The facelift, also referred to as rhytidectomy or cervicofacial rhytidectomy, is a plastic surgery procedure designed to rejuvenate the lower face and upper neck, providing a more youthful and rested appearance. It’s important to note that a traditional or standard facelift rejuvenates only the lower one-third of the face whereas a ‘full facelift’ would include a brow lift, blepharoplasty and midface lift in addition to a lower facelift in order to rejuvenate the brow, eyelids, midface and lower face.

Because a traditional or standard facelift targets the lower one-third of the face and the upper neck, patients should not expect the facelift to impact the forehead and brow position, the appearance of the eyelids, or the midface area. These areas may be better treated with a browlift, blepharoplasty, and/or midface lift. In addition, the facelift will not correct deep smile lines termed nasolabial folds which are better treated with a midface lift and/or volume enhancement with filler injections.

Healthy men and women who are bothered by sagging, lose skin along the lower face and upper neck may be good candidates for a facelift. Individuals with unwanted jowling along the jawline may also be good candidates. Patients with deep smile lines (nasolabial folds) will not benefit greatly from the facelift. While the surgery may soften these lines to some degree, they are better treated with a midface lift and/or volume enhancement with filler injections. Patients who actively smoke or have a history of a bleeding disorder are not considered candidates for facelift surgery as there is an increased risk of complications.

Our facial plastic surgeon, Dr. John Hilinski, usually performs the facelift in an outpatient surgery center, although some facelift patients elect to remain overnight in the hospital or a recovery facility.

Patients may elect to have either deep sedation (twilight anesthesia) or general anesthesia for the facelift surgery.

The facelift surgery begins with carefully planned and placed incisions that are hidden along the hairline and border of the ear. The skin located in front of, below and behind the ear is then gently lifted. The deeper tissue layer beneath the skin that attaches to the facial muscles is termed the superficial musculoaponeurotic system, or SMAS. It is the SMAS layer that is then lifted up and tightened in front of the ear. The SMAS is continuous below the ear with a wide, thin muscle that crosses the entire front of the neck, termed the platysma muscle. Similar to the work on the SMAS, the platysma is lifted and tightened below and behind the ear. By lifting and tightening both the SMAS and platysma, the lower face, jowls and neck line are repositioned to a more youthful level. Permanent sutures are used to stabilize the SMAS and platysma layers in their new position to ensure a long-term result with the facelift. Essentially all of the tension for the lift procedure is placed along the deeper SMAS and platysma layers, thus ensuring that no unwanted tension is transferred to the skin layer where it could cause excess scarring. In addition, improper technique that does not rely on the SMAS suspension and instead relies on pulling the skin excessively taut often leads to the undesirable and unnatural ‘windblown’ look.

Once the SMAS and platysma have been tightened, the skin is redraped and the excess amount is trimmed. The skin layer is then closed in meticulous fashion with fine sutures, which includes recreating and realigning the natural skin creases in front of the ear, such as the tragus. If liposuction of the front neck is planned, this is performed with thin instruments through a very short incision below the chin. If the platysma muscle requires tightening in front of the neck, termed a platysmaplasty, this is done through a slightly wider hidden incision below the chin and the muscle is tightened much like a corset to form a tight sling or hammock effect across the neck and below the chin. This will essentially redefine the desired youthful angle along the front neckline. Once all of the incisions are closed, a compressive facelift dressing is applied to stabilize the surgical changes while minimizing the risk of bleeding.

The standard or lower face lift typically takes four to six hours to complete.

The incisions for the facelift are generally well-concealed in and around the natural curves of the ear and extending into the hairline behind the ear. A slightly modified incision in front of the ear is usually required for male facelift patients. In these cases, the incision is placed more along the border of the bearded facial skin, ensuring that hair-bearing skin is not lifted onto the ear where it can create problems with shaving after surgery. An additional short incision is made hidden beneath the chin if there is an excess of fat beneath the chin or if the front of the neck is going to be tightened along with the lower face (during a platysmaplasty).

While the incisions made for the facelift will result in scars, they are generally well-concealed in and around the natural curves of the ear and extending into the hairline behind the ear. In some cases, an additional short incision is made in a well-concealed location beneath the chin. Once healed, facelift incisions are very difficult to see.

Any pain or discomfort that patients experience after the facelift is usually not significant and is well controlled with low-dose prescription medication. Facelift surgery is often described as being more uncomfortable than painful.

After the facelift, patients can elect to be admitted overnight to the hospital for nursing observation rather than going home with close observation by a responsible party. San Diego Face and Neck Specialties can assist you in arranging for a private nurse to accompany you home if necessary. Patients should sleep with the head slightly elevated at a 30 degree angle during the first few days to minimize swelling in the face and neck. Any pain or discomfort that patients experience is well controlled with low-dose prescription narcotic medication.

Within twenty-four to forty-eight hours after surgery, the bandages will be changed and patients will be checked to make sure that there is no unwanted bleeding along the surgical site. Patients are then seen again on day five or six after surgery during which time the sutures are removed and a lighter, removable bandage is placed. Patients will be instructed on wound care and will then be seen every several weeks for the first few months.

Swelling and bruising can be seen to various degrees during the first seven to ten days after surgery. You can help to minimize swelling and bruising by avoiding blood thinners like aspirin and ibuprofen for at least two weeks before surgery and by taking Arnica Montana before and after surgery. Most patients are presentable in public and able to return to work within seven to ten days after surgery. At this time, make-up can be worn to help conceal any remaining bruising. Though the scars may appear pink to red for several weeks after surgery, they will begin to gradually fade with time and will fully mature and disappear within six months or more.

Facelift patients are advised to minimize rotation of the neck (for instance, turning your head to look backward) for the first several weeks of their recovery. This helps to decrease the amount of unwanted pull, or tension, along the back of the ear, which could otherwise cause excess scarring. While the aging process resumes from the point of the last suture being placed, facelift patients have undergone a permanent change to their anatomy with rejuvenating changes that typically will always allow them to appear that much younger for that particular age.

Patients are usually able to return to work within seven to ten days after the facelift, or sooner if they are not bothered by the bandages.

Aerobic activity and reconditioning can usually be resumed within ten to fourteen days after the facelift, while more strenuous activity and resistance workouts may be resumed within three to four weeks.

The stitches are removed within five to six days after the facelift.

As with all types of surgery, there are potential risks associated with facelift surgery. Potential X Trusted Source What are the risks of facelift surgery? American Society of Plastic Surgeons Go to Source risks include bleeding, infection, changes in skin sensation, and anesthesia risks. There may be other short or long-term complications that Dr. Hilinski will review with you at your consultation appointment. It is important to follow all pre-procedure directions and guidelines, as there are certain things you can do — such as discontinuing blood thinning medications and quitting smoking — that can reduce your risk of X Trusted Source Face-lift Mayo Clinic Go to Source complications.

The facelift is generally not covered by insurance when performed for cosmetic reasons alone.

The average cost of facelift surgery at our San Diego practice is $8,500, but it is important to understand that pricing varies because every patient has different needs and goals. Facelift pricing for your customized treatment plan can vary depending on a number of factors, including medical history and desired results. During your facelift consultation appointment at our San Diego office, you will learn more about which surgical options are right for you and have the opportunity to discuss the cost of facelift surgery, along with any other questions you may have.

The mini facelift, also known as an S-lift, is a plastic surgery procedure designed to rejuvenate the lower face and upper neck in order to provide a more youthful and rested appearance. The mini facelift is ideal for patients who do not have advanced signs of aging and/or do not wish to undergo a more extensive formal lower facelift.

The mini facelift targets the lower face and upper neck and will not affect the forehead and brow position, the eyelids, or the midface area. Other procedures like a browlift, blepharoplasty or midface lift can better treat these areas.

Good candidates for the mini facelift include healthy men and women who are bothered by sagging, loose skin along the lower face and upper neck. Patients with unwanted jowling along the jawline may also be good candidates for the procedures. The mini facelift is ideal for patients who do not wish to undergo a more extensive formal lower facelift or those who not have advanced signs of aging. The mini facelift is not appropriate for patients who actively smoke or those with a history of a bleeding disorder due to an increased risk of complications.

The mini facelift is an office-based procedure.

The mini facelift is performed with local anesthesia with or without oral sedation.

The mini facelift begins with carefully planned and placed incisions which are located in a hidden position along the hairline and border of the ear. Once the incisions are made, the skin located in front of, below and behind the ear is gently lifted. The SMAS layer is then lifted up and tightened in front of the ear. The SMAS, or superficial musculoaponeurotic system, is the deeper tissue layer beneath the skin that attaches to the facial muscles and is continuous below the ear with a wide, thin muscle that crosses the entire front of the neck, termed the platysma muscle. The platysma is also lifted and tightened below and behind the ear. This lifting and tightening of both the SMAS and platysma allows the lower face, jowls and neck line to be repositioned to a more youthful level. Permanent sutures stabilize the SMAS and platysma layers in their new position, ensuring a long-term result with the mini facelift. By placing essentially all of the tension for the mini lift along the deeper SMAS and platysma layers, there is no unwanted tension transferred to the skin layer where it could cause excess scarring. After the SMAS and platysma have been tightened, the skin is redraped, excess skin is trimmed, and the skin layer is then meticulously closed with fine sutures. This includes recreating and realigning the natural skin creases in front of the ear, such as the tragus. If the front of the neck requires liposuctioning, this is first performed with thin instruments through a very short incision below the chin. After all of the incisions have been closed, a compressive facelift dressing is applied. This dressing is intended to stabilize the surgical changes while minimizing the chances of bleeding.

The mini facelift takes about three to four hours to complete.

The incisions for the mini facelift are similar to those for a formal lower facelift as they are located in and around the natural curves of the ear and extending into the hairline behind the ear. They are generally well-concealed and, once healed, will be very difficult to see. Male patients will require a slightly modified incision located in front of the ear, more along the border of the bearded facial skin. This will ensure that hair-bearing skin is not lifted onto the ear where it can create problems with shaving. Patients with excess fat beneath the chin will have an additional short incision hidden beneath the chin.

The incisions made for the mini facelift do leave scars. In general, however, they are well-concealed in and around the natural curves of the ear and in the hairline behind the ear, resulting in scars that will be very difficult to see once they are healed.

The mini facelift is generally thought of as more uncomfortable rather than painful. Further, any discomfort or pain that patients do experience after surgery is well-controlled with low-dose prescription narcotic medication.

After the mini facelift, patients are sent home to recover in the presence of a reliable party. During the first few days, patients are advised to sleep with the head slightly elevated at a 30 degree angle to help minimize swelling in the face and neck. Low-dose prescription narcotic medication can control any pain or discomfort that patients experience. The bandages are changed within twenty-four to forty-eight hours after surgery, at which time patients will also be checked to ensure that there is no unwanted bleeding along the surgical site. The stitches are then removed within five to six days after surgery and a lighter, removable bandage is put in place. Patients will also be instructed on wound care. During the first few months, patients will be seen every several weeks.

Varying degrees of swelling and bruising will occur during the first seven to ten days after surgery. This can be minimized by avoiding blood thinners for two weeks before surgery. Taking Arnica Montana before and after surgery can also help to minimize swelling and bruising. Within seven to ten days, most patients are presentable in public and able to return to work. Makeup can usually be worn at this time to disguise any remaining bruising. The scars may appear pink to red during the first few weeks after surgery. However, they will begin to gradually fade and, though it may take upwards of six months to a year, they will fully mature and disappear. Patients are advised to minimize rotation of the neck, for instance turning the head to look backward, for the first several weeks of recovery after the mini facelift. This will minimize the amount of unwanted pull, or tension, along the back of the ear, which may otherwise result in excess scarring. Though the aging process does resumes from the point when the last suture has been placed, mini facelift patients have fortunately undergone a permanent change to their anatomy with rejuvenating changes that usually allow them to appear that much younger for their particular age.

Patients are usually able to return to work within five to ten days after the mini facelift. Patients who are not bothered by the bandages may be able to return to work sooner.

Aerobic activity (reconditioning) can be resumed within ten to fourteen days after the mini facelift, while strenuous activity (resistance workouts) may be resumed within three to four weeks.

The stitches are removed within five to six days after the mini facelift.

As with all types of surgery there are potential risks associated with the mini facelift. In general, the risk of infection and bleeding is very low as long as patients follow instructions to stop taking blood thinners two weeks before surgery and stop smoking at least two to three weeks before and after surgery. As with any surgery of the face, there is the potential risk of damaging the facial nerve which helps to control movement on that side of the face. There are five separate branches that can be injured individually or altogether, but because these branches happen to run along a predictable path below the SMAS and platysma layers there is very little risk of damaging the facial nerves provided that the surgery does not extend too deep below these layers. Swelling and bruising near the nerve may result in temporary weakness in select branches of the facial nerve, though this recovers fully in nearly all cases and only rarely does permanent damage of the facial nerve develop. There is also the risk of numbness occurring near the ear which can result from injury to the great auricular nerve which runs adjacent to the platysma layer. Numbness in most cases is temporary and caused by bruising of the nerve. Permanent numbness of the great auricular nerve is quire rare after mini facelift surgery. It is also possible for some patients to develop unfavorable scars despite excellent technique by the surgeon. This is related more to the patient’s inherent ability to heal and form scars rather than the surgeon’s ability to properly close the incisions. This may occur several weeks after surgery as slightly raised or deeply red scars and, in most cases, the appearance of these scars can be improved with topical or injectable steroids.

The mini facelift is considered cosmetic and, as such, is typically not covered by insurance.