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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

Can I get a facelift after weight loss?

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

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

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

What are staples used for in a facelift?

Generally, surgeons reserve staples for anything in the scalp area especially for incisions along the hairline because they provide excellent eversion and do not compromise blood supply (thereby reducing hair loss).

How is tumescent fluid used during a facelift?

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

Can I have a facelift when I have a cold?

It is probably best to have facial surgery when the respiratory system is clear and breathing isn’t affected. If the body is generally stabilized at this point, the facelift should be fine.

Did my doctor mess up my fat transfer?

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

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.

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.

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.

Can weight fluctuation impact fat grafting?

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

Can peroxide be used as an antibacterial agent during and after a facelift?

Patients using peroxide should probably stop using it as an anti-microbial agent as it is known to slow wound healing and cause a drying of the skin edges. Skin sloughing at this point could also be a problem due to excess tension on the skin.

Can a lower facelift address sagging chins?

What is generally found with a lower facelift is that it addresses the lower two thirds of the face, causing the jawline to become sharper and the angle of the jaw to become more acute. Sagging chins, on the other hand, are more caused by a lack of projection (AKA loose skin and fat), or, in other words, the absence of structure. The best method of treatment, in this case, is to do a chin implant since the problem is not skin laxity.

How can pain be controlled post-facelift?

Pain medications are often helpful in treating pain, but for great swelling and burning pain, other medicines like Neurontin or Lyrica may be needed. Consult with your doctor before taking any potentially harmful medications.

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.

Why do I have numbness and tingling after a deep plane lift?

Generally, numbness and tingling is caused by the disruption of nerves and changes in nerve activity following the procedure. It usually takes up to 3-6 months for the face to feel normal again

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.

What is the Catio Lift?

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

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.

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.

Can buccal fat pad suspension help with jowling?

The buccal fat pad is located in an area superior to the fat around the jowls and thus will have very little impact on jowling if suspended. The true method to treating jowls consists of an SMAS Lift possibly combined with fat resection.

Can a facelift correct droopy eyes?

Droopy eyes are caused by sagging eyelids, not by facial skin laxity. Skin laxity is treated using facelift that tighten the skin and muscles underneath; sagging eyes are treated with eyelid surgery or browlift to adjust the anatomy.

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

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

What are good solutions for younger patients, other than facelifts?

For younger patients wishing to change their inherent facial structure, the facelift would probably not be the option to go for. Instead, non-invasive methods, like fillers, would be a far superior first line of treatment. Consulting with their specific plastic surgeons and obtaining a detailed exam and treatment plan would be the best option at this point.

Is blinking difficult after a facelift?

It shouldn’t be. Patients having trouble with the eyelids or lips following surgery may have sustained temporary damage to the facial nerve. It is important that, for the time being, the patient makes a sustained effort to keep the eye lubricated and consult with a specialized neurologist in order to pinpoint the extent of possible nerve damage.

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.

Why am I in so much pain months after a facelift?

It is uncommon for patients to experience a great degree of pain 6 months post-op or swelling in a great amount. Consulting with the plastic surgeon is probably the best option at this point.

Can I do a facelift following a parotidectomy?

I would not recommend getting a facelift following a parotidectomy simply because of the increased risk of facial nerve injury. This is because, after a superficial parotidectomy, the position of the facial nerve changes and is unknown to the surgeon.

Is there a risk of having nylon sutures post-facelift?

Nylon sutures which are left in post-procedure are generally not toxic and do little internal harm. The problem is that they tend to work themselves out of the skin, meaning that they must be removed when they are near the skin.

Do I need General Anesthesia for my facelift?

Statiscally general anesthesia is for the majority of Facelift procedures done in America, however it has no direct bearing on the results of the Facelift. General anesthesia primary functions to eliminate of patient anxiety during a procedure so that they can tolerate the operation. Surgeons using Local anesthesia take just as many precautions to minimize the risk of surgery, and can achieve the same results. We prefer twilight anesthesia, referred to as IV sedation, which is much like the anesthesia for colonoscopies.

What facelift best improves chin definition?

The best treatment for chin definition would probably be the lower facelift which improves sagging jowls and removes excess skin from the lower areas, repositioning tissues along the way. Areas from the mouth, neck, and ears remain relatively unaffected.

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

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

Did my bilateral swelling post- op come from the facelift?

Patients when trying to diagnose glandular swelling post-op must try to make sure that it is not in fact swelling from the facelift procedure itself. During a facelift, it is unlikely for the parotid gland to be disturbed in any way.

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.

When can I have dental work done post-facelift?

I personally recommend patients to avoid dental work for the first month or so after a facelift. However, even at seven weeks or so, patients should inform their dentists about their surgery and advise caution.

What is the pros vs cons of an extended MACS facelift?

The problem with the extended MACS facelift is that, though it is a vertical facelift and the results look more natural than most others, it does not address lax skin on the neck and definitely does not target fat and banding around the platysma muscle.

Is asymmetrical tightness post-facelift normal?

It is normal for patients to feel tightness more sharply on one side of the face than the other, yet massage and time usually helps even things out.

Does muscle tightening always occur in a facelift?

Most facelifts frequently used today, whether they be SMAS, deep-plane, or even mini facelift, have at least some interaction with the SMAS layer beneath the skin. Tightening of the muscle layers underneath the skin usually always happens with any of these procedures.

What can I do about asymmetrical post-facelift sagging?

Post-op, many patients will find that sagging can be asymmetrical. However, this is not due to the skin laxity which required the facelift, but more so because of fat/volume loss in the cheeks. This can easily be corrected with fat grafting or fillers.

Will the MACS facelift make my cheeks bumpier?

Especially on patients with thin skin, the MACS Lift which involves pursestring sutures that elevate deeper tissues can often create noticeable lumps on a patient’s face post-op. For these patients, a limited traditional SMAS Lift may be the better option.

Will steroid injections cause weight gain or flare-ups for rosacea patients?

Dilute steroid solutions should not cause either.

Can eyebags be caused by fat injections?

No.Fat injections should generally be added along the tear trough, which is the deep grove along the bone of the lower eyelid.

Is a mini facelift less risky?

Again, for surgeries like the mini face lift, there is less invasiveness and, therefore, less risk. The trade-off, however, is the lack of long-lasting results which one would find in a facelift. However, the procedure varies from surgeon to surgeon so patients should consult with their individual surgeons.

Is Valium helpful post-facelift?

Valium is an anti-anxiety medication which allows the patient to rest for the immediate post-op period. It is good for patients looking to avoid hematomas which are usually attributed to strenuous activity in this post-op period (rise in heart rate and blood pressure). Consult with your surgeon, however, for long-term use.

Are there any OTC scar treatments?

There are no OTC medicinese available to treat scars, but several treatments including laser and Neosporin application have been shown to.

Should I look for an MD or DO in my facelift surgeon?

Again, it does not truly matter what sort of degree the doctor has. If he is adequately trained and has a good reputation combined with the experience which you are looking for, the surgery should go smoothly regardless.

What is the downtime for a mini facelift?

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

What is a dissolvable implant?

The “dissolvable” implant which surgeons refer to during this procedure is probably an endotine anchor which holds the results of the facelift together until the tissues have healed.

What should I do about loose skin following a lower facelift?

Patients with loose skin following a lower facelift would probably best be comforted by a platysmaplasty performed under local anesthesia.

Is the Serdev Suture Lift worth it?

The Serdev Suture style has been acknowledged for having minimal invasiveness to the face, lack of scars, and a quick recovery time. However, Dr. Serdev has been known for using unique sutures and instruments which are not widely available in the United States such as specially designed needles and sutures. Before patients fly over to Bulgaria, however, they must recognize that the procedure is a very short-term solution as the sutures dissolve over a short number of years, but that the procedure is good for people who do not want an invasive procedure.

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.

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

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

How can I time surgeries done under general anesthesia?

For patients looking to do liposuction and facelifts, surgeons must remember that doing them concurrently could increase the risk of blood clots and other medical problems. Generally, though they can be combined, liposuctions should be done first with the facelift done much later.

Can I get a facelift at 43?

It is important to recognize that the timing of a facelift is again related mainly to the physical stage of a patient, rather than the patients themselves, and are controlled by genetics and environmental factors. Even though you may be young for a full facelift, you could easily qualify as an ideal candidate for a mid-facelift. This facelift is ideal for those who have lost definition in the eye area and who are beginning to show the signs of sagging.

Is swelling post-endotine face lift normal?

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

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.

Where is scarring post-facelift?

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

Should I have fillers before or after a lower Facelift?

As we age we first lose volume in the face, and then the skin starts to become lax. If you are at the stage where you have loose skin in the form of jowls, bags and neck folds, then you should be thinking about having a facelift. Facelifts address laxity, and fillers address volume loss. We address both problems simultaneously by doing some sort of volume replacement (Fat Transfer, Restylane, Perlane, Radiesse) before, during, or after a facelift.

How should sun exposure go post-facelift?

Sunscreen in the post-op days, when the skin loses its normal ability to respond to sun exposure and damage, is especially important. Patients should stay out of the sun for about 3 weeks, after which sunscreen can be applied (I recommend a zinc-based sunscreen for minimal chemical absorption).

How can I improve my eye and cheek area?

Patients looking to improve the periorbital and cheek area should look into the cheek augmentation option via fat grafting. Jowling can also be fixed temporarily with chin implantations.

Can you differentiate between a mini facelift and a midface lift?

A mini facelift is a procedure in which incisions are placed around the ears and the skin is pulled up to these incisions and trimmed at the suture line. A midface lift, however, is usually performed through an extended lower eyelid incision, a preauricular (in front of ear) incision or a combination of both.

Can I resolve smile lines via facelifts?

Unfortunately, patients will not find any improvement with smile lines or nasolabial folds following a facelift. These are more likely resolved with fillers or fat grafting.

Can I get a Corset Platysmaplasty in concurrence with a facelift?

Generally, patients who are in need of playsmaplasty are those who have platysmal banding. If such symptoms are not present, the procedure is simply not worth the swelling and recovery time unless an extremely tight neck is desired.

How do I combat excess fat after a maxillofacial surgery?

Patients who have excess fat above and below the platysma post-maxillofacial surgery could have many of their problems with a neck lift combined with a platysmaplasty designed to remove this fat and sew the platysmal muscle next to the hyoid bone.

Is numbness on my forehead normal post-facelift?

Numbness following trauma to the skin is a very normal part of healing and should normally heal after a year, but complete feeling is not guaranteed. Again, it depends on the actual extent of the incision, with superficial incisions having a higher chance of full recovery.

What is the Recovery like after a facelift?

The healing time varies for each patient, but typically you will be able to resume most normal daily activities by the 2 week mark. Dr. Kassir usually removes any sutures at day 7, and some patients are able to resume exercise by day 10. You will be ready to show off your rejuvenated face at public events (weddings, reunions, birthdays, etc) by 2-3 weeks.

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 drains needed post-facelift?

Generally, surgeons will need to include drains after performing a major facelift as a way of speeding up healing by preventing fluid accumulation. Drains are usually left in for a day post-op and are carefully removed by the surgeon.

How can I address my concerns about general anesthesia?

It is perfectly normal for patients to have concerns about general anesthesia and, if this is the case, they should consult with their plastic surgeon about it prior to surgery. However, anesthesia is very safe and patients should not be concerned unless health problems present an issue.

What is the difference between the SMAS vs Deep Tissue Suture Lift?

Generally, the SMAS Lift which manipulates and repositions the inner contours of the face will yield a much more long-lasting result than the deep tissue suture lift which generally just elevates the tissue without doing much repositioning.

Who should have a mini facelift?

The mini facelift procedure should be used for younger patients who are dealing with minimal jowling and looseness in the neck.

Is it common to have spotty bleeding post-facelift?

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

Can loose skin be corrected non-surgically?

Unfortunately, skin laxity cannot be addressed by a non-surgical method, but only through a facelift.

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.

What differentiates a facelift from liposuction?

There remains an important difference between a facelift and a liposuction in terms of procedure. A liposuction is merely the removal of fat in the chin (submental area) and in the neck since facial fat is good for maintaining youth. A facelift, however, is much more involved and consists of removing fat above and below the platysma, tightening neck muscles, etc.

Restylane didn't fix my facial issues. Can I get a facelift?

Patients must remember that a facelift is not the ideal solution for addressing volume loss in the face, but is rather more suited for addressing skin sagging and laxity. Patients having problems with fillers should consider fat grafting.

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.

What is a SOOF lift?

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

What should I do about the blood blisters on my face post-facelift?

Post-surgery, it is extremely uncommon to find blood blisters on the face. Consulting with a plastic surgeon who performed the procedure is probably the best option at this point.

How can I deal with transition lines post-facelift?

Transition lines can often be dealt with quite effectively with a variety of options including surgical revision (major or minor), Juvederm fillers, or subcision of scar lines (in order to smooth out the bands by relieving adherence to the deeper tissues).

Why do I have indentations in my face post-facelift?

Indentation following a facelift may be the result of fluid or residual laxity but it is difficult to truly pinpoint without the benefit of a full surgical exam. If the issue remains unresolved for months, fat grafting may be the best option to correct any deficiencies.

What type of surgeon is best for facial surgery?

The best option, generally, for facelift surgery is to have it done by a board certified plastic surgeon or, even better, a board certified facial plastic surgeon.

When should I use Sculptra as opposed to hyaluronic acid fillers?

Sculptra is generally used as a deeper volumizer primarily used within the cheeks and the temples and may require multiple treatment sessions for the desired effect. Acid fillers are probably better for under eye filling, as are fat transfer options.

Are cysts prior to a MACS lift a problem?

Generally, the presence of cysts prior to surgery is problematic in that it could increase the risk of post-op infection. However, if found early, cysts can be easily removed or avoided during surgery.

Are there any cheek issues associated with endoscopic lifts?

Patients with an endoscopic lift may have issues with elevated cheekbones, issues which usually resolve themselves over time.

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.

How should I sleep post-facelift?

Post-facelift, patients are recommended to sleep with the head elevated and perfectly straight (not on their side where they could put pressure on various parts of the face).

Why are fat transfers not effective for me?

Fat transfers and many other minimally invasive procedures tend not to address the issue of skin laxity. Fat transfers can correct volume loss issues seen in younger patients. To address skin laxity problems patients need to consider undergoing a Facelift procedure

Any good tips for patients undergoing facelifts?

The best way to avoid complications during and post-surgery is by making sure that all questions are answered. Be frank and open with your surgeon and ask anything which could be troubling. Also, quitting smoking and following other orders by your surgeon is also important.

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.

Why do I have pins and needles sensations on my feet?

Tingling and numbness post-op is fairly common after surgery as nerve endings are attempting to regenerate themselves. This should continue for about a year until the conditions subside.

Is the age of a surgeon important for a facelift?

Determining whether a surgeon is still capable of good surgical technique often lies with examining recent before and after photos of patients and seeing whether he or she demonstrates the technique which they once did. Again, a facelift is a very challenging procedure and should be taken seriously.

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

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

What can be done about loose facial skin for younger patients?

For younger patients, I would recommend having deep layer fat compartment augmentation simply as a method of restoring structure and weight to the face, mainly because skin laxity is usually not a problem for people in their 20s and 30s. If skin laxity is a problem, however, further facelift options may be needed.

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.

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.

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.

Where will the scars for my Facelift be?

A good surgeon practices placing their incisions in the least visible places, and at the same time allows for the right amount of tension to have smooth scar formation. Most Facelifts have scars behind the ears, but the MACS Facelift has them directly in front of the ear.

Why can't younger patients get facelifts?

Younger patients who are serious about having a facelift should probably have a consultation with a qualified surgeon to see if that is the only option for them. Facelifts are most commonly used for facial aging due to the drooping of midfacial tissues or for patient who have very little volume in the face. However, younger patients are more encouraged to maintain proper nutrition and have less invasive procedures like cheek implants, etc.

Does platysmal banding post-facelift require a revision?

Patients dealing with platysmal banding after surgery, usually the results of aging, shortening, and fibrosing of the neck muscles, can usually only be treated with revision platysmaplasty. This procedure consists of a small incision made under the chin through which the platysmal muscle is tightened.

Are neck bands post-facelift normal?

The presence of neck bands following a particularly invasive facial surgery is generally not good and probably indicates a neck placation or a platysmal band which was not treated fully. Revision surgery may be needed, but, until then, vigorous massage and warm packs can also be utilized as methods of treatment.

Can I have microcurrent treatments post-facelift?

To be honest, I see no real benefit OR harm in having microcurrent procedures done because they only affect muscle rather than the fibrous tissue layer (SMAS) which was affected during the facelift. I have always been wary of these microcurrent treatments as stimulating muscle repeatedly could cause further wrinkling of the skin.

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.

How long does post-facelift pain last?

For most patients, some pain is normal after surgery for which pain medications are designed to lessen the pain. Generally, however, pain should be rather low as swelling usually dies down after two weeks or so and bruising fades. Pain medications should generally not be needed until a few days after surgery is done as the skin is pretty numb at that point.

Are there any issues to expect post-facelift?

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

What is the thread facelift?

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

Why do I have ropey fullness on my neck post-facelift?

Ropey fullness on the neck tends to be the mark of fluid collection which can easily be aspirated by a surgeon. Even untreated, the symptoms will eventually begin to heal on their own. Consult your surgeon to check it out.

Can I do a fat grafting followed by a facelift?

Following a fat transfer, patients should wait until any firmness, edema, etc. is healed completely before doing a facelift. This usually occurs after 3 months.

Should I protect my neck post-facelift?

It is important for patients post-op to take it easy on the face and neck area especially in an effort to avoid platysmal banding and the stretching or straining of delicate post-op facial structures.

What is the Segmental Stepwise facelift?

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

Is there any specific diet needed prior to a facelift?

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

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.

Is getting a facelift early detrimental?

Though patients should not get facelifts until they are truly ready, there is no harm in having one early under the hands of an experienced and capable surgeon. Especially if early signs of aging are present, treating them earlier may help create more long-lasting results. But consult with your plastic surgeon about this.

When will my facial movement return to normal post-facelift?

Due to post-surgery tightness and local edema (not to mention swelling), facial movement is always impaired after surgery. However, as these issues begin to resolve themselves out, the range of facial movement tends to increase and weakness usually recovers smoothly. Again, though, it is best to consult with your plastic surgeon or even a neurologist if any concerns are there.

Can I do a scar revision below the temple?

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

What is the ClearLift?

The ClearLift procedure makes use of a Q-switched laser which mainly treats loose skin at the surface after a series of treatments and is usually best reserved for patients with thick skin. Yet, usually, this procedure is best used for skin wrinkling rather than facial structure issues, especially for older patients. For addressing the issue of severe jowling and fat below the neckline, there is again no substitute for a comprehensive neck lift.

Can dermal fillers be put in before the surgery?

If patients wish to have fillers added prior to surgery, the best initial option would be to first consult with their surgeon. However, inserting fillers prior to surgery will distort the anatomy of the face and will probably not address areas which could be hollowed-out post-op. Generally, it makes more sense to have fat/filler injections done during or after surgery.

What is the cost of a ribbon lift?

Again, over the years, the ribbon facelift has gone down in popularity simply based on the overwhelmingly high cost to benefit ratio. I personally would not recommend this procedure, but, if dead set on this particular technique, average costs hover $3500 to $5,000.

Is it normal to have hearing loss post-facelift?

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

Is it normal for jowling to return post-SMAS facelift?

Generally, for such invasive procedures, it may be too early to make a truly accurate call as to the effectiveness of the surgery. For now, try looking at before and after photos, trying to maintain clear, rational expectations for yourself. However, SMAS lifts specifically target the jowls, meaning that you may need revision surgery.

Does an Endotine facelift cause nerve damage?

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

Will the MACS facelift impact my eyes?

Generally speaking , this should do very little in the eye area besides removing excess skin, so it should not be a concern to patients.

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.

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

What is the burning sensation I feel post-facelift?

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

Does a lumpy post-op neck require revision?

Patient who have a neck lift surgery may find that, over time, the skin in the submental region has become attached to the underlying muscle, causing a lumpy appearance under the neck. If this occurs, revision surgery is needed in which the original facelift incisions are opened up and the skin is redraped.

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Disclaimer: This site only provides information about cosmetic surgery and this information is not meant to be taken as medical advice. For more information about plastic surgery, contact Dr. Kassir.