete revision neck lift consisting of redraping the skin, a platysmaplasty through an incision under the chin and other steps. Consulting with a plastic surgeon may be the best way to find other options as well.

Why am I still swollen and lumpy 2-3 weeks post-facelift?

For many patients, the two to three week mark indicates the worst effects of the surgery. At this point, patients can expect to be quite swollen and have lumps which probably indicate minor blood collections that will heal over time. Massaging these lumps can help, but overall, time is the best cure.

What do I do about fat dissipation post-facelift?

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

What is a mini facelift?

A mini facelift, as suggested by the name, is less invasive than a full facelift and relies mainly on lifting the jowl area and providing minimal tightening of the skin. A full facelift, however, goes deeper affecting the SMAS layer under the skin, repositioning facial contours, tightening the neck muscles, etc.

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.

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)

Should I massage after a facelift?

Sometimes, scars are best left alone in order for the healing process to increase in speed, particularly weeks out from a procedure. Consult with your physician about the best possible options.

How do I deal with residual fat pockets after a lower facelift?

A fat pocket left over from surgery can easily be removed with direct skin excision or even through direct removal.

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.

Can fat transfer be accompanied by a facelift?

For patients experiencing midface hollowness with very little evidence of jowling, perhaps the best option would not even be surgery. Fat grafting often substitutes very effectively for surgery and is less invasive.

What is the Laser Facelift?

Lasers are generally used for the elevation and tightening of the skin rather than the actual facelift procedure itself (which consists of repositioning the SMAS layer of the skin). This is a very new procedure which offers the benefits of less bleeding, less bruising, less swelling, and quick recovery.

What is the miracle facelift?

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 can I tell if my facelift was well done?

Examining the results of a facelift consists of carefully inspecting the before and after photos taken with the same facial expression to check for any differences. Take care to look for aging features in both photos and examine them from different angles. Ultimately, the surgeon’s job is to create a younger looking more natural version of the patient.

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

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.

Should I get a facelift at age 19?

At age 19, there should be no reason to be thinking about a facelift of any kind. Many nonsurgical treatments (e.g. fillers, fat augmentation, implants, etc.) are available and should be used more frequently as potential first lines of treatment.

Can surgery activate granuloma and nodules?

It is certainly possible that surgical trauma could activate granuloma, nodules, and biofilm, especially if the filler used was semi-permanent like Sculptra or ArteFill.

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.

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 it better to have different surgeons for different procedures?

It may seem like a better idea to have different specialist treat different aspects of the face, but patients must remember that surgeons can often specialize in several different things, meaning that different procedures can be done all at once. Again, consultation is probably key, so see which surgeons you feel comfortable with.

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.

Can Sculptra be done post-facelift?

For patients willing to plump their cheeks and rid themselves of tear troughs, a Sculptra procedure can be done post-surgery once the swelling has disappeared (6 months or so post-procedure). This is in order for the patient to have more symmetry in the face prior to Sculptra procedure.

Is nerve damage a risk during a facelift?

Board-certified plastic surgeons must undergo rigorous training and must be extremely familiar with the anatomy of the face to earn this high level of certification. Therefore, if you selected a capable surgeon, you are probably in good hands and need not worry about nerve damage.

Does a facelift address the eyes and neck?

Facelifts generally do not include the eyes and neck and instead encompasses the reposition and tightening of facial tissue around the cheeks and the very upper neck. Necklifts and blepharoplasties (eyelid surgeries) are considered entirely separate procedures.

What is your opinion on SMAS vs MACS vs Short Scar Lifts?

All three of these procedures are considered true facelifts. The only variance between them, however, is the scale on which they are performed and the areas they specifically address. A mini-face lift, more frequently used for younger patients, consists of a small incision made behind the ear and only adjusts the skin, leaving the underlying muscular structures intact. This procedure is more frequently used for younger patients and is generally less invasive. In an attempt to avoid the windswept look (AKA the windtunnel face) which is a potential side effect of normal facelift, the MACS lift relies on the vertical lifting of the skin, creating a more natural, less apparent look. Surgeons often describe it as a variation of a normal “short-scar” or “S” Lift because of this. The operation of the MACS lift involves the creation of a small incision within the hairline in front of the ear. The traditional facelift, however, is more extensive and involves an incision near the hairline which extends behind the ear. During this procedure, excess skin is cut and the remaining skin is pulled and sutured. This surgery is more frequently used for those with excessive neck fat and it corrects skin laxity in the lower face.

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.

Can I have a facelift done by a doctor in a Fellowship program?

Though fellowship doctors have a lower cost, it is important that they be monitored by the Fellowship director for quality control and teaching purposes.

What is the cause of hard swelling post-MACS lift?

Patients experiencing this symptom could be experiencing a laundry list of symptoms from a deep hematoma to a hardening of surrounding tissue caused by tightening due to a MACS Lift Suture.

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 facial scarring be reduced via a facelift?

Patients looking to reduce facial scars should definitely not look into facelifts as a primary method of treatment, particularly if they are young. Fat grafting, neck liposuction, even fillers, etc. may be better methods of treatment.

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.

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.

Can malar bags be addressed via a midface lift?

A midface lift is known for its role in addressing the cheek area and addresses sagginess. However, more often, surgeons will use fillers like Restylane or Juvederm to address problems in this area because of their low risk and, in general, greater effectiveness.

Can the greater auricular nerve be damaged during a facelift?

Compression or injury to the greater auricular nerve during a face lift or neck lift will result in numbness to the ear lobe and a small area of the neck just below the earlobe. To be frank, this nerve is purely sensory and cannot be treated if damaged, except naturally. Usually, it will heal after 12 months.

Can facelifts cause hair loss?

Facelifts generally do not cause the loss of hair. However, if a facelift is performed concurrently with another upper-face procedure like a browlift, this may have been the cause for hair loss. General anesthesia used during surgery has also been known to cause hair loss.

Can spacer grafts be performed during a midface lift?

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

Can I have a facelift after adding fillers?

Generally, having a facelift is not a problem after fillers are added so long as it is placed in a convenient position which will not interfere with the procedure.

What are my options for the midface lift?

Like many facial surgeries, the midface lift varies from surgeon to surgeon in terms of technique. Some surgeons prescribe endoscopic lift marked by the use of a camera used to lift tissue, whereas others may prescribe thread-lifting with the use of small barbed sutures. However, others will recommend a lower eyelid incision which, though carrying the risk of possible temporary ptosis, yields longer lasting results.

How long does Lifestyle Lift last?

For many of these branded techniques, it is difficult to estimate their longevity. After all, the Lifestyle Lift is not a particular type of facelift. Generally, results will last a very small amount of time: as little as one week or so before fading.

How can I prepare for the swelling after a Facelift?

You can expect that majority of the swelling will resolve in 2 to 3 weeks, and the remainder will slowly resolve over a 3 to 4 month period. To try to lessen the amount of swelling you should avoid salty food before and after the surgery, and sleep with your head elevated to help the fluid drain. These measures may have some minimal effect on the swelling, but giving the body time is the best method.

Why do I have redness and irritation around my incision site?

Redness near the incision site is most likely the mark of a suture which should be removed as soon as possible. After this, the wound should be treated with vinegar washes or topical antibiotics.

Why do Hollywood stars have such bad facelifts?

The stereotypical windswept look of a celebrity facelift can usually be attributed to simple inexperience and lack of technique on the part of the surgeon. Just because a surgeon works in Hollywood does not mean he/she is at the top of their field and the results often show this.

What should I consider when choosing to undergo a facelift?

Generally, the best way to determine where to undergo a facelift is to evaluate the surgeon’s experience, training, and their before and after photos. Patients should choose the doctor who they are most comfortable with.

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.

What are cost-effective facelifts?

Many patients with minimal jowling and slight neck skin excess will do great with a mini facelift provided that the procedure takes care of the SMAS. If patients have excess jowling and neck skin then a traditional facelift is probably in order. Again, price should probably not be the guide and patients should do their research when selecting a surgeon and procedure.

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

Why do I have this feeling of migrating tightness post-facelift?

It is not unusual to feel migrating tightness post-mini facelift. Normal post-operative scars will feel their tightest at around 6-12 weeks post-op, but can be easily treated with massage and hydrocortisone cream.

What procedures can be done under local anesthesia?

Procedures like endoscopic browlift, mini facelift, cheek implants and eyelid surgery can all definitely be performed under local anesthesia, but IV sedation would probably be more recommended.

I got parotid swelling months after facelift. Why?

Generally, if deficiencies are not present immediately after the surgery and appear a while post-op, they are usually not related to the results of the surgery. It is more likely the result of a parotid gland problem which can be resolved by seeing an ENT.

Is there an issue with bald patients having a facelift?

Again, there is no real issue with bald patients having facelift surgeries. The problem lies in placing the incisions where it is least conspicuous. In many cases, the incisions are placed normally (behind the ear and around the structure of the ear) and will usually be noticeable for about 3-4 months as they turn from red to a natural fleshy color. Patients can help the process along by using makeup 1 week post-op.

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.

When are sutures and staples removed after a facelift?

Sutures can be removed from incisions in front of the ear about 7 days post-op while staples and sutures behind the ear or in the scalp can be taken care of after about 2 weeks.

What is the recovery time for a facelift?

Facelifts, depending on the time, have a maximum recovery time for anywhere from 2 to 4 weeks during which bruising and swelling are at their worst.

Can I get black eyes post-facelift?

It is somewhat unusual for patients to have black eyes after 2 months, even with genetics, medications, and all other factors considered. Problems with drainage post-procedure may be to blame, but exercise and massaging (warmth as well) could also be used to help treat these various conditions.

Why do I still have tightness several months post-facelift?

Generally, tightness can be seen as a good sign, indicating that nerve activity in formerly numb areas is beginning to recover. It is usually caused by the removal of skin during surgery but also by the contraction of scarring, all of which are good signs.

Is 7 hours under general anesthesia for multiple procedures a stretch?

7 hours is not unusual for multiple facial procedures especially for rhinoplasty. Concerning general anesthesia, the most important thing to consider is the ability of the patient to tolerate it. Make sure to have your surgeon consult all this with you.

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.

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.

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.

Can a facelift address asymmetrical faces?

Again, I would not recommend opting for a facelift surgery at your age even with the symptoms you are describe (marionette lines, etc.). For people with disproportionate faces, the problem often lies in the underlying fat structure of the face for which a facelift and a liposuction can do greater damage. I would consult with your plastic surgeon about your individual options.

Can I have a facelift at an outpatient center?

Generally, if outpatient surgery centers are located adjacent to a hospital, patients will want to look at the credentials of the outpatient center alone. Unless the outpatient center is hospital-owned, they are usually on their own, so having one that is AAAHC certified is probably the best option.

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.

What is an endoscopic facelift?

A technique that is far less mainstream than traditional or minor surgical facelifts, an endoscopic lift is a minor facelift in which a small endoscope is inserted through the hairline through three or more small incisions that are less than one inch long. These cameras then transmit small video images to a larger TV screen, thus guiding the surgeon through the repositioning of surface tissues. This particular operation is usually done on an outpatient basis using local anesthesia or intravenous sedation.

What is the Silhouette Lift?

Again, like many brand-name surgical improvements, I remain apprehensive about the Silhouette Lift. The procedure is a variant of the thread lift which uses barbed sutures to lift and hold the skin in a suspended position. Unfortunately, with its expense, it provides very minimal improvement and I would not recommend it.

Can skin creams give me surgical results?

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

How can I treat seroma scars post-facelift?

Seroma scars can be treated with cortisone injections, but may need to be properly aspirated to avoid any long-term damage. It is probably best to consult with the surgeon and avoid making hasty decisions.

How painful will it be post-facelift?

Generally, facelifts, though associated with tightness in the skin and possible swelling and bruising of the skin, are relatively pain-free compared to many other procedures. Patients will often benefit from facelifts combined with other procedures like blepharoplasties or filler/fat injections.

What is the “One-Stitch Lift”?

“One-stitch lift” may refer to a procedure where a surgeon uses one stitch to suspend the midface. This procedure should not be considered a true facelift. The term may also be a substitute name for a procedure called the Thread Lift. This procedure takes one to two hours under a local anesthetic (some patients opt for IV sedation for the sake of comfort) and its main purpose is to elevate and reposition loose skin on the brow, face, and neck with a less invasive type of surgery. This involves tiny threads being inserted under the skin which are then passed into the area of operation with a special needle. The threads grab onto the soft tissue/muscle of the area, allowing the entire structure to be lifted as a whole. Over time the thread becomes fixed in the skin, holding the results of the surgery in place. The benefit is that this procedure does not require a great deal of actual stitching, but the results are often very minimal and are certainly not worthy to be called an “facelift”.

What are these lumps on my neck post-facelift?

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

How do I know if my surgeon will do a good job?

When trying to find a good surgeon for a facelift, it is best to find one with a good reputation and to also consult with them to find the best possible surgery for you. Looking at before and after photos can also be helpful.

How can I correct facial asymmetry?

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

Can I take amoxicillin for an infection prior to surgery?

For people dealing with infections prior to surgery, it is probably best to completely resolve these issues before undergoing surgery.

Can I address jowling with liposuction?

Liposuction should only be used when skin laxity is not a problem and only fat is the issue. However, liposuction used when jowls and lax skin are the problem is not ideal and could cause nerve injury to the areas around the mouth. Consulting with a surgeon is probably the best option for people concerned about this problem.

Are drains always used post-facelift?

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

What are my facial rejuvenation options at age 37?

Various options exist depending on what areas need to be addressed. Mini facelifts address the mouth, lower cheek, and the jowl area, whereas soft tissue fillers are more used for the cheeks and nasal labial folds.

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.

How can I correct deep nasolabial folding?

Patients who have very little success with fillers and fat grafting generally experience better results with a lower and mid-face or cheek lift in a way that would help the tissue falling over the corners of the mouth to be elevated. Botox in the mouth could also help with the “frown” look.

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.

Can I wear my earrings soon after having a Facelift?

It is recommended that patients do not wear any kind of facial jewelry for at least 4 weeks after undergoing a Facelift. The tension from earrings may worsen the scarring and stretch out the earlobes

Do facelifts require an overnight stay?

Facelift procedures generally do not require an overnight stay unless there are complications with the anesthesia post-surgery.

What are the pros and cons of Acculift?

Generally speaking, the Acculift procedure, in the grand scheme of things, does very little for patients who are serious about facelift surgery, particularly those in their later years. Residual neck bands and poor facial definition are just some of the post-op complications which can occur.

Are the cheek pads repositioned during a facelift?

Procedures like the mini facelift or marketed facelifts generally do not interfere with the muscle layers of the skin known as the SMAS (where cheek fat is generally centered), so repositioning of malar fat pads is not a concern here. For deeper procedures, surgeons may reposition them entirely or may trim it, depending on the surgeon.

Can patients prone to keloid scarring undergo a facelift?

Patients prone to keloid scarring should have no problem undergoing a facelift as what most patients see as keloids are simply hypertrophic scars (thick, itchy raised scars) which can easily treated by the surgeon. However, the surgeon which whom you are working may want to consider alternative incisions methods to combat the possibility of major scarring.

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.

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.

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.

Is Beverly Hills the only place to get quality plastic surgeons?

Though it may seem like all the best plastic surgeons are in the Beverly Hills area, there are plenty of other surgeons throughout the country who can probably do the same work for a cheaper price. Most board-certified plastic surgeons are perfectly capable, but patients must make sure to check credentials and certifications beforehand.

What is the polydiaxanone suture?

The PDS is a reabsorbable monofilament suture which is slowly broken down in the body and retains tensile strength for months after a surgery. It is commonly used as a method of fixating repositioned deep tissues.

Fillers haven't helped me. Do I need a facelift?

Just because the use of fillers was unsuccessful does not automatically mean that a patient requires a facelift. Flat cheekbones can corrected with fat injections and other areas can easily be corrected with microliposuction.

What can teens do to address facial sagging?

Young adults are somewhat limited in facial rejuvenation options. The best options at that age would probably be maintaining good hydration, no sun tanning of the face, and good medical skin care.

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.

Any recommendations for facelift surgeons in South Florida?

The ASPS website has a physician locator feature that will provide a list of qualified surgeons. It is probably best to consult with several surgeons in order to find the one that best meets your needs.

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