Deep Plane Facelift

A facelift is a cosmetic surgery that elevates the skin of the face to access the deeper soft tissues of the face that droop with time. These deep soft tissues, referred to as the SMAS, are elevated and repositioned in a more youthful fashion. In a similar fashion, a necklift addresses the deeper layers of the neck that sit underneath the skin. This includes tightening the platysma muscle, removing excess skin, and contouring glands to achieve a better neckline.

Most patients who are healthy and who display signs of facial aging are good candidates for a facelift. It is important to review your anatomy and goals with a surgeon, and have a full medical history and physical to ensure good health prior to undergoing an elective, cosmetic surgery such as a facelift.

The terms full facelift, mini facelift, and other trademarked techniques are confusing and can be misleading. A facelift is a surgery that addresses the deep tissues of the face from the jawline to the cheeks to reposition them in a more youthful position. A necklift addresses the deeper tissues and skin of the neck below the jawline. A mini facelift is a marketing term used by some surgeons and can lead to mini or inadequate results. The most important thing is to find a surgeon that is transparent about their technique and results prior to moving forward with surgery.

Finding the best facelift surgeon starts by searching for board certified facial plastic surgeons in your area or within reach by travel. Next, review the surgeon’s content, which includes website, before and afters, reviews, and word of mouth (if possible). Next, select 2-3 surgeons whose aesthetic matches yours and call their office to discuss details with their staff and schedule an in-person consultation.

There is no best age to get a facelift. If you have signs of facial aging, which include loss of facial volume, deeper folds between the nose and mouth, or jowling, then you are a candidate for a facelift. There are some patients who, due to a combination of factors, have signs of facial aging as early as their 30s. Others don’t show signs until their 50s and 60s. I believe that once signs of facial aging are visible, then it is reasonable to get a facelift, as long as you discuss your goals with a qualified surgeon and ensure you are a healthy candidate for elective surgery.

Facelifts alone take between 1.5-2.5 hours. However, most facelifts are combined with necklift and other facial rejuvenation surgeries such as browlift, eyelid lifts, lasers, and others. This can increase the length of the procedure. On average, a patient who undergoes a combined deep plane facelift and deep plane necklift is asleep for about 3.5 hours.

Yes, facelifts are very safe procedures. They are low-risk surgeries that are reproducible and create wonderful results. As with any surgeries, there are risks, benefits, and alternatives; however, in experienced hands, risks are unlikely.

Most surgeons use general anesthesia for facelift procedures. This includes intubation to secure the airway and TIVA, which is a form of general anesthesia that does not require intubation. Both are safe and effective ways of achieving comfort during a facelift. The decision is often up to the surgeon and their staff. I recommend the patient discuss options thoroughly with the surgeon prior to proceeding with surgery.

Facelifts are surgeries that require incisions to gain access to deep tissues of the face and surgical reposition them to more youthful positions to rejuvenate the face. This is often combined with a necklift to rejuvenate the neck and create an improve neck and jawline together. Fillers use gel-like substances to increase volume where they are applied. They cannot lift or reposition tissues, but they can improve certain wrinkles and camouflage some signs of aging temporarily. Botox, or other neuromodulators, temporarily paralyze muscles and can prevent wrinkles that form when you move certain parts of your face (like the brow, crows feet, and forehead). Filler and neuromodulators are adjuncts to facelifting that can add some improvements, but not replace a facelift.

Generally speaking, no - facelifts and necklifts are considered elective and cosmetic and are not covered by insurance. There are some patients in very specific situations who can have facelifts covered by insurance, but this is rare. My office does not take insurance for elective, cosmetic surgeries.

Financing or payment options vary by practice. Our practice accepts CareCredit, Alphaeon, and PatientFi.

A typical recovery after facelift surgery involves tightness and very mild pain in the face and neck area for 1-3 days. There is often a dressing that stays wrapped around the head for one day and is removed the day after surgery. There is swelling and bruising for 3-5 days, usually located 3 finger breadths in front of and behind the ear. Sutures are removed around day 7 and most patients feel comfortable returning to their public routine in 2 weeks.

Facelift surgery is not painful. There is tightness and soreness, but there should not be a significant amount of pain. We prepare our patients with pain medication and anesthetize the face accordingly to minimize pain in the post-operative period.

Most patients return to work 2 weeks after a facelift. Depending on the social event, most people are comfortable returning to in-person social events 2-4 weeks after surgery. Exercise can begin with mild activity 2 weeks after surgery with gradual increase to full exercise in 4 weeks.

Swelling and bruising is normal after a facelift. In face, no swelling/bruising would be abnormal. Most patients have swelling and bruising 3 finger breadths in front of and behind the ear, and 2 finger breadths under the chin for 3-5 days. Bruising usually resolves after the first week, but swelling can linger for a few weeks, especially in the high cheeks and under the chin. Gentle massages can help, along with an optimized diet and sleeping elevated.

Facelift results are permanent. However, time and gravity continue and aging does not stop. I tell most patients that facelifting is similar to a conveyer belt of time. We will pick you up and move you 10-15 years back and put you down. The conveyer belt will keep moving and you will age gracefully moving forward.

Most people see the final results of their facelift at 6 weeks. However, even at 6 weeks some patients have swelling that hasn’t fully resolved and some incisions have not fully healed. At the 6 month point, almost all patients have healed enough to consider this a final result.

The answer is yes to both. Deep plane facelifting in experienced hands will look natural as the aging, droopy tissue will be repositioned into a more youthful position. My goals are for facelifts results to be noticeable, but not obvious. I want patients to look younger and more refreshed, rather than unusual and distorted. This is achieved by discussing goals and techniques with patients transparently, and making appropriate, yet conservative, changes to the face.