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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

How can I fix my excess skin between my eyebrows post-blepharoplasty?

This is somewhat difficult considering that the thin skin closest to the nose is very difficult to incise without creating an obvious scar. If this is a particularly bothersome issue, consult with your surgeon about your options.

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”.

Should I get a surgeon of MY specific ethnic background?

Surgeons who are educated in plastic surgery will often be quite in tune to the various ethnic backgrounds of their patients and will recommend the best options they can for all patients. Therefore, finding a good surgeon, regardless of their background, is probably the best option for any patient.

I experience platysmal banding after weightlifting. Is that normal?

During strain, contraction of the platysma muscle could expose banding areas, especially if the patient loses weight due to frequent work outs.

Is 40 Too Young for a Facelift?

To answer the question, No. There are different types of lifts and if under 40 you don’t need to have one of the major operation that is typically reserved for patients over the age of 60. These advanced procedures have deep incisions into the muscular structure of the face in order to adjust the outward look of the face. Even though you may be too young for a “Full” facelift, you may be ideal for a mid-facelift. This facelift is best suited for those who have lost definition in the eye area and whose cheeks are beginning to sag. This procedure works on the deeper layers in the middle of the face and places them over the cheekbones to create a fuller look in that area. The total effects are expected to last about 5 to 6 years.

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.

How do midface lift revisions work?

Contrary to popular belief, younger patients who have had facelifts can easily consult surrounding surgeons for a revision. Sometimes, it is as simple as cutting internal stitches and loosening/trimming more excess skin.

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 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.

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.

When will I look "normal" after a facelift?

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

Can ultrasound address facelift scarring?

Generally, it is unusual for patients to experience deep scarring after three weeks of surgery. What patients believe are “scars” may actually be small fluid collections or old blood under the skin. While ultrasound may be useful for bumps post-op, it is probably best to consult with a plastic surgeon as to using it for facelift scarring.

Is paralysis of the eyebrows normal post-facelift?

If major damage like paralysis occurs to the facial nerve, it may take quite a while before full recovery of the nerve (if full recovery even occurs). Generally, for these types of cases, patients should expect to wait 6 months before recovery ensues.

How can a 40-year old patient address sagging?

Generally, for patients in their early 40s, it is best to address jowling and sagging with a mini facelift with touch-ups repeated every 7-10 years.

Is post-facelift mouth movement difficulty normal?

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

How can I determine if a clinic is up to standard for a facelift?

Patients should check if offices have some sort of safety standards, preferably AAAHC or JCAHC (or even Medicare facilities) which hold surgeons, RNs, etc. responsible. Patients can also avoid general anesthesia if they are especially anxious.

Should I revise my cheeks several months post-facelift?

Patients must be careful in deciding to undergo revision surgery, especially because the healing process is not yet finished after several months post-surgery. Consulting board-certified surgeons is probably the best option in addressing patient concerns.

Why is my face partially paralyzed post-facelift?

Patients dealing with facial paralysis usually have their symptoms subside within 9 months to a year. However, this is an unusual symptoms and consultation with a neurologist may be necessary.

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.

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).

Are post-facelift spasms normal?

Spasms are usually very common in most post-surgery patients. They usually heal themselves as time goes on.

What defines an experienced facelift surgeon?

Often, it is better to not get bogged down with numbers when it comes to surgeries. Examining before and after photos and deciding whether you are completely satisfied (COMPLETE is emphasized here) is probably the best option when it comes to opting for surgery.

What is a short-scar lift?

Short scar lift/mini facelifts, like many facelifts, are done under local anesthesia and are performed by creating an incision in the back of the ear towards the earlobe. They, however, merely address the skin, rather than the underlying muscle tissue (SMAS layer of the skin), meaning that the results typically last for a maximum of about a year (the usual recovery time is about 2 weeks).

What can I do about swelling and pulling around my earlobes post-facelift?

Patients should remember that swelling following facelift surgery is extremely common, but should also take care not to touch the areas around the earlobes too greatly because results may be altered tremendously. If pulled earlobes are a major concern, patients should talk with their surgeon immediately.

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.

What can be done about my droopy smile?

Fillers can be used on patients who are having droopy corners on their mouths when they smile.

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.

Can hormone replacement therapy impact a facelift?

HRT treatments during surgery may increase the risk of blood clotting so it is advisable to stop this treatment before surgery if possible.

Is the cheek fat pad repositioned/removed during a facelift?

Again, not all facelifts are the same. Some procedures including the SMAS facelift involve the repositioning of the cheek (buccal) fat pad and often involve the partial removal of it as well.

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.

Can I use Ice to help with swelling after a facelift?

Patients should expect the most swelling the first few days after a Facelift and a significant decrease over the first 2 weeks. Ice can help reduce the swelling, but using it too much can damage the skin.

How can I reduce Swelling and Lumps after a Facelift?

Firstly patients should consult their surgeon so that they can make a clinical judgment about the swelling and lumps. To help the reduce lumps and swelling, it may be helpful to soak with warm water and massage the area, however this will not help resolve hematomas. Hematomas that appear soon after surgery should be drained. The most effective tool to reduce swelling and lumps is allowing time for the body to heal on its own.

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.

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

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

Can dissolvable sutures be used post-facelift?

The placement of sutures and the types of sutures used depend mainly on the surgeon’s preference. Generally speaking, though dissolvable sutures aid in the conspicuousness of the surgery, they are known for being absorbed too quickly before lending any support to the structure of the new face. If patients are particularly worried, they could use permanent sutures to ensure that the sutures hold long enough for the doctors to remove them if need be.

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.

What does a MACS facelift cost?

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

How is aging affected post-facelift?

The extent to which aging increases/decreases post-facelift depends on the way the surgery was performed. Generally, if performed adequately, the surgery should not cause any changes in skin texture or blood supply to the skin, meaning that aging should not be affected generally. The point of a facelift is not to alter the aging clock, but simply to reverse it temporarily. A facelift, if done correctly, should be followed by normal aging without any facial distortion.

What does a Midface Lift address?

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

How much bandaging will be used after my facelift?

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

Mini-Face Lift vs. Mid-Face Lift vs. Traditional Facelift

These three procedures are considered true facelifts. The difference between them is the areas of the head and neck that they address.

Mini-Face lift: used more frequently in younger patients, and consists of a small incision behind the ear and only adjusts the skin, leaving the underlying muscular structures intact.

Mid-Face lift: addresses the mid-face (triangle formed on either side of the face from the corners of the eye to the corner of the mouth), specifically around the cheek area (saggy cheeks, etc). The incision is made in the hairline and the fatty layers of the skin are repositioned over the cheekbones.
Traditional facelift: most extensive and involves an incision near the hairline which extends behind the ear. The muscular layers are repositioned, tightened and 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.

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.

I have strange aches and pain years post-op. Is this permanent?

Generally, patients who are still dealing with nerve problems years after their surgery must accept the fact that such feelings are most likely permanent. Again, though, if deemed absolutely necessary, a consultation can be done with a neurologist.

Can nerve damage be cured by facial exercises?

After a facelift, it is probably best for patients to wait at least a year before making any judgement calls. Facial exercise at this point are useless.

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.

Can a 21 Year Old Get a Facelift?

It is highly irregular for a patient of your age having a facelift. A facelift is only necessary for patients looking to address the sagging of skin and muscles due to laxity of these constituents and, for young patients, this is rare except in the case of a tumor, extreme weight loss (causing the loss of structure in the face, etc.). I would not recommend it for you empirically based on your testimony.

How 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.

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

In general, forehead wrinkling and other skin-related issues can be easily resolved with Botox injections repeated every 4 to 6 months. Fillers can also be used for the saggy mouth areas especially on the corners, but surgery may be required for more long-term results.

What is the Segmental Stepwise facelift?

I would remain wary of such “gimmick” procedures which promise much but actually provide little.

Can fillers be done in conjunction with a facelift?

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

What can be done about jowling post-facelift?

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

Can premature aging in the 30s warrant a facelift?

Patients at the age of 32 are well below the normal age of a facelift. Many other options exist, some of which are not nearly as invasive, like fillers, Botox, fat grafting, photofacial, laser treatments, etc. Either way, a facelift is usually out of the question.

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.

What is the treatment for saggy eyes?

The treatment for saggy eyes can generally consist of a combination of browlift combined with blepharoplasty, fat/filler injections, fat grafting, and possibly ultherapy. Keeping a good skin care regimen is also quite useful.

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.

Is the tightness post-facelift permanent?

Generally, patients, following a facelift procedure, should experience a degree of tightness in the face. However, it should not be long term and follow-up care with the surgeon should be taken at ALL costs if symptoms persist for a great deal of time.

When can I have a facelift after doing Lifestyle Lift?

Unfortunately, many marketed procedures are ineffective, but revision surgery can usually be done 6-12 months after the failed procedure during which scars can be removed and/or repositioned.

What can I do about chin sagging?

Patients dealing with extra skin (not to mention skin laxity) around the chin/neck area may require a lower facelift in addition to a chin lift. Platysmaplasty may also be required to deal with post-op neck banding following the surgery. In addition, though patients may be concerned about hitting the thyroid gland during surgery, these procedures rarely touch it.

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.

Are there non-surgical facelifts?

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

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

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

Can I get a facelift for malar bags and sagging skin?

Generally, younger patients are discouraged from pursuing a full-on, invasive facelift surgery. Many patients who have malar bags are discouraged to get facelifts and should instead opt for small cheek implants to enhance the fullness of these areas and give structure (thus fixing the problem of the sagging skin).

How can I correct facial asymmetry?

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

What should I do if my cheek implant shifted post-facelift?

Generally, it is important for doctors after a cheek implant to fix it in place with a screw which may require surgical incision. A simpler method of treatment could be to inject fat into the area to hold up the implant in place.

How long is recovery post deep-plane facelift?

For an invasive surgery like a deep-plane procedure, the swelling will usually last for several weeks to several months. Patients should expect to out of work for at least 2 weeks and should plan on having someone take care of strenuous activities and tasks where bending is needed.

Do Facial Microcurrents do the same thing as a facelift?

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

Can I use Aquacool face masks to address post-facelift swelling?

Short term swelling can easily be treated with a cool compress or cooling mask, but could be easily substituted with ice, frozen peas, 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.

How will I age after a Facelift?

A Facelift does not alter the rate of aging, it simply reverts your face back to an earlier time. After a Facelift aging will continue, meaning that 20 years later you will look older, and may desire another facelift.

How does facial tightening work post-facelift?

Generally, after a period of several weeks, facial tightening begins to fade unless sutures were placed poorly in which case the surgeon must be found as soon as possible to avoid infection.

Where is scarring for a facelift, blepharoplasty and a subnasal lip lift?

Facelift scars generally fall behind the outline of the ear along the edge of the hairline. Blepharoplasty scars fall in the natural crease above the eye and just below the eyelashes on the lower lid. Finally, the subnasal lip lift is marked by an incision under the nostrils.

What is the cost of a facelift vs a Lifestyle Lift?

In plastic surgery, it is probably the best idea NOT to let price be the sole guide for going through with certain surgeries and to remember that you often get what you pay for. The Lifestyle Lift is generally a modified version of the S-Lift which offers very little benefits for its rather high cost. A facelift, on the other hand, costing from anywhere between $5,000 to $25,000, is a procedure proven to yield significant results and is the one I would advocate to many of my patients (depending on need, of course).

Am I too young for a temple lift?

In their early 20s, patients can easily substitute a temple lift surgery with Botox for the lateral brow area. Other options include lasers, light peels, and skin care treatments.

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 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 are procedures for sagging at age 24?

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

Why do I have a depression of the zygomatic arch post-facelift?

A depression in the zygomatic arch could be attributed to the atrophy of the temporalis muscle. In this situation, fillers, fat grafting, or even Sculptra treatment could all help.

Can a facelift result in mental issues?

It is unusual to hear of patients dealing with mental problems as a direct result of facelift surgery and is probably not true. Surgery can take its toll psychologically, particularly if the results are not satisfactory to the patient. Such patients should seek psychiatric help if symptoms persist.

Can a facelift be done at age 43?

Good candidates for facelifts are those with sagging cheeks, jowl formation, and severe skin laxity. Volume loss, which is the problem that many people in their forties have as opposed to skin laxity, is best addressed by injectable fillers or fat grafting. Consult with your surgeon about the best option for you.

Should I get an ABPS or ABFPRS surgeon?

Both ABPS (requires the longest training) and ABFPRS are solid credentials for a plastic surgeon to have. However, the best results are often the ones in the hands of experience. Find a surgeon who has the capability and technical skill to adequately perform facelift procedures.

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 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.

Is an ultrasound facelift effective?

Patients should not look at ultrasound facelifts and expect the same results as a traditional facelift.

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.

Should I get a facelift at an ASC or at a hospital?

Most hospitals in which facelift surgery is performed usually have an associated ASC so the chance for infection in either location is usually low as long as they have good certifications/credentials (preferably AAAHC). If the surgery is performed in an ASC, it is probably best to ensure that the surgeon has hospital clearance so that, if complications arise, he/she can have you admitted into the hospital.

Can I have a facelift at 80 years old?

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

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 are my stitches popping post-facelift?

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

Should I consult with a facial plastic surgeon or just a general one?

In general, it does not matter what type of plastic surgeon your doctor is, as long as he/she is experienced and has the necessary medical training and certifications to take on the surgery. One would hope that he/she has the experience necessary, regardless of where the surgeries are conducted, to repeat successes and do it consistently.

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.

Why do my nasolabial folds look bigger post-Endotine lift?

Unfortunately, patients looking to correct nasolabial folds and other problems in this area, the endotine lift is probably not the best option. Revision surgery can certainly be done, but only by a board-certified plastic surgeon (if the patient wants the best results).

Why does my doctor want my previous surgeon's notes before my revision surgery?

Prior to doing a revision surgery, it is often helpful for revision surgeons to have the notes from the previous surgery. Physicians are legally bound to release these records upon patient request as many patients have varying positions of vital structures on their face.

How long does a deep plane facelift last?

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

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.

What is the Y-Lift?

The Y-Lift, from my research, is a form of the liquid facelift in which a different instrument (blunt cannula) is used as opposed to sharp needles.

Is it normal for swelling and bruising to exist weeks post-op?

Swelling and bruising are extremely common for up to 4 weeks after surgery. Generally, some patients will experience lumps and bruising which are accumulations of blood under the skin which have acquired collagen buildup. Sometimes, in these cases, steroid injections can help along with pressure dressings.

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.

Why do I still have hematomas post-facelift?

Especially for patients who are several weeks post-surgery, it is unlikely that hematomas could form. If they do, however, aggressive massage is not recommended as it may increase the risk of inflammation. Gentle fingertip massage and simple patience may be the best option.

What is Decadron?

Decadron is a steroid which works on the cellular level to decrease swelling and nausea in the patient. Even patients taking hydrocortisone for adrenal insufficiency are able to take this medication.

What is this oozing behind my ears post-facelift?

Often, patients will find that oozing behind the ears can happen followed by the movement of thread through the skin. These threads are prolene sutures which can easily be removed at the surgeon’s office.

Can my facelift scars be excised to let my ears move into a better place?

Scars can be easily excised causing any lower pole on the ear to move into a better position. After this is done, soft tissue can be activated to fill the defect.

Can I have fish oil post-facelift?

Fish oil and other medications should probably be avoided weeks before and after surgery. The surgeon will provide an indication as to which medicines should be avoided.

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.

What is the variation in facelifts?

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

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

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

How can I address rippling post-facelift?

It is unusual for patients to demonstrate ripples, especially months after a facelift. This may be caused by residual swelling, but more importantly, may be the result of underlying scar tissue. If the problem continues for about half a year, it is probably best to consult with the surgeon. Until then, patients are encouraged to massage the area.

What should I do about jowling and platysmal retraction post-facelift?

Patients experiencing jowling post-op may definitely require a facelift in order to lift the SMAS and a liposuction of the neck to improve platysmal retraction.

How will smoking affect my Facelift?

Anyone who is actively smoking a few weeks before their Facelift or smokes with several month of their Facelift, increases their risk for permanent scarring and noticeably dead skin. Smokers should quit 1 month before undergoing a Facelift. The chemicals in smoke alter the blood vessels of the face (and the rest of the body), and result in constriction.

When does bruising subside post-facelift?

The amount of bruising for patient is dependent on the surgeon’s skill, potential drains, the patient’s history of bruising, etc. Patients tend to heal after about 2 weeks, but it may take as long as 3.

How do I discuss options with my surgeon?

Often, when discussing surgeries, different surgeons will recommend different procedures for the same problems. The best way for patients to find the best options for them would be to look at many before and after photos for each procedure to find what they want.

Can 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.

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.

What is the downtime for a mini facelift?

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

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 do I have persistent long-term pain post-facelift?

The problem in your case could be dysesthesia which occurs when nerve pains do not go away shortly after surgery with massage, etc. Some potential methods of treatment could be massage. However, if nerve pain persists, patients may want to consult neurologists or pain specialists.

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.

Can a facelift fix my neck?

The only case in which facelifts would be required to fix the neck area is if the patient demonstrates laxity in the skin, shown especially by the presence of jowls. Generally, patients who demonstrate this will often do the facelift concurrently with a neck lift for the best possible results.

Do I need a revision facelift if I see asymmetry post-op?

Generally, what patients see as asymmetry is usually not, meaning that full examination of a patient is needed to determine if treatment is needed (usually by a Board Certified Plastic Surgeon). Waiting 9 to 12 months before considering surgery is probably best. In the meantime, I would consider volume replacement with fillers or fat grafting.

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.

Do you favor trampoline neck lifts?

The choice of a facelift depends on the patient’s skin laxity and submental fat present. A minilift allows for minimal jowl addressing and the tightening of the neckline, but smart lipo may not be as long-lasting as a minilift.

What can I expect in the way of bruising after a facelift?

Typically bruising is at its peak 3 days after surgery, and will gradually disappear over a 6 week period. If you develop a hematoma it may extend the normal healing process a little bit, but in the end you will look great. Keep in mind that you will look worse before you look better.

What is the best age to do a Facelift?

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

Can I look natural after a facelift and fillers?

In my opinion, anything is possible in the hands of an experienced plastic surgeon, especially concerning fillers and facelifts. A physician who is experienced and has a good reputation in his/her field and whose before and after patient photos are stellar is probably the best way for patients to achieve a “natural” result without the look of plastic surgery.

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.

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.

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