Carolina Facial Plastic Surgery

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Face and Neck Procedures FAQs

 

Cheek Augmentation FAQ
Coming soon!

Chin Implants FAQ

Q: I’ve had a terrible profile my entire life. Chin Implant or Chin Lipo? Is buccal fat removal an ideal thing for me as well?

A: You’d get nice improvement with a chin implant that would bring your weak chin into alignment with your lips, plus facial liposuction to remove the excess fat under your chin. Your profile will be stronger and your jawline sleeker and cleaner. As for your cheeks, I almost never recommend buccal fat removal; you will appreciate the volume as you age. To slenderize your face and make it more heart-shaped, some Botox in the masseters will help. That needs to be re-administered every 6 months. I hope this helps.

Q: I would like to know the details of a chin implant. Is it for me? Are there future risks if I get this done when I am young?

A: Chin implants are easy to place; the operation can be performed in the office with only local anesthesia. There’s about a 7-day recovery period, during which time you’ll be swollen and sore.

I prefer implants made of silicone, as they can be shaped exactly to the patient’s needs, are porous enough to adhere well to the bone, and can be removed easily if the patient changes his/her mind or grows into needing another size. My patients have been very happy with their implants. They can last for many years or decades.

Inserting an implant is a much safer and less invasive operation than a sliding genioplasty. I wouldn’t recommend that procedure for most patients. If you are feeling reluctant to move ahead with your implant, try a chin augmentation with Sculptra or Voluma first to see if you like the change that a more projected and/or wider chin brings to your face. I hope this helps.

Q: How can I fix my chin? I’m a male in my early 20s. The two main things that bother me are: -deep crease (upside down ‘u’ shape under my mouth) -‘orange peel’ texture on chin these are the two main things that I really dislike about my chin. Sometimes the crease can form a full circle on my chin??

A: Your chin is recessed, which is throwing off the balance of your face. A chin implant will create a stronger jawline that will look more masculine and “average.” The orange peel skin is caused by an overactive muscle. This can be addressed with Botox or with surgery. The creases can also be addressed during the implant procedure. I hope this helps.

Q: Will the edges of the chin implant be palpable?

A: Chin implants that fit you well should not be noticeable. The ends are tapered so that they meld onto the surface of the bone. However, if you press on your skin and tissues, you may be able to feel them. You will not notice them otherwise, nor will they be visible. I hope this helps.

Q: What procedures recommended for more facial definition and protruding mouth?

A: The reason you feel unhappy with the way you is because you have a recessive chin that throws off the balance of your face. A chin implant will make a tremendous difference in the way you look. It will balance with your mouth better, plus create a strong and confident jawline. I would suggest getting the implant first before moving on to the other procedures. The chin implant may be all you need to feel happy about your looks.  I hope this helps.

Q: Is there a way to achieve a better side profile without surgery or is chin and nose surgery my best option? Is the kybella a good option or a chin augmentation? Also do my cheeks need anything?

A: If you’re not sure you’re ready for surgery, but still want to improve and strengthen your profile, I’d suggest augmenting your chin with Sculptra and/or Voluma. I’d also remove the fat underneath your chin with liposuction or Kybella. These two improvements will give you a much more balanced profile. You may not even want rhinoplasty after you make these changes. And, if you like your new look, you can make it permanent with a chin implant. I hope this helps.

Q:  Is a chin implant my only option for jowls with a weak chin? Or can I get satisfactory results without an implant?

A: If you’re noticing chin implants, then they were not placed correctly.  Chin implants should look 100% natural and therefore are not noticeable at all. I think you would be quite happy with the results if you found an expert facial plastic surgeon to help you choose the right implant.

However, if you’d like to avoid surgery, or at least “audition” a chin augmentation, then I’d suggest starting with dermal fillers such as Sculptra and Voluma to build out your chin a bit. That would give you a stronger profile and also stretch out the jowls. You have a lot of submental fat, which can be removed with Kybella or with liposuction using mini cannulas. This could also improve your jowls.

Your skin is losing elasticity, so I might also recommend lasers and/or titan laser to tighten it. If you’re happy with your nonsurgical chin augmentation, you might move on to an implant one day. I hope this helps.

Q: Would you recommend chin implant? I prefer not to change my look from the front.

A: A chin implant would improve your profile by bringing your chin more in alignment with your lips and balancing your nose. You can choose an implant that doesn’t add any length to your face, which will allow your frontal view to remain as is. I hope this helps.

Q:  Chin implant, jaw implant or chin lipo?

A: You would do well with a chin implant to bring your chin more in line with your lips. This will also help to take up some of the slack in the skin along your jawline. In addition, I’d recommend liposuction with microcannulas under the chin to remove the submental fat. Both of these procedures require very small incisions that can be hidden under the chin. They can both be performed in the office on the same day. The scar should heal to the point where it’s nearly invisible.  I have yet to see a keloid form from this procedure but it is a risk.  Your surgeon will need to take additional steps to prevent a keloid formation.  I would use a series of 5-fu injections to prevent the formation of the keloid at the incision. I hope this helps.

Q: What type of procedure would I have to get to look like this?

A: You do need liposuction to create a cleaner jawline, but this would not be sufficient to create the strong jaw you want, as you do not have much fat under your chin. A chin implant would bring your chin in line with your lips (the ideal) plus create a stronger and sleeker look to your jawline. I hope this helps.

Q:  How can I fix my profile?

A: You can bring your chin into better alignment with your lips using a small chin implant that will improve projection only. The right implant will not add any length to your face. My office is in North Carolina and I specialize in facial aesthetics and facial plastic surgery, including chin implants. Feel free to call for a consultation. I hope this helps.

Q: Do I have a weak chin?

A: Your chin is recessed, which is sometimes referred to as a “weak chin.” Ideally, the lips and chin should be on the same plane. A chin implant could add projection to your chin so that is better aligned with your lips. This will also balance your nose, making it look more in proportion to your face. I hope this helps.

Q: I’m a 52 y/o male who lost weight and now has sagging skin on my jowls (neck). Would chin implant correct this?

A: More than anything, a chin implant will strengthen your profile and provide you with a stronger jawline. It will also give you a very slight lift to your jowls and sagging neck. However, I don’t think you would find this satisfactory. I would recommend chin liposuction for you and, if you are vehemently against a full neck lift, then a skin-tightening neck lift with just a small incision in the submental area. If you want to avoid even that level of surgery, then Kybella might be your best solution. It can dissolve the neck fat plus slightly tighten your skin. It would probably take several treatments to get the results you’d want. Further treatment with Ultherapy (ultrasound, not lasers) could increase the tightening. I hope this helps.

Q: Is my mid face or lower third more elongated than ideal? What could I do to improve my appearance?  

A: Your face from the frontal view looks proportionate. In profile, your chin is recessed. It can be brought into line with your lips with a chin implant. This can be easily inserted in the office under local anesthesia. When well placed by an expert, a chin implant can last for decades or a lifetime. You can choose a chin with will give you a better projection from the side without widening your face from the front. I hope this helps.

Q: Is a chin implant necessary in my situation?

A: You have a very nicely shaped nose, so I am not clear why you are interested in rhinoplasty. As for the chin implant, your chin is recessed so I believe your profile would be improved and strengthened by a chin implant. The ideal chin is in line with the lips; your chin is currently behind your lips.

Chin implants are very safe and made of materials that are well tolerated by the body, such as silicone. They last for a lifetime.  I hope this helps.

Q: Am I a good candidate for a chin implant?

A: A chin implant would give you a stronger and more masculine profile. It will also help balance out your nose and create more harmony in your face overall. A chin implant is easily inserted in the office. Recovery takes about 5 to 7 days. You can return to work after a week.  I hope this helps.

Q: Would a chin implant be enough to achieve this result?

A: You don’t have any submental fat that I can see, so I would not recommend liposuction. I believe that a carefully chosen and placed implant would give you the results you desire. A good chin implant can last for decades or even a lifetime. I hope this helps.

Q: I am a flute and sax player and scheduled for chin implant and lipo around chin and neck area. How long is the downtime?

A: The good news is that there should be no permanent effects from a chin implant and neck liposuction that would affect your ability to play your instruments. However, both of these procedures are surgical and therefore create trauma to the body that needs some time to heal. You may be bruised, sore, and/or swollen for a couple of weeks or even a few months. However, after the first week or two, these side effects should be manageable enough to return to your normal daily routine, including playing the flute and saxophone. I hope this helps.

Q: Do you think a chin implant would improve my profile?

A:You have an enviable nose; I wouldn’t touch it. You can strengthen your profile with a simple chin or jaw implant. These can be inserted in the office in less than an hour. They adhere to the bone and can last a decade or more – sometimes even a lifetime. A facial plastic surgeon will help you choose the right type and size implant during a consultation. I hope this helps.

Q: Filler or chin implant?

A: Your chin is quite recessive. You would get the most improvement with an implant. However, because you are feeling indecisive, you may want to start with a filler such as the hyaluronic-acid based filler Voluma. If you like the look of a dermal filler augmentation, that can help your surgeon pick the best chin implant for you. If you don’t like it (sometimes people mourn the loss of their original look), Voluma can be easily dissolved. I hope this helps.

Q: 25 y/o, really self conscious about my side profile, should I get a chin implant or a nose job?

A: Your overbite is slight, but you can talk to an orthodontist about correcting it. In my opinion, you have a nicely formed nose that balances well with your face; I wouldn’t change it. However, your chin is weak and can be strengthened with a chin implant. This will make your jawline and profile much stronger. I believe that once this procedure has been done, you will be much happier with your profile and your nose. I hope this helps.

Q: Do I need a chin implant and/or nose job?

A: You would benefit greatly from rhinoplasty, which would narrow and refine your nose and improve its appearance from the front. The length doesn’t need to be modified. As for your profile view, you do have a little submental fat that could be removed with two or three sessions of Kybella. This will give you a sleeker and stronger jawline. You might also benefit from a slight chin implant to strengthen your profile. I hope this helps.

Q: I’m 26. Feel like a couple things could use improvement in my face. Any advice?

A: You could get a stronger and more masculine look with either a chin implant or a jaw implant. Your cheeks are also flat and could be improved either with cheek implants or a long-term dermal filler such as Vycross Juvéderm. Start meeting facial plastic surgeons who can show you good results on men. You should be able to find someone to help you achieve the look you want. I hope this helps.

Q: Chin implant made face too wide?  

A: It looks like you had rhinoplasty in addition to a chin implant, so you have a lot of changes going on. From your photo, your “new” chin looks good and gives you a more masculine face shape. However, you just had your surgery and you are still swollen. Give your chin a couple of months to heal. Your nose will take about a year to completely heal.

Sometimes it takes a while to adjust to the changes you’ve made in your face. Even though you wanted a new look, you may go through a period of mourning your old look. If you continue to be unhappy after you heal, you can either remove the implant or switch it to a smaller one that still gives you some definition. I hope this helps.

Q: Do I need genioplasty?

A: A sliding genioplasty is a complex operation that isn’t justified by the degree of chin recession you have. A small chin implant could bring your lips and chin into alignment instead. That, in combination with your rhinoplasty, will give you a stronger and more flattering profile. I hope this helps.

Q: What surgeries would you consider to create a stronger jawline?  

A: A chin implant would make a dramatic improvement in your profile and can even give you a stronger, more masculine look from the frontal view. During your consultation, you and your facial plastic surgeon would go over the various types, sizes and shapes of implants to find one that creates the effect you desire. Chin implants, when expertly placed, adhere to the underlying bone and can last for decades, or even a lifetime. I hope this helps.

Q: Cost of cheek AND chin implants? Can both surgeries be done simultaneously?

A: It’s not only possible, but preferable to do a chin implant with a cheek implant or fat grafts at the same time, as it makes recovering much easier to only have to do it once. Many facial plastic surgeons will work out a discount for multiple procedures, but this will vary by practitioner. More important is to find a surgeon whose results impress you and who inspires confidence. As for cost, you can find ballpark estimates for your area on this site. I hope this helps.

Q: Will I move my implant around by massaging the chin area after a chin implant to help reduce swelling?

A: I would not recommend massaging your chin after the placement of an implant. The bruising and swelling you see is self-limiting and should go away on its own. Massaging and manipulating the chin does risk moving the chin implant out of its position before it’s had a chance to fuse to the underlying bone. I hope this helps.


Q: Can a chin implant change other facial features?

A:  A chin implant would improve and strengthen your profile and jawline.  To resolve the jowls and sagging of your neck and midface, a full rhytidectomy (facelift) is your best solution. You may also benefit from a facial fat grafting to smooth out your nasolabial folds and perioral wrinkles. In addition to a brow lift, I’d probably recommend upper blepharoplasty. I hope this helps.

Q: Will my chin implant drastically affect the way my face looks from the front?

A: Most of the time, the change in your face from front view does not alter much after a chin implant. However, there will be a difference. If you are feeling uncomfortable or wary about your upcoming procedure, feel free to give your facial plastic surgeon a call. They could generate a digital photo for you that would give you a better idea of your results from all angles. I hope this helps.

Q: Once getting a chin implant, is there any need for revisions or maintenance?

A: If the correct size of chin implant is chosen and it is well placed, there should be no need to ever remove or replace it. Once the chin implant is placed it actually begins to adhere to the jawbone as well as to the soft tissues during the healing process. This holds the implant in place so it should not need to be moved or replaced. However, I prefer to use silicone implants because if a patient ever changes his or her mind about their looks or gains/loses weights and wants the implant removed, it is easy to do so. A chin implant will not only give you a stronger profile, it cleans up the jawline and can even resolve slight neck laxity. I hope this helps.

Q: Improvements for a poor profile?  

A: A chin implant and facial liposuction or Kybella for your double chin would be the best first step for you, as it would give you a stronger profile and sleeker jawline. Your nose seems to be a good length for your face. You may be less bothered by its shape after you strengthen your weak chin. However, your nose does look rather broad from the front, so you may opt for tip rhinoplasty to create more harmony in your face. I hope this helps.


Q: Can I still be a candidate for a chin implant if I have a deep overbite?  

A: A chin implant is placed only on the lower jaw and will not be affected by how your mouth closes. A chin implant can be inserted in the office, usually in just an hour or two. There is very little downtime. Chin augmentation will make your profile look much stronger and more defined. A facial plastic surgeon can help you choose the right size and shape implant that will best flatter your natural features. A well-placed implant can last 10 to 15 years or more. I hope this helps.

Q: What can I do to make my face more attractive?  

A: If you are looking to make permanent improvements, a chin implant would help balance out the fullness of your upper face and create a more heart-shaped look, which is very feminine. If you’re not sure if you want to take that step, Sculptra or Voluma could be used to create a stronger chin and jaw. The results will last up to two years. At that time, if you like the effect, you could opt for a more permanent chin implant, which will last between 10 and 15 years or more.

Rhinoplasty could narrow your nose and refine the tip, but you would need to find an expert in ethnic rhinoplasty. There are important anatomical differences between Caucasian noses and ethnic noses that need to be considered. Also, your facial plastic surgeon must have expertise in aesthetics to create a nose that is harmonious with your face and yet still reflects your heritage. The rhinoplasty and chin augmentation could be done in the same session. I hope this helps.

Q: I feel like I have a small chin and I don’t have very pronounced cheeks and jaw. What should I do?

A: A chin implant would create a stronger and more masculine-looking jaw and profile. In addition, I would recommend facial liposuction to remove your double chin and create a cleaner jawline. As for price, that varies by region and practice. You can usually work out a payment plan, if needed. I hope this helps.

Q: Thinking about chin implant, are my expectations reasonable?

A: Your expectations for improving your profile with a chin implant are not only realistic, but modest. The aim with chin implants is to create a strong profile, where the chin and lips are on the same plane. In your “after” photo, the chin is still recessed. Your facial plastic surgeon will help you choose the right shape and size of chin implant to give you the stronger and more masculine profile you are seeking. I hope this helps.

Q: What kind of procedure would help fix my chin/jaw?

A: A chin implant would vastly improve your profile, bringing your chin more into balance with your nose and giving you a stronger jawline. Chin implants are very easy to insert in the office. You will have some slight bruising and soreness afterward, but this will resolve within days. Chin implants can last for many years and even decades. I hope this helps.

Q: One of my best features is my dimples, would a chin implant change them in any way? And would my smile change?

A:  A chin implant will strengthen your profile, clean up your jaw, and create more balance with a large nose. It will not affect your cheeks or your smile. Your dimples are safe. I hope this helps.

Q: How can I get a more defined Jaw line? Can TMJ effect the appearance of my jaw line?

A:  You have two issues with your profile: One is the double chin you mentioned. The other is that your chin is a little weak. Generally, chins look most balanced when they are in line with your lips; yours is recessive.

To give you a better profile, I’d recommend facial liposuction or Kybella to remove your double chin, plus a chin implant. Chin implants are easy to insert under local anesthesia in the office. They can last for years or a lifetime.

As for the TMJ,  injections could relax your masseter muscles and give you some relief. The TMJ shouldn’t affect the look of your profile. However, once you get  in the masseters, it will slim down the look of your face a bit. I hope this helps.

Q: Best options, weak chin with submental fat?

A: If you are looking for the least invasive means of improving your profile, I would recommend a combination of a chin implant to strengthen your jawline with Kybella to remove the double chin. A chin implant can be inserted in the office in under an hour using local anesthesia. There will be some postoperative bruising, but it should resolve in days.

Kybella uses deoxycholic acid to melt fat in the submental area – that is, under the chin. It takes about 5 to 10 minutes to accomplish. Again, there is some slight bruising or soreness afterward, but it will resolve in days. You will need at least two or three treatments spaced about two weeks apart. Or, if you want a quicker improvement, you could opt for facial liposuction. However, the recovery period is a little longer because it is a surgical procedure. I hope this helps.

Q:I have a nice dimple in my chin which is fairly noticeable. However, because I have a recessed chin, I am considering getting a chin implant to improve my profile. But in the process, I do not want to lose the dimple in my chin. So my question is: is it possible to avoid losing your cleft chin when you get an implant?

A: A chin implant should not affect your dimple – if you don’t want it to. The dimple is caused by an indentation in the fibrous tissue of the chin. The implant is placed underneath this area and thus may smooth out the dimple slightly. If you tell your facial plastic surgeon that you want to keep the dimple, he or she can add a stitch, if necessary, to maintain the cleft. I hope this helps.

Q: I have a very small chin which makes my maxilla look bigger. I want my chin to be very sharp and pointy to achive a heart-shaped, symmetrical face. Should I opt for a chin implant or an advancement genioplasty? I consulted several maxillo facial surgeons who came up with differnt suggestions.

A: A silicone chin implant would be an excellent solution to build up your small chin, give your lower face more definition and obtain the heart-shaped face you desire. Chin implants are easy to insert and can be placed with local anesthesia. It only takes about an hour to do the procedure. Your results will be visible in about three months. A chin implant is a much less invasive and risky procedure than sliding genioplasty. Implants can last for years or even a lifetime. I hope this helps.

Q: Jaw Implant For Round Face? I have a very round, “moon” face with little definition and bone structure. I was wondering if jaw implants would help give more definition and help give my lower face a more v-shape by giving my mandible angle more projection and then have the rest of my face taper in. If so, what type of jaw implant would you recommend and what is the average price range for such a surgery? Thanks!

A: In general, jaw and chin implants can help to create a longer or more heart-shaped face in some patients. Because you didn’t post any photos, I can’t say whether you are a candidate for this cosmetic procedure. Your best bet is to begin consulting with facial plastic surgeons to find out what their recommendations are. You can get a more precise idea about price that way, too. I hope this helps.

Q: Chin and Jawline Implant or Augmentation for a More Defined Jawline? I’m 32 & would like to add more definition to my jawline. I’m not overweight, I’m quite thin but I feel I have excess skin starting to sag under my chin & even appear to have a double chin in some pictures. My jawline has no definition & seems to blend into my neck. I’ve considered a chin implant but I don’t feel my chin is that small, at least not from a frontal view & would it help my jawline? I know injections help but how long do they last? I’d prefer a perm option. Would Elixis help at all?

A: Your photos suggest that you would benefit from a chin implant to strengthen and define your jawline. You also might need some Kybella or facial liposuction to remove the fat under your chin. You can try the hyaluronic-acid based dermal fillers such as Juvéderm before moving onto an implant, but they will only last 12 to 15 months. I hope this helps.

Q: How Long do Medpor Chin Implants Last? What happens with a Medpor chin implant (attached with screws) over time? What can a patient expect in 20 years? 30 years? Thank you.

A: In my center, we use implants only made of silicone.  These all have a very high safety profile and level of patient satisfaction. I prefer silicone implants over Medpor because they are easier to place; meld well with the patient’s own tissue to keep them well situated; and, if necessary are easily removed. Medpor is porous and actually adheres to the bone, which makes it challenging to remove. Chin implants can last for decades. However, because a patient’s body changes with time and age, they sometimes decide to remove an implant or switch it out for another size. This is easy to do with silicone and that’s what I recommend. I hope this helps.


Q: What do you recommend to improve my chin/jaw line (side profile appearance)? I don’t have a bite problem-had braces. I’ve always been bothered by my side profile, I have no chin/jaw line. Under my chin is not all fat, the problem is that there is just no space under the chin. I feel like I either have a very short chin or a very short neck. It’s genetic – my mum has it, my uncle has it. When I smile I always look like I have double chin. I don’t mind my front profile, in fact some angles make my front profile look very nice. What can I do to improve my chin? Willing to travel. Any suggestions welcome! 🙂

A: From your photos, you actually do seem to have quite a bit of submental fat, which can be removed with minimally invasive facial liposuction. Since you seem to be quite young, your skin is probably elastic enough that it will need no intervention to adapt to its new shape. In addition, a small chin implant will give you a stronger yet still feminine profile. The combination of these two procedures is the easiest and most effective way of giving you a sleeker and stronger profile that harmonizes with your natural beauty. I hope this helps.

Q: Would a chin implant be good for me? (Photo) I want my chin to jutt out so it evens out my face and not making my nose look big. I don’t know if a chin implant would even make my chin just out that far, so I am not sure.

A: From your photographs, it looks like a chin implant would be an excellent choice to create a more defined profile. An implant will give you a stronger, more masculine jawline and will balance out your nose better. The improvement will be significant. Chin implants are easy to insert under local anesthesia. There is very little downtime. I hope this helps.

Q: Would the front of my face look really different after a silicone chin implant?

A: No plastic surgery, if it is well performed, will change your look drastically or make you unrecognizable. A chin implant is such a subtle improvement that most people won’t even think you had “work” done; they’ll just notice that you look better, somehow. The implant will most significantly change your profile by lending it strength and balance. Your front view shouldn’t change much. As for the percentage of change, that depends on what you need and what you want. It’s also impossible to say, without an in-person consultation, if an implant would make you look more mature. Start consulting facial plastic surgeons who specialize in chin implants to learn more about the changes you can expect with this procedure. I hope this helps.

Q: Do I need a chin implant? I’m looking for a more defined jawline! I have a double chin but I’m not sure if I just need to do something with that or would a chin implant help? I have a really round face and I think my chin is weak but I’m not sure which procedure I need!

A: A chin implant is an excellent and relatively easy way of improving your profile and jawline.  If you have loose skin or excess fat in the neck, you may want to consider neck liposuction or a neck lift.  Without photos and an in-person consultation, it’s impossible to say for sure that this is the best procedure for you. Find a board-certified facial plastic surgeon to help you. I hope this helps.

Q: My mom had breast implants 20 years ago and her body rejected them. Does that mean my body will reject a chin implant?

A: I’m sorry your mother had to go through such an ordeal. Chin implants are made of a variety of materials, including a more solid type of silicone than that used for breast implants. At my center, we offerin implants made of silicone elastomers, ePTFE, and porous polytheline. These are all quite malleable and porous, which allows them to be held in place by soft tissue and grow into the bone while healing. I have never had a problem with a patient being unable to tolerate an implant. If a patient ever did have a problem with an implant, removing it is a relatively simple procedure. I hope this helps.

Q: Will Chin Implant Give Me a Better Jawline?

A: A chin implant can make your face look stronger and more masculine. The size and type of implant will be based upon your anatomy and what would best harmonize with your features. This will be discussed and decided upon when you consult in person with a facial plastic surgeon. I hope this helps.

Q: Chin Implant for a Teenager?

A: If you are under 18, you would need your parents to sign off on any procedure. I don’t put any chronological limits on who can have surgery, or what type is best for them. My decisions are based on evaluating each patient’s anatomy, growth, and skin quality. For younger patients, making sure that they are having the procedure done for sound reasons and ensuring they are psychologically ready for an invasive cosmetic surgery is also important. From your photos, it does look like you would benefit from a chin implant to make your profile stronger. Many patients feel more confident after getting a cosmetic procedure done. I hope this helps.

Q: Chin implant my best bet for a stronger jaw line? Want a Natural Result.

A: Chin implant balances nose, and creates stronger jaw line. It can be inserted in the office while you are awake. By adding to your chin, your face will look more balanced and your profile will be stronger, yet natural. As far as your upper lip is concerned, I would suggest hyaluronic acid fillers, such as Juvéderm and Restylane, to plump up the top lip. I hope this helps.

Q: I’m interested in getting a chin implant to enhance a weak chin. I also would like my jaw to be enhanced as well, and I was wondering if a chin implant with “wings” that extend towards my jaws would enhance my jawline significantly. Also, do they make square chin implants with wings? I am most interested in a square shaped implant. Thank you.

A: There are many different types and sizes of chin implants. I prefer to use silicone chin implants, as they can be customized to match an individual’s anatomy and create better balance and symmetry in his or her face. This includes creating wings and a squared shape to build up a weak jawline. I hope this helps.

Q: I feel like my chin is a little recessed and causes my face to look out of proportion from the front. Would a chin implant help add vertical length to the face?

A: Although you are quite attractive, your face is slightly out of balance, with a greater emphasis on the upper face. Lengthening your chin slightly with an implant could create a more harmonious look for you and give you a stronger jawline. I hope this helps.

Q: I have a very hidden jawline, along with virtually no chin. I am just looking for a defined, attractive jaw line and chin. If it’s possible for it to look like that, what is the expected cost?

A: A chin implant will give you a much more defined and masculine look. To get a sleeker jawline as well, you will probably need facial liposuction to remove the fat from underneath your chin. I hope this helps.

Q: Will A Small Chin Implant Be Very Noticeable?

A: Getting a chin implant while simultaneously having rhinoplasty will probably distract from the augmentation. In general, any cosmetic surgery should only make you look better, rather than “done.” I hope this helps.

Q: Chin Implant or Genioplasty?

A: The information and photos you provided aren’t sufficient to give a definitive answer. If your bite is uneven, you may need to see an oral surgeon. However, if it is only the chin that troubles you, an implant from a facial plastic surgeon may be the best solution. A combination treatment of liposuction and skin tightening, such as Ultherapy, may also be needed. If you do decide to go forward with genioplasty, trying the implant first allows you to audition your new look to be sure you like it. I hope this helps.

Q: Chin implant and Rhinoplasty to change my profile. Is this realistic?

A:Rhinoplasty and chin augmentation are very effective ways to resculpt your profile so that it looks stronger and cleaner. If you are going for rhinoplasty, be sure to find a board-certified facial plastic surgeon who specializes in ethnic noses, which often have extra challenges and require extensive knowledge of facial aesthetics for all ethnicities. The best way to approximate the costs of surgery is to research board-certified plastic surgeons in your area. I hope this helps.

Q: Chin implant or rhinoplasty first?

A: Ideally, doing both procedures at once will allow you to work out a do-able price with your facial plastic surgeon and will also minimize your recovery time. If you must choose between one or the other, I’d advise the chin implant. First, it’s an easier procedure and will take much less recovery time. Second, giving your chin more volume will balance out the length of your nose and may ease your discomfort with it. I hope this helps.

Q: How can I get a stronger jawline and chin, square face? Hello everyone! I am 26 years old Finnish model and I’m looking for surgery in the United States. My problem is that I have a weak jawline and chin, but I think my face type is square as you can see my images. For example Jenna Dewan and Alena Shishkova have the same facial structure as me so my question is that can I get a similar chin and elegant jawline as Alena Shishkova and how? I also want to get nose surgery because my nose is broken and a little awry. Thank you so much for reading this!

A: A chin implant will give you a stronger profile that is still in harmony with your natural beauty. The implant will balance your face better and may obviate the need for further work on your jawline. I hope this helps.

Q: Solution For My Recessed Chin/Jaw? I am 19 years old, had braces however my chin is now quite recessed and the skin on my chin is very tight when I close my mouth. Second side profile picture is what my jaw and chin look like when I push my jaw out.This is ideally what I would like to look like. What surgeries would you recommend to achieve a something like the second side profile? Also is there anything I can do in the meantime to perhaps improve it slightly, maybe see an orthodontist or get a small implant for the short term?

A: A chin implant can be an ideal solution for someone with a recessive chin. You can determine if your chin is truly recessed by placing a finger vertically on your lips. If your chin does not touch the finger, you probably need an implant to obtain a harmonious profile. Implants are made from silicone , ePTFE or porous polytheline. Chin augmentation is a fairly simple procedure that is done on an outpatient basis and takes about one hour.  I believe you would be a good candidate for a chin implant procedure. Full results are visible after about three months. Implants can last for a lifetime. Hope this helps.

Q: What is the reason behind someone having a weak chin? I have a weak chin and I have been thinking about it a lot, I am not good with things in general as normal guys are but I am artistic. Is it the same reason why people with stronger chins are considered to be more masculine (like actors) because they can do thing in a manly manner. I also think that because I talk less, the muscles of my chin haven’t developed. My question is that whether it is because of genes or it’s because of the environment we grow in?

A: Underlying your question about what causes a weak chin seems to be an assumption that men with weak chins are perceived as less masculine and powerful than those with stronger jawlines. The type of chin and jaw we are born with is mostly determined by genetics, and does not seem to be related to behavior or exercise. In our society, we do tend to associate masculinity with a strong jaw and increased testosterone levels. Although there are no direct correlations between physiognomy and personality, by altering people’s perceptions of you, you may actually alter how you feel about yourself, which could then transfer to behavioral changes as well. Certainly many of facial plastic surgery patients report increased confidence after their procedures, which in turns influences how they are perceived. I hope this helps.

 

Q: I’m 19 years old and on a bit of a budget, but I have an extremely weak chin, which I would like corrected. I don’t know if I should be looking at a chin implant, or jaw advancement. I’m very reluctant to get rhinoplasty, mainly due to price, but it’s something I’m considering as well. Any suggestions?

A: To create a profile where each element of the face is in balance, we often perform rhinoplasty and chin augmentation at the same time. However, a chin implant alone is often sufficient to balance out a larger nose. Some patients may choose this option because it also allows them to preserve their ethnic identity. As for jaw advancement, like rhinoplasty it is a major surgery that could be outside your particular budget right now. I hope this helps.

Q: Hello, my question regards to what I can do about a weak jawline. I am 22 years old and have been extremely self conscious about my profile for many years. I am so embarrassed when I see a photo of me taken of the side of my face… I always look awful. I am tired of feeling this way and want to know if there is anything I can do. Any research into this shows me solutions for more mature skin’s sagging, which I am not sure is a suitable solution for me as my issue is not age related (or rather the skin losing elasticity over time), since I have never had a good jawline. I would like to try to avoid a chin implant if possible, as many that I have seen look very unnatural, but I would like to hear any and all options I have.

A: The goals of plastic surgery are to enhance patient’s natural beauty by improving balance and harmony to the face. In a 22 year old, it would be highly unlikely that you would require a lifting or tightening procedure.  If you have a weak or recessed chin it can create:

  1. Shorten jawline
  2. Poor defnintion in the neck
  3. Disrupt facial balance and proportion

If you have a weak chin, a chin implant is a wonderful procedure.  It can dramatic improve the facial features while creating a natural result.  The procedure is quick and the recovery is rather easy.  

I hope this helps.  

Q: I Have No Jaw, my Neck Runs Straight to my Chin. What Can I Do?

A: While each individual case is different, it is not uncommon that someone who has a recessive chin also has excess fat and/or skin on their neck that accentuates the recession. Although you would need to schedule a consultation with a board-certified facial plastic surgeon to learn about all of the options that would be best for your particular case, some things to explore would be a chin implant, neck liposuction to remove excess fat, and possibly a neck or facelift.  I would let your anatomy guide my recommendations.  

I hope this helps.

Q: Do chin implants look and feel natural?

A: When performed properly using the best materials available, yes, chin implants both look and feel natural. Make sure to visit a skilled, board-certified facial plastic surgeon for your chin implant surgery who will be able to assess your facial features and anatomy and provide you with the best type of implant for a natural and harmonious look.

Q: How do I know if my chin implant is too big? I’m 3 weeks post op and am frightened by the size of my chin.

A: At three weeks post chin implant surgery, you are likely still swollen. Be patient and wait for the swelling to go down, and you should have some idea of what your final results will be after 3 months. If after that time you are still unhappy with the size of your chin, see your surgeon to discuss your options for correction.

Q: My chin is so long and square after my chin implant 5 months ago. Is it still swollen? Will it change any further? I don’t want to remove it and do it again, what are my options?

A: At 5 months post surgery, most of the swelling has likely resolved and there is not much chance of a significant difference in appearance happening. Unfortunately the best option at this point is to have a revision surgery and replace your current implant with a smaller and less angular shaped implant. Please visit a board-certified facial plastic surgeon for a revision consultation.

 

Q: Is it okay to get a chin implant before rhinoplasty, or would the results be better if I did them both at the same time?

A: If you are looking to have both a chin implant and rhinoplasty performed, I would recommend having them at the same time. While the results will not be affected if you have them done at different times, doing them at the same time allows you to have just one recovery period and will likely be less expensive as well.
Additionally, augmenting the chin can help bring the nose into balance with the face.  There are times when a chin implant is required to get the best results from a rhinoplasty.   I hope this helps.

Q: Can chin implants be revised to make my chin shorter? There’s still some swelling at 3 and a half months post surgery, but I don’t like the length and if it doesn’t go down any further I want to have a revision surgery if it’s not too risky.

A: I’d advise you to wait until all of the swelling has gone down before considering revision surgery. After the swelling has completely resolved and you can see your final results, if you are still unhappy, you can make an appointment with your plastic surgeon for a follow up to discuss revision of your chin implant and what the best options are to ensure that you get the results you want. I hope this helps.

Q: I’m planning to have a rhinoplasty done, and my doctor recommended a chin implant as well. Is it okay to have the chin implant done a year later, as the rhinoplasty is expensive?

A: Yes, there is no reason why you couldn’t have a chin implant done at a later date if that is best for you financially. Chin augmentation and rhinoplasty are often complementary procedures and can be done at the same time or separately. I hope this helps.

Q: What is chin implant recovery like? When can I return to work?

A: At my practice, most patients are able to return to work approximately 5 days after surgery. You can expect to be swollen and bruised for the first 5-7 days, and your final results will appear after around 3 months. The majority of the swelling will dissipate after the first week, but there may remain some residual swelling for another few months.  During the first week, the lip will feel tight and it can be difficult to move the lip.  This will greatly improve over 2-3 weeks.  Patients can resume normal activity at 2 week after surgery except for contact sports.   

Q: Is Radiesse chin augmentation possible? I think I’d look better with a bigger chin.

A: Chin augmentation with Radiesse or HA fillers is possible and can be a good option for patients who want only a subtle enhancement or who want to see what a bigger chin would look like before committing to implants. The procedure takes about 15 minutes and little recovery associated with it.  I recommend visiting a board-certified facial plastic surgeon with experience in both dermal filler chin augmentation and chin implants for a consultation to see what the best course of action for you would be.

Q: How much does a chin and jaw implant cost, and what’s the safest type to use?

A: Costs for a chin implant will vary depending on a number of factors, including whether or not you undergo general anesthesia, the facility fee, and the surgeon’s fee, which can vary depending on skill, experience, and location. At my practice in North Carolina, chin implants generally run anywhere from $3000 to $7000. There are a number of different types of chin implants, including silicone elastomers, ePTFE, and porous polyethylene. None of these are safer than the other, and it is simply doctor preference which to use. Personally, I like to use silicone implants because they can be molded and customized easily.

I do not usually recommend jaw implants, as a square jaw can be achieved more easily simply with the use of dermal fillers. Hyaluronic acid fillers or collagen building fillers can both be injected in a short and virtually painless procedure to achieve a subtle, natural jawline enhancement. I hope this helps.

Q: I have no jaw, my neck runs straight to my chin. What can I do?

A: It is difficult to say without seeing you in person, but there are a few options that may benefit you. A chin implant could be a good way to increase projection and definition in the chin, while liposuction to the neck could help to get rid of any excess fat that may be causing your neck to run straight to your chin, as you say. If your problem is loose skin instead of fat, a surgical neck lift or facelift could be a better option. A neck lift will address drooping skin and “turkey neck” very efficiently and create a youthful, sculpted jawline. I perform neck lifts by tightening deep tissue and the platysma muscle, allowing for a smooth and defined neck and jawline. The results of a neck lift will last for a very long time as long as you take proper care of your skin. A neck lift can be performed in conjunction with liposuction to the neck and jowls for optimal results. Please see a board-certified facial plastic surgeon for a consultation to find the best treatment plan for you. I hope this helps.

Q: What can I do to improve the appearance of my neck and décolletage?

A: You have brought up two important issues about neck aging. The first is the quality of the skin, which tends to degrade with age. This can be remedied with laser treatment, which will smooth out the bumps and crepey texture as well as stimulate collagen production. I would recommend doing this before proceeding to a neck lift, which will address your sagging. Depending on the degree of sagging, you may not only need excess skin and fat removed, but also may need to have the platysmal muscle tightened. Neck lifts usually last 10 years. I hope this helps.

Q: What non-surgical procedure is appropriate for a 25 year old with a saggy neck and undefined chin? My weight has fluctuated my whole life and I want to tighten the skin and define the jaw, but I don’t want a drastic change.

A: Without seeing you in person to assess the extent and nature of your concerns, it’s impossible to give a good recommendation. That being said, there are a few options that can help in general. If your skin is still fairly elastic with minimal sagging, a non-invasive skin tightening laser such as Titan may help. You say your chin is undefined, so chin augmentation (either surgical or non-surgical, done with fillers) could help to enhance the chin and profile. If your sagging comes from fat, then liposuction or a non-surgical option such as Kybella or CoolMini could help to reduce that fat, thus helping to contour the jawline. I suggest seeing a board-certified facial plastic surgeon for a consultation to help come up with a personalized treatment plan. I hope this helps.

Q: I’m a 32 year old male, and I recently lost about 50 lbs and am working towards more through diet and exercise. I’ve noticed a huge change in my body, but not my neck. My mom and brother have the same kind of neck, so I don’t expect further weight loss to do much. Should I do neck liposuction, a neck lift, a chin implant, or all 3?

A: It sounds as though you may be a good candidate for neck liposuction and a chin implant. Liposuction can work very well to contour the neck and jawline, and an implant could further enhance your profile, bringing your features into balance. At 32, it’s unlikely that you need a full neck lift, although if you are left with significant loose skin following your weight loss that does not retract on its own you may be a candidate. A consultation with a board-certified facial plastic surgeon will help you to decide on a treatment plan to meet your goals. I hope this helps.

Q: I want to get rid of my double chin and fullness around the neck and chin area, do I need liposuction, a neck lift, or both? I’m 44 and slightly overweight.

A: Liposuction is a great procedure to reduce a double chin and contour the neck and jawline. It can be done under local anesthesia and requires just a few days of recovery. If you are noticing significant sagging of the skin and jowls due to age and gravity, or if you begin to notice it after liposuction, you may be a candidate for a neck or facelift as well. I hope this helps.

Q: I’m at 4 weeks post chin liposuction and at first my results were great, but now I’m noticing asymmetry as well as some loose skin. Is this normal?

A: At four weeks post chin liposuction, you are most likely experiencing swelling. Swelling can be asymmetrical and is a normal and expected part of the healing process. Be patient, and the swelling should resolve and any loose skin should tighten up on its own. If you still have loose skin after 6 months that you are unhappy with, see your surgeon for a follow-up to see about skin tightening procedures that can be done. I hope this helps.

Q: I’m a 20 year old female and I feel like the lower half of my head is smaller than the rest, and my chin is asymmetric. Would a chin implant help?

A: From your photo, it appears as though a chin implant may help to harmonize your features and bring the lower half of your face into balance with the rest. An implant may possibly help with asymmetry as well, although it’s hard to tell from the photo.  For patients that have significant asymmetry, I would consider a custom chin implant.   A custom chin implant is designed from a CT scan and the chin implant is designed by a computer to compensate for underlying bony asymmetry.  It is more expensive than a standard implant but the results are worth it for the correct candidate.   A consultation with a board-certified facial plastic surgeon will be your best bet to discuss your options and come up with a custom treatment plan. I hope this helps.

Q: Would a chin implant help improve my profile? I have a larger nose and receding chin.

A: Yes, chin implants can often help to significantly improve a patient’s profile, and can even make the nose appear smaller and more in proportion to the rest of the face. Facial balance and harmony between features is key to creating a beautiful profile. A chin implant procedure takes about 1 hour, can be completed while the patient is awake, and can last a lifetime.  I recommend a silicone implant over the other types of implants.  I hope this helps.

Q: Other names for high-SMAS facelift? Is “extended smas facelift” same with “high-smas facelift” ? Or deep plane and high-smas same techniques? Is there any other term for high-smas facelift? I am not able to find surgeons performing high-smas technique.

A: Thank you for your question. I am not aware of other names for the High SMAS facelift, though many practitioners develop variations on the techniques involved and may change the nomenclature. High SMAS is a deep plane facelift that should be performed by a board-certified facial plastic surgeon with years of expertise and training in facial aesthetics and anatomy. High SMAS means that the we begin the border of SMAS flap closer to the top of the cheekbone than in traditional facelifts. This allows us to lift the cheek and lower eyes, which usually are not affected by a facelift. I hope this helps.

Q: What is the best lower face lift around?

A: When considering major surgery such as a lower facelift, it is imperative to allot sufficient time to researching and interviewing facial plastic surgeons. Ask for referrals from people you know who have had work done. Research the sites of plastic surgeons who interest you and look at their Before-and-After photos. Ideally, your surgeon should have training that specializes in facial anatomy and aesthetics. Most important, please interview several highly qualified candidates so that you find one that inspires you with confidence and whose work is excellent. Many facial plastic surgeons can help you find accommodations if you need to travel outside your state. I’ve included a guide below that should help you make good decisions leading up to your surgery.

Q: How do surgeons know what sensations are normal following facelift surgery if they haven’t had the surgery themselves? I’m 6 months out of a face and necklift and am experiencing uncomfortable pulling sensations in my neck. My surgeon said it was scar tissue contracting, but how does he know that everything is ok underneath?

A: A facial plastic surgeon knows what patients are experiencing and what is normal or not because of the many facelifts that he or she has performed. After performing so many facelifts and listening to so many patients, we have a good idea of what type of sensations patients experience following surgery. We know what to look for in terms of complications and what types of sensations are atypical. A pulling sensation is typical following face and necklift surgery, and while it may be uncomfortable, it is usually not dangerous. I hope this helps.

Q: Is “recovery therapy” following a face and neck lift that includes ultrasound, electrostimulation, lymphatic drain, therapeutic massage, and deep oscillations necessary? A plastic surgeon in Costa Rica recommended it but do other doctors agree?

A: No, these types of treatments following a face and neck lift are not necessary. Patients will heal on their own following surgery with no need for extra treatments such as these. If you want to utilize them they probably won’t do any harm, however. If you are having surgery abroad, take extra care to find a board-certified, experienced, ethical, and legitimate facial plastic surgeon. Remember that cheap surgery is never worth the added risk and you may potentially end up spending much more money on revision than you did on the initial surgery. I hope this helps.

Facelift FAQ

Q: Do I need a facelift surgery or just exercise help? I am 27 and moderately built though i am underweight. My cheeks is already sagging at the cheeks area with the lips drooping.

A: Being underweight can be just as unhealthy as being overweight. If you are truly too thin for your frame, then you might consider a slight, healthy weight gain to see if that adds volume to your face. Exercise can’t hurt, though I’m not sure it would help. At your age, I wouldn’t recommend a face lift. If you want to maintain your current weight or if the weight gain doesn’t change your face enough, then adding volume with fat grafting, Sculptra, or Voluma could make a big difference.  I hope this helps.

Q: I had Dermabrasion, chemical peel and a facelift. My surgeon has told me in time this will heal. Is she right?

A: You have a significant degree of swelling and bruising, but seem to be very early in the healing process. Each of the procedures you mentioned — chemical peels, Dermabrasion, and a rhytidectomy (facelift) — have long healing periods. Your skin has gone through a lot of trauma. Let your body do its job and take the time it needs to heal. A facelift alone can sometimes require a 6-month or more healing period. Be patient, distract yourself with other things, take arnica to minimize the bruising, don’t smoke, don’t drink, and get enough rest. You should start to see some good results within the next few months. I hope this helps.

Q: How long after face and necklift surgery can I wash my hair?

A: You should check with your facial plastic surgeon, because everyone has different recommendations. However, I allow most of my patients to shower 24 hours after surgery, provided they remain upright, use a very light touch, and do not bother their sutures. It’s important not to invert your head (for instance by washing your hair under the tub spigot). Don’t use a hair dryer or hot curlers for at least a month. I hope this helps.

Q: Please can you explain to me the difference between a SMAS facelift and a PSP facelift, or are they the same thing?

A: A frustration that both facial plastic surgeons and patients experience thanks to internet marketing is the constant rebranding of standard procedures, or small modifications that are made to increase a procedure’s novelty. A PSP facelift, in my opinion, is not an adequate facelift. Rather than dissecting the SMAS layer and moving it upward, trimming off the excess and then suturing the remaining SMAS into a higher position, the SMAS is merely folded upon itself and sutured into place. The lift this provides is much less dramatic than an SMAS lift. It’s not as elegant nor as effective a procedure. I know that people are always trying to save money and avoid a long recovery time, but when it comes to a major procedure like a rhytidectomy, gimmicks are not worth the price you ultimately pay.  I hope this helps.

Q: What can be done for wrinkles sagging skin after cancer treatment?  

A: Congratulations on beating cancer. I’m sorry that it took its toll on your skin. As long as you are recovered and are not undergoing any treatments, you should be able to get whatever procedure you want. For a sagging lower face and wrinkles, I’d recommend at least a mini face lift with chemical peel to improve your skin quality and stimulate more collagen. If you aren’t interested in surgery, liquid facelifts can make a big difference, too. Begin consulting with facial plastic surgeons so that you can learn more about your options. I hope this helps.

Q: Most expensive facelift doctor says he makes literally invisible facelift scars by letting incisions heal without tension. How?

A: Lifting and suturing the SMAS layer to minimize tension on the skin is an advanced technique used by the most expert facial plastic surgeons around the world — with much variance in price. I studied with world-renowned plastic surgeons, such as Dr. Paul Nassif of “Botched,”  in Beverly Hills. My patients in North Carolina get an expert level of care without undue costs. If you have the resources to pay top dollar, you might want to add more value by traveling and taking a restorative vacation during the healing phase after your procedure. Feel free to contact my office for a Skype consultation.

Q: Vertical facelift: can i get the same result from pulling my skin up from the temple?

A: A vertical lift would be an incomplete and unsatisfactory procedure. You cannot trim excess skin, and the SMAS is left in place, which means it will be pulling downward on the uplifted skin. Don’t try to figure out on your own what can be done to correct the sagging and drooping you’re seeing in your face. Start consulting with facial plastic surgeons in your area. If you’re not ready for a full rhytidectomy (facelift), there are many other options. I hope this helps.

Q: Can I do a revision? Or is the face like a dress – once you cut the hem to much it will be impossible to fix it?

A: I’m sorry that the results of your facelift have been disappointing. It takes extra expertise to perform revision facelifts because of some of the issues you raise, such as insufficient skin for lifting, scarring, and deformities such as Pixie Ear. If your SMAS was not dissected, this might be addressed in a revision. As for your hem analogy: The difference between cutting cloth and cutting skin is that skin will continue to stretch and sag with age. Eventually, you will have excess skin again. My advice at this point is to give your face a bit of a break. Let the tissues relax. In another month or two, if you really feel like you need a revision, spend time finding a true expert. I hope this helps.

Q: I am only 23 but more droopiness and soft features give me a very tired old saggy look, I am interested in achieving a tight look with more defined features and a significant change. What are my options?

A: You do not need a facelift and I doubt a nonsurgical tightening procedure would be beneficial at your age. My suggestion would be to consult with a facial plastic surgeon and talk more specifically about the improvements you’d like to make. Cheek implants would create a more balanced, elegant and lifted look. Hyaluronic acid-based dermal fillers such as Restylane could fill in your tear troughs. Botox could smooth out your glabellar lines. There are many, many nonsurgical options that can help you feel better about the way you look.I hope this helps.

Q: I have done fillers. Will facelift take that out when it’s done? Should I have had the facelift first?

A: Many of my rhytidectomy (facelift) patients have gone through a stage where they first used dermal fillers to try to combat the early stages of aging. They can be very effective … for awhile. But once the sagging becomes significant, a facelift is the only satisfactory solution. So, the answer to your questions are No, the fillers don’t have to be removed before or during the facelift and Yes, it’s OK to follow fillers with a facelift. I hope this helps.

Q: Face Lift? Eyelid surgery? (38 y/o). I’ve aged much faster than my peers.

A: I don’t believe you’re ready for a full rhytidectomy yet. Though you have some sagging —including a hint of jowls — it’s not significant. Laser resurfacing with the Titan laser could be enough to give you a beautiful rejuvenation that can last into your 40s. As for your eyelids, they are heavy and could be improved by upper blepharoplasty. I hope this helps.

Q: Odd looking cheeks after high SMAS lift. Can filler help this issue, and if so, which one?

A: It’s too soon to judge the results of your facelift. You are still swollen. You are still healing. Give yourself a few months before you even think about changing your face. It’s time to let your body do its work. If you’re still unhappy 4 to 6 months down the road,  there will be many options open to you to get the look you want. I hope this helps.

Q: I have wrinkles and sagging from corners of mouth to chin, making me look OLD. How can I fix this?  

A: Many women your age notice a significant degree of sagging and wrinkling that is best remedied with a full rhytidectomy (facelift). Though your photos are not complete, they seem to show some volume loss in the mid face, which can be improved with fat grafting done during the facelift. I’d also recommend a neck lift with platysmaplasty to fix your sagging chin and neck, plus a chemical peel to improve the wrinkling and stimulate the production of new collagen. Microneedling could help improve the scars.

Moisturizer isn’t enough at your age; you need a serious skin-care program that includes retinol and hyaluronic acid. Also, because you live in Nevada you have to be sure to wear sunscreen outdoors, while indoors near windows and while in the car. Don’t go outside without a hat; sun will damage your skin sooner than anything. I hope this helps.

Q: What is best in my case, an upper eye and forehead lift, lower lift or both at the same time?

A:  In my opinion, it’s much better to combine a number of cosmetic surgeries at once, rather than performing them separately over time. In the hands of an expert facial plastic surgeon, doing multiple surgeries will still result in a beautiful, natural looking rejuvenation. You get the added benefit of only one recovery time. To split up your surgeries would mean you’d spend the better part of a year recovering from one after another. I hope this helps.

Q: I had a lower face/neck lift 6 wks ago but it looks like jowls are coming back, is this just swelling?

A: The photos demonstrate a very nice improvement in your neck and jowls, so I would urge you to relax as your body continues to heal. The jowls you are seeing may be an indication that something further needs to be done, or they may be just part of your swelling/healing process. It’s too soon to tell. If, after 6 months, you feel that you are not as tight as you’d like to be, you can ask your surgeon for a revision. Sometimes it’s better to under-tighten than over-tighten, to avoid creating a windswept look, and perhaps that is what happened here. There are also nonsurgical options to give you that last little bit of lift, such as Ultherapy and/or ThermiTight. I hope this helps.

Q: Hair regrowth after SMAS facelift?

A: You may want to wait a bit more to see if your sideburns grow back on their own after your SMAS facelift (rhytidectomy). If not, hair transplants would be the best solution for regrowth, as Rogaine only leads to temporary hair regrowth. Although I can’t see your face fully in the photos, you appear to be female. In that case, you might consider leaving your temples as is, because many women actually shave their sideburns because they think it looks more feminine. The choice is yours. I hope this helps.

Q: What’s the best way? Would a total facelift be the best way to fix my issues or lip injections, fillers and thermitight?

A: If you go the nonsurgical route and get ThermiTight with fillers and thread lifts, you will very quickly spend as much as it costs to get a more permanent and satisfying rhytidectomy (facelift). You have a significant degree of sagging that would only be partially alleviated with nonsurgical means. And there’s no guarantee that a procedure like ThermiTight would do much to lift your face; your skin already has to be in pretty good shape to benefit from heat-based therapies. You have a lot of laxity.

I’d recommend biting the bullet and going for the full facelift with fat grafting to add some softness back to your midface, necklift with platysmaplasty to tighten the neck and underlying muscles, and lower blepharoplasty with fat repositioning to help improve your under-eye area. I would also give your skin a chemical peel during the facelift procedure to improve the quality of your skin and speed up healing.

While this is not an inexpensive route, if you find a truly great facial plastic surgeon, it will save you money and aggravation in the long run. You will get an amazingly natural rejuvenation that will turn the clock back by about 10 years and help you look healthy and younger for another 10 years. It’s also a nice way to reward yourself for losing so much weight. If price is still a deterrent, payment plans can be discussed.  I hope this helps.

Q: I had PDO feather lift Jan 2017, it was a waste of money. I’m scheduled for mini neck facelift Jan 2018, is it safe?  

A: Many of my facelift patients come to me for just that reason: they’re unhappy with their thread lifts.  I am not a fan of feather or thread lifts at all. They don’t last long.

Based on your photo, though, I’d recommend a full facelift with fat grafting and neck lift with platysmaplasty rather than a Mini Lift, because you have significant volume loss and sagging in your mid face as well as your lower face. Doing just a Mini Lift would probably not feel very satisfying to you.

It is perfectly safe to have either a Mini Lift or a facelift (rhytidectomy) after thread lifts; the threads can be removed during the procedure. I hope this helps.

Q: Facelift vs. fillers at age 64?

A: Photos would help to give you a definitive answer. However, based on your description you have significant volume loss and possibly sagging skin. The only satisfying fix for you at this point would be a full rhytidectomy (facelift) with fat grafting and probably a neck lift with plastysmaplasty. This would restore volume to your face, getting rid of the sunken and gaunt look that’s troubling you.

As for the fine wrinkles, I would take care of them with a chemical peel done at the same time as the facelift. This will improve the quality of your skin, aid in healing, and lend a real “wow” effect to your rejuvenation. A good facelift will turn back the clock by about 10 years and last for about 10 years. I hope this helps.

Q: Is it possible to reverse a SMAS facelift?

A: I’m sorry that you are unhappy with your facelift at this point. You didn’t mention how long it’s been since your surgery. It does take the face a few months to settle down after a rhytidectomy and for your full results to be visible. However, it sounds like the lift has accentuated volume loss in your face. Once you are several months post-op, if you still feel like your face looks flat, volume can be added with either autologous fat grafts, hyaluronic acid fillers such as as Juvederm and Voluma, and/or by building up your cheekbones with Sculptra and Voluma, or with cheek implants. As to your other question, no it’s not possible to “reverse” a facelift, as the excess skin has already been removed. I hope this helps.

Q: Are there any possible cons from having a facelift and cons from a facelift years down the road?

A: Almost any “con” associated with a facelift would be due to inexpertise on the part of the surgeon. That is why the most important part of your facelift procedure (rhytidectomy) is doing the research to find a highly skilled surgeon with a strong sense of aesthetics. Well done, a facelift should turn back the clock about 8 to 10 years and last about a decade. At that point, you may opt for a revision facelift. However, if you keep your skin in top shape with chemical peels, sun avoidance and high-quality skin care, it may last even longer than that. It’s fine to have more than one facelift; once every 10 to 15 years or so is the norm. I hope this helps.

Q: I am 28 years old and I look 40. How do I start looking like my age?

A: I am very sorry for your loss. Grief can take quite a toll on us physically. However, you do not look 40 and you do not need a facelift or any major procedures to make your skin look vibrant and healthy. Chemical peels, sun avoidance, microneedling, great skin care and a healthy diet and exercise regimen will help you feel more like yourself. Find a medical professional you can work with over the long term, to reclaim your feeling of youth and vitality now and to help you manage the signs of aging when they do begin, in time.

Q: What is the best and most cost effective approach to keep my face young and fresh?  

A: You do not yet have enough sagging to justify a facelift. Concentrate on preventing sun damage by protecting your skin with sunscreen, hats and clothing. Have your dermatologist recommend a medical-grade skin care regimen with retinol and hyaluronic acid. Get regular chemical peels. If you do start to see some jowling, the first surgical procedure I’d recommend is a mini lift, with or without a neck lift, depending on your needs. I hope this helps.

Q: What is the best procedure to restore, not change my face?  

A: The best way to age naturally and gracefully while looking younger than your peers — yet not “done” — is to find an expert facial plastic surgeon and come up with a long-term treatment plan. The reason you are distressed by how some people look with fillers is that they’ve been inexpertly administered. No cosmetic procedure should make you look “different” unless that is your goal. Rejuvenating procedures, such as fillers and facelifts, should only make you look revitalized and healthy.

Based on your photos, I think you would benefit from a full rhytidectomy (facelift) with fat grafting to restore volume in your mid face. This will also help resolve the hollows under your eyes. A neck lift with platysmaplasty will tighten your neck muscles and remove the excess, sagging skin. A chemical peel during the facelift will help your skin heal and will make your face look bright and healthy. A good facelift will keep you looking young for about 10 years. I hope this helps.

Q: Is there anything else besides fillers to fill my cheeks up? Will a mini facelift work?

A: Your frustration with fillers, their lack of efficacy and their continual cost is common. Better to plunge in and get the one procedure that will give you a dramatic but natural looking improvement and a rejuvenation that can last up to 10 years or more: a full facelift (rhytidectomy). I recommend a full facelift rather than a mini lift in your case because you are distressed about the lost volume in your cheeks. A mini lift will only address the lower face and (in some practices) the neck and chin.

If you want to restore youth and vitality to the midface, a facelift with fat grafting and a chemical peel will work wonders. This combination gives a “wow” effect that makes you look vibrant and stunning, without looking “done.” Take your time to find an expert facial plastic surgeon to help you get the rejuvenation you want. I hope this helps.

Q: What is the average recovery time for a facelift? And are any special creams advised for scarring or just for general healing?

A: A facelift (rhytidectomy) is a wonderfully rejuvenating and long-lasting procedure, but it is major surgery and therefore you must give your body adequate time to heal. I recommend my patients do little to nothing the first few days and then drastically curtail activities for two weeks. While the stitches are generally removed after 1 week, you will still be quite swollen. I always recommend getting help with housework and  taking time off from the job during this intensive 2-week recovery period. It will take about 4 to 6 months for your face to completely heal and for your final results to be visible.

As for creams to aid in scar healing and fading, each facial plastic surgeon will have his or her own preferences and recommendations. Also, in my practice I am meticulous about where and how I make my incisions, so the scars generally heal well enough that they are barely visible. If you’re bothered by them, they can be improved with chemical peels and MicroNeedling after the facelift has fully healed. I hope this helps.

Q: Is it a common procedure to wash hair after SMAS facelift while still under anesthesia?

A: It is common practice to wash or at least rinse the patient’s hair after an SMAS facelift. This helps to remove residual blood, anesthetics, and sweat. It only takes a few minutes and does not add to the price; it’s simply included in the procedure. If you would rather not have your hair washed while under anesthesia, you can discuss this with your facial plastic surgeon before your procedure.  I hope this helps.

Q: Is a second plastysmaplasty needed needed during a facelift?

A: I would need to see you in person or at least examine some photos in order to answer your question more specifically. A platysma tightening usually lasts about 10 years. If your neck still looks good, then it may not need to be redone.

However, you are evaluating your neck based on how your face looks now. Once you have your rejuvenating facelift (rhytidectomy), your neck may look much older in comparison. As for tightness and discomfort, if you only need the skin tightened and trimmed, that will cause less discomfort than going for the full platysmaplasty. My suggestion is to start meeting with facial plastic surgeons so that the quality of your neck skin can be evaluated and you can get more specific recommendations. I hope this helps.

Q: 52 year old woman with too much fat and skin in the neck. What are my options?

A: I would need to see you in person to make a specific recommendation. However, if you already have excess fat and skin in the neck, plus loss of volume in the face, a full rhytidectomy would probably make you happiest. When I perform a facelift, I almost always also perform a neck lift with platysmaplasty, which tightens the neck muscles and removes excess skin and fat. In addition, I do a chemical peel to the face to help with healing and usually add fat to the midface to compensate for volume loss. This combination results in a real “wow” effect. You will look rejuvenated and refreshed without looking “done.” A facelift will last about 10 years. If you’re not ready for surgery, Kybella, Ultherapy and dermal fillers such as Voluma and Sculptra could help. However, none of these will be able to give you as dramatic an improvement as a facelift. I hope this helps.

Q: Why is liposculpture done sometimes during a facelift?

A: I would almost never recommend liposculpture to the mid face, particularly not during a rhytidectomy (face lift). In fact, to keep the face looking volumized and youthful, I most often add fat to the midface during a facelift, plus give the patient a chemical peel to rejuvenate and plump up the skin. I will, however, use conservative liposculpture with mini cannulas on the jowls and under the chin, if necessary. I also perform a neck lift in that case, so that the skin doesn’t droop after the removal of fat. A truly expert facial plastic surgeon will address each patient’s individual needs and do whatever needs to be done to make her or him look refreshed, revitalized and rejuvenated. I hope this helps.


Q: What would be the best treatment options for my sagging neck and jowls?  I’m a 43-year-old woman looking for some guidance.

A: It’s becoming more and more common for women in their 40s to take charge of their aging with a facelift. A facelift (rhytidectomy) at this stage would turn the clock back about 8 years and keep you looking fresh and rejuvenated for another 10. I almost always include a neck lift and platysmaplasty (tightening the neck muscles) as part of my standard facelift procedure. This would take care of your jowls and sagging neck. I would also recommend some fat grafting to the mid face to replace lost volume and help the lift look natural.

Finally, during a facelift I almost always do a chemical peel of the face and neck, too. This aids with healing as it stimulates the production of new collagen and elastin — the building blocks of skin. It also creates a glowy and youthful look to your skin after you heal. I hope this helps.

Q: Turning 60 this yr, bilateral mastectomy derailed the SMAS planned 4 years ago. Starting the search now for PS.

A: It can be confusing trying to find an expert for a procedure as highly specialized and life altering as a rhytidectomy (facelift). First, focus on facial plastic surgeons rather than general plastic surgeons. Facial plastic surgeons have been trained to go beyond providing remedies to problems such as loose skin and muscles; our goal is to create a new and rejuvenated look that is in harmony with your current facial features and that makes you look refreshed, revitalized and more lovely without looking “done.” This requires not only great and specialized surgical skills, but an understanding of facial aesthetics.

Many of my patients have traveled across the world to be treated at my facial plastic surgery center. I studied with two of the top facial plastic surgeons in Beverly Hills, both of whom are internationally known and respected. I am located in North Carolina, which provides beautiful, relaxing scenery in which to recover. Feel free to contact me for a consultation. We can meet in person, over the phone, or on Skype. I hope this helps.

Q: Is a full facelift needed?

A: You didn’t specify your age, but from the photos it looks like you could be in your early forties. While your sagging has just begun and could be controlled for awhile with noninvasive methods, such as ThermiTight, these will not give you as dramatic an improvement as a rhytidectomy (facelift).

Modern facelifts are truly rejuvenating. Not only do they lift, they restore volume and, ideally, improve the quality of your skin. In my practice, I accomplish this by adding fat grafts to the midface to restore volume and by resurfacing the skin with Fraxel or other lasers. Lasers not only improve the texture of skin so that it looks younger and fresher, it actually thickens and strengthens the skin by stimulating the production of new collagen. It is quite common now for women to get their first facelift in their forties, so they can get a jump on the aging process. A good facelift can last up to 10 years. With proper maintenance, it may last longer. I hope this helps.

Q: Advice on face and neck (lifts and/or injections, cost, recovery time)?

A: If you are in the middle of weight loss, I would suggest holding off on your rhytidectomy (facelift) until you are at your ideal weight. Losing weight after a facelift risks the development of loose, sagging skin – exactly the opposite effect you want.

As for what to do now, I would not recommend going the dermal filler route. You have a significant degree of sagging and volume loss in the mid and lower face and neck. You would get a dramatic rejuvenation with a well-performed SMAS facelift with fat grafting, neck liposuction, neck lift and platysmaplasty (tightening the neck muscles). You would also benefit from blepharoplasty and laser resurfacing – both of which can be done at the same time as your face lift.

While you are losing your weight, interview facial plastic surgeons in your area and/or those that you would be willing to travel to. We facial plastic surgeons are not only skilled at surgery but have a highly developed sense of aesthetics that ensures your lifted look will be natural and flattering.

You should be attended to overnight by a dedicated nurse after your surgery. This can be done at our offices, where we provide the nurse, or in your home or hotel room. You will need to wear a facial bandage for a week, removing it only to clean your incisions, shower or to run short errands. After a week, your sutures will be removed. You can continue to wear the bandage at night to speed recovery. Your swelling will persist for about 2 weeks. You will need to avoid strenuous activity and heat – including saunas and curling irons – during that time.

After your facelift, you can find a surgeon who specializes in the body for your mommy makeover. I hope this helps.

Q: Redoing a facelift, can anything be done to correct this?

A: I’m sorry that you are so disappointed with the results of your facelift (rhytidectomy). There is quite an improvement based on your Before photos, but you would definitely benefit from more tightening on your lower face and neck. I would suggest finding a new facial plastic surgeon based in the US; while the price may be higher, if you take the time to find an expert you should get results that will last 10 years or more. Be sure that your new surgeon tightens the facial and neck muscles as well as the skin: That’s what’s going to give you a better and longer-lasting rejuvenation. I hope this helps.

Q: SMAS facelift 10 weeks ago, a dimple has appeared under my chin, will this improve?

A: You are early in the healing process.  I would let the area heal for 4 months and then evaluate.  If it is still dimply at that time, I would consider additional procedures.  

Q: For sagging skin (mouth to chin), is the only remedy a facelift or will fillers work?

A: Your photo shows a significant degree of sagging from the midface down. I don’t think you would be happy with anything but a facelift, which would not only correct the sagging, but also would restore volume to the midface via fat grafting. When I do facelifts (rhytidectomies), I include a neck lift with platysmaplasty. This will tighten the underlying neck muscles, plus remove excess skin. A facelift will give you a dramatic yet natural looking rejuvenation that can last for up to 10 years. I hope this helps.

Q: Can a person’s skin be too thin for a facelift or other treatments to get rid of a turkey neck?

A: Poor skin quality can affect the success of a facelift (rhytidectomy) and neck lift to some degree. However, you can still have a facelift and you will look significantly better than if you had not received one.

To improve the look of your skin after a facelift, I’d recommend concomitant laser treatments or chemical peeling to resurface and thicken the skin by stimulating the production of new collagen. Also, fat grafting can help the facelift look natural and rejuvenating. As for the neck, if your skin is very thin and you notice sagging after your necklift, you may get some relief with a nonsurgical skin-tightening treatment such as ThermiTight. All of these issues will be addressed and potential solutions discussed when you consult with a facial plastic surgeon. I hope this helps.

Q: I’ve wanted a face lift for a long time but am not sure what kind or what I can reasonably expect after it?

A: You could get a dramatic improvement with an SMAS facelift that tightens the muscle as well as tightens and removes excess skin. The look you are creating in the photos where you are pulling your face would probably not be flattering; pulling skin without adding volume makes you look windswept, not younger. I would suggest fat grafting in the midface to add volume and make your lift look natural and rejuvenating.

Your neck looks pretty good but could use some tightening. The lower face should be cleaned up and tightened to remove the jowls and give you a cleaner, more masculine jawline. Take the next step and start meeting with expert facial plastic surgeons who specialize in rejuvenating the male face. During these face-to-face consultations you’ll get a better idea of what kinds of results you can expect. A good facelift should help you look younger than your peers for at least 10 years. I hope this helps.

Q: Can this be done a cheek Smas lift/ or implants and a neck lift only?

A: Your best bet is to begin in-person consultations with expert facial plastic surgeons in your area. A good surgeon will only do surgeries that benefit the patient. There are many different options for just about any issue you have. Recovery from an SMAS lift alone or a neck lift with implants or both at once is about the same. I hope this helps.

Q: Lower half of face is falling. I’m 37. Least expensive but more permanent procedure?

A: You are relatively young, but you already have slight jowling. While you could begin a liquid facelift and laser resurfacing, you might not be satisfied with the results. A lower facelift would lift your jowls and help correct the marionette lines.

It looks like you also have flat cheeks, so it may be that a full facelift (rhytidectomy) is the better choice to rejuvenate your face. However, decisions like this have to be made in person. As far as expense goes, the cost of a Mini Lift or facelift is initially higher, but when you consider the maintenance costs of a liquid facelift, there isn’t much difference over time. You should choose the procedure(s) that confer the most dramatic and longest-lasting benefits. Costs can be worked out. I hope this helps.


Q: 42 years old. Is it time for a facelift?

A: No longer is 42 considered too young for a facelift. It’s common to have the first lift at your age or even younger. Once the face begins to sag and you notice sagging cheeks, the beginnings of jowls and loose or sagging neck skin, you will benefit from a facelift (rhytidectomy). I would also suggest resurfacing your skin with laser therapy to stimulate the production of collagen. This will give your lift a real “wow” effect. Regular laser treatments, plus a medical grade skin-care regimen and sun protection could help your facelift last 10 years or more. A facelift, lasers and skin care will give you a more satisfactory and long-lasting result than continually re-administering dermal fillers. I hope this helps.

Q: I had a face/neck lift 8 months ago, and am seeking second opinions on the results of the necklift?

A: You have a significant improvement in your neck since your surgery, but you do have some residual sagging. While you may experience some more healing in the next few months, I don’t think it would be enough to tighten your neck to the degree that you probably want.

From your “Before” photos it looks like you waited quite a long time to address the sagging on your neck and lower face. Your surgeon may have been conservative in his or her approach, because removing too much skin at once could cause the lift to look unnaturally tight. It’s not uncommon for older people with significant sagging and poor skin tone to require revision surgery; even if the initial surgery removed sufficient skin, poor skin quality could lead to sagging soon after the surgery.This is why getting a facelift and/or neck lift sooner rather than later is more rejuvenating.

Whether you decide to opt for more surgery or not, I would suggest you start laser resurfacing with Fraxel to improve the quality and tone of your facial and neck skin. Fraxel stimulates the production of new collagen and also tightens the skin. I hope this helps.

Q: Are non incision SMAS Lifts effective? How long do they last? Are they performed anywhere other than South Korea?

A: I can understand the reluctance to commit to a facelift with SMAS tightening and lifting because it is a major procedure, but it really is the best and longest lasting way to rejuvenate your face and neck. The non-incision lifts that you refer to appear to be a variation of threadlifts. Threadlifts have a long history of being inadequate, both in terms of efficacy and in terms of longevity. All they can do is lift the skin.

We actually stopped doing skin-lift only facelifts decades ago because they cannot create a dramatic or lasting rejuvenation. I would suggest that you begin consulting with facial plastic surgeons in your area so you can get a better idea of how rejuvenating an SMAS facelift can be. While there is a longer recovery period than with threadlifts, the results can last for up to 8 to 10 years or more. Other procedures need to be repeated much more frequently than that. I hope this helps.

Q: Is the recovery time and side effects less from a skin-only face/neck lift?

A: Remember the old Hollywood facelifts that made celebrities look like they lived in a wind tunnel? That’s the best result you can expect with a skin-only face and necklift. We don’t do those anymore because they don’t look natural and the results do not last. When the skin is pulled but the muscles are left loose and sagging, gravity will pull the face back down quickly. That’s why we now always tighten and lift the SMAS, plus frequently add fat to increase facial volume through fat grafting.

It would be helpful to know what your condition is and why you don’t believe you can have your SMAS tightened and lifted during your surgery. If an SMAS lift (which is, by now, just a standard facelift, i.e. rhytidectomy) is not an option for you, then I’d recommend a Mini Lift and neck lift/plastysmaplasty with fat grafting, laser rejuvenations, chemical peels, and dermal fillers such as Sculptra and Voluma. A Mini Lift has a shorter recovery time than a full facelift. Your best option is to begin face-to-face consultations so that you’ll find out how to look younger without compromising your health. I hope this helps.

Q: How Long Does It Take for Facelift Scars to Mostly Disappear?

A: To ensure that your facelift is well done and that scars are barely visible, you must find an expert facial plastic surgeon. Scars are generally hidden around the ears for a facelift. The incisions take about two months to heal and start fading. You can also fade them further with procedures such as MicroNeedling. I hope this helps.

Q: Does a Facelift Also Include the Eyes and Neck?

A: A facelift (rhytidectomy) generally addresses the lower face, including the jowls, and the midface. In my practice, I almost always include a neck lift with plastysmaplasty (tightening the neck muscles) as part of a rhytidectomy, but this varies by practice. Surgeries to address the top of the face, including the eyes and brow, are separate procedures. If you are having multiple procedures done at the same time, you can sometimes work out a package price.

There are many reputable and wonderful facial plastic surgeons in the LA area. I trained in Beverly Hills with Dr. Paul Nassif of “Botched” and “The Real Housewives of Beverly Hills” and Dr. Babak Azizzadeh – both of whom are internationally recognized as excellent surgeons. You may also consider traveling for your surgery. Because a facelift requires a recovery period of at least two weeks, patients often take the opportunity to go somewhere new and recover in private. You can get ballpark estimates of cost by using this site, but your best bet is to start over-the-phone and/or in-person consultations to find an expert you feel comfortable with. I hope this helps.

Q: What procedure should I do first, total facelift or eyelid surgery, after chemo?

A: Congratulations on being a survivor and for giving yourself a gift of “a new you.” Chemotherapy should not be interfering with your healing process at this stage. I always recommend doing eyelid surgery and a facelift on the same day to minimize downtime. The scars should be minimal and mostly hidden. I hope this helps.

Q: In a deep plane or SMAS facelift, how and where are the muscles anchored?

A: Generally, in an SMAS lift, the muscles are tightened and maybe trimmed, but are not dissected from underneath the muscle. In a deep-plane facelift, the SMAS layer is dissected and moved. In both lifts, the sutures attach to muscle for greater support.

Which procedure is best for you will depend on your needs. That’s why a face-to-face consultation is so important. Don’t worry too much about what type of facelift to get: find a professional whose results are beautiful and natural. I hope this helps.

Q: How to get a natural looking facelift that just makes you look better?

A: Congratulations on becoming proactive in your aging process and for giving yourself sufficient time to find the right expert to help you with a facelift or Mini Lift. Too many choices can be confusing and overwhelming. Luckily, the web can help you narrow things down. Search the facial plastic surgeons on this site who are in your area or to whom you could comfortably travel. Take a look at their websites – especially at the Before and After photos. Call their offices if you think their results look natural and healthy. Talk to former patients. And then book a few in-person consultations with the ones whose results have impressed you the most. After the surgeon’s skill, the next most important element is a feeling of trust and comfort. I hope this helps.

Q: 48 and volume loss around eyes/cheeks. Been told fillers do not elevate cheeks & lifting is better, is that correct?  

A: Unfortunately, nothing can make you look 25 again. As we age, we not only develop looser skin but also our bones and muscle atrophy. In fact, it’s the loss of this underlying support as well as the degradation of the skin itself that causes the sagging.

You can add back some of the lost volume with fat grafting. That, along with a well-done facelift will be able to turn the clock back about 5 to 10 years and last at least 10 years. However, it is a little difficult to determine if you would be a good candidate based on the photos you provided. While you have lost volume in your cheeks, you don’t seem to have a significant degree of sagging in the lower face. Start meeting in person with facial plastic surgeons to determine your best course of action. I hope this helps.

Q: Follow-up Question: Hydro Laser Before Facial and Neck Surgery or After?

A: Every facial plastic surgeon has a preferred method of working. My preference is to resurface the skin with a laser as part of a neck lift and/or facelift. Not only does this limit you to only one recovery period, which lessens the amount of downtime you’ll have, but by stimulating the production of new collagen with the laser, healing is facilitated. When your facelift heals and your skin replenishes itself at the same time, you get a real “wow” effect of healthy radiance. That’s the kind of effect you want from a facelift: Not just younger, but healthier and brighter. I hope this helps.

Q: Lower SMAS face lift: 2 different techniques.

A: If you are going to make the significant investment of money and recovery time that a cosmetic procedure demands, then it is my opinion that you choose the option that will give you the best result while limiting risk.  Without seeing photos, it is not possible to tell you what procedures are best in your particular case. However, both are reasonable recommendations.  If you are young, a non smoker, and have good skin elasticity with early stages of aging, then neck lipo with fat grafting could be the best.  If you are older with more advanced aging changes, an SMAS lift would likely be better.

Q: What to do 7 months after complete face, neck, upper & lower eyes? I look like I did prior to surgery!

A: I am sorry that you are disappointed with your facelift results. Your “before” photo shows a significant degree of sagging in the upper and lower face, eyes, jowls, and neck. Much of this has been improved by your facial plastic surgery.  I can appreciate the residual jowling and looseness of the neck skin. You could consider an additional surgery to tighten this further. I believe a frank and honest discussion with your operating surgeon is appropriate. It is always easier to go back and tighten a little more the second time than over pulling the first time.

Q: I am a fair skinned white male. How long could I expect bruising to last after a standard facelift?

A: In most cases, bruising after a rhytidectomy (facelift) will resolve within 10 days to two weeks. If you bruise easily, and with fair skin you might, the bruises could still be evident for up to three to four weeks. If you have prolonged bruising, you can use makeup to cover this up.  Be sure you find a facial plastic surgeon who has expertise operating on the male face. I hope this helps.

Q: Is it too much stress for your facial skin if you get a full face CO2 fractional at the same time as a facelift?

A: While every patient is different, and some may have issues that preclude performing a facelift (rhytidectomy) and skin resurfacing at the same time, it’s actually my preferred method of working. Resurfacing the skin during surgery allows both procedures to heal simultaneously, minimizing downtime for the patient. As the facelift begins to heal, the skin also starts to produce more collagen from the laser treatment. This will give your results a real “wow” factor as your skin will not only be tighter, but thicker and more resilient. However, each facial plastic surgeon is different. If you’d like both treatments at once, find somebody who can help you do that who also can show you great results he or she’s gotten in the past from patients whose skin quality and needs are similar to yours. I hope this helps.

Q: Is this wrinkled skin on my neck fixable with a revision?

A: At 4 months post-SMAS lift, you are still healing. Your skin may now be producing collagen that will help resolve the neck wrinkles. If you continue to see loose skin a couple of months from now, I’d recommend laser resurfacing or another noninvasive or minimally invasive skin-tightening procedure. MicroNeedling and chemical peels could also help. There are many different modalities out there that can help you get a smoother, more lovely neck. I wouldn’t recommend a revision surgery for this. I hope this helps.

Q: Is it possible to have a facelift if I have previously permanent thread put in?

A: Your situation is not uncommon. Most people who have threadlifts become dissatisfied pretty quickly and move on to a traditional rhytidectomy (facelift) or Mini Lift. Thread lifts do not last and I don’t recommend them to anyone. The threads can be removed during your facelift procedure. I do not charge extra to do this, as it is a simple procedure, but every facial plastic surgeon has different policies. I hope this helps.

Q: At early 50’s I feel very older on the outside than my inside.  Do I need deep plane facelift???

A: Aging can be stressful and feeling stressed can be aging. Your photos suggest that you would be an excellent candidate for a traditional rhytidectomy (facelift) with fat grafting to help compensate for the volume you’ve lost in the midface. A full facelift would also resolve your jowls and help to smooth out your nasolabial folds.

I commonly treat my facelift patients with a resurfacing laser or chemical peel to give a real “wow” effect to their rejuvenation. Blepharoplasty can be performed at the same time as a facelift. If you want rhinoplasty, that can be discussed, too. However, you will need to find a facial plastic surgeon who has been trained in aesthetics to help you design the best treatment plan and get results that accentuate your natural beauty. You will also need to institute a high-quality skin-care regimen to keep your skin looking fresh and youthful for the 10 years or so that your facelift will last. I hope this helps.

Q: I am considering a facelift. I am a male 55 yrs old looking for advice on what surgery would be best for me?

A: What kind of facelift is best for you depends on the degree of sagging and your skin quality. At 55, you might just have minimal sagging in the lower face and neck, in which case a Mini Lift might be sufficient. Or, you may have already developed significant volume loss in the midface, in which case a full rhytidectomy (facelift) with platysmaplasty and fat grafting would be your best shot.

A good facial plastic surgeon will spend time evaluating your bone structure, volume loss, and skin quality before making recommendations. There is no one-size-fits-all solution based on age or sex. As a man, however, you do need to take extra care to find a facial plastic surgeon who regularly performs facelifts on males, as it is imperative that such things as beard and sideburn position are maintained. I hope this helps.

Q: Do you stay in hospital overnight for a smas facelift?

A: A traditional rhytidectomy, which includes repositioning and tightening of the SMAS, is surgery that will require 1-2 weeks of recovery time. I recommend that my patients either remain overnight in our private recovery suite with a dedicated nurse to change the dressings or go home with someone they trust to help with simple wound care.  I check all patients the next morning to make sure your healing is progressing well.

Some patients opt to go home directly after their procedure. In these cases, you need to pre-arrange for someone to pick you up and drive you home, plus help take care of you during those first 24 to 48 hours. I hope this helps.

Q: Is a repeat facelift better before jowling becomes really bad or better to wait until really necessary?

A:  If you are happy with the way you look, then there is no reason to rush into a facelift revision simply because your surgeon is retiring; I am sure you could find another wonderful facial plastic surgeon to help you when you are ready. That said, you do have significant sagging under your chin and on the neck and it looks like you may have some new jowling as well. While there is no reason to rush, there is no reason to wait, either. If you are bothered by the sagging skin, then I’d at least recommend a necklift with or without a mini lift.

Waiting until your jowls get really bad before lifting them is a bit like waiting until your car is filthy before washing it. Yes, the change will be most dramatic when the car is dirtier, but then you’ve been driving around in a vehicle for months or years that doesn’t look its best. Based on your photo, you are a very attractive woman and there’s no reason to delay a procedure that will once again turn back your clock by years. While you are trying to decide, I’d suggest consulting with a few new facial plastic surgeons who are not nearing retirement, so that you have a few options and don’t feel rushed by someone else’s timetable. I hope this helps.

Q: Should I lose weight before my facelift or after?

A: If you read through the questions on this site, you will run across some relatively young people seeking facelifts simply because they’d lost a great deal of weight. Without the volume of the fat to support their skin, their faces have begun to sag. If you are planning to lose weight, please do so before your facelift. You should also be at a stable weight because repeatedly gaining and losing weight is another cause of skin sagging – not just on the face but anywhere on the body.

A facelift is a major investment in yourself, both in terms of money and of time. Make the investment pay off as well as it can by investing further in your health and well-being. Once you have stabilized your weight and have a healthy diet and exercise regimen in place, that would be the ideal time for your facelift.

Conversely, if time goes by and you find that you cannot lose the weight, or if you believe a facelift would give you the “boost” you need to feel good enough about yourself to make some lifestyle changes, then do the facelift first. Just know that if you subsequently lose a significant amount of weight, you may have some facial sagging that will need to be remedied with lasers, fillers, and possibly another lift or mini lift. I hope this helps.

Q: What type of facelift and/or other procedures are now best for my gaunt aging male face?

A: Another fat graft to your midface would improve the gauntness considerably. I suspect that underneath your beard you may have some evidence of sagging/jowling as well. It is difficult to determine from the photo whether you have any neck laxity. I would recommend consulting in person with several facial plastic surgeons to see if you would best be served only with fat grafting or with a facelift and fat grafting. A facelift, well performed, always looks natural. Results last up to 10 years. I often recommend resurfacing the face with lasers or chemical peels for patients who are undergoing fat grafting and/or facelifts. However, the fat grafting alone may improve your skin quality sufficiently. If you do opt for laser therapy, I’d recommend avoiding a drastic resurfacing as that may result in a less than masculine look. I hope this helps.

Q: High SMAS FL, upper/lower eyes, necklift, and ear pinning. Can this all be done at one time to get the recovery over with so I can miss the least amount of work?

A: It’s not only possible, but preferable that you have multiple facial plastic surgeries performed during the same operation rather than spacing them apart. I always include a neck lift with plastysmaplasty when performing an SMAS facelift. It is also quite common to perform upper and lower blepharoplasty at the same time. Adding in otoplasty extends the operation by another 1 to 2 hours. While surgical time is longer, having only one recovery period is easier for your body to heal from and also, as you pointed out, prevents you from missing too much work. I hope this helps.

Q: Interested in a facelift with fat transfer simultaneously. What type of lift would you suggest for me?  

A: Based on your photos, you would be an excellent candidate for a full rhytidectomy (otherwise known as a facelift). I almost always include fat grafting and a neck lift as part of a facelift as these two other procedures help the facelift look more natural and last longer. A neck lift is the only procedure that can actually remove the excess skin from your neck, tighten the underlying platysma muscle and clean up your jawline so that it looks sleek and young again.

Many women your age and younger opt for a facelift because it’s the only thing that can dramatically turn back the clock and keep it there for ten years or more. You will age during that 10-year period, but you will continue to look younger than your peers.

I don’t believe in a cookie-cutter approach to facelifts, so I would have to examine you in person to determine exactly where your incisions would be. In general, I place them behind the ears for the facelift and under the chin for a necklift. When the scars heal, they will barely be visible. I hope this helps.

Q: Face Lift/Y Lift/Thread Lift/Fillers, it’s all so confusing. What do I choose? I am 60.

A: We are lucky to live in a time when there are so many effective options for combatting the signs of aging. However, it can be quite confusing to decide which will be best for you over the long term. At 60 years old, you would probably benefit most from a full rhytidectomy (facelift) with fat grafting and a neck lift. You may need fillers to even out your eye troughs. It’s important to find a facial plastic surgeon for your facelift to get the best results and to not look “done.” Take the time to interview surgeons who understand facial anatomy and aesthetics and are committed to enhancing your own natural beauty. A good facelift should last at least 10 years. As for a tummy tuck, whatever numbness that may follow should resolve over time. I hope this helps.

Q: I’m 57. Is it time for a facelift. Too many fillers?

A: Hyaluronic-acid based fillers such as Voluma or a calcium hydroxylapatite (CaHA) microsphere-based formula like Radiesse can be very effective at staving off the early signs of aging, such as slight sagging or loss of volume. With time, however, the facial sagging becomes significant enough that the fillers can’t provide enough of a lift to keep you looking younger. This is what has happened in your case.

At this point, a traditional rhytidectomy (facelift) would be the most rejuvenating procedure you could have. A facelift with fat grafting and a rhytidectomy would remove your jowls, tighten your neck, clean up your jawline and chin, and add volume and lift to your midface. The difference will be dramatic but natural. You will look up to 10 years younger. Though you will continue to age, the benefits of the facelift will last about 10 years. I would also recommend an upper blepharoplasty. I hope this helps.

Q: Surgical procedure or laser? Which is best all round for the money spent on lifting the face?

A: You look like an excellent candidate for a facelift (rhytidectomy) with fat grafting and a neck lift with platysmaplasty. These are procedures that I usually do together for the best and most long-lasting effect. These procedures would tighten your neck, clean up your jaw and chin, remove your jowls, and lift and add volume to your midface. I would also recommend blepharoplasty to remove the excess fat on your upper eyes and trim the excess skin. Botox and fillers could help smooth out your glabellar (frown) lines, but you might also need a slight brow lift. These procedures will dramatically rejuvenate your face, turning back the clock by about 10 years.

Lasers alone would not give you much of a lift at this point. They would, however, help to fade the hyperpigmentation and even out your skin tone. Lasers will also stimulate your skin to produce more collagen and elastin, which will give your facelift a real “wow” effect. I commonly recommend laser resurfacing or a chemical peel at the same time as a facelift to get the best results possible. 

Q: I’m a 64 year old women and I want just a facelift, neck and eyelids. Is it okay to smoke a electric cigarette?

A: Smoking any kind of cigarette can inhibit the body’s uptake of oxygen and interfere with healing. Facelifts, neck lifts and blepharoplasties are all invasive surgeries that require you to be in good health to have an optimal outcome. I don’t know what is in the e-Cigarettes you are referring to, but I would advise you to stop smoking them at least two weeks before your procedures at a minimum.  There are some neck lift techniques that will advise a patient to stop smoking e-cigs for 3 months before surgery.  We even recommend that patients refrain from taking herbal supplements, such as ginger, garlic, and St. John’s Wort’s because they can thin the blood and otherwise inhibit healing. Take this time of self-improvement to move closer toward better health and rejuvenation by giving up smoking for good. I hope this helps.

Q: I’m thinking of having a smas lower facelift mainly because of Jowls and my neck has a bit of laxity, not so much under my chin but front of neck mainly.

A: I almost always include a neck lift and plastysmaplasty as part of either a lower facelift or full facelift. Thus, at my center any SMAS lift will address neck laxity, jowls, and the lower face. Each facial plastic surgeon has a different protocol, so consult with several until you find one who is offering what you need. I hope this helps.

Q: I had a face lift/neck lift 18 months ago with underlying layers lifted. Can I get a revision removing skin only?

A: It would be helpful if you would post photos. From your description, it sounds like you may not have had a fat graft as part of your rhytidectomy (facelift). This is actually a standard step in most of the facelifts I perform as it creates a more natural look and the extra volume helps the skin stay lifted. I commonly recommend laser resurfacing or chemical peel as part of the rejuvenation procedure. Not only does it make your skin look fresh and youthful, it actually stimulates the production of new collagen and elastin, which creates stronger and more resilient support for your skin. This skin always loosens a little over the first couple of months.  It may be normal what you are experiencing.  You could request a revision rhytidectomy from your original surgeon, find a new facial plastic surgeon to help you, and/or see if laser treatment alone would be sufficient to give you more of the look you were hoping for. I hope this helps.

Q: When can I see visible fat transfer results after a facelift?  

A: Your facelift looks good for this stage of healing. It can take up to four months before the swelling subsides enough for you to evaluate the success of your fat transfer. Not all of the fat will survive. If you are dissatisfied with the amount of volume you have, you can have another fat transfer or opt for the less invasive dermal fillers, such as Juvéderm. Give your face some time to heal and then you can discuss your options with your surgeon. I hope this helps.

Q: Will a deep plane facelift address my neck at all?

A: If I am performing a deep plane facelift on a patient, I commonly include a neck lift with platysmal tightening as part of the process to fully rejuvenate the neck and jawline. These are done to create the best and longest lasting effect that also looks natural and rejuvenating.  If funds are an issue, it would be best to save to get the correct procedure to have the best results.  I hope this helps.

Q: Why do some women have a pulled look to their eyes after a Facelift?

A: Facial plastic surgery should always natural and be unnoticeable except for giving the patient a more radiant, rested and healthy appearance. A pulled look to the eyes is completely unacceptable and will not happen if the facial plastic surgeon is well trained, experienced, and an expert in facial anatomy and aesthetics. Don’t let the bad effects of poorly performed surgery dissuade you from getting the procedures you need to feel better about yourself. The women around you who look amazing and yet seem to have had no work done at all could very well be examples of expertly performed facelifts and mini lifts. Please research and find the most skilled facial plastic surgeon to help you.

 

Q: Advice please on what order to do Facelift, Laser Resurfacing, Fat Transfer for best results?

A:  You would see a dramatic improvement in your appearance after a facelift with fat transfer and neck lift, plus brow lift with blepharoplasty. I almost always do fat grafting and a neck lift as a standard part of a facelift. You do have quite a bit of wrinkling and crepe-ing of your skin that can be resolved with laser resurfacing. Depending on the expertise of your facial plastic surgeon, this could be done at the same time as surgery, before the procedure to improve skin quality, or after you have healed. I hope this helps.


Q: What types of face lift would be recommended for me?

A: I believe you would benefit most from a full rhytidectomy (facelift) with fat grafting to the cheeks to resolve your facial sagging and jowling, plus a necklift with platysmaplasty to tighten your platysma muscles, remove excess skin, and clean up your jawline.

Fat grafts utilize your own fat and therefore are biocompatible. They will add volume to your cheeks and make your facelift look natural.  The downside to fat grafting is that it is not as predictable as fillers in the office.  Of the fat transferred only 30-50% is going to survive.  If you gain excess weight overtime, it could become apparent in the face if you have fat grafting.  

You also have a significant amount of hooding on your eyes, so I would recommend upper blepharoplasty with a brow lift. Finally, resurfacing your skin with lasers will smooth out your wrinkles and make your skin more elastic and youthful looking. A good facelift should last at least 10 years.

Q: Should I go with my gut preferences or allow a doctor to decide what I need? I am 65 years old need full facelift and necklift.

A: Based on your photos, I do not believe you need a full cut browlift.  I believe that could make your eyebrows too high and create a surprised look.

You have blocked out your eyes so I can’t comment on the need for blepharoplasty, although it looks like you do have lower eye bags that could be resolved with lower eyelid surgery.

I do agree with your surgeon that your skin needs to be resurfaced to smooth out the wrinkles and stimulate new collagen. If you do not want to deal with the harshness and recovery time associated with CO2 lasers, there are many other laser or chemical peel options that are available to you. Or, if you would rather, chemical peels could be an option.

While you may have had good results with this particular surgeon in the past, I would suggest meeting with several other facial plastic surgeons and then choosing the one that feels right to you. Go with your gut. Ultimately, the choice should be yours.

Q:  At 70 years old, I have loose skin on neck and marionette lines on chin. I worry about scars showing through my hair when I am swimming. What is the least I could do to look better.

A: Your photo shows quite a bit of sagging in your face and neck. The only real and long-lasting solution would be a traditional facelift (rhytidectomy) with fat grafting and a neck lift, including platysmaplasty. The fat grafting would replace the volume in your midface that’s been lost to age; even though you’ve always had a thin face, due to volume loss your face now looks gaunt. The neck lift with platysmaplasty would tighten the plastysma muscles in your neck, plus remove excess skin. The result will be a rejuvenated face and neck, with a sleeker and younger looking jawline.

 

The results of a facelift with fat grafting and neck lift will last about 10 years. You will continue to age during that time, but will also look significantly younger than your peers who did not address their aging. If you feel reluctant to commit to a full facelift, the next best solution would be a mini lift or lower facelift. However, that will not give you as dramatic or long lasting an improvement. As for the scars, they should not show through your hair nor interfere with eyeglass wear. I hope this helps.

 

Q: Should cheek and lip injections be dissolved before a SMAS face lift?

 

A: There is no need to dissolve your fillers before your rhytidectomy (facelift). While Voluma can do an excellent job of filling out the midface, two syringes does not make a difference significant enough that it would affect how your facelift is performed or influence the final results. The lip fillers will not affect surgery at all, either. I hope this helps.

 

Q:  Can I have a touch up lower face lift after having a lifestyle lift 11 years ago?
A: Yes, it is absolutely fine to do a lower face lift to continue the good results you had from your lifestyle lift 11 years ago. Surgery will always give you the most dramatic and long-lasting results rather than trying to add volume and lift with dermal fillers. A lower lift will address your jowls and also tighten up your jawline and neckline. As for your marionette lines, the mini lift will smooth them out to some degree but if they are very deep you may still need a hyaluronic-acid based filler to even them out. I hope this helps.

Q:Will my face tighten anymore as it heals? I had the facelift 3 months ago.

A: While it takes between three to six months for a facelift to fully heal, the skin will not get tighter than it did immediately after the procedure. Swelling, however, will subside. If you feel your skin is still lax after your facelift, you may need resurfacing with lasers or a chemical peel. Your best course of action is to go back to your facial plastic surgeon to find out how you are progressing in your healing and if anything else needs to be done to get you the results you were hoping for. If the answer doesn’t satisfy you, then I’d suggest getting a second or third opinion. I hope this helps.

Q:Want a more youthful face. Unhappy with lack of definition and my crooked, small unmatched lips. I am 57, healthy. had a mid face-lift with fat removal from cheeks, jowls and upper eyelids 12 years ago. Great results now fading with age. What would you suggest to give me a more youthful and pretty face? Something more defined and symmetrical. Prettier lips. Fillers do not work on me. Interested only in fat grafting/removal and surgery.

 

A: A full rhytidectomy (face lift) with fat grafting to restore midface volume, a neck lift and platysmaplasty will give you a much more uplifted and youthful look. It will also resolve your jowls and sagging neck. As for your lips, you definitely need more volume in your lower lip. Although you say that lip fillers don’t work for you, I’d recommend giving it another try with the new Volbella, which looks soft and natural and can last up to 18 months, rather than trying surgery, which often looks overdone. I would also recommend rhinoplasty to correct your crooked nose. This will help your face look more symmetrical and balanced. I hope this helps.

Q: Is it possible to do a neck/lower face lift by placing the incisions behind the ears only? At 52, I am so ready for a lower face / neck lift to remove sagging jowls, but, like most patients, I absolutely fear the ugly scars. I work with A-list celebrities here in Los Angeles and although they have access to the best plastic surgeons in the world, I have yet to come across someone whose front-of-ear scars aren’t a dead give-away, especially when the incision has been made inside the Tragus and it looks even weirder. So, is there really no technique that allows for behind-the-ear cutting only?

A: Sadly, celebrities can be the worst possible advertisements for facial plastic surgery, as they often have procedures that are poorly done or over done. However, you have probably encountered some A-list celebrities whose facelifts were expertly handled, but didn’t realize it because their scars are virtually imperceptible. Read the recommendations on this site, quiz women your age who look good but seem to have had no work done, and meet with a number of facial plastic surgeons until you find one who can give you the results you want. I hope this helps.

Q:Is SMAS neck lift the same as lower face lift? My primary concern is lower face sagging and jowls, along with under the chin skin laxity. I am getting a SMAS neck lift and am confused by some of the terms – I did speak with my surgeon again and sounds like he will tighten the area above the jaw line (SMAS I think) and will use an incision around the front and back of my ear to remove excess skin, as well as an incision under the chin (may have fat removed if any). Is this the same as a lower lift? Will this address the lower 2/3 of my face and neck?

 

A: If your physician is planning to incise around your ear, then undoubtedly he is dissecting the SMAS muscle to lift up your lower face and jowls. The chin incision will be used to remove fat and tighten the neck and submental area. Different facial plastic surgeons use different terminologies. If you are getting confused, the best bet is to give your doctor a call again and just clarify what areas will be addressed during your surgery. We want our patients to feel confident, clear and relaxed about their procedures. We are here to help.

Q:Should I get a facelift or should I get fillers and Botox like to look younger? Don’t like the creases on my-lips Also would like my lips fuller they have shrunken my eyelids are baggy and I got fat pockets under my eyes

A: In my opinion, fillers and Botox wouldn’t make enough of a difference to feel satisfying to you. A facelift with fat grafting will give you a much more dramatic rejuvenation — turning the clock back by about 10 years. From your photo, you would also benefit from blepharoplasty to remove the fat pads and excess skin around your eyes, and from a browlift. Laser resurfacing of the skin would not only even out the tone and texture but stimulate the production of new collagen. A facelift will last about 10 years. Fillers and Botox must be re-administered every few months to a year. I hope this helps.

Q: Most Effective Facelift Procedure on Jowls, Eyes, Neck?

 

A: A traditional rhytidectomy (SMAS facelift) will address the lower face and jowls by lifting the skin and underlying muscles up and outward for a natural lift and rejuvenation. To truly look rejuvenated, however, it is generally best to do some volume restoration with fat grafting to the midface, using the patient’s excess abdominal fat. If the neck is significantly sagging and/or has excess submental fat or skin, then liposuction under the chin plus a plastysmaplasty to tighten the neck muscles and remove excess skin may be needed. A chin implant can be added to create a more angulated, sleeker and stronger jawline. The eyes are not addressed during a facelift. If there is excess or droopy skin around the eyes you may need an upper blepharoplasty and/or lower blepharoplasty. Which of these procedures are needed in your particular case can only be answered by a face-to-face consultation with a board-certified facial plastic surgeon. I hope this helps.

Q: Facelift and Laser Resurfacing at Once Recommended? Do you recommend Facelift and Laser resurfacing at the same time? One doctor wants to do this but others say it’s crazy to do both at once.

 

A: A facelift will only address facial sagging, so I usually offer a combination of services to rejuvenate a patient’s face, based on need. Fat grafting restores volume. Chemical peels and laser resurfacing can remove most wrinkles. Fillers may be needed in some cases. Whether laser resurfacing and a facelift should be done simultaneously will depend on the quality of the patient’s skin and health. If you feel confused by the conflicting advice, I’d suggest talking to the former patients of the facial plastic surgeons you consulted. Or, just wait a few months after your surgery to do a resurfacing or peel. I hope this helps.

Q: Sensitive skin and facelift. I am considering a lower facelift and neck lift for sagging jowls and turkey neck. I have thin, sensitive skin with broken blood vessels. I can look quite normal, but when my skin is dry and itchy, it can be flaky and areas become red and capillaries become visible. (mostly in the winter). I have a patch of capillaries under my ears along the jaw lines. I have no flushing but I blush easily. Is it possible that a facelift might ruin my skin further? Thank you.

 

A: A lower facelift will not worsen your skin condition. When you consult with a facial plastic surgeon, you will be guided toward treatments and care routines to help improve the quality of your skin. You may need MicroNeedling or chemical peels before your facelift. Fat grafting – which is a standard part of many facelifts – can also create a thicker skin. I hope this helps.

Q:Is a SMAS Facelift right for me?  Help! I’m 47 and VERY unhappy with my sloped neck and jowls. My right cheek is also larger than my left; can this be fixed by reducing the right cheek or adding fat to the left cheek? What are the different procedures available for Jowls, Sloping Neck and Uneven Cheeks?

 

A: An SMAS facelift will lift your lower and midface upward and outward, to create a rejuvenating effect. While it can lift the jowls, it will have little to no impact on your neck. In a situation like yours, I would suggest an SMAS lift along with a neck lift with platysmaplasty, to tighten the neck muscles and remove excess skin. You may also need some chin liposuction to create a sleeker jawline. I hope this helps.

Q:Facelift for Patient Prone to Keloids? Can you have a Facelift if you are prone to keloid scarring? Can I have a Eye lift, too?

 

A: The good news is that facial skin is less prone to keloids that skin on other areas of the body. The other good news is that eye surgery rarely results in keloids. The bad news is that keloid and other hypertrophic scars can be a result of poorly performed facelifts and are especially common in “lite” lifts that create a great deal of tension on the sutures.

 

The best news is that if you take the time to find a facial plastic surgeon who has expertise and finesse, you should not have a problem with scarring. You do not mention whether your skin is dark or light. If you do have darker skin, it will be more prone to scarring and in that case it’s essential that your facial plastic surgeon has a great deal of experience performing facelifts on ethnic skin. I hope this helps.

Q:I’ve been told that I’m not a candidate for a FaceLift! I was recently told that I am not a candidate for a FaceLift due to the strong facial ‘muscles’ that are causing these extreme wrinkles/folds consistently evident when I smile. :(. I’m always smiling and can no longer accept the severity of these deep folds bilaterally on my mid face including crows feet. I’ve tried Botox and fillers but that doesn’t provide much help at all! Help! I’m looking for a procedure that will last about 7-10 years, or would a certain type of Lift work? Thank you!

A: From the photos it looks like your facial skin is fairly lax and that you would benefit from a facelift. Skin resurfacing with a laser can also help to soften some of the deeper wrinkles caused by smiling. However, I would need to evaluate you in person and see what your face looks like in repose to make a final determination. The surgeon you consulted was correct in saying that your dynamic muscles may once again begin to cause wrinkles and creases after your surgery. However, a facelift will turn back the clock significantly and should last for about ten years. If you are not happy with the advice you got in your first consult, I strongly suggest meeting other professionals until you find one that “clicks.” I hope this helps.

Q: Opinions on Stem Cell Facelift? Is the “stem cell facelift” hype or something worth looking into? I have seen wonderful before and after photos, but I have learned not to always trust them. Thank you for your input.

A: While it is possible to “supercharge” fat grafts with extra, isolated stem cells, there is no solid evidence that this provides a better result than an excellent facelift with fat grafting. I’ve used fat grafting as a standard part of traditional rhytidectomy for many years, with some really spectacular results. When our faces age, they not only lose tightness, they lose volume. So merely lifting and tightening the skin is not sufficient to rejuvenate your face. A fat graft uses fat from the abdominal area and places it in the mid-face to create a natural looking and youthful volume to the lifted face. These fat grafts, by the way, are already loaded with stem cells. I’m not sure there is any verifiable value to adding more. Other procedures I often recommend as an adjunct to a face lift are blepharoplasty, brow lift, chin liposuction and sometimes even a chin implant to provide more angulation of the jaw. These procedures done together create a “wow” factor that takes years off your face while still looking natural and “un-done.” I hope this helps.

Q:Want and need a SMAS facelift but afraid! I have a good doctor and want to have the SMAS lift but am afraid of potential jaw, nerve or gland pain as well as the neck tightness from a submental platysmaplasty. Any words of encouragement? I know there are no guarantees or easy ways through this!

 

A: While no procedure can be 100% guaranteed, an SMAS lift should not result in nerve or gland pain, as these structures will not be cut into or moved during your lift. Aside from postoperative bruising, swelling and pain that can be managed with over-the-counter medications, icing, bandaging, and rest, you should experience no real side effects and certainly nothing long-term – providing your surgeon is experienced and skillful.  For this reason, the doctor you choose is the most important decision in undergoing facial plastic surgery.  If you want a neck lift as well as an SMAS lift, that is a separate procedure called a plastysmaplasty. I usually perform this as part of a regular facelift procedure, as it gives the best results. If you are feeling nervous about your SMAS lift, you might ask your facial plastic surgeon to put you in touch with prior patients who were happy with their results. Their experience should help calm your fears. I hope this helps.


Q: Best Treatment for Sagging Mouth and Wrinkles? What is the most economical way to improve the sagging corners of my mouth as well as smooth the wrinkles in my forehead? Since I am 44 years old, is it better to get some type of facelift for a more permanent solution or would paying for fillers and Botox every several months be more cost effective? Thank you.

 

A: The only real “cure” for a sagging face is a facelift, which will set your clock back around 10 to 15 years – a dramatic difference. Fillers can restore volume, but the lift they offer is minimal. Plus, they must be re-administered frequently, which quickly adds up to the cost of surgery over time. From your photo, you seem to have some sun damage in addition to sagging. The best course would probably be laser resurfacing to even out your skin tone and smooth some of the wrinkles, plus a facelift with fat grafting to get rid of the sagging and restore volume to your midface. You might still need intermittent Botox to control the glabellar lines (11s). I hope this helps.


Q: Facelift – how long will I have to sleep upright?How long will I have to sleep sitting up after having a face lift ? I am planning a face lift , breast implants , lipo sculpting , and trouser lift tummy tuck in one surgery . I am worried about coping with the pain on my above bottom cut line whilst sleeping upright wondering how long I will have to open and any ideas on how to ease the pressure on this area?

A: I recommend sleeping elevated after a facelift. The morning after surgery, I’ll check on you to make sure you’re recovering well and, if so, send you home with a bandage that will stay on for the next week. You’ll be able to remove it for showers and short errands. After a week, the bandage and stitches will be removed. You can continue wearing the bandage at night to speed recovery. You will probably be bruised and swollen for at least two weeks and should curtail most activities during that time. I hope this helps.

Q: Facelift followed by laser or peel. Any suggestions? Could I please have some advice. I am planning a full facelift inc neck and eyes. My skin has some deep wrinkles. Is it safe or ok to have laser or a peel at time of facelift or is it too much trauma on the skin? I have had conflicting answers from 2 different PS. One said as the skin has been lifted and separated from muscle that it must heal first, the other said it didn’t matter. I am confused. Thank you in advance.

A: For optimal rejuvenation, I highly recommend doing laser resurfacing at the same time as a facelift – especially if the patient has a lot of wrinkles or poor skin quality. Lasers not only remove wrinkles and hyper or hypopigmentation but also stimulate collagen production, which will aid in healing from the rhytidectomy. I hope this helps.

Q: Will a face lift get rid of jowls? What can I expect?  I am 51, slender, non drinker, non smoker, clean water, and skin is sagging. I live a healthy lifestyle. Why is my face dropping rapidly? My mother is 70 and her skin is tight. I use sunscreen.

A: Congratulations on staying slender at 51! Your lack of fat, however, may be partially why your face is sagging faster than your mother’s. In the past, French women used to lament that they had to choose “ the face or the fanny” when trying to maintain a youthful look. With a full rhytidectomy plus fat grafting, you don’t have to choose. You can have a slender, fit body plus a lifted face with a youthful look. I hope this helps.

 

 

Q: Is it possible to have a smas facelift after having a threadlift a month ago? Had very disappointing results with threads.

Answer: Your question is a perfect illustration of why I don’t do threadlifts: they historically are not predictable and fraught with problems. One month is too soon to have another surgery. Wait another five months or so and then go for the SMAS lift. The results will be much more dramatic and can last up to 8-10 years. In the meantime, shop around for your ideal facial plastic surgeon. I hope this helps.

 

Q: How many time in whole life can I have facelift and still look natural?

A: The unnatural look you are referring to can arise from poor technique on the part of the facial plastic surgeon, a loss of volume in the patient’s midface that could be easily corrected by performing a fat graft during surgery, or a psychological affliction such as body dysmorphia that compels the patient to undergo surgery again and again – even though it’s not needed.

If you are physically and mentally health, a facelift is a dramatic and very satisfactory anti-aging procedure that can turn back the clock by 10 to 15 years. It should keep you looking younger than your peers for up to a decade or more. After that time, you may opt for another surgery. This can be repeated as long as you are healthy and your skin quality is good. The scars are hidden behind the ears and should not be visible, even with multiple procedures. Many of my repeat patients are in the 70s and 80s. I hope this helps.

Q: I had a facelift 18 years ago when I was 50. I believe I still look at least 10 years younger. Am I too old to do it again?

A: At 68, you are not at all too old for a second facelift. That you were able to maintain the benefits of the first facelift for almost 20 years suggests that your skin is healthy and will respond well to additional surgery. Ideally, the muscles underneath will be retightened so you can go another 10 years or more with good results. You may also need fat grafting at this time, if you have lost volume in your mid face. I hope this helps.

Q: How short can I cut hair after facelift?

A If you plan on changing your hairstyle and would consider shaving your head, your surgeon needs to design your incisions with this in mind.   In your situation, I would only have the incision on the back of your ears, and I would not place incisions that go back into your hairline.. I hope this helps.

Q: Should I get fillers or a facelift? I lost 30 pounds a couple of years ago and my skin is sagging. I workout a lot and building muscle has helped but not with my face.

A: Congratulations on your weight loss. Sagging skin can be an unfortunate side-effect after losing a significant amount of weight after a certain age. You can dramatically improve your angulation and definition with a facelift. I believe in 3D rejuvenation in the face as the face both deflates and sags overtime.  A facelift will lift sagging tissue.  Fillers can be used in conjuction with a facelift to replace lost volume.  This can be an expensive method.  I prefer to use patient’s own fat to add volume back to the face during a facelift.  This procedure is call facial fat grafting.  This can be a great and affordable option.  I hope this helps.

Q: Is it safe to get a facelift under local anesthesia?

A: A traditional rhytidectomy, or facelift, is cab be performed under general anesthesia or local anesthesia.  This is a complex surgery that comprises many steps, such as:

  • Removing excess fat from the chin
  • Performing a platysmaplasty, which removes neck bands and tightens the neck
  • Lifting the SMAS upward and outward
  • Removing excess skineplacing or moving the fat to restore volume in the midface

A full facelift will take several hours to perform, but will give you the most dramatic and long-lasting results, turning back the clock about 10 years. The rejuvenating effects should last another eight to 10 years. It depends on the patient’s personality and how long the procedure will take to decided what type of anesthesia is best.  Generally, a full facelift on a patient with a heavy neck will require general anesthesia because it takes a while to perform.  A patient needing less aggressive surgery with early aging process are better candidates for local anesthesia.  It’s very important to find a facial plastic surgeon with expertise in facial aesthetics and anatomy to get the best results. I hope this helps.

Q: How Many Facelifts Can You Have in a Lifetime?

 

A: Providing you have had well-performed facelifts and you are healthy, there is no limit to the number of revisions you can have. Plastic surgery is based on need and viability, not an arbitrary number. Even after a full rhytidectomy, in which the SMAS layer is lifted upward and outward, your face will continue to age and lose volume. Many people opt for a second facelift after 10 years to continue their rejuvenation. Fat grafting during a facelift helps to make the results look more natural. You can also opt for a mini lift or use facial fillers, such as Juvéderm Voluma, to maintain facial volume between lifts.  Generally, it would be unusual for a patient to require more than 3 facelifts over a lifetime.  I hope this helps.

Q: Advice for 43 Year Old Considering Facelift?

A: The most important decision in undergoing a facelift is choosing the best doctor.  There are a variety of techniques for facelifting.  It is known that all facelifts that lift the deeper facial muscles/SMAS have the best long term results.  Some believe that a deep plane will last longer but others disagree.  There is no proof that a deep plane last longer.  A deep plane has potentially a longer recovery and increased risk due to it more aggressive surgical nature and an increase proximity to vital structures such as the facial nerve.  

I hope this helps.  

Q: Is TMJ a Contraindication for SMAS Facelift?

A: A facelift lifts and tightens the underlying SMAS plus lifts, tightens and removes excess skin. It should not affect the functioning of the jaw or any other bones or joints. It should have no affect whatsoever on your TMJ. I hope this helps.

Q: Will a FaceLift at 50 last you into your 60’s?

A: A full rhytidectomy, or facelift, will take about 10 years off your face and should last about 10 years – regardless of your age at the time of the procedure. This does not mean that you do not continue to age during that decade; you do, but you will be aging from a turned-back set-point and so will continue to look younger than peers who have not had facelifts. You can further slow the clock and maintain the benefits of your facelift by adopting an anti-aging skin care regimen, including chemical peels. I hope this helps.

I’m 76 years old, Can I get a facelift?

A: I never consider chronological age as a deterrent to facial plastic surgery. Health is the #1 consideration; this becomes more important over the age of 65. I would need you to have medical clearance and would also evaluate you in my office to be sure you have no contraindications to surgery and are not using any medications that might interfere with a good outcome and/or healing.

Because you have severe wrinkling in addition to sagging, I would probably recommend chemical peels in addition to the face lift, and would get you onto an appropriate skin care regimen that you could use to maintain your results. A facelift should take approximately 10 years off your face. You will look rejuvenated, but not “done.” With proper skin care and a healthy life style, results should last about 10 years. You will continue to age during this time, but with the clock set back so far by your surgery, your satisfaction with your results should be quite long lasting. I hope this helps.

Q: Is a FaceLift right for me at 40?

A: Decades ago, people usually waited until their 60s or beyond before getting a facelift. It is now common to begin surgical rejuvenation at a much younger age. There really is no satisfying nonsurgical solution to sagging jawline, neck and jowls. Your skin shows significant laxity and you would benefit from a facelift, which can turn back the clock about five to ten years and last for up to a decade. Fat transfer for would replace lost volume and create a “wow” effect. I hope this helps.

Q: Can men have successful facelifts? Are they different from the standard facelift that women get? And how do they hide scars since men usually have less (and sometimes no!) hair?Thanks for your help.

A: Ensuring that the beardline and sideburns are placed naturally post-surgery are two of the extra challenges that must be met when performing a full rhytidectomy (facelift) on men. Skin and muscle are also heavier in men, which requires more force when lifting and stronger sutures for holding. It is very common for men to have facelift surgery. Please find someone with expertise in treating men. I hope this helps.

Q:When a facelift is performed, do surgeons just pull the skin or both the skin and muscles in the face?

A:For the most natural result, the SMAS (superficial muscular aponeurotic system) will be pulled and tightened in both an upward and outward direction. The SMAS is composed of deep-layer facia and muscle. The skin will be pulled in a similar direction and excess skin will be removed. These layers are then fastened with deep sutures to hold the lift in place. Fillers or fat grafting can be added to restore volume to the cheeks. I hope this helps.

Q:  I am Noticing My Jowls are Sagging Slightly. Is There A Procedure Recommended For This?

A: It’s unclear from your question whether you would like to keep your dimple or lose it. A mini facelift will not detach the skin from muscle at the point of the dimple. If you wish the dimple removed, you need to request that specifically from your facial plastic surgeon. You might also need a hyaluronic-acid based filler such as Juvéderm to even out the depression. I hope this helps.

Q: Any Advantages to Getting Fat Transfer During Facelift V.S. Injecting at Later Date?

A: Generally, I prefer to perform fat grafting at the same time as a facelift. One of the most obvious signs of aging is loss of volume in the face. Therefore, simply lifting and stretching the skin in a traditional rhytidectomy can make the face look too taut. Fat grafting fills in the lost volume. Combining a lift with fat grafting restores the look of youth to your face in the most natural manner possible. Performing both surgeries at once will ease your recovery as well. I hope this helps.

Q: Will mini face lift involving lateral platysmal tightening and SMAS remove dimple close to corner of my mouth when I smile?

A: It’s unclear from your question whether you would like to keep your dimple or lose it. A mini facelift will not detach the skin from muscle at the point of the dimple. If you wish the dimple removed, you need to request that specifically from your facial plastic surgeon. You might also need a hyaluronic-acid based filler such as Juvéderm to even out the depression. I hope this helps.

Q: What can I do to correct downward-turned mouth corners and the loose skin that has appeared under my chin? I am 39.

A: So far, I have not been impressed with any of the noninvasive methods of tightening loose neck skin and lifting the face. I am also not a fan of thread lifts, which give only temporary results. The best solution for sagging neck and chin skin is a lower facelift or neck lift. Surgery can also address a down-turned mouth. Once the skin and muscles have been tightened, you may look into other anti-aging regimens, such as lasers and peels, to keep your skin youthful and elastic, prolonging the dramatic lift you should get with surgery. Lower face lifts typically last at least 8 years. I hope this helps.

Q: Hi doctors, I had my cheekbone and jawline reduced and now experiencing soft tissue laxity. When I lift my skin up from my temple I achieve the desire heart shape look I want. Is a facelift able to achieve this look?

A: The initial consultation is one of the most important aspects of having a satisfying and successful facelift. The look you are creating by lifting your skin by the temples may or may not be possible, depending on your anatomy, skin quality, and desired results. Being evaluated in person by a facial plastic surgeon will give you better answers than your mirror can. I hope this helps.

Q: Can a high SMAS facelift, lift corners of upper lip/corner of mouth? Can it improve or reverse a bad midface lift?

A: Lifting the SMAS can improve the look of your lower face, including drooping mouth corners. Performed expertly, it can be used to revise an unsatisfactory mid-face lift. Be sure to work with a facial plastic surgeon who takes the time to evaluate your anatomy properly and find a solution that looks harmonious and natural. I hope this helps.

Q:How many years can one look younger with a facelift?What is real in your opinion? In my opinion most women or men just look a bit younger or refreshed. However, some Hollywood stars look 30 years younger than their real age. How is that possible? Is it the money they spent? Is it that their plastic surgeons are artists while others are just handymen? Do these women get secret proceeding that regular women don’t know about?

A: A well-done facelift will take off about 10 to 20 years from your face while still looking natural and appropriate. Celebrities who are able to age gracefully generally are blessed with good bone structure and skin, plus spend a great deal of time and money to maintain it. In addition to finding facial plastic surgeons with expertise in aesthetics, they use skin resurfacing techniques such as lasers, ultrasound and chemical peels, plus well-placed fillers and Botox. You can find plastic surgery professionals with the same level of expertise as those the stars use throughout all areas of the country. For instance, I studied with some of the top facial plastic surgeons in the world in Beverly Hills, but I practice in North Carolina. I hope this helps.

Q: How effective is a brow lift? What can I expect to achieve?

A: A brow lift is a very effective means of bringing back youth and vibrancy to your face and illuminating your eyes. I offer several different types of brow lifts, depending on your needs:

  1. One-centimeter-incision brow lift – minimally invasive lift for early aging. Gives a subtle and natural lift to the lateral brows (the part closest to the temples).
  2. Endoscopic brow lift – Using several incisions along the top of the forehead, the entire brow is lifted for a more dramatic rejuvenation. Your hairline may also be lifted slightly.
  1. Direct brow lift – This is usually done only in instances when the sagging brow limits vision. Tissues just above the brow are removed to lift it. Direct brow lift is most commonly performed in men.
  2. Coronal brow lift – I rarely recommend this highly invasive procedure except in cases of extreme sagging. The entire scalp-line is incised from ear to ear, tissue removed, and the brow lifted and tightened.
  3. Whichever procedure you choose, it should be done under the guidance of a facial plastic surgeon who understands the aesthetics and anatomy. I hope this helps.

Q: After a Facelift, could it take months to recuperate?

 

A: A full facelift, or Traditional Rhytidectomy, is a major surgical procedure that will heal gradually over the course of several months. The healing occurs in stages. During the first week, you will have a bandage on your face and must curtail most activities. After one week, your stitches are removed and you can add in activities that are not strenuous. You may wish to continue to wear a bandage at night to speed recovery. At the two-week mark you can usually return to your normal routine. However, your body is still healing and you should avoid activities such as saunas, steam baths, curling irons, blow dryers (cool setting is OK) and hot rollers. Each patient is different. It takes about four months to appreciate your final results.

 

Q: Is an SMAS facelift a good choice for me? How is recovery? I am 46 years old. I have a slight waddle on my neck line…no fat, just skin. I have slight jowling and nasal labial folds. I am mainly worried about going too far, looking unnatural, and having a difficult recovery if I go the more aggressive route.

 

A: Lifting and tightening the underlying SMAS always gives better and longer lasting results. An SMAS lift can also address early jowling and minor waddles. However, if you have significant sagging in your neck you may require a necklift as a separate procedure. As far as recovery, the goal at my center is to make any procedure as minimally invasive as possible, depending on the individual patient’s anatomy and needs. You may have bruising and swelling for up to two weeks after an SMAS lift. I hope this helps.

Q: I’m 65 years old and had a facelift seven years ago that I was delighted with. I’m beginning now to see the need for perhaps another minor procedure even though I do Botox. I wasn’t happy with my Juvéderm injection for the nose-to-mouth line so prefer not attempting that again. Any suggestions as to another facelift and the type or would this be an overkill on my part? Thanks!

A: As long as you are in good health and have good quality skin, you should be an excellent candidate for a second, or revision facelift. Most facelifts last about ten years so it is not unusual for you to start wanting to make changes at the seven-year mark. Botox and filler maybe an option to improve facial balance.  It all depends on your goals and expectations on which path is going to be best for you.  I hope this helps.

Q: How soon can a person return to normal activity after a traditional Facelift?

A:  A facelift is a major surgical procedure, so you must be prepared to give yourself adequate recovery time to achieve optimal results. You will wear a bandage for one week, which can be removed for showers and light errands. You need to avoid strenuous activity for 2 weeks, and avoid curling irons, steam baths, saunas, and hair dryers (unless on the “cool” setting) for 2 months.  Most people begin to look pretty good by 2 weeks but the results will continue to improve for the first 3-4 months as the swelling resolves.

Q: I am noticing that my face is dropping and one day will fall on the ground!!!! I am 48 and look much older that my counterparts. I have searching and searching for a solution but this is only increasing my confusion.

A: You are a great example that aging occurs in 3 dimensions.  Not only do you have sagging skin, but you have significant volume loss to the face.  I believe you would benefit from both a lift and fill fo the face.   Depeding on your concerns, you could have a neck or facelift to define the neck and jawline.  For the remainder of the face, you need volume.  This could be achieed during surgery with facial fat transfer or facial implants.  You could have volume added to the face with in office fillers.  It is a personal choice which approach to take.  You have many options so a consult with a few doctors would be helpful.  

 

Q: Do you have to completely shave of your beard and moustache before getting a facelift?

A: Each practitioner will have different recommendations about shaving and plastic surgery. I prefer a clean-shaven face before the procedure. However, you do not have to worry about your beard being in the “wrong place” after your facelift. The natural growth line of the beard and mustache are taken into consideration when planning where/how to lift. I hope this helps.

Q: Is the Area Under the Jaw Considered the Area for Lower Face Lift or for Neck Lift?

A: Thank you for your questions. Both lower facelifts and neck lifts have similar recovery times of about 10 days. The neck lift will not take care of the jowling that is evident in your photo. For that, you would need a lower facelift – which can tighten the neck, too – or a full facelift. The definitive answer can only come after an in-person consultation. I hope this helps.

Q: Facial Microcurrent: Do They Work Like a Facelift?

A:  There are no nonsurgical facelift methods that can give results as dramatic as a full rhytidectomy (face lift). Well-performed face lifts do not merely lift the skin; they are also used to tighten and lift the underlying musculature; the nonsurgical methods cannot do this. As for your other question, you do not have to wait after receiving Juvéderm or Voluma before undergoing a Microcurrent Facelift; the procedure will not affect the hyaluronic-acid based fillers. You can have both procedures done at the same time. I hope this helps.

Q: Does Lifting and Tightening the SMAS Cause Cheeks to Flatten?

A: During an SMAS lift, the muscle and skin are lifted. If the cheekbones are already flat, fat from the lower face can be brought upward to fill out the cheekbones. Or, fillers can be used later. A lift will not make cheeks look flatter if it’s performed well. Be sure to find a facial plastic surgeon who has extensive experience in facial anatomy and aesthetics. I hope this helps.

Q: Is 70 Too Old for a Facelift?

A: I would never rule out a patient for a facelift simply because of chronological age. Every person must be evaluated individually, taking into consideration their skin elasticity, overall health, and how realistic their expectations are. I hope this helps.

Q: After a year of healing from a mini facelift can you wear your hair pulled back without scars showing?

A: For the first 1-2 weeks after your Mini Lift, you will probably want to wear your hair down to hide the scars, which will run in front of and behind your ears in the crease. As the scar heals, it will probably fade to a barely noticeable white color. My patients are usually comfortable with any hairstyle within 3-4 weeks after a Mini Lift. I hope this helps.

Q: Why Do Some Doctors Say to Expect Feeling Depressed After a Full Face and Brow Lift? I had a face lift in the past, and felt for the most part, just fine. I had absolutely no depression or mood changes. However, some docs are not telling me it is normal to expect a depression after such surgery. Could you please explain why this might be.and how long it can last.

A: It is not surprising that some patients feel depressed after major surgery such as a facelift. Some factors that may affect mood are:

  1. Lack of energy owing to the healing process

  2. Curtailment of normal activities during “downtime”

  3. Distress over how the face looks while it is still healing

  4. Reaction to anesthesia

  5. Changes in sleep and appetite in the postsurgical period.

A facelift represents a major life change and, like all life changes, it takes some adjustment. I always try to prepare my patients for the possibility of feeling not quite like themselves in the first two to three postoperative weeks. Knowing ahead of time that depression may become an issue allows them to prepare emotionally, just as they prepare themselves physically, for surgery. I’m glad that wasn’t your experience.

Q: Can a brow lift raise the medial brow?

A brow lift is a good permanent solution to resolving your “angry” look. By lifting the muscles that are dragging down your brows, that should alleviate some of the tension you feel as well. Depending on your anatomy, you may need some Botox, too, to break the muscle’s habit of contracting. I hope this helps.

Q: How soon is too soon to have another neck and lower face lift? I had a neck lift and lower face lift about 8 years ago. Is it too soon to have another? I feel like I need refreshing again. Is it even advisable to do another one?

A: While many patients can go up to 10 years between face lifts, if you are seeing sufficient sagging to bother you after 8 years, it is not too soon to address that. As long as a year has passed since your first lower facelift and neck lift, there is no medical reason to wait.

Q: Best FaceLift procedure for thin saggy face?

A: The lax, sagging skin that is evident in your photos is best treated by a traditional face lift. A facelift will also tighten your neck skin and give definition to your jawline. Fat grafting can help fill out your cheeks, which have lost volume with age. As long as you are healthy and follow your surgeon’s post operative guidelines, you should be back to most of your normal activities approximately 2 weeks after receiving either a facelift or rhinoplasty. Both will take approximately year to fully appreciate the final results. Good luck.

Q: Is It Safe to Have Another Facelift Seven Years After?

A:  As long as you are in good health and have good quality skin, you should be an excellent candidate for a second, or revision facelift. Most facelifts last about ten years so it is not unusual for you to start wanting to make changes at the seven-year mark. Botox and filler maybe an option to improve facial balance.  It all depends on your goals and expectations on which path is going to be best for you.  I hope this helps.

Q: How long do Neck Lifts last for? Face lifts? 

A: It is not unusual to find noticeable sagging in the neck five years after a neck lift. Each patient responds differently. Longevity also depends on how vigilant they are about subsequent sun avoidance and protection. The sagging, therefore, may or may not be related to Ehlers Danos, and could be a manifestation of continued aging.

Q: Face lift – short term gratification or long term result?

A: Whether you have a facelift or not, your skin and muscles will continue to age. However, after a lift, you have turned back the clock from 5 to 10 years or more. So, as you age, you will still continue to look younger than you would if you had not had the procedure. Many patients will have a second or third lift at 10-year intervals. Others opt for liquid facelifts or mini lifts. I hope this helps.

Q: How to Prevent Wrinkles on Forehead and Between Eyebrow? I’m a 25 year old female and I want to get Botox as a preventive treatment for wrinkles on my forehead and in between my eyebrows. On average how many units would that be for someone my age with few wrinkles?

A: It is becoming more and more common for younger patients to think ahead about their aging process and to treat key symptoms prophylactically. Particularly if you notice a genetic trait in your family, such as a propensity for forehead wrinkles or “11” lines, preventive Botox is a good choice. How much of the neuromodulator is necessary varies by patient and skin condition. On the low end it would take about 15 units of Botox to treat this area.  I hope this helps.

Q: How Long Will a SMAS Facelift Last? After a SMAS Facelift is performed, what prevents the sutures from slicing thru the tissues and the face dropping back down and what causes little fat pouches beside the side of the mouth after Facelift?

A: As in any surgery, the sutures used to close the wound in an SMAS facelift either dissolve or are removed within a week to 10 days. Therefore, the face is not “hanging” off of thin threads. Rather, the sutures act to seal the tissues together as they heal, allowing them to form scar tissue that can then support the new position of the face for up to 10 years even as the patient continues to age. As for the fat pouches beside the mouth, these will not occur in a facelift that has been performed by a board-certified facial plastic surgeon with deep knowledge of anatomy and facial aesthetics. Lifting the face is not sufficient; all of the elements of the patient’s facial structure must be in symmetry and harmony and look perfectly natural. That is the mark of a successful SMAS facelift. I hope this helps.

Q: Why do celebrity Facelifts look so bad?

A: Although we might assume that all celebrities are wealthy and can hire the best facial plastic surgeons when they are seeking solutions to aging, that is not always the case. First, not all celebrities are wealthy. Second, even wealthy people sometime shops for “bargains.” However, when it comes to facial plastic surgery, price should never be the primary or even secondary consideration. The cost of a bad facelift is higher than just the embarrassment of having that “wind-swept” look you refer to. Patients who are unhappy with their initial surgery often need to purchase revision surgery, which of course obliterates the “savings” from the prior procedure and still may not result in a natural look.

I believe many celebrities look poor secondary to having to many aggressive surgeries.  Many Times, they will have 2-4 facelifts.

Whether you are a celebrity or a layperson, take the time and energy to interview several board-certified facial plastic surgeons who have training in facial aesthetics and choose the one you believe will give you the best results. The time you expend on finding the right person to perform this complicated and potentially life-changing procedure is the greatest “bargain” you can find.

Q: How soon can a person return to normal activity after a traditional Facelift?

A: A facelift is a major surgical procedure, so you must be prepared to give yourself adequate recovery time to achieve optimal results. You will wear a bandage for one week, which can be removed for showers and light errands. You need to avoid strenuous activity for 2 weeks, and avoid curling irons, steam baths, saunas, and hair dryers (unless on the “cool” setting) for 2 months.  Most people begin to look pretty good by 2 weeks but the results will continue to improve for the first 3-4 months as the swelling resolves.

Q: Will lift up a face or will lift toward both sides during a Facelift? I would like ask that during a facelift , toward which side lifts the face? Toward up or toward both sides? Or that is depend from type of surgery or from surgeon? Also will lift up surgeon the end of eyebrow during a facelift? Or that is different surgery? Thanks.

A: A facelift addresses sagging in the neck, lower face and cheek area. Lifting the browline is a separate surgery, although it can be accomplished at the same time.

During a facelift, a small incision is made underneath the chin, where it will not be seen. Excess fat and skin are then removed from the chin and neck area. The neck muscle, or platysma, is also tightened. Further incisions are made at the temple and hairline, then continued around the ear so they will be hidden by the ear or a natural crease. Next, the superficial muscular aponeurotic system (SMAS), which comprises deep-layer fascia and muscle, is identified and lifted in two directions: upward in the cheek region and outward in the neck region. These opposing forces help to create a natural look. The excess skin is then removed and the incisions are closed with sutures. An individual consult will help you decide which procedures will work best for you.

Q: I am 65, slim, with a long face, It has been suggested to me that fat grafts would not be very successful in my case as I do not have (quality or quantity) of good fat supplies. I have been contemplating a face lift for many years and fat grafting to deep folds and lack of volume has been suggested but this comment about the success of this procedure is confusing. Healing time for nose surgery at my age.

A: The lax, sagging skin that is evident in your photos is best treated by a traditional face lift. A facelift will also tighten your neck skin and give definition to your jawline. Fat grafting can help fill out your cheeks, which have lost volume with age. As long as you are healthy and follow your surgeon’s post operative guidelines, you should be back to most of your normal activities approximately 2 weeks after receiving either a facelift or rhinoplasty. Both will take approximately year to fully appreciate the final results. Good luck.

Q: Would like opinions on whether lower facelift would be my best best for jowls and neck?

 

A: If you are only showing the early signs of aging, such as slight jowling and neck sagging, then a lower face lift, or “mini lift” would be ideal for you. During the procedure, we will remove excess loose skin, tightening up the jawline and blunting the neckline.

 

 Q: Should I Lose Weight Before SMAS Facelift and Neck Lift? Should I lose weight before SMAS Facelift and Submentoplasty Neck lift?  I am having a Face lift & Neck lift & Brow Lift is being covered by Insurance. Should I lose weight before having anything done? If I don’t lose weight now and lose weight later will my new face be all saggy?

A: Generally, patients should be at a stable weight before an SMAS Facelift. Losing weight after the surgery will reduce the volume of the face and may lead to some sagging. However, it is not uncommon for patients to lose a bit of weight after a facelift, as they are motivated to continue their journey toward their optimal physical self. If you desire to lose a great deal of weight, doing so in a healthy manner take a year or more. In that case, you may not wish to delay your facelift, especially if you think the boost you’ll get from the procedure could act as a further motivator toward a healthier weight.

Q: Facelift and chin implant or augmentation in one surgery? Do Board Certified plastic surgeons perform a facelift and a chin implant or augmentation in one surgery? Is this too much facial surgery in one day for the patient and doctor?

A: It is common for a facelift and a chin augmentation to be performed at the same time. Depending on your anatomy, an implant can help define your jawline, angulate the neck, and enhance the effects of a facelift.

Other procedures can add to the “wow” factor of a successful facelift, such as:

  1. Fat transfer to the cheeks to make them look more youthful and defined
  2. Liposuction to neck or jowls to remove excess fat
  3. Cheek implants to create higher cheekbones.

If you have a lot of wrinkling, you might also consider laser resurfacing or medical-grade chemical peels before surgery to improve the skin’s quality and elasticity. I hope this helps.

Q: Are Revision Facelift and Neck Lift Surgeries Common? I had a face and neck lift 5 months ago. There is still laxity in the neck area which is concerning and disappointing. Is it true that sometimes a surgeon can only take up so much laxity the first time and that revisions are sometimes needed to achieve the desired results? What is the suggested time to wait? Thank you.

A: I am sorry that you are not feeling satisfied with the results of your facelift. Ideally, your surgeon should have alerted you that the neck can be a difficult area to treat as the skin in that area is thin and tends to lose elasticity. However, your surgery was relatively recent and you may not be seeing the full results yet. I would suggest waiting for one year to allow your skin to heal and regenerate.

If you are still dissatisfied with your appearance at that time, you might consider nonsurgical procedures to tone and lift the skin, or consult for a necklift or revision surgery. I hope this helps.

 

Q: Should I go for a threadlift or a facelift? I have a very droopy face it is more pronounced on the left side of my face than the right. In general I look tired always, can you please suggest a procedure that I can look into.

A: While a threadlift may seem like an easier option, as excess skin is merely lifted and sutured into place to give a slight lift to the skin, threadlifts do not last long and I believe you would be disappointed with the results. Although I would need to see you in person to evaluate your facial structure and skin tone, from the photos you provided it does seem that you could benefit greatly from a facelift, as it would help define your jawline and give you a more youthful appearance.

A mini lift would be a good choice for you if your primary concerns are the neck and lower face. The surgery is much less invasive and requires less anesthesia. Recovery time is significantly faster than it would be with a full face lift. An eye lift would be a separate procedure. You could have it done at the same time, or schedule it later. Consulting with a board-certified facial plastic surgeon will allow you to explore all of your options and also to ask as many questions you need to alleviate your fears.

Q: Facelift pointy chin. How do surgeons avoid this?

How do so many women end up with the ‘Witche’s’ chin look after facelifts? I have seen some outstanding natural results but also some where the person looks really bizarre afterwards in chin area – extremely pointy crafted and unnatural 45degree vertical slant angle between neck and chin. How do surgeons do this is it an aggressive necklift that causes it? I really don’t want to have this when I get my op – how do surgeons avoid this?

A: Although having plastic surgery to the face does not create the phenomenon known as “witch’s chin,” by not taking time to understand each patient’s unique bone structure and musculature, some surgeons mistakenly accentuate disharmonies that are already present in the face. My training in facial aesthetics by some of the top plastic surgeons in the country means that I examine each patient’s face thoroughly and develop a plan that works with their unique features and natural beauty. When it comes to facial plastic surgery, there is no “cookie-cutter” method. Decisions about where to lift and how much tension should be applied to each portion of the skin and muscle must come from thoroughly understanding that particular patient’s anatomy.

A witches chin can occur if the chin region is not properly undermined and a step off forms in the area. 

I hope this helps.

Q:Facelift or mini lift; which is better?

Answer: While many women are drawn to the “mini” lift because it is easier to perform, requires only a local anesthetic, and has a faster recovery time, these procedures are best for people who still have some elasticity to their skin and have only begun to experience early age-related sagging. Mini lifts can lift the jowls and neck and give a refreshing, rejuvenated look to the face that can help you look up to 5 years younger.

Older patients and those with significant sagging would benefit more from a traditional facelift, where excess fat in the neck is removed, the underlying muscles are tightened and the cheeks are elevated. This procedure brings definition to your face and gives it a lifted, more vital and youthful look. You can look up to 10 to 15 years younger with a facelift, particularly if it is done in conjunction with other rejuvenating techniques, such fat transfer to the cheeks, laser resurfacing of the skin to remove fine wrinkles, and liposuction of neck and jowls. Taken together, these therapies will produce a real “wow” effect as they restore beauty and radiance.The results from a well-performed facelift and adjunctive therapies can last for up to 10 years or more, even as the face continues to age naturally. A consultation will help clarify and aid you in making an education decision.

Q: Can a mini facial be done under local anesthesia?

A: In my practice, I almost always perform a mini lift for early signs of aging under local anesthesia. This means that you will be awake during the procedure. I give my patients oral anesthesia plus numb the area to be treated. In addition to lifting and removing excess skin during the mini, I also lift and tighten the underlying SMAS, which ensures the longevity of the lift. Recovery is quick, with most patients returning to their normal lifestyle at 2 weeks. It’s an excellent procedure for:

  • Excess loose neck skin
  • Early jowls
  • Blunting of the neckline

I hope this helps.

Q: How Effective is a Brow Lift?

A: A well performed brow lift can rejuvenate your face, making you look more awake, alert and rested. The lift should be subtle and natural so that you don’t end up with the “surprised” look we sometimes see in celebrities. A brow lift can help lift sagging eyelid skin, reducing the need for blepharoplasty. I hope this helps.

Q: If I have a SMAS facelift, would a surgeon cut behind my ears or in front??

A: If you are deciding on a SMAS lift or a full facelift, the scars will be hidden behind or around the ears and along the scalp line so that they will not be noticeable. Incisions should be made based on your anatomy and goal results.  If you are looking for more tightening in the neck, then you may only require incisions behind your ear.  If you are looking to lift the jowls or cheek region, then you will need an incision in front of the ear.  This incision can be well hidden.  All facelifts in my opinion are SMAS lifts.  The SMAS is the deeper muscular layer that is tightened on all facelifts and neck lifts.  

Q: I’m 75 and I want to look younger. Would I be better off with fillers to add volume to my cheeks and fill nasolabial folds or a lower facelift with possible fat transfer?

A: An in-person consultation is necessary to examine you more closely and come up with a custom treatment plan. That being said, from your photo, it appears as though you would likely benefit from a combination of facelift surgery and fillers. A facelift can tighten and lift sagging skin, while fillers will add volume back to the cheeks and help to reduce marionette lines and nasolabial folds. I hope this helps.

Q: I had an SMAS lower facelift and neck lift 4 months ago, and while I’m happy that my jowls are gone I still have wrinkles around my mouth and upper lip and on my forehead. What can I do to get rid of these?

A: I’m glad to hear you had a good result with your face and neck lift. As for wrinkles around the mouth, a facelift will not correct those; you will need either laser resurfacing, dermal fillers, Botox, or a combination in order to correct perioral wrinkles. Forehead wrinkles are best treated with Botox. Please see a board-certified facial plastic surgeon to come up with a custom treatment plan. I hope this helps.

Q: What is the cheapest facelift surgery in North Carolina? Do any places have payment plans?

A: When it comes to facelift surgery, it is not a good idea to simply look for the cheapest option. You only get one face, and if you visit a surgeon based only on price the chances are very high that you will be disappointed and need to have revision surgery, which often costs more than the original facelift surgery. Good surgeons are priced the way they are because of their experience and proven results. That being said, some surgeons do offer payment plans to help you afford a better quality surgery. I personally do offer payment plans through Care Credit, and would be happy to see you for a consultation. My practice, Carolina Facial Plastics, is located in Charlotte, NC. Please follow the link below to visit my website.

Q: I had a facelift, upper eyelid surgery, and lip injections a few days ago. I’m very swollen, when will I start to look normal?

A: The first 48 hours after surgery is when the worst of the swelling happens. After one week, the swelling will have begun to subside, and by two weeks you should be looking and feeling much better. Healing will continue and you will see progressive improvement after this time. Be patient, and continue following up with your surgeon. I hope this helps.

Q: Can an 86 year old woman have facial surgery to decrease wrinkles?

A: As long as you are healthy, age is not a deterrent from facial surgery. There are also non-surgical options that work very well to reduce wrinkles, including laser resurfacing and chemical peels. Please see a board-certified facial plastic surgeon for a consultation to see what treatment options would be best for you.

Q: Are so-called “lunchtime” mini-lift procedures effective? How much facial rejuvenation can I expect from one?

A: A true mini facelift, at least as performed at my practice, is a surgical procedure requiring downtime. The results are long-lasting and better than what you can get with non-surgical “lunchtime” procedures, however, you will not be able to go straight back to work. If you are looking for minor facial rejuvenation, non-surgical procedures such as Botox, fillers, and laser resurfacing can provide some benefit. However, if you have significant sagging of the skin, a surgical procedure will always give you better and longer-lasting results. I suggest visiting a board-certified facial plastic surgeon for a consultation where you can discuss your goals and concerns and come up with a custom treatment plan. I hope this helps.

Q: Do mini facelifts cost less?

A: While mini facelifts generally do cost less than full facelifts, price should never be the determining factor in choosing a surgical facelift procedure. A mini lift, as performed at my practice, is a good option for patients who are just beginning to see signs of skin laxity and jowls; however, it will not be a good option for someone with heavy jowls and significant laxity. Please see a board-certified facial plastic surgeon for a consultation, where you can discuss your specific concerns and goals. This will help determine if a mini lift is appropriate for you. I hope this helps.

Q: Five weeks post facelift, my left side is noticeably more swollen than my right side and very asymmetrical. Is this normal?

A: Asymmetric swelling is completely normal following facelift surgery and can last for a while. Five weeks is still early to tell what your final result will be. Be patient and if after several months you are still unhappy with your result, visit your surgeon again to find out what happened and the best course of action, if necessary. Keep in mind that everyone has some degree of asymmetry to their face, which they might not notice until a facelift brings it to light. I hope this helps.

 

Q: I had a facelift two days ago and my cheeks look really flat, is this normal?

A: Two days post facelift surgery is not a long enough time to have a good idea of what your final results will look like. Keep in mind, swelling is at its peak the first few weeks following a facelift, so the best thing to do is be patient. If you are concerned, you should visit your surgeon for a follow up appointment so that they can examine and reassure you. I hope this helps.

Q: I’m in my early 30s but I already have jowls that are destroying my face shape. Should I consider a lower facelift? I tried a thread lift but didn’t see improvement.

A: It is difficult to say based on your photos alone, but it does appear that you may be a candidate for a mini lift even at your young age. The main indication for a facelift is not age, but rather skin quality, and it appears as though you are beginning to see skin laxity leading to jowling. A mini lift as performed at my practice is a less aggressive, minimally invasive version of a lower facelift that is perfect for people who are just beginning to see the appearance of jowls and loose skin. See a board-certified facial plastic surgeon for an in-person consultation to find the best treatment option for your concerns. I hope this helps.

Q:Will a deep tissue lift or SMAS resection plication affect skin color or tone, and is there skin bunching around the incision site?

A: It is possible to have skin color or skin tone changes after a facelift.  This is would be very rare. Normally, a properly performed SMAS lift will give the appearance of better skin tone due to the tightening of the skin and underlying muscle layer, but skin tone itself is not affected. Skin tone can be improved through other means such as laser resurfacing, a good skin care regimen, proper use of sunscreen, and a good diet. As for bunching around the incision site, this should not happen if the skin was draped properly. I hope this helps.

Q: If I lose 30-40 lbs after a facelift, will my face be saggy again? I’ve been postponing my facelift because I want to lose the weight first but I’m not getting the weight loss results I want.

A: If you think you can seriously lose 30 to 40 lbs, you should lose that weight before having your facelift. Significant weight loss will affect the skin on the face and most likely cause laxity, thus distorting your facelift results. If you can lose 15 to 20 lbs before your facelift, that would not cause as much laxity if you were then to lose another 15 lbs or so after the facelift. My advice is to get as close to your goal weight as possible before having your facelift done in order to achieve the best, longest-lasting results. I hope this helps.

Q: Can I do a facelift in my early 30s? I have heavy, sagging lower cheeks and jowls. I tried a thread lift without much improvement.

A: While the 30s is often considered young for a facelift, age is not the deciding factor when looking at a facelift; instead, we look at skin quality and amount of sagging. From your photos, it appears as though you may be a good candidate for a mini lift, which at my practice involves a less aggressive lower facelift that sculpts the jawline and corrects early signs of jowls and laxity. Mini lifts can be performed on younger patients with great results. I hope this helps.

Q: I’m 20 years old but I have droopy cheeks and pronounced nasolabial folds. Would a midface lift help?

A: It is highly unlikely that a 20 year old would have enough sagging to warrant a facelift of any kind. If you are unhappy with your cheeks and nasolabial folds, filler injections can be used quite effectively to enhance the cheekbones and smooth the nasolabial folds. Without seeing you in person and without any photos it is difficult to say for sure what procedure would be best, however. I suggest visiting a board-certified facial plastic surgeon for an evaluation, and to try non-surgical methods such as fillers before resorting to surgical procedures at your age. I hope this helps.

Q: What’s the best solution for lax skin following a SMAS lift? Overall I’m very pleased with the results of my lift, but over the past month I’ve noticed my “wattle” returning.

A: It’s not unusual to see a small amount of loose skin return after a facelift, as unfortunately a surgical facelift cannot address actual skin quality. If the amount of lax skin that has returned is small enough, you may benefit from a non-surgical skin tightening option such as the Titan laser. Otherwise, a minor revision necklift may be done at least a year following your previous facelift. I would suggest discussing your concerns with your plastic surgeon to come up with the best plan. I hope this helps.

Q: I’m 10 days post face and neck lift with continued swelling and signs of an infection at the incision site; I’ve called my surgeon but can’t speak with him directly, only his staff. I’m taking antibiotics but have fever and chills.

A: Infections are rare but they can happen after any surgery. Fever and chills are definitely a sign that you need to see a doctor. Call your surgeon again, explain in detail everything that you are experiencing, and make an appointment to see him as soon as possible. Any decent and ethical plastic surgeon will follow up with and provide aftercare to his or her patient, especially if they are showing signs of infection. If your surgeon refuses to see you, which he should not, make an appointment with your primary doctor or visit an ER or urgent care facility. I hope this helps.

Q: Does a mini lift tighten the muscle or just the skin? How does the price compare to a full facelift?

A: It will depend on the surgeon if the underlying SMAS layer is tightened as well as the skin. Personally, I do tighten the SMAS layer as well as the skin when performing a mini facelift, as I find that it provides longer lasting and better results. A mini lift will generally be less expensive than a full facelift, but you should never decide on a surgery based on price. Surgical procedures should be done in accordance with what is necessary to achieve the patient’s goals. If you will benefit from a mini lift alone, go ahead and do it, but if your skin is sagging enough to warrant a full facelift, I would strongly consider having the full facelift instead of the mini. I hope this helps.

Q: My right ear is still numb 6 weeks after facelift surgery. Should I be concerned?

A: It is common to experience some numbness following a facelift, which can last anywhere from a few weeks up to a year. Six weeks is still early in the recovery process, and most likely, you have nothing to worry about. It is possible that sensation will not return, although this is very rare. Be patient, and eventually you should start to notice sensation coming back. I hope this helps.

Q: I’m 24 years old with a sagging face due to hypothyroidism. What procedures could I do to help with my facial sagging? Facelift, or something else?

A: While skin quality, not age, should be the primary concern when it comes to having a facelift, 24 is actually quite young for such an invasive procedure. An in-person consultation is necessary to fully evaluate your condition and see if you have enough sagging to warrant a facelift, but most likely, you would benefit more from a combination of facial fillers to restore volume in a non-invasive manner. I hope this helps.

Q: I’m 7 days post-op face and neck lift with fat graft to cheeks and lips. All is going as expected except that now I can’t chew without excruciating pain on both sides of my jaw. Is this normal, and when can I expect it to go away?

A: While pain is subjective, severe pain following a facelift is usual. The most common symptoms are discomfort, a sensation of tightness, numbness, swelling, and some soreness. It is possible that you could be having issues with your TMJ or jaw joint from the tube down your throat. I recommend visiting your surgeon for a follow-up visit to see what’s going on. I hope this helps.

Q: Is it too soon for a facelift? I’m 29 years old with children and a high stress job that is contributing to aging in my face. My eyes look tired and my mouth pulls downward. What are my options?

A: Rather than age, skin quality is what I look for when evaluating someone for facelift candidacy. If you have enough sagging skin in the lower face and neck to warrant a facelift, then it may be a solution for you. Otherwise, there are a variety of non-invasive options that can help to restore vitality and youthfulness to the face, including laser resurfacing and facial fillers. I recommend visiting a board-certified facial plastic surgeon for an in-person consultation to come up with an effective treatment plan for you. I hope this helps.

Q: If I get a facelift and then lose weight later on, would that affect my results?

A: If you lose a large amount of weight over a short amount of time, this could affect your facelift results, as it is possible that your skin will become loose due to the weight loss. However, if you lose a moderate amount of weight over a longer period of time, chances are good that your facelift results would not be affected, especially if you have fairly good quality skin. Ultimately, if you are planning to lose a large amount of weight, greater than 20 pounts, I would recommend losing the weight before having your surgery. Visit a board-certified facial plastic surgeon for an in-person consultation to discuss your weight loss plans and facelift goals and formulate a timeline. I hope this helps.

Q: Is there any way a facelift can affect hearing, since the sutures are so close to the ear?

A: Facelifts themselves do not affect hearing. However, there are potential side effects to a facelift that may cause a temporary sensation of decreased hearing. These include blood in the ear canal, which can be removed by your doctor after examination, and swelling near the ear canal, which is temporary. If you feel your hearing has decreased after a facelift, you can visit your surgeon for a follow-up visit to ascertain the reason for it and see if anything can be done. The sutures themselves do not affect hearing in any way.

Q: Do I need a facelift, or will Juvéderm work? I want to lift my chin and the lines around my mouth, but I’m afraid of surgery – I had a tumor removed and it left behind keloids. What are my best options?

A: While Juvéderm can be used effectively to treat some lines around the mouth, it won’t do much for sagging skin on the neck and chin. If you want a comprehensive facial rejuvenation, a facelift or mini lift is probably a better choice. In the hands of a skilled, experienced, board-certified facial plastic surgeon, the risk of bad scarring is very minimal. An in-person consultation with a facial plastic surgeon to assess your skin condition and come up with the best plan to meet your goals is the best thing to do.

Q: My doctor wants to use filler while doing my facelift. Is this normal procedure?

A: Fillers can actually quite often help to provide a more comprehensive effect on the face. Facelift surgery addresses skin laxity, but not volume. If you are suffering from both sagging skin and volume loss, facelift surgery plus dermal fillers could be an ideal combination. At my practice, I often perform secondary procedures along with a facelift for the best results, including fat transfer, liposuction, and cheek or chin implants. I prefer to use your own fat to add volume during a facelift. Your own fat will work well and will last longer than dermal fillers.

Q: I’m almost 34 and I look much older than I am. I’ve already done temporary procedures such as Botox and fillers multiple times. A doctor suggested a facelift, is this a good idea?

A: From your photos, it appears that your main concerns are skin texture and volume loss rather than significant skin sagging, which is the main indication for a facelift. An in-person consultation with a board-certified facial plastic surgeon is necessary to evaluate your condition and come up with an appropriate treatment plan. However, just from looking at your photos, I would recommend laser resurfacing or chemical peels combined with fillers or fat grafting to address your textural issues rather than a surgical facelift. I hope this helps.

Q: I had a facelift about 6 years ago with very natural results, but now I have a “puckering effect around my mouth. I’m using a cream I got from a dermatologist, but it’s not having much effect on my fine lines. Is it time for another facelift?

A: An in-person consultation with a board-certified facial plastic surgeon is necessary to evaluate your concerns and come up with a custom treatment plan, but from what you’re describing and without any photos, it sounds as though you would probably benefit from skin resurfacing rather than a second facelift. Skin resurfacing procedures such as laser resurfacing, chemical peels, and MicroNeedling can have a great effect on fine lines and wrinkles around the mouth. Dermal fillers may also be an option.

Q: I’m a 54 year old male in need of a facelift, but I’m worried that the scars will be too obvious. What’s a realistic expectation as far as scarring after a facelift?

A: The amount of scarring left behind after a facelift depends on the technique of the surgeon. A double board certified facial plastic surgeon with experience and skill is able to perform a facelift in such a way as to result in almost invisible scarring. At my practice, my facelifts involve lifting of deep tissue, which is then secured with sutures. The skin comes along with the deep tissue, excess skin is removed and the remaining skin is secured without any tension, which results in an easier healing process and almost invisible scar. In addition to this technique, I place incisions in less visible or noticeable areas, and a scar cream can be used to help healing as well. I understand how important it is especially for men with short hair to have scarring that is not obvious, and one of my goals is to help you achieve the most natural looking results with the most minimal scarring possible.
Incision location is different on a male than a female. For a male, the incision will be hidden in a crease in front of the ear to prevent moving the location of the beard.

 

Q: Which type of facelift is best for a 56 year old woman with a very saggy neck? I’ve narrowed my search down to two surgeons, one who uses a traditional SMAS lift (45 degree) and one who wants to perform a deep plane lift (60 degree).

A: The specific technique used for a facelift is generally not as important as the skill of the surgeon performing it. Each individual is different and will benefit from a different type of treatment, and the key is finding a surgeon who understands this and will tailor an approach based on your specific concerns and goals. Different surgeons may prefer different facelift approaches, but ultimately the results are what matter.

I would look for a double board certified facial plastic surgeon, as these types of surgeons devote their entire career to facial procedures, and thus tend to have the most experience and are able to obtain the best results. You can look at before and after photos, read testimonials, and of course see the surgeon in person for a consultation in order to help make your decision.

Q: Is a facelift too premature for a 45 year old woman? I have undereye bags and nasolabial folds that bother me, and the doctors that I’ve talked to have recommended different approaches, including a full facelift, but I don’t think my face is that bad yet and I’m wondering if it would be better to just have the facelift now or do separate procedures that just address my problem areas.

A: Age should not be the primary factor when deciding whether or not to have a facelift. Some people have amazing skin and don’t need a surgical facelift even at 60, whereas others may feel like they would benefit from one at 40. The question is whether or not you feel comfortable having a full facelift. It sounds as though you don’t think you are yet at the stage where a full facelift would benefit you, so it may be better for you to have smaller procedures done first that just address your eyes and nasolabial folds. Ultimately, the choice of whether or not to have a facelift is yours alone.

Q: I’m 21 years old and recently lost a lot of weight, and now I’m noticing that my skin is sagging. Do I need a facelift, or are there other means I could use to address this issue?

A: I would generally not recommend a surgical facelift at age 21. While skin laxity can become a problem following large weight loss, in someone so young with good skin quality, there is a good chance that your skin will tighten on its own given time. In the meantime, you could try facial fillers or non-surgical tightening procedure. Visit a double board certified facial plastic surgeon who can evaluate you in person and recommend the best course of action. Good luck!

Q: I’m considering a facelift, but the thing holding me back is the scarring. I have friends who have had facelifts done and they have terrible, prominent “bunching” and white scars behind the ears. It seems like my choice is between sagging or never wearing my hair up again?

A: The most important thing when it comes to scarring after a facelift is surgeon technique. An experienced, double board certified facial plastic surgeon who performs thousands of facelifts will generally have the knowledge, technique, and skill necessary so that the patient ends up with nearly invisible, unnoticeable scars. After care is very important too, making sure to apply any topical treatments your surgeon gives you and staying out of the sun. I recommend researching facial plastic surgeons and looking carefully at their before and after photos to see if you can notice the scarring, read patient testimonials, and of course go in for an in-person consultation before deciding on a surgeon. You should not have to choose between sagging skin or terrible scarring!

Q: After my facelift, the doctor took out some sutures, but then later I found more that had to be removed by a nurse. I had to visit 3 times to have sutures removed by a nurse. Should I be worried?

A: During a facelift, dissolvable sutures are often used under the skin. These sutures are meant to dissolve over time, but different people absorb them at different rates and it is possible that the stitches will begin to be expelled by the body and end up poking through the skin. While this may be annoying, it should not be a problem unless the stitches begin to cause irritation.

Q: I had a facelift procedure three and a half weeks ago, and I’m still experiencing numbness all over as well as lumpiness, especially around my mouth where a cyst was removed. Is this normal?

A: Numbness and swelling are both common side effects following a surgical facelift. That lumpiness you feel is most likely swelling, and is perfectly normal following a facelift. While the majority of swelling should dissipate fairly quickly, minor swelling can persist for months. Numbness as well can last for up to a year in some cases, depending on the individual. If you are concerned about your healing process, I recommend visiting your surgeon for a follow-up visit to make sure everything is progressing well.

Q: What are the potential side effects following a facelift?

A: The most common side effects following a facelift are swelling and numbness. There may also be some bleeding, itchiness, bruising, tightness, a feeling of heaviness in the face, asymmetry (due to uneven swelling), and lumps or bumps. The majority of these side effects should resolve within the first two months following your surgery; however, swelling and numbness may last longer. The key to minimizing side effects is to find a skilled, qualified, board-certified facial plastic surgeon. A facial plastic surgeon devotes their entire career to surgeries of the head and neck, and generally has more knowledge of facial anatomy, skill, and experience in performing facelifts than a general plastic surgeon. Do your research and find the best surgeon, and your facelift experience should be a good one.

Q: How long after facelift surgery should bruising be expected to appear and spread? I had a facelift done and now I’ve got bruising all the way down my chest as well as inside my lower lip and on my chin. Is this acceptable?

A: Bruising is a common side effect following facelift surgery, and it can “fall” downward onto the neck and chest before resolving. Most bruising should disappear after around two weeks, and should be able to be covered with makeup after one week. If your bruising is accompanied by significant swelling, I would advise visiting your surgeon for a follow-up visit to make sure you don’t have a hematoma.

Q: I still have significant swelling two weeks after my facelift, when can I expect this to go down?

A: The majority of swelling in most of my patients resolves after 14 to 28 days, although it can take up to six months for swelling to resolve 100 percent. In the meantime, there are steps you can take to help minimize swelling, such as sleeping with your head elevated and sitting upright as much as possible. Good luck!

Q: How long should swelling and numbness last after a facelift? I’m 6 weeks post-op and still swollen and numb. Is this normal? How long will it last for?

A: Each person heals differently after a surgical procedure such as a facelift. Healing time depends on a number of factors, including the skill of the facial plastic surgeon and the patient’s individual rate of healing. For most of my patients, the majority of swelling and numbness is resolved by 6 weeks, although there may still be some residual swelling or numbness that may last longer. Numbness in particular may take up to a year to completely resolve.

Depending on the severity of your swelling, you may want to visit your plastic surgeon for a follow up to be sure that you are healing properly. You don’t mention the extent of your swelling and sensations of numbness, so it is difficult to say if it is something to be concerned about. Good luck with your recovery!

Q: What’s the best way to get rid of jowls that are beginning to appear? I tried Restylane with limited success, and am wondering if there is a better, longer lasting treatment to “lift” jowls. I’m 51 years old and have good skin otherwise.

A: Thank you for your question. If your jowls are just beginning to appear, then I think you may be a good candidate for a mini-lift. At my practice, I perform a procedure called a mini-lift on people with good skin and early jowling. This procedure is less invasive than a full facelift, with less recovery time required, but it is much longer lasting than just fillers such as Restylane would be.

A mini-lift at my practice involves using minimally invasive techniques to angulate the jawline and remove excessive skin of the lower face. The deep muscular tissue is lifted vertically and tightened, then the excess skin is removed. This technique is very effective for jowls and rejuvenation of the lower face.

Q: What is the best procedure for firming the neck and chin? I’m about to turn 50 and have skin in pretty good condition, so I don’t need a facelift, but my neck and chin area doesn’t look as good as the rest of my face. 

A: There are a few options available for tightening and firming the neck and chin, including non-invasive options, but the most effective and longest lasting solution is a surgical neck lift. A neck lift is less invasive than a full facelift, but it will provide dramatic and long lasting results. It’s a great option to reduce skin laxity and sagging on the neck by lifting and tightening the muscles and deep tissue. The neckline will become smoother and more defined following a neck lift.

If you also have excess fat under the chin, liposuction can be performed in conjunction with a neck lift in order to achieve more comprehensive results.

Q: How long does a facelift last? What kind of factors determine facelift longevity?

A: Thank you for your excellent question. There is unfortunately no one answer as to how long a facelift will last, as it will be different for each individual. Some factors that affect the longevity of a facelift include the surgical technique used (superficial tightening of the skin will not last as long as a procedure that tightens the deeper muscles and tissue) and the individual’s genetics and lifestyle. A healthy lifestyle with a good diet and protection from the sun will generally result in longer lasting results, while individuals who smoke, have poor dietary and exercise habits, don’t take proper care of their skin, or are more exposed to environmental pollutants may have results that don’t last as long. Wearing sunscreen and taking advantage of auxiliary procedures such as injectables, laser treatments, peels, and other procedures for the skin can also help extend facelift longevity. There is no such thing as a “permanent” facelift, as it is impossible to stop the aging process, but a well done facelift and healthy lifestyle can certainly take years off the appearance for years.

Q: Is a facelift the only answer for marionette lines and jowls? I’m 66 years old, and I’m afraid to have a facelift, but I have deep lines that make me look sad and fat pockets along my jaw that I’m tired of trying to hide behind my hair. What solutions are available?

A: While there are non-surgical solutions available to treat marionette lines, such as dermal fillers, these solutions will not provide the dramatic and long-lasting results that a surgical facelift can. Dermal fillers such as Radiesse or Restylane can be used to add temporary volume to lines and folds, but these are all temporary solutions that can only provide minor results.

I understand your concern about having a facelift; surgical procedures can often seem frightening. However, facelift techniques have come a long way, and as long as you have the procedure done with a well qualified, board-certified, experienced facial plastic surgeon, there is no need to be afraid. A facelift will be able to provide long-lasting, dramatic results that non-surgical methods simply can’t. I recommend visiting a board-certified facial plastic surgeon for a consultation to discuss your options. They will be able to assess your condition and determine if non-surgical means will be enough to make a difference or not, and they can walk you through exactly what a surgical facelift entails in order to lessen your concerns. I strongly recommend visiting a specialized facial plastic surgeon rather than a general plastic surgeon, as they will have more expertise in facial anatomy and be able to provide a better result.

Q: Is 40 too young for a facelift? My skin and facial muscles have started to sag, I’ve lost volume in my cheeks and eyes, and while I don’t have wrinkles, I have pretty deep marionette lines. 

A: Thank you for your question. Personally, I believe that a person’s age does not matter when it comes to having a facelift – the most important thing is the condition of the skin. There are people who, at 40, have more wrinkling or jowling than other people do at 60. There are many factors that come into play when it comes to how a person ages, including lifestyle, habits, location, and genetics. If you are a good candidate for a facelift, then you are a good candidate, no matter your age.

The best thing to do would be to have an in-person consultation with a board-certified, qualified, experienced facial plastic surgeon to assess your condition and determine if a facelift would benefit you. There are also other options you could consider, such as fat grafting/transfer, dermal fillers, laser treatments, or a less invasive mini lift. An in-person consultation is absolutely necessary, preferably with a facial plastic surgeon over a general plastic surgeon, in order to determine if a facelift is a good choice or if you would benefit more from non-invasive procedures.

Q: What should I look for in before and after photos when researching plastic surgeons? How will I know what’s good?

A: Before and after photos are a great way to get an initial impression of a plastic surgeon’s aesthetic and technique. There are a few things you should keep an eye out for:

-Make sure that the before and after photos were taken at the same angle and in the same lighting, and try to find photos where the patient is not wearing makeup.

-Try to find photos of patients with similar concerns and a similar face shape to you. If your main concern is jowls but you’re looking at photos of brow lifts, that’s not going to tell you anything relevant.

-Take note of how natural the results look. Some plastic surgeons have a more artificial aesthetic, and may create an overly smooth appearance. Try to find a surgeon whose aesthetic most closely matches what you want your results to be.

-Try to find a double board certified facial plastic surgeon. Facial plastic surgeons specialize in facelifts, rhinoplasty, blepharoplasty, and other facial procedures, and generally have more skill and knowledge when it comes to surgery of the face.

Keep in mind that before and after photos are only part of the process. It’s important to visit any facial plastic surgeon in person so that you can talk to them, discuss your concerns, and come up with the best treatment option. If your facial plastic surgeon does not make you feel comfortable during the consultation, or doesn’t answer all your questions, it’s okay to keep looking! You want to build a relationship of trust, especially since it’s your face in question.

Q: How is a facelift different from a mini-lift or midface lift?

A: Mini lift and midface lift are terms that may mean different things at different surgeons’ offices. At my practice, a mini lift is what we call a less invasive procedure to lift the lower face and neck in patients who are just beginning to show signs of age. The mini lift involves less aggressive and less invasive techniques, resulting in less recovery time for the patient. However, the mini lift will not provide the same dramatic results as a full facelift, and is only recommended for patients who still have good skin quality and are only beginning to see sagging of the lower face and neck.

A mid-face lift most likely refers to cheek augmentation or fat repositioning in the upper cheeks. These techniques could help reverse dark circles under the eyes and restore lost volume in the cheeks. You would need to talk to your surgeon to see what their personal definition of a mid-face lift is.

A full surgical facelift can help refresh the neck, jawline, and cheeks through removing excess fat and skin and tightening underlying facial muscles in order to bring more definition to facial structure. Facelifts can be tailored to each individual to address their personal concerns and create the best, most natural results.

Different surgeons will have different terms for the types of surgeries they perform, so it is highly important to visit a well qualified facial plastic surgeon for an in-person consultation where you can ask questions and they can explain what each procedure entails and work with you to come up with a good, customized plan. For a facelift, it’s also important to visit a facial plastic surgeon for the best results, as they exclusively specialize in procedures of the head and neck, and thus have more knowledge and experience than a general plastic surgeon when it comes to the face.

Q: What is the best age for a first facelift? I notice that many people get one around age 60, but isn’t younger better to prevent sagging and deepening of lines?

A: The best age for a first facelift is entirely dependent on the individual. There is no one “right” or “best” age to get a facelift. If you are concerned about signs of aging and are psychologically ready for a surgical facelift at age 40, that’s okay. If you are 70 and decide you want to get a facelift for the first time, that’s okay too. There are more subtle and less invasive procedures that can be done as well, and there are non-invasive procedures such as dermal fillers and neuromodulators that can be used also. Facelift surgery is a major decision and I generally don’t recommend having one for solely preventative purposes, but it is true that younger patients with less signs of aging who have a facelift tend to see results that last longer. The best thing to do is to visit a double board certified facial plastic surgeon for an in-person consultation to find the best treatment option for you.

Q: How long until swelling is 100% gone after facelift surgery? It’s been 3 months and while I’m happy with my results, I’m still a little puffy and swollen on my cheeks.

A: Recovery time and resolution of swelling is different in every patient. That being said, it is fairly common to still have some swelling at 3 months post-op. Swelling and numbness are some of the last side effects to resolve, and while the majority of the swelling should be gone by 3 months, it may take up to six months or even a year for it to resolve 100%. If you are concerned, I suggest visiting your surgeon for a follow-up and prognosis.

Q: What’s the most cost-effective and natural looking way to correct an aging mouth that’s drooping at the corners?

A: Without seeing you in person, it’s difficult to recommend a specific treatment option. If you are just beginning to see drooping and lines at the corner of your mouth, dermal fillers may be a good option. These are simple, quick injections that can restore some lost volume. However, if your signs of age around the mouth are more pronounced, you may benefit from a lower facelift for better and more long-lasting results than fillers alone can provide.

Q: What’s the best position to sleep in post-op, and what skin care regimen would you recommend pre and post op?

A: It’s best to sleep with your head elevated following facelift surgery. Make sure you have either a thick, firm pillow or multiple pillows that will keep your head elevated approximately 30 degrees while sleeping. This will help to prevent undue swelling. As for skin care, it’s important to try to stick to a healthy diet and lifestyle, which will help keep skin in good shape, and at my office we offer a variety of effective skin care options that we can tailor to your specific needs. Your surgeon should go over post-operative care instructions with you to ensure a good result and recovery period.

Why Does Botox Make Forehead Look Shiny? I notice shiny foreheads in Botox users.

A: The shiny forehead you have observed on some patients who have received Botox injections is normal.  A board-certified facial plastic surgeon with expertise in Botox uses only enough of the neuromodulator to relax the muscle underneath the forehead, and it can inhibit the pilosebaceous glands, which might result in a shiny forehead.

Q: What is the best treatment option for my under eye wrinkles and crowsfeet? I would love to find something that would not only treat but also prevent this from becoming permanent.

A: Prevention is always the best course in medicine or cosmetic surgery. Botox can relax the muscles that cause crow’s feet, which should diminish the wrinkles you have now and prevent new ones from forming in the future. The effects last from three to four months. You also may need some hyaluronic-acid based fillers, depending on how deep your wrinkles are. I hope this helps.

Q: Would my wrinkles disappear completely with the use of botox?

A: Botox will relax the muscles underneath the skin that are causing your wrinkles. In most cases, that will smooth out and soften the wrinkle considerably so it will not be visible. This will depend partly on your skin type and quality. Consulting with a board-certified dermatologist or facial plastic surgeon will give you the answer you need. I hope this helps.

 

 Q: Do surgeons prefer to see patients without Botox for an initial facelift consult? I have Botox in my forehead and am wondering if this will affect my evaluation in case I need a brow lift or blepharoplasty.

A: While a skilled, board certified facial plastic surgeon should be able to accurately evaluate you despite the presence of Botox, if possible I would advise coming for a consultation with your face as natural as possible. It is by no means absolutely necessary to have your consultation without Botox, but a natural face is always best for an initial consultation. I hope this helps.

Q: Is a facelift right for me? I’m 25 but often mistaken for being in my 40s. I don’t know what exactly makes me look so old, but I think it might be my sagging face shape. Should I get a facelift even though I’m not in the typical right age group?

A: While age should not be the primary concern when thinking about getting a facelift, the 20s is typically too young just because it is extremely rare that a 20-something has the necessary skin laxity to warrant a facelift. From your photo, it does not appear as though you would be a good candidate for a full surgical facelift. I recommend visiting a board certified facial plastic surgeon for an in-person consultation to evaluate your concerns and see if there are other, less invasive options available that may help you to look and feel more youthful. I hope this helps.

Q: Is 40 too young for a lower facelift to correct saggy skin following chin lipo? I’ve had two Thermi treatments but it didn’t help much. My surgeon and another plastic surgeon both said I’m too young for a facelift, but I don’t understand why.

A: Age should not be the primary concern when thinking about a facelift, but rather skin quality. If you have enough skin laxity, even at 40, a lower facelift or a less invasive mini facelift could be a good option. However, there is no benefit in having facelift surgery if your skin condition doesn’t warrant it. I recommend visiting a board-certified facial plastic surgeon to discuss your concerns and options. At my office in Charlotte, I’ve performed successful facelifts on younger patients, but on the other hand, I’ve also recommended less invasive or non-invasive procedures for patients who I felt did not need surgery.  Pictures would be helpful to answer your questions. You may want to consider adding some pictures the next time you post a question.

Q: Do I have a hematoma? I had facelift surgery ten days ago, and I’ve been patient with bruising but I have these two lumps that are not getting better. My doctor is out of town but I’m going to go in tomorrow to see the nurse, but can I get some opinions here?

A: It is impossible to say without an in-person consultation, but from your photos it does not appear that you have a hematoma. It appears as though you are just experiencing typical swelling. Swelling can often feel like “lumps,” but is a common side effect following surgery and should subside within 14 to 28 days, although minor swelling may persist for longer. It is good to hear that you were proactive and made an appointment to visit your surgeon’s office to make sure everything is in order.

Q: I’m 52 years old and I want to look younger. I’ve tried fillers and Botox but I’m still not happy. Is it time for a facelift?

A: It is hard to say without an in-person consultation whether or not you are a good candidate for a facelift. That being said, a facelift can be a great option to achieve a more youthful, refreshed look. There are a variety of different surgical procedures that can be done depending on your specific concerns, your goals, and your overall skin quality. I recommend visiting a board-certified facial plastic surgeon for a consultation and evaluation to come up with the best custom treatment plan for you.

Q: I had a mini lift when I was 50. I’m 58 now and am unhappy with my chin and neck that have begun to sag. Can I do another mini lift? I want natural results again like I had the first time.

A: At age 58 with significant neck sagging, it might be a good idea to do a full facelift or necklift. I can’t say for certain without seeing photos and without an in-person consultation, but generally in the late 50s and early 60s most people are better candidates for full face or necklifts rather than mini lifts. At my office, we mostly perform mini lifts on people who are just beginning to show signs of age, who are generally in their 40s or early 50s. That being said, there is no “right” age for a facelift or a mini lift, and the only way to tell for certain which is best is to have an in-person consultation with a board-certified facial plastic surgeon. If your facial plastic surgeon is skilled enough, you should be able to obtain natural looking results, no matter which procedure you decide to have.

Q: I have an overbite which makes my chin look even smaller. What can be done to fix this?

A: Your overbite is not severe. A chin implant would be a good solution to creating a stronger jawline and more commanding chin. In most instances, chin implants can last a lifetime. I hope this helps.

Q: Can plastic surgeon insert chin implant or I should choose facial plastic surgeon?

A: Both facial plastic surgeons and plastic surgeons should be qualified to place a chin implant.  It is important to choose a surgeon that you trust and dedicated his practice to facial aesthetics.  Your face should be evaluated precisely to ensure that your chin implant is in balance and harmony with the rest of your features. I hope this helps.

Q: Should a plastic surgeon address pixie ear and hearing problems after a facelift without charging more money? My plastic surgeon is charging me $800 to fix the one earlobe.

A: Different surgeons will have different policies regarding charging for revisions. Some surgeons may charge a facility fee and waive their surgeon’s fee, while others may perform the revision free of charge and still others will charge the full amount. If you feel that you are being overcharged for your revision you may want to ask your surgeon what the $800 is for. As far as your hearing problems are concerned, I would recommend that you visit an ENT doctor to get that checked out. Generally, a facelift should not result in hearing loss, pixie ear or not.

Q: I recently scheduled a facelift, but I’m concerned because all my life, whenever I get stressed my throat tightens and I feel like I can’t swallow. Two people I know have had facelifts and they both complained of tightness, and this really worries me because of my throat, plus I have claustrophobia. Should I be concerned?

A: I would definitely recommend discussing these fears with your surgeon before proceeding with your facelift. While the facelift itself will not cause that amount of tightness in the throat, a general feeling of tightness is absolutely to be expected after your surgery, and your anxiety may lead to significant discomfort. There are medications available that can help to calm anxiety pre- and post-op that may be able to help you get through it, but you should discuss this with your surgeon and decide whether or not this facelift is a good idea for you. I hope this helps.

Q: How long does tightness last after a facelift?

A: Each individual is different, but generally, I’ve found that for most of my patients, tightness is greatest in the first few weeks, after which it begins to subside. Some degree of tightness may persist for several months, but rest assured, your face will eventually return to feeling completely normal! Just be patient and wait it out.

Q: I’m 7 weeks post facelift surgery, and I still have swelling near my earlobe. My PS wants to wait 6 more weeks before steroid injections. What is your opinion, should I give it more time to heal? Are there side effects of steroid injections?

A: At 7 weeks post-op, it is common to still have some swelling. Swelling may not fully resolve for several months, although most of my patients find that the majority of swelling dissipates within 14-28 days. Steroid injections should not be rushed into, as they can cause skin and fat atrophy that may lead to permanent depressions. My advice would be to be patient, and if you still have significant swelling after another six weeks then see your surgeon again for a follow-up. Good luck!

Q: 5 months after a revision facelift, a lump behind my ear started to ooze and now a thread has migrated through my skin. Will this be okay if I just leave it alone? I can’t afford another surgery.

A: The good news is that you do not need another surgery to correct this issue. It looks as though one of the dissolvable sutures placed under your skin is being expelled by the body, and has become irritated and inflamed. Visit your surgeon and they should be able to take it out no problem, and your other symptoms will resolve after it’s been removed.

Q: It’s been six months since my full facelift and eye lift surgery. I’m still feeling some tightness, itchiness, and puffiness, and I want to know when I can expect this to be gone? Is there anything I should or shouldn’t do in the meantime?

A: It is fairly normal to still feel some tightness, itchiness, and “puffiness” at six months after a facelift. Each patient heals differently, and while some may be totally symptom-free at 6 months, others may take a while longer to fully heal. If you are worried, I would visit your surgeon for a follow-up visit, but the main thing to do is just be patient. Most symptoms should resolve within another six months if not earlier.

Q: I’m considering going out of state for a facelift, and am wondering what the recovery is like and how long I should stay before returning home.

A: I would recommend staying for two weeks before returning home to allow for the majority of bruising and swelling to go down. This will also allow yourself time to rest, and to be able to visit your surgeon in person for follow-up visits and in case there are any complications. I find that in most of my patients, bruising resolves enough to be covered with makeup after one week, and fully resolves by two weeks, while swelling will be most pronounced for 24-72 hours following surgery. There will be other symptoms such as tightness, numbness, itchiness, and further swelling that may last for months, but these should not interfere with your ability to travel or go out in public. Wherever you go for your surgery, make sure that you choose a board-certified, well-qualified facial plastic surgeon in order to minimize recovery time and ensure a good result! Facial plastic surgeons generally have more experience than general plastic surgeons with facelifts as well as more head and neck anatomical knowledge that allows them to achieve superior results.

Q: I’m 35 years old, but I look much older because of my job. Can I get a facelift?

A: Without seeing any photos or examining you in person, it is impossible to tell if you would be a candidate for a facelift. That being said, while 35 is generally considered young for a surgical facelift, age is not as important as skin quality when considering one. If your face has prematurely aged as much as you say it have, it is possible that you could be a candidate. Otherwise, nowadays there are many non-invasive facial rejuvenation techniques, such as dermal fillers, non-surgical skin tightening, and neuromodulators, that could be a better option for you. Visit a board-certified facial plastic surgeon for an in-person consultation to determine a custom treatment plan for you.

Q: What is the safest type of facelift for a smoker, MACS or deep plane?

A: I would not advise having any type of full facelift procedure done if you are a smoker. The risk of skin necrosis and scarring is much higher, and recovery will take much longer as well. If you are able to quit smoking for a few weeks before and after surgery, you may be a candidate for a less invasive procedure such as a mini-lift, and there are a variety of non-surgical skin rejuvenating options that could be considered as well. If you are dead set on a surgical procedure, make sure that you only visit a highly experienced, skilled, board-certified facial plastic surgeon who has performed successful facelifts on smokers before and can give you an honest evaluation and opinion.

Q: What level of pain is considered normal after a facelift? Should prescribed pain meds be enough to numb the pain? If not, is something else wrong?

A: Pain after a facelift is actually usually pretty minimal. Your surgeon should prescribe some pain medications, but often patients only use them for a day or two after surgery. Rather than pain, patients most often experience discomfort from swelling, tightness, or itchiness. This will be most pronounced in the first few days after surgery, then should continue to subside over the next few weeks and months. Individuals may have different pain tolerances, however, and if your pain medications don’t help, I would advise visiting your surgeon for a follow-up visit.

Q: What’s the maximum number of facelifts a person can have? I’ve heard that it’s 3 or 4. Do mini facelifts count?

A: There is no set maximum number of facelifts that a person can have; instead, how many facelifts can be performed while still retaining a natural appearance depends solely on the individual and will vary due to a number of factors, including when they first had a surgical facelift, skin quality, and surgeon technique. Generally, a facelift lasts for around 7 to 10 years, depending on how well you take care of your skin afterward, genetics, and lifestyle. No facelift is permanent, because the aging process continues to happen no matter what cosmetic procedures you have done. Facelifts are also not the only means of rejuvenating the appearance; some people may find that non-surgical procedures such as Botox, fillers, or laser resurfacing can help extend the life of their facelift or help push back the age that they have their first facelift at. Instead of worrying about how many facelifts you can have, concentrate on getting the highest quality facelift possible that is tailored to your unique concerns, and remember to always visit a board-certified facial plastic surgeon for your facelift surgery.

Q: If I have a facelift at 45, will I need to have another one in seven years? I’m wondering if it’s a good idea to have it now or if I should wait until after menopause.

A: Facelift results can last for ten years or beyond if you take good care of your skin and lead a healthy lifestyle. The face does continue to age, but generally, if you have a facelift at 45 you will still look younger and better at 55 than you would had you not had the facelift. If you feel that the effects of age are too much, you may decide to have a second facelift in five, ten, or fifteen years, but the choice is entirely yours. If you are a candidate for a facelift and are psychologically ready for it at 45, there is no reason to wait until after menopause. I suggest visiting a board-certified, expert facial plastic surgeon for an in-person consultation to discuss your goals and come up with the best treatment plan.

Q: Can I have a facelift with Grave’s disease? I’ve been treated for it for about a year and my hormone and antibody levels have just about come back to normal. I’m on one tablet of carbizmole a day.

A: As long as your Grave’s disease is well under control, there should be no problem having a facelift. Make sure you get clearance from your endocrinologist first and let your facial plastic surgeon know about your condition.

Q: Am I a candidate for a facelift? I’m 30 years old but I’ve aged significantly in the past year and am not sure why. I have wrinkles around my eyes, hollow cheeks, bags under my eyes, and thinning lips. How much would something like this cost to correct?

A: Skin quality, not age, is the primary factor when determining if someone is a facelift candidate. That being said, very rarely do 30 year olds have enough skin laxity to warrant a facelift. From the concerns you describe, it sounds like you would be better off looking into Botox and facial fillers to correct your wrinkles and volume loss respectively. Fillers can be a great choice to correct volume loss in cheeks, temples, jawline, and lips. Botox or Dysport is the best first step for correcting crow’s feet wrinkles in the corners of the eyes. You may benfit from medical grade skin care to improve to overall quality of your skin. Visit a board-certified facial plastic surgeon for an in-person consultation to determine which procedures will be best and the cost for your treatment plan.

Q: I had a face and necklift fat transfer four months ago. Is it normal to still feel swelling in the neck and temples?

A: The majority of swelling following a facelift generally resolves within a few weeks, but there can be residual swelling for up to six months. If your swelling is severe, I recommend visiting your surgeon for a follow-up visit to make sure everything is healing well.

Q: I’m 41 years old. I’ve lost weight and still have about 20 pounds to go, but I’m already disliking my face and neck droop. Is a facelift and necklift the best option for me, or are there any mini procedures that could be done? I’d also like to get an estimate of the cost.

A: An in-person consultation with a board-certified facial plastic surgeon is necessary to discuss your goals and determine what kind of procedure would be best for you. If your sagging is not too severe you may be a candidate for a less invasive mini lift, but it’s hard to say without seeing you in person. Before you have any kind of surgery, though, it’s important to be at your goal weight. If you have surgery now then lose an additional 20 lbs, you may end up with additional sagging skin which would then need to be corrected with another surgery.

Q: Will a facelift help to tighten pores? I know it won’t help much with acne scars, but pores are my main concern.

A: No, a facelift will not help tighten pores. Facelifts do not address textural issues on the surface of the skin; rather, they help to tighten lax, sagging skin and create a better neck and jaw contour. If you are concerned about surface issues such as pores or acne scars, laser rejuvenation, chemical peels, or MicroNeedling may be better for you. I suggest visiting a board-certified facial plastic surgeon or dermatologist who can assess your skin during an in-person consultation and come up with a custom treatment plan to address your concerns.

Q: I’m still really swollen 6 days after a MACS facelift and blepharoplasty. Should I worry? I haven’t seen any improvement in my swollen face since my surgeon took the bandages off.

A: It is normal to still be swollen 6 days following a facelift and blepharoplasty. In most of my patients, the majority of swelling resolves within two weeks, although there may still be residual swelling for up to six months. If you are concerned with your level of swelling, I suggest visiting your surgeon for a follow-up visit to make sure your healing is progressing well

Q: Is there such a thing as a non-surgical facelift? What is involved in one?

A: A facelift is by definition a surgical procedure. “Non-surgical facelift” is a marketing term that usually describes using a combination of non-surgical procedures such as Botox, facial fillers, laser resurfacing, etc to rejuvenate the face without surgery. These procedures can be effective in the right candidate, usually someone younger who is not a candidate for a true facelift yet, but the results will not be as dramatic and will not last as long as a surgical facelift will. I recommend visiting a board-certified facial plastic surgeon who offers both surgical facelift procedures and non-surgical procedures for an in-person consultation to discuss your concerns and come up with the most effective treatment plan for you.

Q: I had a facelift last year with great results, but now I want to lose 15-20 pounds. Will this weight loss affect my facelift results? I’m 55 years old and have read that losing weight at my age can lead to dramatic aging of the face.

A: Each person loses weight differently, so it is difficult to say what kind of effect losing weight would have on your face. It’s definitely better to lose weight before any cosmetic procedures, but you shouldn’t let fears of affecting your facelift results prevent you from being healthy. If you lose volume in your face from weight loss, it may be possible to correct this with facial fillers rather than needing a second facelift.

Q: Does a mid face lift actually remove skin?

A: Yes, most facelift procedures, including a mid face lift, will remove excess skin for the best result. See a board-certified facial plastic surgeon for a consultation if you are considering having any kind of facelift procedure done so that they can evaluate your concerns and come up with the best customized treatment plan for you.

Q: Can a facelift be performed after having a lifestyle lift done 7 years ago?

A: Yes, it is fine to have a facelift 7 years after a “lifestyle lift.” No cosmetic procedure is permanent, as aging and gravity continue to take their toll even after the best facelift results. Because of this, it is not uncommon for patients to seek out a second facelift years after their first procedure. This time, I recommend that you visit a board certified facial plastic surgeon who will evaluate you and come up with a custom facelift plan, instead of having a one-size-fits-all procedure such as the “Lifestyle Lift.”

Q: How long does swelling last after a facelift? My 61 year old mom got a complete facelift and double chin removal four months ago and she’s still very swollen.

A: While for most patients the majority of the swelling after a facelift resolves after two weeks, with further minor swelling lasting for another few months, each patient is different and swelling may resolve at a different rate depending on the patient’s individual healing rate, the type of surgery done, after care, and more. I would encourage your mother to visit her surgeon for a follow-up visit to make sure that everything is healing properly. I hope this helps.

Q: How many stitches does a facelift require? What’s considered a normal amount?

A: The number of stitches used is ultimately not as important as the technique of the surgeon placing them. Each individual will require a different number of stitches based on their individual facial anatomy and the type of facelift they are receiving. A skilled surgeon will place just enough stitches to ensure the best healing and results with minimal scarring. Instead of worrying about the exact number of stitches used, be sure to do your research and visit a skilled, board-certified facial plastic surgeon with enough experience and expertise to help you achieve your goals.

Q: What type of facelift will best address sagging jowls without noticeable scars? Is 40 too young for a facelift? Are there any less radical procedures that would be effective for jowls?

A: At my practice, I perform a minimally-invasive, less aggressive surgery that I call a mini-lift. Mini-lifts address only the neck and lower face, and are a great option to reduce jowls. A mini lift involves less scarring and less downtime than a full facelift, and tend to be ideal for women just beginning to show signs of age but who aren’t ready for a full facelift yet. If your jowls are very large, however, you would probably benefit more from a full facelift. Age is not as much of a concern as skin quality when considering a facelift, and some people are ready for one at 40 while others may get their first at 70. An in-person consultation with a board-certified facial plastic surgeon is necessary in order to evaluate your concerns and discuss with you the best treatment options available. I hope this helps.

Q: I have sagging skin around my mouth and chin that makes me look old. What procedure is best to help with this issue?

A: Depending on the extent of the sagging, you could be a candidate for a facelift or a mini lift. A full facelift will provide the most dramatic results, but if you are not ready for a full facelift or if your sagging is in early stages, a mini lift may be a better choice. At my practice, a mini-lift is a minimally invasive procedure that addresses loose skin of the neck and lower face with fewer incisions, which in turn results in less recovery time for the patient. I recommend visiting a board-certified facial plastic surgeon for an in-person consultation and assessment to come up with the best treatment plan customized to your needs.

Q: Can a bald person have a facelift? Where will the incisions be?

A: Yes, a bald person can have a facelift. However, incision placement must be very precise and care must be taken so that the scars are as small and inconspicuous as possible. It is unfortunately impossible to stop scarring from occurring entirely, but there are steps that can be taken to ensure scars heal as invisibly as possible. The most important thing is to visit a highly skilled, experienced, board-certified facial plastic surgeon who will be able to customize your facelift for the best results possible.

Q: How long does a facelift last? I want to know about sagging after having the procedure done at 50.

A: How long a facelift lasts will depend on the individual and their lifestyle and skin care habits. Unfortunately there is no such thing as a permanent facelift, as there is nothing that can be done to stop gravity and the aging process. However, if you take good care of your skin, avoid the sun, eat healthy, exercise, and in general maintain a healthy lifestyle, your facelift results will last longer than if you maintain unhealthy habits such as eating junk food or not wearing sunscreen every day. Facelift results in people who lead healthy lifestyles can last 10 to 15 years, and many people find they don’t necessarily want a second one after that time because they still look better than they would have had they not gotten their first facelift.

Q: I’m 28 and am developing nasolabial folds. Could a facelift be a smart move for me? I want to treat these folds as aggressively as possible and prevent them from worsening. I’m discouraged from fillers because they’re so temporary.

A: While age should not be the primary consideration when thinking about a facelift, skin quality is. At 28, you most likely do not have the amount of skin sagging that would necessitate a full surgical facelift procedure. While I understand wanting a longer lasting procedure than fillers can provide, it would most likely not benefit you in the long run to have a facelift now. There are fillers available today that can last for up to a year or even two. I recommend visiting a board-certified facial plastic surgeon for an in-person consultation to come up with the best treatment plan for your individual case.

Q: How long should I wait to take a 24 hour flight after a full face, eye, and neck lift?

A: Each patient heals at a different rate, but generally, it should be okay to fly two weeks after having surgery if you are healing well and feel comfortable not being able to visit your surgeon easily for follow-ups. I would not recommend flying earlier than that, because the first two weeks are both when discomfort is highest and also the most important time to be able to visit your surgeon for follow-ups. Talk to your surgeon before making plans, because he or she may have more specific advice for you based on the specific procedures you had and after-care protocol.

Q: Will the scars from my stitches minimize with time, or are they permanent?

A: Scars from facelift incisions generally heal well over time if the surgery was done by a skilled, board-certified facial plastic surgeon. Talk to your surgeon about scar management and care; there are topical gels that can be used to help diminish the appearance of scars. The best thing to do is to follow your surgeon’s advice and be patient; scars may look prominent now, but over time they should fade.

Q: How can I avoid a pulled, “windswept” look from a facelift?

A: The best way to avoid the unnatural “windswept” look is to do your research and visit a highly skilled, reputable, experienced, board-certified facial plastic surgeon. Most facial plastic surgeons should have before and after photos that you can look at to see if the results are in line with what you want out of surgery, and you can also look at reviews and patient testimonials. Windswept results are due to the wrong directions of pull during a facelift. I hope this helps.

Q: I had a facelift in 2009 to tighten my neck, but the skin is loose and crepey again. I don’t have extra fat or heavy jowls, just loose skin. I don’t want to undergo a full facelift again. What are my options?

A: Without seeing you in person it is impossible to determine what procedure would best help you. That being said, there may be a few options available. At my practice I perform what I call a “mini-lift” on appropriate candidates who are showing early signs of skin laxity, but who do not yet have heavy jowls or turkey neck. This surgery can be performed while the patient is awake. This procedure is minimally invasive, with fewer incisions (and therefore less scarring) required than a full facelift. Another option may be a non-invasive skin tightening treatment such as the Titan laser or Ultherapy. These treatments do not require any incisions or downtime, but be warned that the effects are less dramatic than can be achieved through surgery.

Q: What recovery time would I need after a full facelift? I’m a health care assistant.

A: Generally, patients who have a facelift done at my practice are able to go out in public and resume most of their daily activities after 7 to 14 days. The majority of swelling and bruising should have resolved after a week, but there will still be some swelling and possibly asymmetry as well as small lumps and bumps, and there may still be some light bruising. It’s possible to resume work at this time, but many patients may want to wait for their appearance to improve further. After 14 days, patients should see some improvement in their appearance and should be able to go out in public looking normal with the help of some makeup.

Q: I had a facelift three weeks ago, and one side feels looser than the other. The side that looks better feels hard, but the other side is soft. Also, I have a mole that didn’t move position on the soft side. Will that side tighten up or am I just stuck with an incomplete facelift?

A: At three weeks post-op, you are most likely still experiencing swelling. Asymmetric swelling is perfectly normal and expected after a facelift. As for your mole, it really depends on where exactly it’s located to determine if it should have moved or not. Most facelifts only address the lower face, so if your mole is in an area that was not tightened, then it wouldn’t have moved. If, however, it is located in an area that was pulled, it should have moved a bit. Without seeing you in person with a “before” photo, it’s impossible to tell if your mole should have moved. I would be patient and wait another few months, and if you’re still unhappy with your results, visit your surgeon for a follow-up to discuss possible revision.

Q: Can you have a deep chemical peel at the same time as a facelift? I decided to have a facelift and upper blepharoplasty, but I also have acne scarring and wrinkles that I want to address with a chemical peel. My doctor said it’s not a good idea to do these procedures at the same time, but I’ve seen photos here that suggest people had them at the same time?

A: I frequently perform additional procedures along with a facelift at my practice, including chemical peels, laser resurfacing, liposuction, fat transfer, and cheek or chin augmentation. Facelifts will address skin laxity, but they do not address wrinkles or acne scars, so if you want to improve your skin texture at the same time, a chemical peel or laser resurfacing procedure may be a good idea. It’s important to visit a skilled, experienced, board-certified facial plastic surgeon for these procedures, since it is very important to know where it is safe to perform a peel and at how intense the peel can be before it is too risky.

Q: I had a facelift 9 years ago and it still looks great, but my neck is sagging. I don’t need (or want) another facelift, so what are my options?

A: Without seeing you in person it is impossible to assess the extent of your sagging and recommend an appropriate procedure. However, depending on your goals and how much laxity you have, there are a few options available. You said you don’t want another facelift, but you may consider just a necklift or a “mini lift.” A necklift addresses only the neck and is less invasive than a facelift, and a mini lift as performed at my practice is also a minimally invasive procedure that requires fewer incisions and less recovery time. If you absolutely don’t want any surgery, a non-invasive skin tightening procedure such as the Titan laser could possibly benefit you if your skin laxity is very mild. Keep in mind, however, that the results from non-invasive procedures are not nearly as dramatic as what you can get with surgery. If you are an appropriate candidate and keep your expectations realistic, you may find that non-invasive procedures are satisfactory.

Q: My doctor said he’d certify me to return as a rural mail carrier 10 days after a facelift, but I want to double check that that’s enough time? My job requires me to lift from 30 to 70 lbs multiple times a week.

A: While 10 days could be enough, I would double check with your surgeon and make sure that he understands the full extent of heavy lifting that you do. Personally, I advise my patients not to do any strenuous activity for at least two weeks, and for extremely strenuous lifting I may even extend that a little bit. While there is minimal risk of something happening, I don’t want my patients to take that chance – better safe than sorry. After all, it is your face we’re talking about. Ultimately, it’s at your surgeon’s discretion as to how long he wants you to refrain from heavy lifting, however.

Q: Will having a facelift result in the loss of a beard for a man? Is a different technique used than for women?

A: Men often have concerns regarding incision placement and hair loss following a facelift, but I can assure you that a skilled, board-certified facial plastic surgeon will be able to utilize different techniques that take into account the different facial shape and facial hair concerns when performing a male facelift. Male and female facelifts involve completely different considerations and the technique has to be adjusted accordingly so that the facial hair is not affected, the scars are well hidden to accommodate a short haircut, and the face retains its masculine shape. I advise visiting a board-certified facial plastic surgeon for a consultation to come up with a customized facelift plan for you.

Q: Do natural facelift options work? I keep seeing forums where women talk about products that can lift and firm the face as well as diminish crow’s feet and frown lines. I haven’t found anything yet that can really lift and firm my face, do I just have too much sagging?

A: These over the counter products that you can buy online will not produce much of an effect as far as firming, tightening, and correcting wrinkles. Currently, the best, proven effective treatment for crow’s feet and frown lines is Botox or a similar neuromodulator such as Dysport or Xeomin, and for lifting and tightening sagging skin, there is no substitute for a facelift. Even non-invasive devices such as Titan or Ultherapy can only tighten to a certain degree, and are best for people who only have very minimal sagging. Don’t waste your money on “miracle” products – stick to proven products and techniques and make sure to take care of your skin following surgery with sunscreen and a dermatologist-approved medical grade skincare regimen.

Q: I’m 5 days post-op and my face is so swollen and there’s bruising. My plastic surgeon said that I could probably return to work in two weeks or even sooner, but I’m panicked because I’m reading answers that say I’ll be swollen and bruised past that time.

A: At 5 days post-op, it’s completely normal to be swollen and bruised. Most of my patients are able to return to work with some makeup at 7 to 14 days post-op, depending on how comfortable they are with going out in public with minor swelling and bruising. After two weeks, it should be fairly easy to cover up any remaining swelling or bruising, and you should certainly be able to go back to work no problem. While swelling can remain for a few months after surgery, it should not be that noticeable to anyone but yourself. It’s far too early to panic, please be patient and you should see your condition improving over the next week or so.

Q: I have dentures and they fit nicely. I booked my consultation and am definitely going to have a facelift, but I’m worried about my dentures – will I be able to wear them immediately after surgery?

A: There is no need to worry about your dentures following a facelift. They will most likely be removed during surgery, but they can be replaced immediately afterwards. No one but your surgeon and his team has to see you without them.

Q: I’m 3 weeks post-op and am happy with my results, but I have a wound behind my ear that’s not healing properly. My doctor said the skin died, and he removed the dead skin and instructed me to keep the wound clean with soap and bacitracin. I trust him, but I want to know what other doctors think?

A: Skin loss can unfortunately occur sometimes following a facelift. I would follow your surgeon’s advice, and make sure to follow up with him if you notice any changes. Congratulations on your good results.

Q: Should I get fillers or a facelift at 32? I have terrible nasolabial folds and it’s damaging to my self esteem to be called “droopy dog” by coworkers. Would fillers even work, or do I need a facelift?

A: Fillers can often work wonderfully to diminish the appearance of nasolabial folds. Make sure you see a board-certified facial plastic surgeon with experience placing fillers for the best result. While age is not the primary concern when considering a facelift, 32 is fairly young and it’s doubtful you have the amount of skin sagging necessary to warrant a full facelift.

Q: Should I lose weight before my SMAS facelift, necklift, and brow lift? If I lose weight after the surgery will my face become saggy?

A: It is always best to be at or near a healthy, stable weight that you can maintain before having a surgical cosmetic procedure. If you lose a significant amount of weight after your surgery, it is possible that your skin will become lax and you will lose some of the benefit of the surgery. Typically, if you are going to lose more than 20 pounds, I would suggest doing it before surgery.  If it is less than 20 pounds, it will unlikely make much of a difference.  I advise visiting a board-certified facial plastic surgeon and discussing your weight loss plans during your consultation.

Q: I’m 2 weeks post-facelift surgery and I’m concerned because my swelling is getting worse, not better. My right ear is also red and inflamed. I had my surgery out of town, and my surgeon says it’s fine but he hasn’t examined me in person. Should I be concerned?

A: While swelling can last longer than two weeks, generally patients do begin to see some improvement rather than worsening at that point. There are certain cases where swelling may get worse, but it’s not the norm. If your surgeon can’t examine you, I would recommend visiting a local surgeon to be examined and see what’s going on. Make sure you visit a board-certified facial plastic surgeon for an expert opinion.

Q: What’s the best option for tightening the jawline and combatting the very beginnings of jowls? I’m 42 years old and have been told that I shouldn’t do a facelift. However, I’ve had Thermage done twice and it didn’t give me the results I want.

A: Age should not be the primary consideration when thinking about getting a facelift. Instead, it’s all about the quality of your skin. If you have noticeable jowls and sagging skin, you may be a candidate for what I call a mini-lift. At my practice, I perform mini-lifts on patients who are just beginning to see early signs of jowling and loose skin. It is a minimally-invasive procedure that requires less downtime and fewer incisions than a typical full facelift, but can produce wonderful results in the right candidate. This procedure can be done without going to sleep or general anesthesia.  I recommend visiting a board-certified facial plastic surgeon for a consultation to see what procedure could be right for you.

Q:Where do the jowls go when the SMAS is lifted and tightened? Do they move upward or just hang? Will the lower face appear heavier if the SMAS is lifted?

A: The SMAS, or superficial muscular aponeurotic system, is a deep underlying sheath of connective tissue that lends the face its shape. As we age, the SMAS descends due to gravity and the weakening of this tissue. A well performed SMAS facelift will reposition the tissue up and back, causing a more sculpted and youthful jawline. The jowls will essentially disappear, although if you have very fatty jowls then liposuction may be recommended as well. In any case, the lower face will not appear heavier after an SMAS facelift, nor will the jowls “hang.” There are many facelift techniques that can be customized to individual patients, so I recommend having a consultation to find out what kind of facelift is best for you. I hope this helps.

Q: At 66, what is the best option for treating the lower face? I don’t think fillers will be enough. Do I need a lower facelift or is there an easier option?

A: At 66, most people have significant skin laxity and jowls due to gravity and slowed collagen production. While there are non-surgical options such as fillers or skin tightening lasers, these will most likely not be effective enough. Likewise, although it is impossible to say without seeing you in person, a “mini-lift” would likely not be enough either. I perform mini-lifts, which involve fewer incisions and less aggressive surgical techniques, most often on people in their 40s or 50s who are just beginning to see skin laxity or jowls. A full face and neck lift, which lifts and repositions the SMAS layer as well as re-draping the skin to recreate a more youthful and contoured appearance, would most likely be best for you. Please visit a board-certified facial plastic surgeon for a consultation to see what options you have. I hope this helps.

Q: I’m 32 years old and I don’t like my side profile. It looks like my tear trough area has sagged enough that it causes me to look sad or older. Would a mid face lift or cheek lift help?

A: If volume loss in your cheeks is your main concern, you would likely benefit more from dermal fillers such as Voluma than from a surgical procedure. Voluma can help lift the cheeks back into a youthful appearance, and this can also help to disguise hollow tear troughs. I suggest visiting a board-certified facial plastic surgeon for a consultation to further examine your concerns and come up with a treatment plan, but I do not think that surgery is warranted at this point. I hope this helps.

Q: I’m 7 days post SMAS facelift, and one side of my neck and around my ear is twice the size of the other. There’s no pain, but it’s soft and I can feel it. My surgeon is on holiday and I’m flying to Saudi Arabia tomorrow, what can I do?

A: Although it’s hard to say without seeing you in person, it sounds as though you may have a hematoma. You should see your surgeon or someone from his office as soon as possible. Cancel your flight and make an appointment, as while hematomas are not necessarily dangerous they should be taken care of as soon as possible. I hope this helps.

Q: During a SMAS facelift, are the masseter muscles cut to help redrape the skin better?

A: No, the masseter muscles (or any other muscles) are not cut during a facelift. An SMAS facelift involves lifting and tightening the skin and the underlying SMAS layer to achieve a more contoured and youthful look, but no muscles are cut during the process. There is no need to cut the masseters to drape the skin. Cutting muscle leads to longer and more painful recovery times, and can lead to complications and bad results. If you wish to reduce the size of your masseters, Botox is a safe and effective option that works very well in the right candidate. I hope this helps.

Q: Would a mini lift help address my jowls and volume loss in the cheek and under eye area? Also, could I do it under local anesthesia?

A: A mini lift as performed at my practice is a great solution for eliminating early signs of jowls and sagging skin. The mini lift is a procedure I generally perform with only oral medication to relax the patient and numbing solution injected into the face, although if patients request otherwise a light anesthesia can be used. During a mini lift I lift and tighten the underlying SMAS layer in order to provide the longest lasting results, and trim away excess skin. As for volume loss in the cheeks and tear troughs, a mini lift will not address those. You should consider either facial fillers or fat grafting to replace lost volume in the cheek and create a more youthful appearance. I hope this helps.

Q: I would like to know if I’m a good candidate for a mini-lift. I’m turning 40 this year and feel like the excessive tanning I did in my 20s caused my skin to age prematurely.

A: At my practice, I perform mini lifts on candidates who are just beginning to see sagging of the skin and jowls. The goal of a mini lift the way I perform them is to angulate the jawline and remove excess skin, thus allowing for a less square shaped jaw and more youthful appearance. I lift the SMAS layer as well, providing for more long-lasting results. From your photo, it does appear as though you may be a good candidate, but an in-person evaluation is necessary to say for sure. A mini-lift will not address your nasolabial folds or any volume loss in the cheeks, however. If you would like those corrected, facial fillers may be a better option. I hope this helps.

Q: I had a neck and facelift around 6 weeks ago, and I’ve been using bioCorneum for the scar cream. At around 5 weeks post surgery, the incisions became oozy, bumpy, and scabby. Yesterday, I got a rash behind my ears. I’m concerned that I may be allergic to the bioCorneum cream. I’ve stopped using it for now, is that the right thing to do? I don’t like not following his instructions but if I am allergic I need to stop using it.

A: It is possible that you are seeing an allergic reaction to the scar cream. You should stop using it if you think it’s causing the irritation and rash you’re experiencing. Visit your plastic surgeon for a follow-up visit as soon as you can to have your condition assessed in person. I hope this helps.

Q: I keep reading that SMAS facelifts are bad for smokers, as there’s a higher risk of the skin dying. Is this true? Should I avoid having one since I smoke?

A: Any type of facelift surgery, not just SMAS facelift, will have a higher risk of complications when performed on a smoker. Smoking greatly increases the risk of vascular compromise during surgery, which can lead to necrosis (skin death). Smoking also interferes with the body’s healing ability. The best thing to do if you are a smoker who wants a facelift is to quit smoking. If this is impossible, there may be other options available such as a mini-lift instead of a full facelift. In any case, you should stop smoking for at least two weeks both before and after surgery, and you should take care to visit a board-certified facial plastic surgeon who has experience performing surgery on smokers. I hope this helps.

Q: I’m 39 years old and considering a facelift for early jowling and skin laxity. I just want a subtle lift to improve my jowls, jawline, and neck. Would you recommend this?

A: At my practice, I perform a procedure called a mini-lift for patients who are just beginning to see signs of jowling and laxity. This procedure involves smaller incisions and is less aggressive than a traditional facelift, perfect for people who want just a subtle lift and who have only minor jowls. From your photos you would seem to be a good candidate for a procedure like this, but a consultation with a board-certified facial plastic surgeon is necessary to say for sure. I hope this helps.

Q: Can I do a facelift in my early 30s? I have heavy, sagging lower cheeks and jowls. I tried a thread lift without much improvement.

A: While the 30s is often considered young for a facelift, age is not the deciding factor when looking at a facelift; instead, we look at skin quality and amount of sagging. From your photos, it appears as though you may be a good candidate for a mini lift, which at my practice involves a less aggressive lower facelift that sculpts the jawline and corrects early signs of jowls and laxity. Mini lifts can be performed on younger patients with great results. I hope this helps.

 

Q: I’m 20 years old but I have droopy cheeks and pronounced nasolabial folds. Would a midface lift help?

A: It is highly unlikely that a 20 year old would have enough sagging to warrant a facelift of any kind. If you are unhappy with your cheeks and nasolabial folds, filler injections can be used quite effectively to enhance the cheekbones and smooth the nasolabial folds. Without seeing you in person and without any photos it is difficult to say for sure what procedure would be best, however. I suggest visiting a board-certified facial plastic surgeon for an evaluation, and to try non-surgical methods such as fillers before resorting to surgical procedures at your age. I hope this helps.

Facial Plastic Surgery FAQ

Q: Am I a good candidate for facial plastic surgery?

A: Patients that are in good general health and have realistic goals are good candidates for facial plastic surgery. Dr. Kulbersh will ensure that you are in good health before scheduling a facial plastic surgery procedure. All patients will get pre-operative health clearance for surgery from an internal medicine doctor. During your facial plastic surgery consultation, Dr. Kulbersh will spend time with you to understand your goals, wishes, and expectations.  It is important for the patient to be completely honest to ensure the best possible outcome.

Q: What is the best age for one to undergo facial plastic surgery?

A: There are a number of factors that influence the “best” age for facial plastic surgery. These include the procedure type, goals, general health, skin type, and body habits. It is best to discuss these factors with Dr. Kulbersh during your private consultation.

Q: Is facial plastic surgery safe?

A: Safety is Dr. Kulbersh’s first priority. All surgeries carry risks, therefore Dr. Kulbersh does everything possible to minimize the risks. Dr. Kulbersh ensures that you are healthy enough to undergo the procedure, and has top-notch medical personal to care for his patients. It is important to follow all medical instructions and attend all follow-up appointments to ensure the best outcome. Also, Dr. Kulbersh ensures that he is available before and after your surgery should issues arise.

Q: What is the difference between a facial plastic and reconstructive surgeon and a general plastic surgeon?

A: A general plastic surgeon completes a plastic surgery residency training. Plastic surgeons complete 5 years of general surgery and 2 years of plastic surgery or 3 years of general surgery and 2 years of plastic surgery. During their training they operate on the entire body, including hands, feet, legs, breast, abdomen, buttocks, neck and face.

A facial plastic surgeon typically does a head and neck surgery residency, and then continues on to complete a facial plastic and reconstructive surgery fellowship. Dr. Kulbersh completed one year of general surgery residency and 4 years of surgical residency exclusively focused on the face and neck. He spent his entire training on the study of the form, function, and aesthetics of the face and neck. After completing residency, he completed an advanced one year fellowship training in facial plastic and reconstructive surgery.

Q: Can you become a facial plastic surgeon without doing advanced fellowship training?

A: Yes. Plastic surgeons and head and neck surgeons can apply to become facial plastic surgeons. In order to do so, they have to pass an examination and a review of their cases.

Q: Is plastic surgery an inpatient or outpatient procedure?

A: The majority of plastic surgery cases are performed as outpatient surgeries, and patients may go home the same day. Patients may have to stay in the hospital following more extensive surgeries or as a result of complications.

Q: What is the difference between Plastic Surgeons and Cosmetic Surgeons?

A: The credentials of Plastic Surgeons, Facial Plastic Surgeons, and Cosmetic Surgeons are all different and frankly confusing. Plastic surgery requires a residency that finishes with plastic surgery. To become a facial plastic surgeon, you either have to do a otolaryngology/head and neck surgery (ENT) residency, plastic surgery residency, or dermatology residency. After your residency you can either become a facial plastic surgeon by doing additional high level training in a fellowship and pass a test or turn in a case series in facial surgery and pass the test. Dr. Kulbersh did a head and neck surgery residency, a competitive fellowship, and passed the test.

Botox and Facial Fillers FAQ

Q: What treatment options are available to fix a downturned mouth?

A: Judging from your photos, there is a strong downward tug on your mouth muscles that could be alleviated with Botox. This neuromodulator will relax those muscles so they release the tension that is holding your mouth down, which will then allow the corners of your lips to lift. You may also need skin resurfacing plus dermal fillers such as Restylane or Juvederm to fill in the creases. I hope this helps.

Q: Can you develop an allergy to Botox even if you never had one before?

A: Unfortunately, it sounds like you were treated by someone who has no expertise in injecting Botox. Your description is not of an allergic reaction, it’s of damage caused by too heavy a hand and possibly an incorrect dilution of the product. Ice and arnica may stop the swelling. Please find a professional to help you next time.  I hope this helps.

Q: Are there different types of Botox injection techniques? Last time was extremely painful and left me with puffy eyes.

A: Other than the prick of the needle, there shouldn’t be any pain when you are injected with Botox. It sounds like the person who treated you is not qualified to administer Botox. Do not go back to her. Find a facial plastic surgeon who understands facial anatomy, has expert injection technique and will not adulterate treatments, as may have happened in this case. I hope this helps.

Q: Will 12 units for both sides with Dysport give a heavy eyebrow a good lift?

A: If you’re not ready for an eyebrow lift, 12 units of Dysport should give you the effect you are hoping for. However, if you are young, you need to consider that getting neuromodulators every few months over a long period of time will be quite pricey. You might want to look into a surgical brow lift at some point for a more permanent solution. I hope this helps.

Q:  How many units of Botox for a slight tip of nose lift?  

A: To rotate your nose upward would take about 4 Units of Botox. The effect would only last about 3 to 4 months. You might want to consider rhinoplasty as an alternative. Because it is a surgical procedure, the changes are permanent. If you add up the cost of lifetime Botox, surgery is less expensive and requires less maintenance, too. I hope this helps.

Q: Does Botox cause loss of hair?

A: Botox only affects the muscles, not the follicles or the hair itself. If you are noticing hair loss, it could be from quite a number of different factors. Best to see your dermatologist, find out what’s causing it and how to improve it. I hope this helps.

Q: What works best for forehead wrinkles?

A: First, make sure you are wearing sunscreen and a hat every time you go outdoors. The damage that the sun inflicts on your skin makes it more susceptible to wrinkling.

Forehead furrows are caused by the frontalis muscles creasing the skin. When the skin is sun-damaged or aging, the wrinkles become permanent. The only way to stop them from occurring is by shutting down the muscle action with Botox. I hope this helps.

Q: Should I shave my beard before getting masseter botox done?

A: Your beard is short and shouldn’t interfere with Botox injections. However, you should verify this with your dermatologist or plastic surgeon, as everyone has a slightly different way of working. I hope this helps.

Q: Light Botox has left some faint lines in my ’11s’ – would simply upping the dose in the area knock these lines out completely?

A: If you can’t scowl after Botox and yet are still seeing your glabellar wrinkles, you may need to add in another kind of treatment. Laser resurfacing and chemical peels can improve the quality of your skin and produce more collagen. The quickest fix would be to use a hyaluronic-acid based filler to even out the grooves. I hope this helps.

Q:  I had 8 units botox at 11 weeks pregnant in the corner of my eyes. How harmful is this to my baby?

A: While there are no studies that address the effects of Botox on developing fetuses, it still should be avoided during pregnancy and nursing. That said, there is no reason to be alarmed. I have never heard of any ill effects on a fetus or baby from Botox and many women have made the same “mistake” that you have. Be assured, only very small doses of Botox are present in 8 Units. Enjoy your pregnancy and don’t worry. I hope this helps.

Q: I hear that when you use botox at a young age that the face muscles will at a later stage need that botox to function?

A: The more Botox you use, the less you may have to use over time. Botox weakens the muscles they treat very slightly: just enough so that with prolonged use you may not need as much neuromodulator. However, Botox will not inactivate the muscle permanently. If you want the muscle to start contracting again, just stop the Botox. I hope this helps.

Q: Other than aesthetics, what are the the benefits of “Scrotox”?

A: The original use of Botox in the scrotum was to control perspiration. That’s the only non-aesthetic benefit. Aesthetic benefits include smoothing out the skin and lowering the testicles. I hope this helps.

Q: Are there different brands for Botox?

A: Botox is one brand name — and probably the best known brand name — for a form of purified, injectable botulinum toxin that can be used to relax dynamic muscles and smooth out wrinkles. Two of the other highly effective FDA-approved neuromodulators used for cosmetic purposes are Xeomin and Dysport. Most patients will respond well to any and all of the three. Be sure you receive your neuromodulator injections from a board-certified physician wherever your travel. I hope this helps.

Q: Can you be a bad candidate for botox?

A: It sounds like the practitioner you consulted with is not very experienced with using Botox in a wide variety of patients. Even with “low” wrinkles, you should be able to benefit from Botox without causing your brows to droop. Shop around and find an expert facial plastic surgeon to help you. I hope this helps.

Q: Do I need Botox?

A: If you are needing to slather on moisturizer to hide your forehead wrinkles, then you are ready for Botox. Botox is a neuromodulator that blocks the signals that nerves send to the muscles, telling them to contract. Without receiving that signal, the muscle relaxes and the skin smooths out. You should still be able to make natural expressions if you are treated by an expert.  I hope this helps.

Q:  Can I still move my forehead after Botox?

A: You can keep yourself looking young and also maintain your ability to express yourself in your roles if you receive Botox from an expert. Botox is only supposed to relax the muscles, not freeze them.  I hope this helps.

Q: Can Botox injections flip the upper lip?

A: There are many excellent facial plastic surgeons in Los Angeles who can help you choose the best treatment for your lips so that you get the results you want. I highly recommend my own mentors – Dr. Paul Nassif and Dr. Babak Azizzadeh. Using Botox to “flip the lip” is an advanced procedure, so please be sure you work with an expert. I hope this helps.

Q: I have residual effects from Bell’s palsy, tight cheek, smaller eye, uneven smile. Could Botox help with these issues?

A: Botox is the gold standard treatment for facial paralysis due to Bell’s Palsy. Please research facial plastic surgeons in your area to find an expert who specializes in using Botox to relax Bell’s palsy. I hope this helps.

Q: Should I get Botox again or fillers for my aging eyes?  

A: Botox alone could be sufficient to address your problems. As you’ve probably experienced, Botox relaxes the muscles around your eyes so that your crow’s feet smooth out. You can also use Botox to lift your brows slightly, which will make your eyelids look less droopy. I hope this helps.

Q: Why should I wait for for 3 months after having Botox for the first time?

A: The 3- to 4- month waiting period between Botox sessions is just that: a recommendation. If the Botox wears off sooner than that for you, it’s perfectly safe to be re-treated as soon as you need it. I hope this helps.

Q: What can be done to make my smile more even – Botox?

A: If you are self-conscious about your smile, Botox or another neuromodulator, such as Dysport or Xeomin, can help. The neuromodulators work by relaxing overactive muscles. A very light touch of Botox could help one side of your smile relax enough to match the other side. You will need to research your facial plastic surgeon thoroughly, as this is an advanced procedure and cannot be left to someone who does not have tremendous expertise. I hope this helps.

Q: Does steam or sauna affect the lifespan of Botox Dysport Xiomon and Juvéderm type products?

A: I do recommend refraining from overheating via exercise, hair dryers or saunas for 24 hours after the injection of Botox or dermal fillers such as Voluma, Sculptra and Restylane. After that, there is no danger in the heat having any effect on their efficacy. I hope this helps.

Q: Can I get Botox, Vobella?

A: Many patients use Botox and dermal fillers at the same time. In fact, a “liquid facelift,” which is becoming increasingly popular, relies both on dermal fillers and on neurmodulators like Botox. The Botox relaxes dynamic muscles that cause wrinkles, allowing the skin to smooth out and the wrinkles to fade. Hyaluronic acid fillers such as Voluma, Volbella, and Restylane, and other dermal fillers such as Sculptra, add volume to wrinkle troughs, lips, the cheeks and midface. There are no interactions between these different treatments. I hope this helps.

Q: Can you use Botox to relax overactive muscle near nose?

A: You should get an improvement in your nasolabial fold if you receive Botox in the muscle that is causing it. Be sure to find a facial plastic surgeon who has expertise in using Botox in this manner to get the best results. I hope this helps.

Q: Botox for bruxism?

A: Botox can be a very effective remedy for bruxism (i.e., teeth grinding). The neuromodulator is injected into the masseter muscles, which lets them relax. This will prevent you from grinding your teeth and will also let your face relax and elongate to resolve some of the bulking up that’s bothering you. I hope this helps.

Q: I’ve heard that getting Botox just above the upper lip can help to “lift” the lip a bit to create a more prominent pout?

A: If you find an expert injector, Botox can give you a subtle upper-lip lift. However, Botox only lasts three to four months. It’s also essential to find someone who has done this procedure before, as the lip must continue to be functional despite the fact that some of the muscles have been relaxed.

I would actually suggest using one of the hyaluronic acid fillers, as your upper lip is not quite at the ideal proportion that we like to see in relation to the lower lip (i.e., 2:3). The filler will also make your lip slightly more visible when you smile; Botox alone won’t be able to accomplish that. I hope this helps.

Q: I have two dimples or indents on my chin when I smile. Would Botox fix this?

A: A small amount of the neuromodulator Botox can probably relax the muscles around your chin area so that they don’t cause dents or dimples. This takes an expert hand, so be sure to find a facial plastic surgeon who has experience using Botox to remodel the lower face. I hope this helps.

Q: Could Botox be used to lift my eyebrow to make them even?

A: You can use Botox to raise the outer edge of your lower brow to make it more even with your other eyebrow. However, Botox will only last about 3 to 4 months. If you like the way your eyebrows look once the asymmetry has been corrected with Botox, you could also consider a permanent solution with a brow lift. I hope this helps.

Q: What treatments can I get to help the wrinkles on my face? I’m only 23.

A: The wrinkles you describe are the “normal” signs of aging, but that doesn’t mean you have to live with them. The neuromodulator Botox will quiet the dynamic muscles that are causing your wrinkles, which allows the overlying skin to smooth out. By keeping the muscles from contracting, the wrinkles also cannot be reinforced and worsened, which they otherwise would be. Botox is therefore both palliative and preventive. You should also institute an anti-aging and sun-protection skin regimen to make your skin healthier and more resilient. I hope this helps.

Q: Am I too young for Botox? I am 26 years old.

A: You are not too young to start Botox at 26. In fact, getting a jump on your aging now will help you continue to look youthful and vital for a long time to come. I hope this helps.


Q: Are there any downsides and or dangers to beginning Botox treatment at the age of 25?

A: Starting Botox at 25 is a great way to get ahead of the aging process. Prevention is always a better solution than finding a remedy after the fact. Injected judiciously, Botox should be able to smooth out your forehead wrinkles. Prolonged use of Botox can weaken the muscle enough so that less neuromodulator may be able to achieve the same effects. You should not be receiving enough Botox to lead to muscle atrophy or brow drooping. You’ll need to find an expert injector to help you with using Botox as part of your anti-aging regimen. I hope this helps.

Q: I was wondering if a Botox will help me to have a slimmer jaw?

A: Either Botox or Dysport can help relax your masseter muscles so that they don’t look so bulky and cause you discomfort. This should also make your face look slimmer and more feminine. I hope this helps.

Q: Is Botox the right option for me if I want resting wrinkle lines filled?

A: Botox won’t fill in your wrinkles, but it can relax them. Technically, Botox is a neuromodulator, which means it will block the signals that the nerves send to the muscles, urging them to contract. When the muscle relaxes instead of contracting, the skin relaxes too. If the crease isn’t too deep, it should disappear. If you can still see wrinkles after your Botox, then a hyaluronic acid filler such as Juvéderm or Restylane could fill them in. I hope this helps.

Q: 18 year old with a forehead crease.  

A: If you lifted your eyebrows a lot in the past, then that is probably what caused the crease in your forehead. Rather than focusing on keeping your forehead still (which may be impossible, since lifting your brows is probably a habit and also a normal part of human expression), you can relax those lifting muscles with Botox. When the muscles can no longer force the skin to crease, the skin will smooth out. I hope this helps.


Q: Frown lines. Should I get a higher dose?

A: As the patient, you are the one who ultimately decides which procedures you need. It sounds as if you feel you were not treated properly at your second Botox session. If you don’t feel listened to and are losing confidence in your injector, you should find another. I strongly advise seeking the services of a facial plastic surgeon who deeply understands facial anatomy and aesthetics to be ensured of the best results. I hope this helps.

 

Q: Sad mouth – is Botox effective?

A: In your particular case, I cannot determine whether Botox is a solution because you didn’t provide photos. However, theoretically Botox might be an effective treatment to relax your mouth corners and give you a more pleasant demeanor. The only way to determine this for sure is to find a professional to evaluate your anatomy and musculature around the mouth. I hope this helps.


Q: Botox causes muscle atrophy over long term use, is this true?

A: The only time Botox creates the reverse effect and makes a patient look older is when it has been over-injected or injected into the wrong muscle. This should never happen if you find an expert injector.

While Botox does relax muscles and, over time, they may lose tone and therefore require less treatment to stop them from contracting fully, they do not actually atrophy significantly. I have many patients who have been using Botox for decades and it still continues to rejuvenate their faces. I hope this helps.

 

Q: My derm told me that in order to do the 11 lines in between my eyebrows I’d have to do my entire forehead. Is that true?

A: I don’t know whether your entire forehead needs to be treated or not, as you did not provide photos and the term “whole forehead” is vague. Every person’s anatomy is slightly different, so you may need a different injection pattern than another patient.

For me, the real issue is that you are not feeling comfortable with your doctor’s judgement. That’s a sign that you need to keep interviewing plastic surgeons until you find one whose advice resonates with you and with whom you feel trust and comfort.

Q: Can I have Botox injections for TMJ but just for clenching only, as it’s disrupting my sleep?

 

A:  The neurmodulator Botox works by blocking the signals from the nerves that cause muscles to contract. If your masseter muscles are injected with Botox, they should relax sufficiently to give you relief from your TMJ. There may be other issues with your jaw that are causing the clicking. Sometimes stress is at the root of bruxism. I would recommend trying the Botox first. It will help alleviate the TMJ. If the other problems don’t resolve, then you would need further evaluation.

 

Q: How often can you do a Botox jaw reduction?

A: Botox takes about three to four months to wear off. If you will not be able to get re-treatment at that time, it is fine to do it slightly earlier. You may not need as much Botox during this second treatment if the effects of the first session are still active. The other alternative is to find a practitioner in your new location to handle the re-treatment on schedule.

Q:Botox or Dysport for Jaw Slimming?  How can you tell if dysport will make a difference in slimming the jaw. My face is oval with the exception of an angled jaw. When I clenched my teeth the area bulges a tiny bit. I can press down on the muscle and see a much slimmer face, but I don’t want to spend the money if it will only help my tmj without slimming the area. Will a doctor be able to tell for sure? Will dysport or botox work better? How risky is this procedure? Will most drs charge by the area or unit due to complexity?

 

A: Botox and Dysport are both safe neuromodulators that can be very useful in slimming overbulked masseter muscles, thus slimming the face nonsurgically. As with any medical procedure, there are always risks, but most of these would be owing to operator error, which is why it is so important to find a professional who has expertise in Botox and Dysport injection. The only real side effects you should expect are slight swelling, bruising, redness and/or pain around the injection sites for the first few days. I hope this helps.

Q:Botox or Laser on Deep, Vertical Forehead Creases? have deep creases going down my forehead on both sides, and look like two horns. Can I get rid of it with Botox or Laser?

 

A: From your description, it sounds like you would benefit most from combination therapy to even out your deep forehead creases. Laser resurfacing will improve your skin quality, stimulate collagen, and smooth out your creases to some degree. If the creases are caused by dynamic muscles, Botox can stop the muscles from contracting, allowing the overlying skin to smooth out. If the creases persist, they can be filled in with Voluma, Juvéderm, or another dermal filler. But the only way to know whether you need one of these therapies or all of them is to meet a facial plastic surgeon in person. I hope this helps.

Q: How Much Botox Units is Needed to Treat Underarm Hyperhidrosis?

 

A: It takes about 50 units of Botox per arm to correct the medical condition known as hyperhidrosis, or excessive sweating. Botox is not a permanent cure. Results only last about three to four months and then the procedure must be repeated. However, my patients who have had Botox to control this embarrassing condition have been very happy and continue to be treated. I hope this helps.

Q: Can Botox Be Used Around the Mouth Area? sides in particular.

 

A: Yes, you can use Botox to correct a variety of conditions around the mouth and lips, such as a gummy smile, smoker’s lines, drooping mouth, uneven lips, etc. However, it takes a great deal of experience to inject in this area and get a good outcome. Take your time finding an expert injector. I hope this helps.

Q: Is Botox Poisonous? Is that true?  Does that make Botox dangerous to use?

A: No, Botox is not poisonous. It has been used safely for decades for cosmetic purposes. Botox is made from a purified version of botunlinum toxin, which if ingested in large amounts in an unpurified state could be poisonous, just as the arsenic found in almonds is. The amount of botulinim toxin used in Botox is minuscule. All it will do is relax dynamic muscles that cause wrinkles, allowing the skin to smooth out and look rejuvenated. It can also be used to control a gummy smile, slim the jawline, control excessive sweating, and manage migraines. I hope this helps.


Q: Can Botox Create a Thinner-looking Face? I’ve heard that Botox can also be injected on the chewing muscles in the mouth to help to create a thinner-looking face. Is this true?

 

A: If your face is wide secondary to large muscles in the face, it can be made smaller by injections of Botox.  Botox is injected into the masseter muscles, which help in chewing, it can shrink them to create a slimmer face.  This will depend, however, on the patient’s anatomy and whether he or she has an overdeveloped masseter that’s causing the face to look wide or masculine. You’ll need to be evaluated by a facial plastic surgeon to find out if you could benefit from this procedure. I hope this helps.

Q: Is Botox permanent? I was contemplating getting Botox. I have heard that if you get Botox once then you have to keep on getting it. When you stop using Botox does the wrinkles get worse? Can you stop using Botox?

 

A: You heard right: If you want to maintain the good results from a Botox treatment, you will need additional treatments every three to four months. Stopping Botox does not make wrinkles worse; time does. Time without Botox = a worsened wrinkle. Time with Botox = improved, smoothed-out wrinkle. That said, you can stop using Botox any time you wish; you’ll just lose its benefits. I hope this helps.

Q: Can botox help my tip from drooping when smiling or talking?

A: Botox is a great way to control your nose tip so that it stays more lifted when you’re talking or smiling. It’s a simple procedure and doesn’t take much time, but requires a great deal of expertise, so please find a facial plastic surgeon. You can discuss cost at that time. I hope this helps.

Q: I’ve heard of people speaking about Botox that only lasts a week or so. What could cause this? Would watered down Botox do that or is this from China? What would cause this?

A: As with any procedure, there are some patients who do not respond to Botox. This, however, is a rare occurrence. If you are hearing reports from multiple people of Botox only lasting a week, I would suspect this is due to an inferior, watered down product, or injector error. Neither of these should occur if you take the time to find a board-certified facial plastic surgeon who has proven expertise in injecting Botox. I hope this helps.

Q: I’m 32 and have some lines on my forehead and one between my eyes. I’m wondering if Botox could help these?

A: Botox is an excellent choice for smoothing out wrinkles in the forehead, including the glabellar lines, or “11”s that occur between the eyes. If you are constantly looking in the mirror to evaluate whether your wrinkles are noticeable or not, then they are bothering you. Botox will not only smooth them out for three to four months, but during that time the muscles that cause them will be relaxed, thereby preventing the deepening of the wrinkles. You will need to be retreated when the Botox wears off to continue your rejuvenating benefits. I hope this helps.

Q: I did Hot yoga 24 hrs after Botox. Am I okay

A: Don’t worry about your hot yoga session affecting your Botox results. It usually takes several days, sometimes up to a week, before Botox will completely relax the treated muscles. Generally I recommend that patients refrain from vigorous activity for at least 1 day after Botox. If you don’t see an improvement in your “11s” after a week or two, please consult with your board-certified facial plastic surgeon. I hope this helps.

Q: Hello, for the past 7 or 8 years I have lived with what I call a forehead cleavage! I’m 29 and I can’t stand the idea of living with it in my 30s. 

A: Botox will relax the muscles that are causing that deep crease between your brows and also the horizontal crease in your forehead. After the muscles have relaxed, your creases can be evaluated again to see if they need to be filled out with hyaluronic-acid-based fillers such as Juvéderm. I hope this helps.

Q: Botox For Drooping Mouth Corners?

A: Botox injected in the depressor anguli oris muscle will weaken it, preventing it from pulling your mouth corners downward. That may be sufficient to give you a more pleasant demeanor. If you have developed wrinkles from the muscle’s action, these can be filled in with a hyaluronic-acid-based filler, such as Juvéderm.

Q: Can A Person Have Botox While On Accutane?

A: Many people continue to have acne breakouts well into adulthood, and therefore have to deal with lesions and wrinkles at the same time. There are no contraindications to using Accutane and Botox simultaneously. I hope this helps.

Q: I have an appointment for a jaw reduction with botox and I am concerned as to how many units should I have? Also, can that procedure cause sagging on jowls? If yes, what can I do to prevent this from happening? Would also the treatment reduce my big cheeks?

A: Your jawline can be slimmed with about 20 units of Botox. Relaxing the masseter muscle does not create jowling. Botox cannot be used to slim the cheeks, but I do not see overdeveloped cheeks in your photo. If you feel your lower face is too heavy, you might consider building up your cheekbones with fillers or implants. But wait until you see the results of your slimmer jawline; that may be all you need to feel happier about your appearance. I hope this helps.

Q: Is it safe to have Botox 3 weeks before knee replacement surgery?

A: Botox is a neuromodulator that is injected directly into a dynamic muscle to relax it, allowing wrinkles in the skin to smooth out. It is a localized treatment that will not affect the body’s overall chemistry. It is safe to have before surgery – particularly in an area not associated with the face. I hope this helps.

Q:Scared of Botox For Forehead Lines- What Are The Risks?

A: Botox has been used since the 1990s to treat wrinkles, such as those that bother you in your forehead. While every procedure has some risks, the risk profile for Botox is very low – especially in the forehead, where only a few units are used at a time. The reports of shallow breathing and swallowing problems have been limited to Botox in the neck and are probably owing to over-injection. The main risk for Botox in the forehead is that an inexpert injector may cause the forehead to sag. This is why it is important to find someone with experience and expertise. I hope this helps.

Q: How much younger can plastic surgery make you look like on average?

A: There is no single answer to that question. Some procedures, such as Botox injections, make you look “better” and “more rested,” as the treated areas will be smoother and more youthful. How many years that “takes off” will vary by the perceiver. For more extensive work, such as surgical facelifts, some people report looking and being told they look as much as 10 years younger. However, no procedure can turn back the clock entirely. One issue that plastic surgery can’t address is bone loss, which occurs as a natural part of aging. So a 70-year-old, for instance, will not look like a 30-year-old, no matter how much work is done. The aim in any plastic surgery procedure – whether Botox, fillers, or surgery – is to make you look the best you can be at this moment in time: healthy, rested, rejuvenated and with a unique beauty that looks natural, balanced and harmonious. I hope this helps.

Q: Botox to Contour Jawline?

A: When slimming the jawline, Botox is injected into the masseter muscle to relax it. How much Botox you need will depend on how developed that muscle is. However, if you are expecting the jaw to be more contoured or lifted, I reiterate my colleague’s remarks that Botox will not do that. It can only make a heavy jawline look less bulky. As for follow-up treatments, Botox generally wears off within three to six months – no matter how much is injected. In patients that need narrowing or shrinking of large masseters muscles, i will use 50 units of Botox.  You need an in-person consult to determine what’s best for you and how much it will cost. I hope this helps.

Q: Do Botox Injections Work on the Neck Bands? Can Botox be used on the neck banding? What else does neck injection offer to a patient?

A: Botox can indeed reduce the two platysmal muscle bands in the neck. It takes some finesse and expertise to use Botox in this area, as misplacement of the neuromodulator could cause some problems with swallowing. The Botox can also provide a slight lift to the neck area.  It does not work for all patients.   I hope this helps.

Q: I want to get Botox under my armpits. Does it take away smell and sweat? It’s 1200 every 3 to 4 months?

A: Patients suffering from hyperhidrosis, otherwise known as excessive sweating, can find relief through Botox. Though the procedure takes a large number of Botox units – up to 50 per armpit – the results can provide a tremendous relief for the patient. When the injections are performed by board-certified plastic surgeon, excessive sweating can be controlled for up to 6 months, depending on the individual case. I hope this helps.

Q: Who is Qualified to Inject Botox? I’m thinking about getting Botox injections in my forehead but I don’t know what qualifications/education pratitioners need to do Botox injections.

A: While qualifications for administering Botox vary from state to state, the most important factor is the degree to which your practitioner has expertise in delivering the neurotoxin into the appropriate areas of the face and at the appropriate dosage.  By analyzing the patient and his or her natural facial movements, using a very small needle and being precise with my injections, I am able to achieve resolution of troubling aging signs such as crow’s feet, “11” lines, and other dynamic wrinkles while allowing the face to look relaxed and natural.

Q: Can Botox or a filler raise the brow 4-5 mm? I am 20 years old and I really don’t want to get surgery, but my eyebrows droop, making me look angry all the time. I heard that a non surgical option can only raise the brow by a couple of millimeters, but I really don’t think 2-3 is enough for me. So, how high can Botox or a filler raise the brow? Can I use artefill as a more permanent solution? Or do I have to resort to surgery?

A: There are multiple options to non-surgically raise the brow.  These options included:

  1. Botox
  2. Dermal Fillers

When performing a nonsurgical brow lift with Botox, I weaken the muscles that draw the brows down while allowing the muscles that raise the brows to function normally. I can also use facial fillers to raise the brow slightly. You can watch the following video to learn more about your options.

Q: Brow Lift – What Happens if my Eyebrows Are Lifted Too High and I End Up with a ‘Shocked Look? I am thinking about having a Brow lift but am worried the eyebrows may be lifted too high and I may end up with a permanently startled look. Could this happen?

A: Any facial plastic surgery or cosmetic procedure should enhance your looks, not work against them. A browlift that results in a “permanently startled look” would be a failed procedure. Your best insurance against an unwanted outcome is to spend time finding a board-certified facial plastic surgeon with training in facial aesthetics who takes the time to evaluate your particular anatomy, learn about your desired outcome, and discuss the realistic results you can expect. A browlift should look natural, giving you a more youthful and rejuvenated look that allows full expression and is in harmony with your facial features. I hope this helps.

Q: Is there any pain following Botox injections? How long does it hurt after you get them?

A: There is no pain following Botox injections for the vast majority of patients. Even the injections themselves are not very painful, due to the small needle and very quick injections; most patients experience just a small “pinch”. Following injection, you may experience minor tenderness, swelling, possible bruising, and a tingling sensation. These resolve very quickly and can be managed with over the counter medications if necessary. I hope this helps.

Q: I had Botox 4 days ago, but I can still frown. It does feel a bit tighter.

A: Botox effects can take up to 7 days to fully set in, with full results at two weeks. Be patient, and if after two weeks you still don’t see improvement, visit your injector again for a touch up.

 

Q: Will Botox give you a lift like surgery, but non surgically?

A: Botox can be used to lift the brow slightly in candidates who only need very minimal correction and are hesitant to undergo surgery. A Botox brow lift will not give you the same results as surgery, but it can be a good option if you just want a subtle correction of a few millimeters. I suggest visiting a board-certified facial plastic surgeon for a consultation to see if you would benefit from a Botox brow lift, or if surgery would be better.

Q: Will I need to have facial filler dissolved before having jowl lift surgery?

A: No, it is generally not necessary to have filler dissolved before facelift surgery. Always let your plastic surgeon know of any fillers that you have in your face or neck, including where the filler is located and what type of filler it is. Good luck with your surgery.

Q: My eyes are hollow with big lids and I hate how it looks. How can I fix it?

A: For hollowing under the eyes and around the upper eyelid like it appears you have, fillers rather than surgery could work very well to reduce the hollowness and restore a brighter, more youthful appearance. Please see a board-certified facial plastic surgeon for a consultation to find the best treatment option. I hope this helps.

Q: Can you go straight back to work after lip augmentation with Juvéderm, or should you take a couple days off to stay out of sight? What’s the recovery time like?

A: Each individual patient is different, but generally I would recommend allowing a few days of recovery time just in case of swelling and/or bruising. Swelling is extremely common after lip injections, and some people may not want to be seen with lips that look that large. Bruising is also a possibility, especially if you took any blood-thinning medications or supplements for up to a week prior to injection. Alcohol can also potentially cause more bruising. The bruising may be dark at first, but it should lighten enough to be covered with makeup relatively quickly. Always visit an experienced injector for the best results. At my practice, I use a blunt cannula method for lip augmentation that greatly reduces the risk of bruising. I hope this helps.

Q: I’m 32 years old and I don’t like my side profile. It looks like my tear trough area has sagged enough that it causes me to look sad or older. Would a mid face lift or cheek lift help?

A: If volume loss in your cheeks is your main concern, you would likely benefit more from dermal fillers such as Voluma than from a surgical procedure. Voluma can help lift the cheeks back into a youthful appearance, and this can also help to disguise hollow tear troughs. I suggest visiting a board-certified facial plastic surgeon for a consultation to further examine your concerns and come up with a treatment plan, but I do not think that surgery is warranted at this point. I hope this helps.

Is there any help to remove a deep furrow in forehead?

A: Botox is an extremely effective and easy way to manage forehead wrinkles, including deep furrows. This neuromodulator relaxes the dynamic muscles that cause wrinkles, allowing the overlying skin to smooth out. Depending on how deep your furrow is, you may benefit from a hyaluronic-acid based filler such as Juvéderm, too. I hope this helps.

 

Mini Lift FAQ

Q: 40 years old. Is a mini facelift too early for me?

A: Your photos show jowling, sagging, and possibly poor skin elasticity. All of these can be influenced by genetics, as well as by lifestyle choices such as smoking, which dries and ages the skin. It’s not too soon to get a Mini Lift in your 40s. In fact, many of my patients get their first cosmetic surgery at that time. It turns back the clock by about 8 to 10 years and lasts that long, too. You can add in a real “wow” effect by getting a chemical peel to resurface and rejuvenate your facial skin at the same time. I hope this helps.

Q: Neck sagging: Is there any other solution except the mini lift?

A: Nonsurgical skin-tightening techniques are appropriate for people in the early stages of aging whose skin has just begun to lose elasticity, but still has some resilience. Once your skin has begun to sag and droop, surgery is the only satisfying solution. From your description, a neck lift with platysmaplasty to tighten the neck and neck muscles, plus a Mini Lift to lift the lower face and remove excess tissue would be my minimum recommendation. It’s quite possible you would benefit more from a full rhytidectomy (facelift) with fat grafting. An in-person consultation will get you more specific answers. I hope this helps.

Q:  Unsure of result of neck and lower face lift six weeks post-op.

A: You are still in the beginning phase of healing after your lower face lift, neck lift and submentaplasty. Stiffness is normal at this stage. It can be alleviated with gentle massage. You should speak with your facial plastic surgeon about how to increase your comfort and maximize your results. Communication is key. I hope this helps.

Q: Should I get a mini-lift revision?

A: It’s hard to evaluate your results without seeing the “Before” photos. It looks like you do still have some minimal signs of aging, such as slight jowling and a little laxity under your chin. These might respond well to a procedure such as ThermiTight. You might also consider fillers that can restore some volume in the midface to help lift up the lower tissues just a bit. You also seem to have some sun damage on your skin. If you want your skin to stay elastic and as firm as possible, you need to avoid the sun, use sunscreen, and start getting regular chemical peels to improve your skin texture and tone.  I hope this helps.

Q: I’m 51 and I’ve been considering a facelift or mini facelift for quite some time. Of all the issues, the one that bothers me the most is the marionette lines. I’ve tried fillers and the lines are still very noticeable, I had Voluma 7 months ago. The waddle neck also bothers me, but not as much. I’d rather have a mini facelift.

A: Once the lower face begins to sag, the neck is usually sagging, too. That’s why I almost always combine a Mini Lift with a neck lift and plastysmaplasty (tightening the neck muscles). That’s the minimal set of procedures that would be beneficial to you. It would lift and tighten your neck, eliminate the waddle, reduce jowling and improve the marionette lines. However, it is possible that you would do better with a full rhytidectomy (facelift) with fat grafting, neck lift, and platysmaplasty. Without full-face photos it’s hard to say. I’d suggest you begin consulting with facial plastic surgeons. Fillers alone will not give you much of an improvement at this point. I hope this helps.

Q: Can you combine a chin reduction and lower face lift?

A: Patients who want both a chin reduction and a lower face lift often opt to have both performed on the same day. This minimizes the amount of downtime you’ll experience. Both procedures can be done with local anesthesia so that you are awake. I hope this helps.

Q: Can another face lift be done say 10 years after in the same area?

A: It’s not only OK, but expected that a mini lift or facelift (rhytidectomy) will have to be repeated every 8 to 10 years. While a mini lift and facelift are extremely rejuvenating, we still continue to age and gravity still pulls the face downward. Many people have 3 or 4 facelifts over the course of a lifetime. As long as they have an excellent facial plastic surgeon, they can look terrific, healthy and natural. I hope this helps.

Q: Am I a candidate for a mini facelift?  

A: In my opinion, you have enough laxity in your lower face and neck to benefit from a mini lift. A mini lift will make your face look more heart-shaped and give you a sleeker jawline. If you don’t think the treatments your surgeon is recommending will make you happy, get second and third opinions in person and then choose the doctor you believe will give you the best results. I hope this helps.

Q: 40 yr old sagging neck: Am I a candidate for lower facelift?

A: The best fix for a sagging neck and loose lower face is a combination of a Mini Lift with a neck lift and plastysmaplasty. This combination will tighten the neck muscles, remove the fat under your chin, tighten the skin on the neck and jawline, and resolve lower-face sagging and jowls. Surgery is the best solution for sagging; anything else is temporary and ultimately unsatisfactory. I hope this helps.

Q: 45 year old with jowls needs mini face lift: UK Recommendations for great job but not inflated price?

A: Please don’t shop by price when looking for a facial plastic surgeon to perform a major procedure such as a Mini Face Lift and neck lift with platysmaplasty. Look for experience, great results, and someone you can trust. Price can be worked out. Payment plans can be made. The important thing is to find the most expert facial plastic surgeon possible — no matter whether he or she is a celebrity or not or has a fancy address or not. Finding the right plastic surgeon takes time and effort. You should expect to interview several before making your final decision. I hope this helps.

Q: Can I use vitamin C serum at night 8 weeks after a mini facelift?

A: At 8 weeks, you should be fine using topical Vitamin C on your skin. However, if you are feeling any discomfort, you should stop. You’ve had a major rejuvenation that is going to make you look younger for some time to come. Holding off on the Vitamin C for a few weeks until you are less sensitive will not affect the quality of your skin. I hope this helps.

Q: Facelift for a very young woman: is there a solution for my sagging jaw line?

A: You seem to be disturbed by the configuration of your lower face, which is not caused by sagging but by your particular distribution of skin, fat and muscle. You look perfectly normal, healthy and attractive. I wouldn’t change a thing. Not everyone is going to have a model’s perfectly V-shaped face. If you continue to be troubled by the way you look, you may consider a nonsurgical solution, such as using dermal fillers to change the shape of your lower face or create a slight chin augmentation that would stretch the skin on the sides.  I hope this helps.

Q: Do I need a mini face-lift?  

A: I’m sorry you struggle with self-esteem; you have a nice-looking, attractive face. From your photos, your skin looks like it is in excellent condition and has little to no sagging. However, you are smiling, which lifts the skin upwards. Nonsmiling photos would be more helpful to evaluate how much laxity you have.

Based on what I see, I wouldn’t recommend any kind of surgery yet. I don’t see evidence of jowling or sagging. Fillers could give you a little more volume. I hope this helps.

Q: Mini facelift. Do all surgeons staple to the cheek muscle?

A: Every surgeon develops techniques over the years that work best in most of their patients. I don’t use staples in face lifts. I find that sutures are better able to withstand the downward pull of tissues, and hold the muscle and skin in place as they heal. The most important thing is to find a facial plastic surgeon who inspires trust and confidence. I hope this helps.

Q: What kind of procedure do I need for the sagging skin and wrinkles between my eyes and mouth? Would a mini facelift be enough or would it need to be a full?

A: Based on your photos, I would recommend a full rhytidectomy (facelift) with fat grafting and a neck lift with platysmaplasty. This would restore volume to your face and cheeks, plus resolve the jowling and sagging in your lower face and neck. A chemical peel will help to resurface your skin and smooth away some of the fine wrinkles; this can be done during your facelift procedure. I would also recommend upper blepharoplasty, as your eyelids are quite heavy and droopy, plus an excellent skin care regimen to help you look rejuvenated over the long term. This combination would give you a dramatic, satisfying and very natural result that would allow you to look as vital as you feel. I hope this helps.

Q:  Would a mini lift dramatically improve my profile?

A: Congratulations on your weight loss; that’s quite an accomplishment. I would suggest waiting until you have finished losing weight before proceeding to a major cosmetic procedure. Otherwise, you might have to repeat the surgery after you reach your goal weight.

Once you are at or near your ideal weight, I’d recommend liposuction with a neck lift to remove excess skin. You might possibly need a lower lift, too. Although you are young for a mini lift, you do have some jowling already. This will probably worsen as you lose fat and the skin begins to sag. Procedures are never prescribed based on chronological age, but on need. You can begin consulting with facial plastic surgeons as you continue your weight-loss journey. Learning more about how close you can get to your ideal may even help you stay committed to your new diet and exercise regimen. I hope this helps.

Q: Best approach to minimize mid cheek groves and nasolabial folds for a 20 year old?

A: Without photos, I cannot comment specifically on your case. It would be rare for a 20-year-old to have significant enough sagging and creasing to warrant a mini face lift (rhytidectomy). However, that may be the best solution in your case, if your skin quality is poor and you’ve lost muscle volume. Find a great facial plastic surgeon who can analyze your bone structure and skin and make recommendations to give you the improvement you want now, plus devise a long-term plan to help you stay youthful. I hope this helps.


Q: Thinking of doing a mini facelift and also upper eyelids. Which should be done first?

A: Ideally, you should do both of these procedures at the same time. This will make your recovery much easier, as you only have to do it once. Also, combining blepharoplasty and a mini lift may be able to get you a discount.

If you choose not to do both surgeries simultaneously, there is no reason to choose to do one first over the other. Do the one that concerns you the most. Please be sure that you take your time to find an expert facial plastic surgeon to perform both of your procedures. I hope this helps.

Q: I would like a (mini?) face lift and rhinoplasty – preferably done at the same time, but have an anesthesia question. I hear (slightly?) better results are obtainable for a facelift under local anesthetic, but rhinoplasty requires general.

A: The reason surgeons prefer local anesthesia to general for a mini lift are twofold: 1. It’s easier on the patient and speeds recovery,  and 2) It allows us to evaluate the lift while the patient is awake and can move her or his face. However, an expert surgeon understands anatomy sufficiently that we can create the same natural effects for a mini lift under general anesthesia.

The choice, ultimately, is yours. If you’d like to remain awake for your mini lift so you can see what it looks like, that can be arranged. You would then be given general anesthesia for your rhinoplasty. If you’d rather sleep through both procedures, that’s possible, too. The surgeon’s expertise is much more important than choosing one type of anesthesia over another. I hope this helps.

Q: One year since lower face lift. Beginning to see vertical lines again on neck. Why is this happening?

A: I’m not sure why are you are beginning to see vertical lines on your neck after your lower face lift. There could be many reasons for this. Perhaps the lift wasn’t tight enough, or the underlying muscles weren’t tightened. This may be something easy to fix with Botox, which would relax the bands, or you may need a revision neck lift. I’d recommend going back to your facial plastic surgeon for an examination to find out what your best course of action is. I hope this helps.

Q: How effective is a lower face lift?

A: A lower facelift is a highly effective rejuvenating procedure for someone who has early signs of aging, such as slight jowling and volume loss in the lower face. It is not good at eliminating the nasolabial fold.  That is better treated with fillers or facial fat grafting.  Whether it’s the right procedure for you can only be determined by an in-person consultation. I’d recommend you start researching and meeting with facial plastic surgeons in your area to find out which type of surgical lift would best benefit you. I hope this helps.

Q: I had a mini face lift to fix my turkey neck 9 days ago I feel like my face is really round and stretched?

A: Your consternation is normal. First, you’ve made significant changes to your face that will take some time to get used to. Second — and more important — you have barely begun to heal from your procedures. Your face will be swollen and feel stretched for a couple of months. It may take up to six months before you see the final results of your facelift. In the meantime, be patient with your body’s  healing process. Also consult with your facial plastic surgeon about the medical-grade skin care and sun-protection regimens so you will reap the full benefits of your procedure. I hope this helps.

Q: Sagging jowls, and under chin, curled down lips and sun damage.

A: A Mini Lift with liposuction to remove your submental fat and a neck lift to remedy the skin under your chin and on your neck that has begun to loosen would give you the most gratifying improvement. I wouldn’t recommend a liquid facelift at this point. If the nasolabial folds don’t improve with the Mini Lift, you can even them out with a hyaluronic acid-based dermal filler, such as Juvéderm. As for the sun damage, I’d recommend regular chemical peels, hydroquinone and a medical-grade skincare regimen plus extremely diligent sun protection. I hope this helps.

Q: I’ve gotten two opinions about a lower face lift. One surgeon recommends for my turkey neck and mild jowling (50 yrs old). He felt that fillers could “keep me going” for 10 yrs. Second doc says it doesn’t look natural to treat part of the face– that it will look obvious and out of balance. Any advice welcome.

A: It’s difficult to evaluate your full face, as your photos show only the lower half clearly. However, you would definitely benefit more from a neck lift with platysmaplasty and a lower facelift than you would from fillers. Well performed by an expert, a lower facelift with neck lift will rejuvenate your entire look. However, it may be that it is not sufficient in your case. If that’s true, I’d recommend a full rhytidectomy (facelift). Fillers are good for early signs of aging, but once jowls and sagging neck skin appears, it’s time to turn to a more dramatic and longer-lasting solution, such as a lower or full facelift. These procedures look beautiful and refreshing, plus last up to 8 to 10 years or more. I hope this helps.

Q: Help with jawline/jowls?

A: You do have some early jowling and lower facial sagging. My recommendation for the most dramatic and longest lasting rejuvenation would be a lower face lift, possibly with neck lift (it’s hard to see your neck in the photo). Either Kybella or mini liposuction would help remove the fat in the jowls. A Mini Lift, with or without neck lift, can be done under local anesthesia in the office. You will need to allow a week or so for recovery before you can return to your full activity schedule. I hope this helps.

Q: What is the best procedure to treat my sagging Jowls?

A: A Mini Lift with liposuction using mini cannulas and a neck lift would give you the most dramatic rejuvenation. Look for facial plastic surgeons in your area, rather than searching for general plastic surgeons. Facial plastic surgeons are trained both as surgeons and as aestheticians who know how to work with your particular bone structure and anatomy to get the most flattering results. I hope this helps.

Q: Anesthesia for Neck Lift/Lower Facelift – confused about different recommendations?

A: It is very helpful to consult with a number of facial plastic surgeons before making a decision about who you want to help you. However, as you have experienced, it can also be confusing as each of them has his or her own preferred methods of working – including whether to give general or local anesthesia.

At my center, I preform a lower facelift and neck lift with both general and local anesthesia.  Local anesthesia is reserved for my patients that have early aging changes and are not undergoing multiple procedures at once.  I think doing a lift in 2.5 hours is rather fast.  In my hands, it takes me longer as I am meticulous.  Rather than worrying about how the procedure is performed, and how long it will take, I’d suggest that you focus on the results that each of these surgeons has been able to show you. Also, pay attention to your gut. What you want is someone who inspires you, relaxes you, and whose patients look phenomenal. I hope this helps.

Q: My marionette lines and neck droopiness has not gone away after my mini facelift, what are my options?

A: A Mini Lift is only designed to resolve lower face sagging. From the look of your photo, it may be that you would have benefited more from a full rhytidectomy (face lift) with neck lift and platysmaplasty. If you want to tighten the neck, then I’d either recommend another surgery (neck lift with platysmaplasty) or skin tightening with ThermiTight. You also may still be healing. If your marionette lines don’t resolve, then fillers and resurfacing could help a lot. I hope this helps.

Q: I had a lower neck/face lift in January early 2016. I thought the scars would not be bad?

A: Talk to your surgeon about how your scars can be improved. Scars usually take a combination of treatments, including lasers and MicroNeedling. If you want hair to grow in the scarred area again, you will need hair transplants from the back of your head. I hope this helps.

Q: Could mini lifting/brow lifting procedures be done in a face that had thread lifting 8 years ago?

A: I’m surprised that you’ve been satisfied with your thread lift for as long as you have been; many of my patients request a full or partial rhytidectomy (facelift) within a year of a thread lift. There is no reason you cannot move on to a Mini Lift at this point. Your threads have probably long dissolved. If not, they can be removed during your surgery. I hope this helps.

Q: My neck and jowls look bad will mini face lift fix that?

A: Each facial plastic surgeon has a different definition of a “mini lift.” At my center, I generally include a neck lift and plastysmaplasty (neck-muscle tightening) when I perform a lower face lift (Mini Lift), but many other surgeons do not.

I cannot tell from the photo if a Mini Lift would be sufficient for you, as I would need to examine your face in repose. You shouldn’t worry about the name of the procedure(s); just find a great surgeon who can help you resolve all of your issues. Combination therapy is often needed for a dramatic improvement, including lasers to resurface and rejuvenate the skin and liposuction to remove excess fat from under the chin. I hope this helps.

Q: What is included in a mini lift?

A: Trying to understand what a “Mini Lift” is can be quite confusing because different plastic surgeons have different definitions. At my center, a Mini Lift is a minimally invasive surgical procedure that lifts the lower face and neck. Now, even that definition will vary by patient. In some patients, the need for a neck lift may be minimal, and so only include some tightening. In others, the platysma muscle also has to be tightened (platysmaplasty). The ideal candidate for a Mini Lift, in my opinion, is someone who has:

  • Minimal signs of aging
  • Slight sagging of the lower face
  • Slight jowling
  • Soft or double chin
  • Some looseness in the neck

A Mini Lift is not appropriate for heavy jowls or very lax and sagging skin. A Mini Lift provides less lifting power and therefore is less invasive and leaves smaller scars. The best way to find out if a Mini Lift is right for you is to begin consulting the best facial plastic surgeons you can find. I hope this helps.

 

Q: Should I get a mini lift and/or a neck lift?

A: Although you are just 45, you have a significant degree of loose and hanging skin, which is probably due to genetics. While nonsurgicial tightening procedures might give you a slight improvement, I don’t think you would find them at all satisfactory and they would not last long.

The best way to resolve your lower face sagging is with a Mini Lift, neck lift and plastysmaplasty. These procedures will resolve your jowls and lower-face sagging and also tighten your neck muscles and remove the loose skin. I almost always include a neck lift and plastysmaplasty as part of the Mini Lift procedure, but every facial plastic surgeon is different. You could probably also benefit from laser resurfacing and filler on your nasolabial folds. A Mini Lift with neck lift should last about 8 to 10 years. I hope this helps.

Q: Can an early facelift be better than fillers?

A: The answer to your question depends on how much “drooping” you have. If you have reached the point where you have jowls or loose neck skin, then surgery is the best option. If you just feel that your face looks a little lower than it used to, you may be able to benefit from a liquid facelift with fillers. However, these can be quite expensive to maintain over time and will eventually be inadequate.

In contrast, a Mini Lift or Facelift gives a dramatic rejuvenation that can turn back the clock by 5 to 10 years and last for that long as well – which means you shouldn’t have more than one surgery per decade or so. Generally, it is fine to have a lift after using fillers, but you should always alert your facial plastic surgeon to any prior work or treatments you’ve had done. I hope this helps.

Q: Is it okay to have filler prior to lower face lift?

A: Most patients who have facelifts these days have used fillers before. They shouldn’t interfere with your results at all. Ideally, you would go to the same facial plastic surgeon for both the fillers and the facelift so that he or she knows what you’ve had done and how to adjust for that, if necessary, during the surgery. If that can’t be managed, be sure to inform your surgeon about the fillers before your facelift. I hope this helps.

Q: Is a mini lift the best option for me? Also can a small eyelid adjustment be done at the same time?

A: It can be difficult sometimes to determine whether you would most benefit from a full rhytidectomy (facelift), or a simpler Mini Lift. A Mini Lift has the advantage of shorter surgical and recovery times, plus it’s a less invasive procedure. However, if you have the following issues, then you will benefit most from a traditional facelift with a neck lift and plastysmaplasty:

  • Heavy jowls
  • Large neck bands
  • Heavy neck or turkey neck
  • Excess fat in the neck

Your photos seem to indicate a large degree of neck sagging, which can only be corrected by a neck lift and a plastysmaplasty (which will tighten the underlying neck muscles). A full face lift with neck lift will also help smooth out your nasolabial folds and marionette lines.

You can schedule a blepharoplasty at the same time you go in for your face lift. I often perform multiple procedures during one surgical session. I hope this helps.

Q: I see on the RealSelf Website that mini-facelifts can be obtained for $6000–Its all I can afford. What does it include?

A: Mini Lifts are meant to address minimal and early lower-face sagging. From your photos, you seem to have a high degree of neck laxity, plus jowling, plus sagging in the upper face. Instead of getting a Mini Lift now and feeling disappointed that you did not get a significant improvement, I’d suggest beginning to consult with facial plastic surgeons about a rhytidectomy (traditional facelift) with neck lift and plastysmaplasty (tightening of neck muscles). If you find someone with the expertise required for a beautiful and natural result, this will cost about twice what you have saved but you should be able to work out a payment plan. Or just wait a little longer and save up the rest of the money to get the rejuvenation that would make you happiest for the longest period of time. I hope this helps.

Q: I’m 41 years old healthy woman, seeking advice on whether to get lipo on my chin, or lipo and lower face lift?

A: Your skin looks thin and there is a significant amount of sagging. Liposuction may exacerbate that, as it removes fat but does nothing to tighten skin. At this stage, your best bet is a Mini Lift with neck lift and platysmaplasty. This will tighten your neck muscles, tighten and remove excess skin, remove the jowls, smooth out the marionette lines, and lift and tighten the lower face. These steps will significantly rejuvenate your lower face and neck; the benefits should last up to 8 to 10 years. I hope this helps.

 

Q: What is the most long term fix for nasolabial folds?

A: Congratulations on taking care of yourself and looking young for your age! It would help if you would post photos so that we could answer you more specifically. In general, I would not recommend fillers except to counter the very early stages of aging – usually in the 30s and 40s. Once there are significant creases and sagging, the best “fix” is a Mini Lift. In my practice a Mini Lift addresses lower face sagging and smooths out the jawline.  It can include a neck lift with platysmaplasty to clean up the neckline if indicated. It’s a very rejuvenating procedure that will turn back the clock about 8 years and last at least that long, too.

I don’t have personal experience with Sono Bello, but have not been impressed with the long-term results of nonsurgical skin-tightening procedures; they don’t last. Liquid face lifts also must be repeated every year or two. The costs of these procedures add up quickly. If affordability is your main concern, you may be able to work out a payment plan with your facial plastic surgeon. I hope this helps.

Q: I am turning 41. I have noticed drastic changes in my elasticity, dryness, jowls/chin/sunspot/uneven and wrinkled lips?

A: You have done your research and you are choosing procedures that seem to be good solutions to the problems you are having with your aging skin. However, I prefer a TCA chemical peel at the same time as a lower facelift.  A TCA peel not only resurfaces the skin to resolve hyperpigmentation, it also stimulates a great deal of collagen and elastin to help add a real “wow” effect to a lower facelift.  I would also consider facial fat grafting to restore the lost volume in your face.  

You will also need to institute a high-quality and rigorous skin-care program with sun protection. While I understand the desire to contain costs, your first concern is to find a facial plastic surgeon who can give you the results you want and with whom you can work over the long-term as you continue to age. Bargain shopping can be costly when it comes to facial plastic surgery. Find someone who is an expert in facial aesthetics first. I hope this helps.

Q: 38 yr old female looking to improve looks as they show signs of aging. Best surgeries required to improve neck and face?

A: You would benefit greatly from a lower facelift (Mini Lift) with neck lift and platysmaplasty. These procedures can remove the excess fat from under your chin, tighten your neck muscles, tighten and trim excess skin from the neck and lower face, resolve the jowls that are beginning to form and smooth out the nasolabial folds. I also agree that you would benefit from a rhinoplasty to bring more balance to your profile. I believe that with a Mini Lift (including neck lift) and a rhinoplasty, you would be satisfied enough with your appearance that you wouldn’t want to augment your chin. I hope this helps.

Q: I’m getting a lower face/neck lift at 53. How long before I can resume exercising like upper body lifting, Pilates and hiking?

A: You will be quite sore and swollen after your Mini Lift. I recommend that patients refrain from exercise and vigorous activity for at least two weeks after a lower facelift. Introduce your activities back into your routine gradually. Hiking, for instance, would be a better first step than Pilates, which might require some inversions that could be uncomfortable while your face is still swollen. Listen to your body, take it as slowly as you need to; you’ll be back to your normal routine soon enough. I hope this helps.

Q: I have lost a lot of weight and its showing in my neck. Would I benefit from a lower face lift?

A: Though losing weight is essential for health, sadly it can be quite aging when we’re older as our skin is not elastic enough to adjust to the change in volume. A Mini Lift (lower facelift) with a necklift and platysmaplasty will resolve the sagging, drooping neck skin that is troubling you. The sooner you do it, the better your results will be. The best time to take action against aging is when the signs appear, not when you hit a certain age. A Mini Lift with neck lift now should keep your lower face and neck looking tight and refreshed for at least eight to 10 years. I hope this helps.

Q: I am 51, what do you suggest for my lower face and neck sagging?

A: The photo appears to show some early jowling and neck sagging. If this is not too significant, then your best option would probably be a lower face lift, or Mini Lift with a neck lift. This can turn back the clock by up to eight years and last at least that long, too. In addition, I’d resurface your skin with chemical peels and/or lasers and use the hyaluronic-acid based fillers such as Juvéderm and Restylane to fill in your deeper wrinkles. This will give you a significant rejuvenation and start you on a road that will allow you to take better control of your aging. I hope this helps.

Q: Considering a mini face lift – concerned about my sensitivity to epinephrine or adrenaline.

A: A reaction to epinephrine or adrenaline is not uncommon, so most surgeons will be able to offer you a variety of alternatives to make your Mini Lift procedure comfortable. One option is a “twilight” anesthesia that avoids the longer recovery time of general anesthesia, but relaxes you sufficiently that you are just barely awake. Consulting with a facial plastic surgeon in person will allow you to discuss your concerns in more depth and come up with the best plan for anesthesia and bleeding control that takes your sensitivities into consideration. I hope this helps.

Q: Can a lower (mini) face lift be done with incisions behind the ear instead of in front?

A: The definition of and steps contained in a Mini Lift will vary by physician. At my center, a Mini Lift includes a neck lift and also lifts the SMAS layer — the muscle beneath the skin on lower face that attaches to the neck’s platysma muscle. It is essential to a successful Mini Lift to include the SMAS rather than just lifting skin. A skin-alone lift looks unnatural and won’t last long.

The incisions for a neck lift can be placed behind the ears. However, the incisions for a Mini Lift must go in front and behind or inside the ears in order to get the right degree of lift and pull and to remove the excess skin. If you lift your face with your fingers, you should be able to see the logic of this. Though I understand your concern about a “visible” scar, the incisions I use in a Mini Lift are very small and barely noticeable once they heal. I also hide them either inside the ear or in an ear crease. If you’re bothered by them, they can be improved with MicroNeedling and lasers. I hope this helps.

Q: Would a lower face lift help with the jowls and marionette lines?

A: My personal belief is that you would benefit most from a full rhytidectomy (facelift) with neck lift and platysmaplasty. However, a lower facelift with a neck lift and plastysmaplasty would also give you a great improvement. Either of these options would eliminate the jowls and rectify the sagging in the lower portion of your face. Mini lifts last up to 8 years, facelifts up to 10 years. While the marionette lines should improve with either a lower or full facelift, you may require facial resurfacing to smooth them out and possibly even continued use of fillers to fill in the troughs. I hope this helps.


Q: My lower half of my face is a mess. What will give me the most improvement?

A: It would be helpful to see a full set of photos showing your entire face front and profile to determine what your best options are for making the improvements you want. Based on the photo, I would say you would probably not need a full rhytidectomy (facelift) at this point, but would benefit from a Mini Lift and a neck lift to resolve the early signs of jowling and sagging. The fat pad can be removed or repositioned during your surgery. The scars can be improved with combination therapy, including MicroNeedling and lasers. Consulting in person will give you a clearer idea of your options. I hope this helps.

Q: What are my options to improve my lower face and neck?

A: You have early jowling and sagging of the neck. The best, most dramatic and longest lasting rejuvenation would be a Mini Lift. The lift will also make your neck skin tighter and resolve your early jowling. Fillers can’t match the “wow” factor that comes with a surgical rejuvenation, nor can they match the longevity. As for cost, that varies by practitioner and can be discussed during a consultation. I hope this helps.

Q: I hate the way my neck is starting to look, but I really hate my jowl area more. Would I need a mini face lift?

A: A mini lift can help resolve early jowling and neck sagging, such as yours. It can turn back the clock about 5 to 10 years. The benefits will last about eight to 10 years. A small amount of Botox should be able to soften the tension around your mouth that’s bothering you. 

Q: Is a face lift easier for a surgeon if there is less loose skin?

A: Skin tone and quality are just two of the factors that go into the decision of which type of facelift is best for a particular patient. Good skin tone without too much excess skin may simplify the procedure somewhat, but the basic mechanics of the lift remain the same.

If is always easier to perform and get an excellent result of a lower facelift the earlier you do it.  Anatomy, not age, determines the timing of surgery.

If you are starting to develop jowls and your neck skin is beginning to loosen, then a neck lift with lower facelift would probably be the best procedures for you. Consulting in person with a facial plastic surgeon will allow you to understand more fully what exactly your own surgery would entail, based on your unique anatomy and needs. I hope this helps.


Q: Recommendations for sagging jowls? Do I need a mini or lower lift? Will Fillers do for now?

A:  Fillers will give you a little volume. Temporarily. They may help to lift the jowls a bit, but won’t do anything for the loose skin that’s developing in your neck. They have to be re-administered every 18 to 24 months. At my center, a Mini Lift will address the lower face, including the jowls, and the neck. Its rejuvenating effects will last about eight to 10 years. I hope this helps.

Q: What can help? Will a mini facelift work?

A:  A Mini Lift will eliminate your jowls, tighten up your neck muscles, remove excess neck skin, and give you a cleaner, sleeker jawline. It can be completed under local anesthesia.  I hope this helps.

Q: What age do you recommend for a mini face lift? I am going to be 70 in July

A: I never consider chronological age when deciding on which procedure will most benefit a patient. The patient’s health, anatomy, skin quality, volume loss, and other physical issues are all that matter. I’m glad you have been satisfied with past procedures. I am not sure what your present question is. If you feel that you are ready for another mini lift and you are healthy, your age should not be a factor. If you are wondering whether you would do better with a full facelift, that would depend on whether you have developed sagging in the mid face as well as the lower face and neck. The only way to have those questions answered is to find an expert facial plastic surgeon for a consultation. I hope this helps.

 

Q: Multiple issues on face, what are my options? Do I need to continue with voluma and botox tor is there a procedure that would correct the majority of the issues?

A: Dermal fillers are a fantastic way to take control of the early signs of aging. However, when you are injecting multiple areas with both fillers and Botox and are still not quite satisfied with the way you look, it’s time to find a more permanent solution. A sagging neck, especially, really needs a neck lift with platysma tightening. Merely tightening the skin with lasers or other therapy is not sufficient. You didn’t provide any photos, so I can’t speak to what procedures you would need, but it sounds like you’d benefit at least from a mini lift with neck lift and possibly would need a full facelift with fat grafting and a necklift with platysmplasty. I hope this helps.

Q: Does a SMAS mini facelift address the neck?

A: The exact definition of a Mini Lift varies by practice. It is also marketed by a number of different names – all of which can be confusing. At my center, a “Mini Lift” refers to plastic surgery that addresses the neck as well as the lower face. It is a minimally invasive surgery whose exact steps will vary by the patient’s anatomy and needs. I don’t do cookie-cutter surgery: Each patient is an individual.

A Mini Lift is less aggressive than a full facelift (rhytidectomy) and therefore is only appropriate for women in the early stages of aging. A Mini Lift is a terrific way to rejuvenate your face if you want to rectify the early signs of aging such as:

  • Excess, loose skin
  • Early jowls
  • A blunted neckline

Because there is less lifting and pulling during a Mini Lift, the surgical time and recovery time are both shorter. I hope this helps.

Q: Are my age (58) and skin sag too much for such a lower facelift and neck lift?

A: Ideally, I would recommend you for a full rhytidectomy (facelift) because you do have a significant degree of sagging and skin laxity in the lower face, plus loss of volume with sagging in the mid-face. In addition, your jowls are significant and might not be fully addressed with just a lower, or “mini” lift.

However, if you cannot afford the time off to recover from a full facelift, a lower face lift with neck lift would still make a tremendous difference. The jowls would be improved, the neck tightened, and your jawline would be more youthful.

I would also recommend a dermal filler, such as Voluma or Sculptra, to build up your cheeks and restore volume in the midface. This would help compensate for the lack of a full facelift by creating a mini lift due to the extra volume. The fillers would need to be re-administered every 18 months. The lower facelift would last about 8 to 10 years. You could return to your normal activities after 2 weeks. I hope this helps.

Q: What type of face lift would I benefit from 45 yr old with lower face laxity? (photos)

A: A Mini Lift with a neck lift and platysmaplasty would be your best bet. This combination would give you a sleeker jawline and eliminate your jowls by tightening the underlying muscles and removing excess skin. Resurfacing your skin with lasers or chemical peels will also help it produce more collagen to stay supple and elastic. I hope this helps.

 

Q: I am a young 69 year old and my jowls are starting to sag. I don’t like it! What are my options with local anesthetic

A: You could get a dramatic improvement in your jowls and neck with a Mini Lift and neck lift that tighten the SMAS and platysmal muscles. These can both be accomplished under local anesthetic so that you can remain awake for the procedure. I’d also recommend laser resurfacing to smooth out your wrinkles and produce new collagen. I hope this helps.

Q: Will Behind the Ear Hearing Aids Make a Difference for Mini Face Lift? I am considering a mini face lift. I am a 70 year old female with very Little sagging for my age but I would like to keep up my appearance. I wear behind the ear hearing aids. Will the incisions interfere with the comfort and/or fit of my hearing aids?

A: Wear your hearing aids to your consultation and tell the facial plastic surgeon of your concerns. By examining you with the hearing aids in place, it will be apparent whether the location of the incisions has to be modified. This should not create a problem nor interfere with the effectiveness of your mini lift. I hope this helps.

Q: Filler or mini-lift? I am 66 old woman that like to know is better filler or mini-lift I am great health, exercise every day and don’t any health issues don’t drink medicines. Thank you.

 

A: It’s not possible to make a judgment without an in-person consultation or photos. However, at age 66, you probably have some facial sagging despite being otherwise healthy. This can only be resolved through surgery, such as a facelift or mini lift. Fillers can add a small amount of volume to the face, but they cannot lift jowls or sagging necks or chins. They also have to be re-administered frequently, whereas a mini lift or facelift will last up to 10 years or more. Your best step at this point is to start consulting with facial plastic surgeons to find out what procedures will be best for you. I hope this helps.

Q: I am a 70-year-old woman very good health; will I need to have a physical before I have the lifestyle lift? 

 

A: “Lifestyle Lift” was the branded name for a mini lift used by a company that I believe is no longer in business. Basically, it referred to a less invasive lower face lift done with local anesthesia. There are many other names for a partial facelift, but at my center we call it a Mini Lift or a Comfort Lift. As long as you are in good health, your age should not be a deterrent to this rejuvenating surgery. During your consultation, you will answer a questionnaire about your medical issues and your facial plastic surgeon should also spend time evaluating your health. I’ve performed many successful partial and full rhytidectomies (facelifts) on patients in their 70s. The mini lift is a shorter surgery than a facelift, can be done under local or general anesthesia, and has a shorter recovery time. It should turn back the clock between five and ten years and last about 10 years. I hope this helps.

Q: Can Mini Lift Also Get Rid of Acne Scars? I am 55 and am looking at a Mini Facelift (Mini Lift). However, also have acne scarring from youth. Does Mini lift cancel out any acne scarring? If not, which should be done first? Acne scar treatment or Mini face lift?

A: A mini lift will do a great job rejuvenating and lifting your face. However, it cannot affect the surface of your skin. To take care of acne scars, you will probably need laser resurfacing. This can be done after your mini lift has healed or, possibly, on the same day as the lift, depending on your skin quality. If the degree of scarring is minimal, it might resolve with a series of chemical peels instead. Treating your acne scars will actually aid your rejuvenation process, as it will produce new collagen in your skin, making your mini lift look even better. I hope this helps.

Q: I want to know about a mini-lift for my neck, jaw line and jowls. Any suggestions? Will a mini lift be a better bet for jowls than a filler? What are my options? What is the cost? Where would the incisions take place? And are there other alternatives?

A: A Mini Lift would help resolve your early signs of aging, such as slight jowling and a lax lower face. It looks like you also have a fair amount of loose skin on the neck. While this will be lifted slightly during a Mini Lift, it’s possible you would benefit more from a neck lift with platysmaplasty in addition to the Mini Lift. “Liquid Facelifts” with dermal fillers will not look satisfactory. Plus, the cost of using injectables over time quickly adds up to surpass the cost of surgery. The Mini Lift with Platysmaplasty will give you a dramatic improvement that will last for up to five to ten years, depending on your skin quality and lifestyle. I hope this helps clarify your situation.

Q: I’m interested in a mini facelift or cheeklift. I understand scars are located behind the ears. Due to my job, I must wear my hair up in a bun. This wouldn’t allow my hairstyle to act as concealment during healing period. Would make up cover the scars enough to be non detectable after 2 weeks?

 

A: After your Mini Lift, you will have incisions in front of and behind your ears in the crease. Stitches come out after one week. It will take about two weeks for your incisions to heal sufficiently that you can apply makeup over them. Consulting with a board-certified facial plastic surgeon will give you a better idea of where the scars will be and how that may affect the way you apply makeup and style your hair. I hope this helps.

Q: What does my neck need? Is it also ok to get mini face lift and neck surgery during summer? I am working on getting a mini face lift and neck surgery this summer. I had bad health issues and lost 20 pounds in hospital bed in 2 weeksand lost a lot of muscle. ( including my face) I had to stay in bed for months afterwards. I gained weight back but now I look suddenly 20 years older. I do not have a neck anymore. I am only 48 years old. Before my health problems I looked a lot younger than my age. I am thankfully healthy now . Any comments from the doctors will be greatly appreciated. Thank you.

 

A: I’m sorry to hear about your difficulties with your health and am glad you have recovered sufficiently to think about rejuvenating your face. From the photos, I don’t think a mini lift would be sufficient to resolve the sagging of your neck, jowls, and midface. You will probably be happiest with a full, traditional rhytidectomy (facelift) and plastysmaplasty, which will tighten up your jawline again.

 

A facelift can turn back the clock about 10 to 15 years and should continue looking good for another 10 years, though you will, of course, continue to age during that time. I would also recommend fat grafting to replace the volume you lost in your cheeks during your ordeal. I hope this helps.

Web Reference: https://carolinafacialplasticsurgery.com/facelift-procedure/

Q: I’m a 52 year old male. How long does a Mini Lift last? I’m a 52 yo male with moderate jowling and NB lines will a mini lift take care of these problems and is this lift the same as a so called life style lift? Also, where are the incisions made on a mini lift?

A: It’s not possible to answer your question without seeing photos. A lifestyle lift is just another name for a mini lift, in most instances. Every facial plastic surgeon has a slight variation on what a mini or lifestyle lift will address. At my center, a mini lift is used to resolve slight jowling and neck sagging. Severe sagging and jowling need a traditional rhytidectomy (facelift). If you fall somewhere in between, a full facelift would probably be the most effective long-term solution. If you opt for a mini lift, you will probably need hyaluronic-acid based fillers to smooth out your nasolabial folds. The incisions for any face lift are hidden behind the ear creases. A mini lift can last from five to 10 years. A full facelift can last up to 10 years or more. I hope this helps.


Q: I’m considering a mini or lite face lift and was wondering how long do they typically last?

A: Mini lifts will turn the clock back about five to 10 years and will last for up to 8 to 10 years. You will continue to age during that time, but will continue to look better than your peers. I hope this helps.


Q:  I am genetically tall and thin with a thin face. So my question is, will a neck and lower FL make my face even thinner?

Answer: I believe you may concerned about looking gaunt after a mini facelift, since you are already thin. Although I would have to see you in person, from your description I would probably recommend fat grafting and a full facelift, rather than just a lower lift. We lose volume in our faces as we age and fat grafting can restore that youthful plumpness. If you’re not ready for a full facelift, then I’d recommend the lower lift and neck lift plus the addition of Voluma or another facial filler to restore volume to your face. I hope this helps.

Q: Is Mini Lift a Good Alternative for Regular Facelift? I have slight sagging. I am unhappy with injectable fillers and afraid of general anesthesia. Is mini lift a good alternative? Is this easier to recover from than a regular facelift? Are the results good?

A: It is impossible to determine what the best procedure for you would be without photos and/or an in-person consultation. However, from your description of slight sagging and an anti-aging regimen that relies on fillers, a Mini Lift might be the best next step. A Mini Lift can help you by:

  • Removing excess loose skin
  • Resolving early jowling
  • Cleaning up the jawline

This may be sufficient in your case. The results of a Mini Lift can last for up to five to eight years. It can be performed under local anesthesia and only needs about two weeks of recovery time.

A traditional rhytidectomy (facelift), if called for, will give you much more dramatic results and will also address midface sagging. Benefits will last for up to 10 years or more. I prefer to perform full facelifts under general anesthesia and include fat grafting of the cheeks and tightening the platysma muscle (neck lift) as part of the procedure. I hope this helps.

Q: Is there a “mini face” lift to address mid face sagging?  I’m a 52 yr old female, smoke 5-10 cigarettes a day. Have read mini face lift safer & been successfully done on smokers without necrosis or other complications because doesn’t involve as much manipulation. Is there a “mini” for midface sagging like mini for the jowls that I can have to address my midface sagging?

A: A Mini Lift is designed to address slight neck sagging and jowling. Smoking increases the risk of complications after a facelift and mini facelift.  The risk of a complication of skin necrosis is less for a mini facelift than a full facelift.  Any patient that undergoes a face lifting procedure will need to stop all nicotine for weeks before and after surgery.  Different surgeons will have different guidelines, but I would think at least 2 weeks before and 2 weeks after surgery is a minimum.  

Q: What Are Pros and Cons of a Mini Face Lift

Answer: At my center, a mini lift includes the lower face, neck and slight jowls. The exact procedure varies slightly by each patient’s anatomy and needs. The mini lift is a shorter surgery that can be done under local anesthesia. Recovery time is also less.

A facelift will give you much more dramatic results, can clean up your neck and jawline, and will also remove jowling, plus lift and rejuvenate the face. Fat grafting can be accomplished at the same time, which will restore lost volume to the face.  I hope this helps.

Q: I think I maybe could benefit from a mini lift to address my loose skin especially when I bend over. Also my jowls and neck. Not sure on my though the lines near my mouth that run down on both sides. Would a mini lift , lift them??? Also I developed hollow eyes, and only one eye seems to be dropping. Thinking mini lift and eyes done. Can someone quote me a price so that I can start saving.

A: If you are not happy with the improvements that dermal fillers have given you, then the next step is a mini face lift or neck lift. No fillers can make as dramatic improvement to your lax neck and jowling as surgery will. If you need lower blepharoplasty, this can be accomplished at the same time as the facelift. Please find a board-certified dermatologist whom you believe will give you the results you want. You can discuss price and even a payment plan at that time. I hope this helps.

Q: Is a thin skinned woman with little fat suitable for lower face and neck lift?

A: The procedure you are describing is called a Mini Lift at my center. From your description, it sounds like you may benefit from this relatively quick procedure, which can be done under local anesthesia. Recovery time is only about a week. However, if you are experiencing a great deal of volume loss in the mid face that is not helped by fillers, then you may actually benefit with adding fat grafting for 3D facial rejuvenation.. Light skin tends to handle scarring well. Your scars will be hidden behind the ear creases. I hope this helps.

Q: Does a lower facelift stretch the mouth out from side to side?

A: The “stretched” look you are referring to comes from a poorly executed lower face lift. The skin needs to be pulled mainly vertically to give a more natural result.  Pulling in a mainly horizontal position can create an unnatural appearance.  The underlying muscle should also be tightened. In some patients, facial fat grafting is recommended smoothen the marionette lines in addition to the lower facelift.  You need to find a facial plastic surgeon who understands anatomy if you want a result that looks rejuvenating without being “done.” I hope this helps

Q: I always had a chubby face growing up, and I have used fillers and whatnot which has kept my jowls at bay – but they seem to know be falling down on my face. I have used fillers, probably more than I need, so I have stopped. I think I need a mini facelift but am worried I am going to look weird. I probably could have gotten a facelift a long time ago my jowls have always bothered me – and looking at my mom it is definitely hereditary! Will a mini facelift or SMAS facelift look good?

A:  Early jowling is one of the prime indications for a mini lift. If you are worried about looking “weird,” you should shop around until you find a facial plastic surgeon who understands your unique anatomy, has a strong sense of facial aesthetics, inspires you with confidence, and has years of expertise in this area. I hope this helps.

Q: I am having a mini lift in a few weeks. I had a threadlift with eight threads in my neck and four in my face. My Dr. says she will have to remove the threads in conjunction with the mini lift to prevent problems down the road. I am very concerned about damage in thread removal. Please advise.

A:  I am not a fan for thread lifts, and your experience demonstrates why: they do not work. They’re a very temporary fix that usually leads patients to seek a mini lift or face lift once their faces begin sagging again. As for the necessity of removing the threads or the dangers inherent in doing so, this should be decided on a case-by-case basis. There is really no danger in leaving the threads in place, but if they can be removed easily or might interfere with the aesthetics of the mini lift, I take them out. I hope this helps.

Q: I am 53 and am very unhappy with my neck. I have some jowls but other than that I am happy with myself so far. I do not feel I am ready for a full facelift nor do I have the time for a month of recovery right now. Would a mini facelift help my neck?

A: Everybody has a slightly different definition of what a mini lift is. In my center, we use mini lifts to lift both the lower face and neck. Other procedures, such as liposuction and skin resurfacing, may also be done, depending on the patient’s needs. It’s impossible to say, without photos or an in-person consult, whether you would benefit most from a mini lift or a full rhytidectomy. If recovery time is your main concern, then you might do better with a mini lift, which only curtails activities for about 2 weeks. Results should last from five to 10 years, depending on how well you maintain your skin. I hope this helps.

Q: Is a mini facelift or fillers recommend for a 42 year old who has loss of volume?

A:  I am sorry to hear about how stressful your life has been. As you’ve experienced, stress can take its toll on our faces. Chronological age never determines which procedure is best to help you feel better about how you look. Fillers are temporary, must be redone and will not be a sufficient remedy for your sagging and jowling. A mini-lift with fat grafting will give your face a real boost, taking at least five years off and lasting for about eight years. The repositioned fat will give your lift a real “wow” effect. I hope this helps.

Q:Filler or fat grafting for Face? When getting mini face lift?

A: A mini lift plus a hyaluronic-acid based filler such as Juvéderm Voluma or Restylane Lyft should provide a natural rejuvenation. You also might use some filler around the eye area and a little Botox to give a slight brow lift. I’m not a big fan of fat grafting. I hope this helps.

Q: Mini facial under local anesthesia?

A: In my practice, I almost always perform a mini lift for early signs of aging under local anesthesia. This means that you will be awake during the procedure. I give my patients oral anesthesia plus numb the area to be treated. In addition to lifting and removing excess skin during the mini, I also lift and tighten the underlying SMAS, which ensures the longevity of the lift. Recovery is quick, with most patients returning to their normal lifestyle at 2 weeks. It’s an excellent procedure for:

  • Excess loose neck skin
  • Early jowls
  • Blunting of the neckline

I hope this helps.

Q: After a year of healing from a mini facelift can you wear your hair pulled back without scars showing?

A: For the first 1-2 weeks after your Mini Lift, you will probably want to wear your hair down to hide the scars, which will run in front of and behind your ears in the crease. As the scar heals, it will probably fade to a barely noticeable white color. My patients are usually comfortable with any hairstyle within 3-4 weeks after a Mini Lift. I hope this helps.

Q: Had a mini done 8 years ago and my neck looks like a turkey again and I would like to get it lifted again. My present Doc has never done a revision and looks at me with a blank stare when I suggest one! Can this be done without another mini or is it better to have both done? I am still out in the work force and want to look good.

A: Another mini lift will give you better results than a neck lift alone. Eight years is quite a long time to have had good results from your mini. It is normal and expected to perform revision surgery, as the face continues to age – regardless of how extensive and dramatic the original procedure. Please find a board-certified facial plastic surgeon who is comfortable and has experience doing revisions. I hope this helps.

Q: Can I have a mini face lift with just local shots and oral medication ?

A: One of the advantages of a mini-lift over a full rhytidectomy (facelift), is that it can be performed with minimal anesthesia. At my center, I usually use just local injections of a numbing agent plus oral medication to keep you relaxed. You will be awake for the procedure. If you prefer not to be awake, we’ll administer a light anesthesia. This makes your recovery easier and decreases downtime. I hope this helps you make your decision.

Q: Can Jowls Come Back After a Lower Face/neck Lift? Is it true that jowls can reappear just a few years after a lower face/neck lift?  What long term results can be expected?

A: While a mini-lift can significantly turn back time by restoring youth and definition to your lower face, it cannot stop the clock entirely. After your surgery, you will continue to age. How much sagging and jowling occurs down the line will depend on your individual anatomy. However, you can help maintain your good results through a healthy diet, exercise and skin care. As time goes by, you may also want to consider nonsurgical boosts such as laser resurfacing, MicroNeedling, Probiotic Youthboosts, Botox and dermal fillers. I hope this helps.

 

Q: Would like opinions on whether lower facelift would be my best best for jowls and neck?

A: If you are only showing the early signs of aging, such as slight jowling and neck sagging, then a lower face lift, or “mini lift” would be ideal for you. During the procedure, we will remove excess loose skin, tightening up the jawline and blunting the neckline.

Q: Is it ridiculous to want a mini facelift at the age of 36? I’m not familiar with all the procedures out there, so it would be great to hear some feedback on this. I’m half asian, so I have great skin; however, I have gained/lost weight with pregnancies so I feel like there’s some looseness going on. I’ve also noticed my “RBF” (resting b*** face) getting a little more pronounced because of the natural drooping that occurs over time from one’s eye line to chin. Thank you.

A: Although 36 is young to be considering a mini lift, chronological age is not the determining factor in what kinds of procedures would most benefit a patient. Instead, individual anatomy, skin quality, and expected outcome are the factors to be considered when making recommendations. Gaining and losing weight can stretch out the skin to the point where it may not “snap back.” Depending on how lax the skin is, it may not even respond to some of the nonsurgical modalities now available.

A mini facelift will clean up your jawline and neck and can last for up to 10 years. If you suspect that your weight might continue to yo-yo, however, you might wish to delay the procedure until it is more stable. I hope that helps.

Q: I am 73 years old and I would like to get a lower facelift and neck done. Any suggestions?

A: A mini lift – which can dramatically restore youth to the lower face, jawline and neck – is usually performed on candidates who have early and minimal sagging and thus is usually the choice of younger patients. However, if you are primarily concerned about the lower area of your face and neck, the mini lift could be beneficial. As a plus, it has fewer risks, less scarring and less downtime. Please note, however, that a mini lift will not affect the cheeks or eyes or improve skin quality.

Q: Will a mini face lift last as long as a regular facelift? I am considering a mini facelift, but am concerned that it means going back for another facelift in the near future thereafter. Would it be better to do a full facelift?

A: First, the term “mini lift” is nonspecific and can mean something different to each board-certified facial plastic surgeon. In my practice, a mini lift refers to minimally invasive surgery that lifts the lower face and neck. A mini facelift can be a terrific, less invasive option for someone who is just beginning to lose skin tone and wants to give herself or himself a “boost.” During the evaluation, I look at the patient’s anatomy and devise the least aggressive and least invasive methods of tightening their neck and lower face to minimize both downtime and scarring. How long a mini lift will last depends on a number of factors, but results will usually last for several years. A traditional facelift will last significantly longer than that.

I hope this helps.

 

Q: I am 55 and considering a facelift, but am a bit scared. Is there a mini-lift I can do?  I do Botox and fillers twice a year, but other than that, I am still a PS virgin! What is the least invasive face-lift? (Please don’t suggest Thermage or Ultherapy because the reviews are poor). Does a mini-lift include eyes, or is that a separate payment? Thank you!

A: It is normal to be concerned when considering a surgical procedure such as a facelift or mini lift. As a board-certified facial plastic surgeon, safety is my #1 priority when evaluating a patient for any procedure, including a mini lift. To be sure you were a good candidate, I would look at your overall health, as well as your facial anatomy. In our interview we would also discuss your expectations to make sure that they are in line with reality so that you will be happy with your results.

A mini lift would be a good choice for you if your primary concerns are the neck and lower face. The surgery is much less invasive and requires less anesthesia. Recovery time is significantly faster than it would be with a full face lift. An eye lift would be a separate procedure. You could have it done at the same time, or schedule it later.

I hope this helps.  

Q: What is Recovery Time on Lower Facelift?

A: In my practice, a “mini lift” is designed to counteract recent aging and sagging of the neck and lower face. The area is lifted, excess skin is removed, and the jawline is accentuated to give a more defined and youthful look. Generally, this is done in a patient who still has fairly elastic, good-quality skin and has only light sagging. Because it is a less aggressive procedure, requiring less pull than a traditional facelift, the recovery time is relatively quick. The procedure is performed with light, local anesthesia while the patient is awake. For the first week after surgery, the patient will wear a light wrap around the face and will clean the incisions twice daily. After a week, the stitches are removed and it’s possible to be out and about in public and even to wear light makeup. After two weeks, most activities – excluding vigorous exercise – can be resumed. Schedule a consult with a board-certified facial plastic surgeon to find out how a mini lift can have a positive implact on your life.

Q: I’m in my early 40s and want to schedule a consultation with a plastic surgeon for advice on having a mini facelift. However, there are a few things I want to know first: Is it detrimental to my consultation if I have fillers in my lower face? Also, do mini lifts have less recovery time than full lifts?

A: It is fine to have a consultation with filler in your face; just be sure to tell your surgeon where it’s placed and what type of filler it is. Generally, mini lifts will have a shorter of a recovery time than a full facelift, because the techniques used are not as aggressive. However, it is important to have a treatment done based on what you need, not how long the recovery.  Mini facelifts should be customized for the patient.    If filler is place in the jawline, I may choose to dissolve it before the surgery.

Q: Which is better, a facelift or mini lift?

A: Determining which surgical procedure is better depends entirely upon you and your individual concerns and goals. A mini lift, as performed at my practice, is a less invasive surgical facelift that is perfect for people who have minor jowling and are just beginning to see signs of aging such as skin sagging and looseness. However, if you have significant sagging and jowls, then a mini lift will not be appropriate and you should consider full face lift surgery. I recommend scheduling a consultation with a board-certified facial plastic surgeon to discuss your specific concerns and goals. I hope this helps.

 

Q: Do mini facelifts cost less?

A: While mini facelifts generally do cost less than full facelifts, price should never be the determining factor in choosing a surgical facelift procedure. A mini lift, as performed at my practice, is a good option for patients who are just beginning to see signs of skin laxity and jowls; however, it will not be a good option for someone with heavy jowls and significant laxity. Please see a board-certified facial plastic surgeon for a consultation, where you can discuss your specific concerns and goals. This will help determine if a mini lift is appropriate for you. I hope this helps.

Q: Is it okay to have a mini lift at 33 years old? I have sagging jowls and no definition to my jawline. I want a surgical procedure but am afraid I might get turned down because of my age.

A: While 33 years old is relatively young for a surgical facelift, everyone ages differently. During a consultation with someone interested in a facelift, I look at the quality of skin, rather than age. Some women may have amazing skin quality at 40 and don’t need surgery, while others may start to form jowls in their early 30s. Visit a board-certified facial plastic surgeon who is willing to look at skin quality over age to see if you are a good candidate for a mini lift. If the quality of your skin does not warrant a facelift, there are also non-surgical options that may help, such as the Titan skin tightening laser. I hope this helps.

Q: How long does it take to feel “normal” after a mini facelift? I had one done 6 days ago and while the results are great, my ears are very painful and swollen and there’s pain around the staples in my scalp. My doctor said this is normal but I’d like a second opinion.

A: It is normal to feel some pain and discomfort after any surgical procedure, including a mini lift. 6 days is still quite early in the healing process, and it is expected to have some swelling and discomfort at this point. Each individual is different, and healing times as well as level of discomfort varies from patient to patient, so I would not worry as long as your surgeon said it was normal. I hope this helps.

Q: I’m a 27 year old male and I have two fine horizontal lines on my neck. I’m not fat, so I think these are wrinkles caused by looking down at my phone etc. How can I treat these?

A: Everybody has these lines on their neck; how prominent they are is a combination of genetics and habit, i.e. looking down constantly. Surgery will not help with these lines; your best bet is most likely a combination of lasers, fillers, MicroNeedling and medical grade skin care. See a board-certified facial plastic surgeon for a consultation to come up with a treatment plan, and make sure you have realistic expectations as far as outcome. I hope this helps.

Q: What would be the best procedure to get rid of my double chin? Neck lift, lipo, chin implant, cheek reduction?

A: From your photo, it appears as though you still have youthful, elastic skin, and thus a neck lift would not be appropriate. Liposuction under the chin could help to reduce your double chin and give you a more contoured neckline.  You may want to consider a small chin implant to help angulate the jaw/neck line.  Please visit a board-certified facial plastic surgeon for a consultation to see what options would be best for you and to formulate a treatment plan. I hope this helps.

Q: Which is best, a mini lift or full facelift? A mini lift sounds much more appealing to me, why would I opt for a full facelift?

A: Whether you are a better candidate for a mini lift or full facelift depends on the condition of your skin. If you are only experiencing mild sagging of the jowls, you may be a great candidate for a mini lift and there would be no need for a full facelift. However, if you have significant sagging, heavy jowls, large bands in the neck, excess fat in the neck, or a “turkey neck,” then you might not be the best candidate for a mini lift and a full facelift, possibly with liposuction, would better address your concerns. At my practice, I perform mini lifts on people who have mild to moderate excess loose skin, early jowls, or early blunting of the neckline. I recommend visiting a board-certified facial plastic surgeon for a consultation to see what procedures are right for you.

Q: What can I expect as far as results, recovery time, and incisions from a mini lift? 

A: A mini lift as performed at my practice involves less invasive and less aggressive techniques to rejuvenate the jawline in people who are experiencing early sagging of the skin. The incisions are smaller and the surgery is less invasive, although I still lift the deeper muscular layer, not just the skin, in order to ensure longevity. Recovery time from a mini lift is typically one to two weeks. After one week, the stitches and wrap are removed, and most patients feel comfortable going out in public with makeup. Two weeks is generally when most patients are able to resume most of their everyday activities.

Q: I would like to know if I’m a good candidate for a mini-lift. I’m turning 40 this year and feel like the excessive tanning I did in my 20s caused my skin to age prematurely.

A: At my practice, I perform mini lifts on candidates who are just beginning to see sagging of the skin and jowls. The goal of a mini lift the way I perform them is to angulate the jawline and remove excess skin, thus allowing for a less square shaped jaw and more youthful appearance. I lift the SMAS layer as well, providing for more long-lasting results. From your photo, it does appear as though you may be a good candidate, but an in-person evaluation is necessary to say for sure. A mini-lift will not address your nasolabial folds or any volume loss in the cheeks, however. If you would like those corrected, facial fillers may be a better option. I hope this helps.

Q: Would a mini lift help address my jowls and volume loss in the cheek and under eye area? Also, could I do it under local anesthesia?

A: A mini lift as performed at my practice is a great solution for eliminating early signs of jowls and sagging skin. The mini lift is a procedure I generally perform with only oral medication to relax the patient and numbing solution injected into the face, although if patients request otherwise a light anesthesia can be used. During a mini lift I lift and tighten the underlying SMAS layer in order to provide the longest lasting results, and trim away excess skin. As for volume loss in the cheeks and tear troughs, a mini lift will not address those. You should consider either facial fillers or fat grafting to replace lost volume in the cheek and create a more youthful appearance. I hope this helps.

Q: Can a “jowl” lift be performed using local anesthetic and sedation?

A: At my practice, I perform a mini-lift procedure that requires only local anesthesia. This mini-lift is recommended for patients who are showing early signs of jowling and excess skin, but is not recommended if you have significant jowls or skin laxity. Without seeing you in person, it’s impossible to say if you would benefit from a mini-lift under local anesthesia or if a deeper face or neck lift would be better. I hope this helps.

Q: I’m a 40 year old mother. What’s the best option to treat my sagging jawline and nasolabial folds?

A: From your photo, you do not appear to have a lot of sagging skin that would warrant a full lower facelift. You may consider a non-surgical skin tightening laser such as the Titan, or possibly a less invasive mini-lift procedure. At my practice, a mini-lift is a minimally invasive and minimally aggressive procedure that can be used on patients who are just beginning to see signs of skin laxity and jowls. For your nasolabial folds, a facial filler such as Juvéderm/Restylane or facial fat grafting would be best in order to restore volume to the midface and smooth those lines. Please see a board-certified facial plastic surgeon for a consultation to find the best treatment option for your case. I hope this helps.

Necklift FAQ

Q: What is wrong with a neck lift only? I don’t need my face done (no jowls).

A: There’s nothing at all wrong with doing only enough surgery to make yourself look better — as long as that’s all you need. However, if you lost a great deal of weight, you may also have some volume loss to the face. That can be rectified with fillers such as Sculptra or Voluma, or with fat grafting.  I hope this helps.

Q: I’m a very young looking 70, and I want a neck lift! How long does it take to recoup? I drive a school bus! Only 4 hours a day.

A: Congratulations on taking such good care of yourself. You will need to rest and recover for at least a week or two after your neck lift. It would not be safe to drive a school bus during that period. Wait until winter break before getting your surgery— as long as the break’s long enough to accommodate a full recovery. I hope this helps.

Q: What procedures would help me to get rid of sagging neck and face and have a little jawline?

A: Your large, sloping neck seems to be genetic. Your best best for improvement overall would be liposuction to remove the excess fat in the neck and under your chin, a neck lift with platysmaplsty to tighten the neck muscle and skin and remove excess skin, plus a full rhytidectomy (facelift) with fat grafting to restore volume to the mid face and lift the lower face and jowls. I hope this helps.

Q: Neck rejuvenation: Fine lines and a little loose skin.

A: The only way to make a significant improvement in a sagging neck is through surgery. A neck lift with platysmplasty to tighten the underlying muscle will give you a rejuvenation that can last for up to 8 years or more. Based on the photo, you might also benefit from a mini lift to resolve the beginning of jowling. Chemical peels could improve the texture of your skin. I hope this helps.

Q:  My neck started to drop when I was only 37. I’ve had ultheraphy and Botox and no major improvement to the key problem area which is apparent in the photo. I am going to go back to the ultheraphist, but wanted to know is there is any treatment that can actually help with this problem.

A: Unfortunately, you probably have inherited thin neck skin that is prone to drooping. The only way to get the kind of tightening that will make you happy is to have a neck lift with plastysmaplasty. These two procedures will tighten the neck muscles, tighten the skin, and remove the excess skin. A good neck lift should last at least 8 years. I hope this helps.

Q: 35 year old – loose skin in lower face and neck after 150 lb weight loss  

A: Congratulations on a major achievement! Losing that much weight is a real accomplishment. However, loose and drooping skin over the face and body often accompany that kind of weight loss. In my opinion, the only way to rejuvenate your neck is through a neck lift with plastysmplasty. This will tighten your neck muscles, tighten the neck skin, and trim away the excess skin. For good. A mini lift to correct your jowls would also make you look significantly younger. I hope this helps.

Q: After a facelift how long will my neck stay tight?

A: I’m not sure if you are complaining about post-op stiffness or wondering how long the tightening procedure you received will last. If the former, it takes a couple of weeks before the skin begins to feel normal after a facelift. Tightness is a common side effect, but it should begin to feel better within a month. As for how long a newly tightened neck will stay taut, a neck lift generally lasts about 8 to 10 years. I hope this helps.

Q: Which therapy you would recommend to a patient with mild neck skin laxity and early jowling and platysmal bands?  

A: I can understand your reluctance to undergo surgery, but noninvasive means of fixing lax skin, jowling and platysmal bands are almost always disappointing. And whatever benefits you do get usually don’t last long. You’d do best with a mini lift to get rid of your jowls and tighten up your lower face plus a neck lift with platysmaplasty to tighten the neck muscles, tighten the skin and trim away the excess. These procedures will give you a natural-looking rejuvenation that can last for up to 8 years or more. I hope this helps.

Q: Aged neck best option: facetite, necklift, mini face lift, platysma plasty, direct excision? 43 years old

A: You have enough sagging and wrinkling to benefit from a neck lift with plastysmaplasty. This will tighten the neck muscles, plus tighten and remove excess skin. You’ll get a dramatic rejuvenation that will help your neck better match your face.

To alleviate stress on your neck and build up the neck muscles once they’ve healed, I’d recommend working with a trainer. Exercise can improve skin tone as well as muscle tone to help your neck lift last longer. I hope this helps.

Q: Neck lift and what to expect – will I need 100 stitches?

A: A neck lift requires many different points of anchoring and quite a number of sutures. How many will vary from surgeon to surgeon. As for whether your doctor will “mess up” or not, the best way to ensure a wonderful outcome is to find a wonderful facial plastic surgeon. If you are doubting the person you consulted with, keep talking to more surgeons until you find the one that’s right for you. I hope this helps.

Q: My neck is sagging – horizontal lines; I’m 55.

A: Nonsurgical methods of tightening the neck tend to give mild improvement. The best remedy for a sagging neck is a neck lift with platysmaplasty, which will tighten the underlying muscles plus remove excess skin. This creates a dramatic and natural-looking rejuvenation that can last for up to 8 years or more. Cost will vary by surgeon; find a great one and then work out the price from there. I hope this helps.

Q: Remove excess neck skin without addressing muscle? 

A: I’m sorry that you’re so nervous about having a plastysmoplasty, as that would be the best solution for your sagging neck. I don’t think you would be happy with a skin-only lift; it would not resolve the two bands in the front of your neck — those are actually part of the plastysma muscles and will still be visible if you do a skin-only lift. If you want improvement without surgery, you could try ThermiTight. Or, you might work with a medical professional to control your anxiety so that you can get the type of surgery that will give you the results you want. Meeting with expert facial plastic surgeons might be a good first step. Finding one that inspires confidence might help you feel more relaxed about the procedure. I hope this helps.

Q: Can a platsymaplasty correct loose skin as well as tighten muscles?

A: At minimum, you would benefit tremendously from a neck lift with platysmaplasty. These two procedures go together. While it may be possible (though not advisable) to perform a skin-only neck lift, there would be no point in only tightening neck muscles (platysmaplasty) without also tightening and trimming away excess neck skin.

While these two procedures would improve your neck (you may need a little liposuction, too, as it looks like you have extra submental fat), your jowls can only be improved with a lower face lift, as a neck lift will not address the lower face at all. A lower face lift with neck lift and platysmaplasty would be the minimum recommendations I’d make to get you a satisfactory and long-lasting rejuvenation.  I hope this helps.

Q:  Is it possible to get a neck lift without general anesthesia? (photo)

A: I almost always perform neck lifts with platysmaplasty using local anesthesia. This makes the surgery less traumatic for the patient and also speeds recovery time. I do recommend that you have the platysma muscle tightened as well as excess skin tightened and removed. I hope this helps.

Q: I am 49 and have lots of excess skin under my neck with developing jowls. My question is will a neck lift on its own resolve the issue. Also when seeing a surgeon, what questions should I ask?

A: A neck lift alone cannot take care of your jowls or the sagging in your lower face. I’d recommend a Mini Lift (lower facelift) with neck lift and platysmaplasty (neck muscle tightening) at the minimum. It’s possible that a full rhytidectomy (facelift) is actually your best, most gratifying solution, but I would have to examine you in person to be sure.

You also need to avoid the sun starting today, reapply sunscreen often when outdoors and get onto a good skincare regimen that includes retinoids and regular peels. You have significant sun-related damage to your skin that is causing it to lose elasticity and become discolored. All of these can be remedied once you find the right facial plastic surgeon to help you address your aging issues. I hope this helps.

Q: I’ve had jowls/turkey neck since I was a child. It has always bothered me tremendously. I am 30 now. Could this be improved or since it’s genetic would there be much difference made?

A: Your turkey neck and jowls are making you look quite a bit older than you are. Even though your condition may be genetic, it can be remedied with a neck lift and platysmaplasty to tighten the neck muscles and remove excess skin, plus liposuction to remove the jowls and submental fat (double chin). To get the most definition in your jawline, you might also benefit from a lower face lift, but I would need to examine you in person to be sure. I hope this helps.


Q: What can I do to fix my neck and jowls?

A: You have a great deal of skin laxity around the jowls and neck. I’d recommend a neck lift with plastysmaplasty to tighten the neck muscles and remove excess skin, plus a Mini Lift to take care of the jowls. I would also resurface your skin with Fraxel to remove the fine lines and wrinkles, plus stimulate the production of new collagen.

You might also consider going for a full rhytidectomy (facelift) because you do have some volume loss in the midface which could be improved with fat grafting, lifting and skin removal. As for the flesh in your nostrils, these could be removed at the same time as your Mini or facelift. I hope this helps.

Q: Post neck lift helpful healing remedies?

A: About 3 to 4 weeks after a neck lift or face lift, I recommend gentle massage to help healing: Either gentle self-massage or a lymphatic massage performed by a professional. Lumps and bumps are a normal part of the healing process. Don’t worry. It takes about 4 months before your swelling will resolve and you see your final results. I hope this helps.

Q: Curious to know what I can have done to help my loose neck skin situation? 43 year old female

A: Congratulations on your weight loss; that is quite an accomplishment. The amount of sagging you have can only be corrected with a neck lift and platysmaplasty. The platysmaplasty will tighten your underlying neck muscles. The neck lift will tighten and remove excess skin. You probably also need liposuction to remove the extra fat under your chin. If you are still actively losing weight, I would advise waiting for neck surgery until after you have reached your ideal weight. If you have the surgery too soon, you may have additional sagging when you lose more weight. I hope this helps.

Q: Is it normal for a 62-year-old to lose muscle tissue on one side of the neck in a 3-month period?

A: It’s not unusual for the neck to sag unevenly. From your description, it would be better to perform a neck lift rather than thinking about adding tissue to correct the asymmetry. A neck lift with plastysmaplasty will tighten the neck muscles, plus tighten and remove excess skin so that your neck looks rejuvenated and symmetrical. If you are not able to do surgery, then I’d suggest trying a skin-tightening treatment such as ThermiTight or Ultherapy. I hope this helps.


Q: Neck lift at 40? What is my best surgical option?

A: I’m not sure why you aren’t interested in liposuction; that would be the quickest and most effective way to remove the excess fat under your chin. The liposuction would be performed at the same time as your neck lift and platysmaplasty (tightening the neck muscles). If you are absolutely against liposuction, then you could use Kybella to remove the submental fat. You would need at least 4-5 treatments with Kybella to get optimal results. I hope this helps.

Q: Candidate for neck lift?

A: The quality of our neck skin is genetically determined – unfortunately. It can be worsened by excessive sun exposure, which it sounds like you had when you were younger. I would absolutely recommend a neck lift with platysmaplasty (tightening the neck muscles) in your case. You have quite a big of sagging and loose skin. I’d also recommend laser resurfacing to make your skin thicker and more resilient, giving your neck lift an extra jolt of rejuvenation. I hope this helps.

Q: Laser Treatment for Crepey Neck Skin?

A: Although there are a great many noninvasive skin-tightening modalities out there, nothing can come close to achieving the results of a good neck lift with platysmaplasty (tightening of the neck muscles). Because you didn’t provide photos, it’s hard to understand what you mean by “crepey” skin. If it’s just a matter of texture, then perhaps you would benefit from a combination of laser resurfacing, MicroNeedling and chemical peels to stimulate more collagen and elastin. If there is any loose skin, however, a neck lift would give you a dramatic and long-lasting improvement that you could enjoy for 5 to 8 years or more. Ultimately, this might feel like less of a “doom” than constant maintenance with less effective noninvasive treatments. I hope this helps.

Q: I am 49 and need a neck lift, but I don’t won’t to go under general anethesia. Is it possible?

A: A lower rhytidectomy, otherwise known as a neck lift, generally requires small incisions and therefore can be done under local anesthesia. In my practice, I don’t just tighten and remove excess skin, I also tighten the underlying neck muscles (platysmaplasty). A good neck lift can last for up to 8 years. I hope this helps.

 

Q: Why do I have lines in my neck I really want to get rid of it, what are my options?

A: Your neck bands are quite pronounced. However, the rest of your neck is difficult to make out in the photo. I think you would benefit from a neck lift to smooth out the bands and remove excess skin, plus MicroNeedling to break up the bands. Even so, they may still be visible. In that case, they could be smoothed out with hyaluronic-acid based fillers such as Volbella. It will take a combination approach to resolve your neck bands. Find an expert who can offer you a variety of solutions that will work synergistically to get you the improvement you want. I hope this helps.

Q: Is it a neck lift I need? After losing over a hundred pounds, it looks like my face is falling.

A: It looks like you could benefit from liposuction with a neck lift and possibly a Mini Lift as well; it seems like you may be developing jowls. A neck lift alone could help with the jowls, but not with the other sagging in your lower face. More photos would be required to give you a definitive answer. A Mini Lift with liposuction will help you get a cleaner jawline and tighter neck. Either a chin implant or – if you want to test out the look first – chin augmentation with a hyaluronic-acid based filler such as Juvéderm, can give you a stronger chin and more becoming profile. Combined with a neck lift, you’d get a much cleaner and stronger profile. I hope this helps.

Q: 31 years-old unhappy about my sagging neck; Am I a good candidate for a neck lift at my age?

A: Thirty-one is young for a neck lift, but you do have a significant degree of skin laxity that is best served by surgery. I never consider chronological age when determining candidacy for facial plastic surgery. As long as someone is over 18 years, is healthy, and would benefit most from a surgical solution, age is not a factor. In addition to a neck lift with plastysmaplasty, I’d recommend you begin annual laser treatments and/or regular chemical peels to avoid your neck skin thinning out too much. You also need a medical-grade skin-care system and sun protection. I hope this helps.

Q: I’m a 55 year old male considering a Neck Lift. I’m wondering about my options, scarring, results, Etc.?

A: You would benefit greatly from facial liposuction under the chin plus a neck lift. It is possible you may also need a Mini Lift, as you do have jowls that might not resolve with just a neck lift and lipo. In the hands of an expert, scarring will be minimal. You absolutely should find a facial plastic surgeon who has expertise in male faces, as the aesthetics are different. The results you want are achievable in the right hands. I hope this helps.


Q: I’m 72; can jowl neck lift be done at this age?

A: As long as you are in good health, there is no reason why at 72 you could not benefit from a neck lift with plastysmaplasty to tighten the underlying muscles, plus a Mini Lift to resolve your jowls. Without seeing photos or meeting you in person, I cannot say for sure, but at your age you might be happier with the results of a full rhytidectomy (facelift) rather than just a mini lift. It is not that much more expensive, adds a little bit of time to your recovery, but can make a dramatic difference that will last up to 10 years or more. I always include a necklift and platysmaplasty plus usually add in a laser resurfacing, too, when performing a rhytidetecomy. I hope this helps.

Q: Is a neck lift my only hope? I had RF treatments and this is the outcome!

A: Unfortunately, nonsurgical “neck lifts” tend to disappoint unless you are relatively young and have a very small amount of loose skin. Neck skin is quite thin. Once it loses elasticity, it is difficult if not impossible to stimulate the production of a significant amount of collagen and elastin – the elements you need to make skin resilient and youthful. I hope this helps.


Q: Do I need neck tightening? I’m a skinny person 44 yo, but been using tanning beds for 20 years.

A: Uploading photos would allow me to give you a more precise answer. However, using tanning beds or lying in the sun severely damages the skin, decreasing its elasticity and strength. Being slender can also create a situation where the skin sags more, as there is no fat underneath to create a support system. If you are wondering if you need a neck lift, do the “finger test” by pulling upwards on your neck skin at the jawline. If you see an improvement, a lift is probably in order. A good neck lift will last about 8 years. You will need to consult in person with a facial plastic surgeon who specializes in neck lifts to determine if you are a candidate. I hope this helps.

Q: How long to wait for a 3rd neck lift revision?

A: You need to let your neck completely heal from your last surgery before attempting a revision. That means at least six months to a year. I agree with some of the other comments that it is best to perform a neck lift or Mini Lift under local anesthesia so that the surgeon can have a more realistic view of what the final result will be. Take this healing time to find a facial plastic surgeon who uses local anesthesia and is expert at revision surgery. Your skin is adhering to the underlying muscle and other tissues. Once you find the right facial plastic surgeon to help you, your neck will be greatly improved. I hope this helps.


Q: 12 years after neck lift with liposuction. I need a revision. Could I get results from a neck lift?

A: You were lucky that your last neck lift lasted 12 years; that’s a very good outcome. The neck shows our age because the skin is so thin and doesn’t adhere well to the underlying muscle. Another neck lift with liposuction will tighten the platysma muscle in the neck, and remove and tighten the neck skin. You might also need a mini lift to resolve your jowls. Another neck lift and/or mini lift will allow you to enjoy another eight to 10 years of rejuvenation. I hope this helps.

Q: My neck looks awful, I’m very self conscious and insecure. Nothing hides it, nothing.

A: You have just the beginnings of jowling and loose neck skin. However, I would need to see more photos or meet you in person to determine whether you would benefit most from a lower face lift or a neck lift. Both of these procedures – expertly done – will give you a long-lasting and very natural looking rejuvenation that should last up to 8 to 10 years. I specialize in facial plastic surgery with an emphasis on creating balance and harmony in the face that enhances your natural beauty. My mentors were some of the top surgeons in the world, located in Beverly Hills. I hope this helps.

Q: Neck wrinkles and sagginess, what’s the best treatment?  

A: The neck is one of the first places on the body that shows our age because the skin is thin and adheres poorly to the underlying musculature. Once the skin has lost elasticity and begun sagging, there is not much that can remedy it except for a necklift. During a necklift procedure, the underlying platysma muscle will be tightened and excess skin removed. This will give you a smoother, more youthful neck and throat. A neck lift will last about 8 to 10 years. You can maintain the benefits of your lift with high-quality skin care, chemical peels and/or annual laser treatments. I hope this helps.

 

Q: Would a neck lift under local anesthetic give a good result on the jaw line without a facelift?

A: Typically a neck lift only improves the neck and throat area. It may make your jawline look a bit sleeker, but will not resolve jowls. I give my patients the option of having the procedure done with only local anesthesia. A Mini Lift (lower face, jawline and neck) can also be performed under local anesthesia. Each procedure I do is based on the patient’s anatomy and needs, so what exactly a Mini Lift or neck lift will entail must be determined in person. I hope this helps.


Q: Help for saggy crepey neck? Ultherapy?

A: Unfortunately, noninvasive lifting modalities, such as Ultherapy, do not have a very dramatic effect on significant amounts of neck sagging. Your skin is quite lax. The only thing that will do a satisfactory job in tightening a neck that has skin and muscle laxity is a neck lift with platysmaplasty to tighten the underlying muscle. A good neck lift will last 8 to 10 years. You also have a significant amount of jowling and would benefit from a lower face lift. These procedures can be done in the office under a local anesthetic. I hope this helps.

 

Q: Neck rejuvenation/tightening. What is the best procedure for this?

A: To put it bluntly, “skin only” lifts are horrible. Forget about the names of the procedures; these are merely marketing tools and yes, they can be quite confusing, I agree. From your photo you have a great deal of neck laxity of both the muscle and skin as well as some jowling. Nothing other than a neck lift or a lower facelift would give you a dramatic and long-lasting improvement. The results are worth the investment. I hope this helps.

Q: A month ago, I had a neck thread lift! Not happy. Is it to early for surgery?

A: Unfortunately, your experience with a thread lift is not uncommon. Thread lifts may look good directly after the procedure, but aren’t secure enough to prevent the face or neck from sagging again. It is important that you are fully healed from your thread lift insertion before going on to a neck lift. That means no soreness, redness, swelling or bruising. The threads can be removed when your neck lift is performed. I hope this helps.

 

Q: Can my creped neck be made more youthful?

A: The best solution for your crepey neck would be a neck lift with plastysmaplasty to tighten the underlying muscles, plus a lower lift with SMAS tightening to resolve the early jowling. Your skin could benefit from laser resurfacing, which would not only make it look smoother but would stimulate the production of new collagen and elastin for a dramatic rejuvenating effect. Your necklift and lower face lift should last at least 8 to 10 years. I hope this helps.

Q: I have recently lost a lot of weight. As a result my neck looks awful! What would be the best way to correct this problem, the saggy skin.

 

A: Congratulations on your weight loss – it’s a real accomplishment. Unfortunately, as we age, losing significant amounts of fat often leaves us with sagging skin. Sagging in the neck, commonly referred to as a turkey neck, can be very aging as the skin there is thin and does not adhere well to the underlying muscle. The best remedy for a sagging neck is a neck lift with platysmaplasty. This dual procedure tightens the platysma muscle, plus tightens and removes excess skin. This will give you a dramatic rejuvenation that can last 10 years or more. The sagging on your neck will be resolved and you’ll have a cleaner jawline. From your photograph, you might also benefit from a lower face lift to resolve some jowling. I hope this helps.

Q:I’m a 61 year old woman and want to know what procedures are needed to regain a more youthful appearance?61 year old diabetic woman, needs to know the best procedures to attain a more youthful appearance. Also how long will the effects of a well done plastic surgery last??? Do I need eye work, neck lift, Smas lift? I’m also a diabetic with control of my A1C. Can I still have extensive work done on my face, or is it too much a risk?

 

A: Thank you for your photos. My recommendation would be for a full rhytidectomy (facelift) with neck lift and platysmaplasty, plus upper and lower blepharoplasty. This will give you a dramatically rejuvenated look that will last anywhere from 10 to 20 years. As long as you are healthy and your diabetes is under control, you should handle those procedures well.  You have a great deal of under-chin sagging and jowling. Only a necklift with platysmaplasty can resolve neck drooping and only a mini lift or facelift can remove the jowls. I hope this helps.

Q: Tape That Is Supposed To Reduce the Appearance Of A Turkey Neck? There is a Tape the is Sold Online That is Supposed to Reduce the Appearance of Turkey Neck. Any Thoughts on It? Temp Fix?

A: Celebrities often use tape to give their faces and necks a quick “boost” for a short-term event such as a premiere. The tape is generally hidden under wigs. It is, at best, a very temporary solution, lasting only hours. If you want to get rid of your turkey neck for good, the only effective way that I’ve seen is a neck lift with platysmaplasty. This combination can turn back the clock about 10 years and will last for up to 10 years. Nonsurgical methods do not have very satisfactory results. I hope this helps.

Q: Options for Jowls and Neck Fat? I am a healthy 42 year-old-male, concerned with the removal of fat around my jowl and neck. This is a common problem found in my immediate family. What treatment(s) would work best for my situation? I am a VA resident, who would prefer to locate a board-certified clinic in my area.

 

A: It is a difficult to assess your full situation without photos or an in-person consultation. However, if you have jowling, the only satisfactory solution is surgery: either a full facelift or a mini lift. As for the neck, liposuction may be sufficient if it is only fat that is bothering you. If there is any sagging (and I suspect there may be, based on the jowls), your best solution is a neck lift with plastysmaplasty and liposuction. This will tighten the muscles of your neck, preventing them from sagging, plus remove excess skin. The liposuction would remove the excessive fat and the neck lift would give you a tighter, sleeker jawline. I hope this helps.Q: Neck Lift Vs Liposuction for Improving Neck? Hello, I have not seen any pictures with the neck I have. So I don’t know if Neck lift is for me. I went to a specialist only for him to say if I have Liposuction, the scar could form into a keloid. And if I choose to go along with the surgery, the doctor said I would have sagging skin. I need help.

 

A: While it is impossible to make a definitive judgment without seeing you in person, it looks like you could benefit from both neck liposuction to remove your double chin and a neck lift with platysmaplasty to tighten your neck muscles and remove excess skin. If you have had any kind of skin-breaking injuries or surgery in the past, you would know if you are prone to keloids. Please consult a few facial plastic surgeons to get a better idea of what your options are. I hope this helps.

Q: Simplicity Lift Vs. Traditional Neck Lift? I am researching options for revitalizing my neck. My neck is quite crepey but I don’t have jowls (yet). I am 58 years old and petite. I have been recently reading about the “simplicity lift” and would like to know if the results are comparable to a traditional neck lift.

A: There are always new techniques and branded names that come onto the marketplace, vying for consumer dollars. However, the only thing you need to worry about are the results. The Simplicity Lift is basically a lower face lift or mini lift. While it does create a pull that will lift the neck skin slightly, it does not actually tighten the underlying loosened platysma muscle, which is what is causing the neck to sag in the first place. The best way to correct a sagging neck is to undergo a neck lift with platysmaplasty. This will give you a dramatically smoother and more sharply angled neck and jawline. However, surgery can’t resolve crepey skin. A lasers can help improve the condition and elasticity of crepey skin, but cannot offer a full rejuvenation. Consult with a few facial plastic surgeons to learn more about the dramatic, results you can expect with a necklift and platysmaplasty. I hope this helps.

Q: I am slender but have loose skin around my neck and have poor skin elasticity. I’ve lost weight but had the loose neck skin even before I lost weight, but it’s now worse. Can this be fixed through surgery? What type of outcome should I expect.

A: It’s very common for older people to have loose skin after a significant weight loss. The laxity that bothers you can be resolved with a neck lift or a full facelift. Either procedure will turn the clock back about eight to 10 years. You’ll continue to get benefits for the next 10 years, even as you continue to age. I hope this helps.

Q: Does a person have to have a facelift in order to get a neck lift? For years I have been contemplating a neck lift. I have had excess skin since I was a baby and has just gotten worse and now I’m 43. In my research, I have noticed that a lot of doctors recommend a facelift as well but I do not have any wrinkles. Is it possible to just have a neck lift only and not a full facelift?

A: It’s absolutely possible to get a necklift without a face lift. I wouldn’t recommend a full rhytidectomy until you have significant midface sagging. Sagging is actually the reason for a facelift – not wrinkles. Wrinkles are best addressed with laser therapy and chemical peels. A necklift will last about 10 years. I hope this helps.

Web Reference: https://carolinafacialplasticsurgery.com/neck-lift/

Q: I’ve committed myself to a fitness and weight loss routine as a result of a borderline hypertension diagnosis. My health and BP has improved greatly, but the loss of weight has emphasized the crepey, paper like skin on my neck. This is a condition that plagues all of the women in my family. Is there something that can be done to improve the appearance of my neck so it doesn’t look so OLD? I am a 50 year old former smoker, I do not drink, and my BP is now normal.

A: Unfortunately, the noninvasive skin tightening techniques that are currently available have produced less than optimal results on the neck. It is my opinion that the only way to get dramatic improvement in loose and crepey neck skin is to go for a neck lift, which will also tighten the underlying platysma muscle. A neck lift will give you a dramatic improvement in your jawline and neck and should last for up to five to eight years.

Q: What is the least expensive and invasive surgery to correct neck and jowls?

A: In your case, fixing only the neck and jowls via a necklift would give you less than optimal results. From the degree of skin laxity that’s visible in your photos, I’d recommend a traditional rhytidectomy, which includes a neck lift, platysma tightening, and jowl reduction. I would also recommend some fat grafting to fill in your hollowed cheeks. All of this can be accomplished in one procedure. Results can be spectacular – turning back the clock by up to 10 to 15 years and lasting for up to 10 years or more. I hope this helps.

Q: I am 39 years old and have been on dialysis for 26 years. I take very good care of myself, weight lift and walk everyday and weigh about 110 at 5’0 and very good shape for being on dialysis so long. My neck is very droopy and loose and what would be the best procedure or treatment to tighten up this area?

A: Your best bet to tighten and remove the excess skin under your chin would be a neck lift/lower facelift. It will also clean up your jowls and give you a sleeker jawline.  I would recommend having the procedure under local anesthesia.  A necklift should last anywhere from five to 8 years or more. I hope this helps.

Q: Hi, I am 43 yrs old, non smoker and fairly healthy. I have developed a horrible double chin and cannot stand my profile. I was wondering if chin lipo would resolve the problem, but I am terrified that I will end up with a saggy neck. Would I be a good candidate? Or do I need a neck lift? If so, where would the scars be and would they be noticeable? What would be the recovery process and how long would it take?

A: Chin liposuction can indeed lead to sagging skin. In your case, I would recommend a necklift, which can address not only the double chin but also the slight jowling you are beginning to develop. It will clean up your jawline and rejuvenate your whole face. The scars will be hidden behind the ear creases, where they will eventually fade. They should not be visible. I hope this helps.

Q: I am 55 years old and would like to know which procedure is best for treating a turkey neck with the least amount of downtime?

A: There are really no satisfying nonsurgical remedies for “turkey neck.” The loosening of the platysmal muscle with subsequent skin sagging respond best to a neck lift with platysma tightening. You will have a dressing for one week. You can return to un-strenuous activity at that time. Full recovery will take 1 to 2 weeks depending on your healing and the aggressiveness of the surgery. The results can last for up to 10 years. I hope this helps.

Q: I have a turkey neck that bothers me, is there a treatment for this?

A neck lift with fat removal can be accomplished in the office and needs about 1.5 to 2 weeks for recovery. During your surgery, not only will fat be removed from under your chin, the skin will be lifted and tightened, excess skin removed, and the underlying platysmal muscle will be tightened to minimize future sagging. A neck lift’s rejuvenating effects should last about 10 years. I hope this helps.

Q: What would be best option to remove fat and tighten the skin on my neck. I will be 50 this year. Do I need a full neck lift or less invasive and less costly procedures can offer significant results?

A: I would recommend surgery because it will give you the most dramatic and long-lasting results. In addition to the fat and loose skin on your neck, you also have some jowling that can be addressed with a mini lift and liposuction. You might also be a candidate for a full face lift. As far as nonsurgical options, they work best when the skin is still elastic and the neck is the only issue. They can be comparably expensive because they require several treatments to achieve optimal results. So, depending on your budget and time you can spare for recovery, I would recommend a necklift at the minimum with a strong recommendation for mini lift and possibly even a full face lift. I hope this helps.

Q: Loose Neck Skin at 35. Options?

A: You are younger than most who have such a degree of skin laxity on your neck, but that is probably due to genetics. The only real solution is to permanently tighten the plastysmal muscle on the neck and remove excess, sagging skin through a neck lift. It’s a simple, outpatient procedure that takes about an hour or two. You’ll recover within a week and your rejuvenated neck and jawline will last for years. I hope this helps.

Q: Sagging double chin/turkey neck. Any suggestions?

A: All surgery has risks, but a neck lift is a relatively quick and minimally invasive procedure that uses very small incisions. You even have the option of remaining awake during the surgery, which cuts down on your recovery time. You will have some downtime, but only directly after the surgery and it shouldn’t last more than a week or two. The necklift itself will last about 10 years. I hope this helps.

Q: Effects of a neck lift vs. laser treatment of neck area. Any suggestions?

A: Nothing can beat a good neck lift to permanently tighten excess neck skin and clean up the jawline. Nonsurgical laser and ultrasound treatments may give some benefits, but they are not dramatic and must be repeated to keep the good results. A neck lift is a relatively noninvasive procedure compared with a full rhytidectomy and will give you a smoother, tighter neck plus a sharper, more youthful jawline. Results should last from five to eight years. You might also consider a touch-up facelift instead, as that will give an even more dramatic improvement that can last up to ten years. I hope this helps.

Q: I hate the way my skin looks on my neck and décolletage. It has a chronic reddened appearance and there are bumps all over it. It is also saggy looking compared my face. What can I do to improve the appearance of my neck and décolletage?

 

A: You have brought up two important issues about neck aging. The first is the quality of the skin, which tends to degrade with age. This can be remedied with laser treatment, which will smooth out the bumps and crepey texture as well as stimulate collagen production. I would recommend doing this before proceeding to a neck lift, which will address your sagging. Depending on the degree of sagging, you may not only need excess skin and fat removed, but also may need to have the platysmal muscle tightened. Neck lifts usually last 10 years. I hope this helps.

Q: I have had a neck lift 5 years ago and my neck skin is already sagging again.

A: It is not unusual to find noticeable sagging in the neck five years after a neck lift. Each patient responds differently. Longevity also depends on how vigilant they are about subsequent sun avoidance and protection. The sagging, therefore, may or may not be related to Ehlers Danos, and could be a manifestation of continued aging.

Q: How Do I Improve the Slight Sag in my Neck from my Jaw?

A: The neck is one of the first areas of the face to show significant aging, because the skin is thin and poorly adhered to the underlying muscle. This tends to start happening in the mid- to late-30s. To improve the sagging you are now experiencing, a neck lift may give you the best results. However, you need to be evaluated in person before such a decision can be made. I hope this helps.My neck looks worse now then before the lipo. Is there anything that can correct this for me? 

Q:I had laser lipo on my chin and neck about a year ago. My results did not turn out well at all. My neck looks worse now then before the lipo. Is there anything that can correct this for me. Thank you for your help.

 

A: It’s not unusual to have lax skin after a fat-removal process. The sagging you are experiencing would probably best be remedied by either a neck lift or a full face lift. I hope this helps.

Q: My neck is causing me to look very aged – what is the quickest remedy to combat this?

A: There are several surgical and nonsurgical options available to you, depending on your individual anatomy and skin elasticity. While you might benefit from noninvasive procedures such as micro-needling to stimulate the production of collagen and Botox injections to relax the platysmal muscle that is causing banding on your neck, a neck lift will give you the most dramatic results. It can also last for up to several years, while the nonsurgical treatments will need to be repeated after 3 to 4 months. To get the specific answer you need, I recommend consulting with a board-certified facial plastic surgeon.

Q: What Causes the Neck Muscle to Loosen?

A: The platysmal muscle in the neck is not bound to other muscles or ligaments and so is extra vulnerable to the effects of gravity and aging. In addition, most people don’t exercise their necks, and so the muscle atrophies over time. Another factor that causes sagging neck skin and “turkey necks” is that the skin on the neck tends to be quite thin and is not well-connected to the platysma. The only way to make a dramatic change in the way loose neck muscles and skin look is to perform either a full facelift or a necklift, where the platysmal muscle is tightened and the excess skin removed and tightened. A well-performed neck lift can last up to 10 years. I hope this helps.

Q: Plastic Surgery to Remove Gobbler Under Chin? Is there a plastic surgery to remove a “gobbler” under chin? It’s not fat, but extra skin. I would like to see photos of post procedure.

A: Aging can be most dramatic on the neck, where the skin is thin and has a very loose connection to the underlying platysmal muscle. It is common to develop sagging skin under the chin – with or without fat. A lower rhytidectomy, or neck lift, can not only remove the excess skin but your facial plastic surgeon can actually tighten the underlying platysma as well. The result will be not only a clean chin, without a turkey neck or gobbler, but also a sleeker, more youthful jawline. You can see some before-and-after photos at the link below. In my practice, we offer the option of using local anesthesia, which means you can remain awake during the procedure and should have a shorter recovery time.

Q: I am considering a mini face lift/neck lift; how do I find a good doctor in my area?

A: Neck lifts and mini-lifts are invasive surgical procedures that must be performed by a board-certified facial plastic surgeon who not only has sufficient training and experience but who understands your individual anatomy and makes you feel 100% confident and comfortable. Spend time researching potential candidates by reading their websites and looking at their before-after-photos. Schedule consultations with at least two or three surgeons so you can be sure you are making the best choice.

Q: CosmoLift – How Does It Compare to Other Mini Lift Procedures? Can anyone tell me about CosmoLift? Please compare to Lifestyle Lift or Quick Lift.  Thanks!

A: The CosmoLift is a reflexology technique that is claimed to give the skin a slight boost, but it is not a permanent solution to a sagging face and cannot really lift it. The other procedures you mentioned — as well as the S Lift, Feather Lift and Thread Lift – are all variations on a “mini lift,” which usually just addresses the neck, chin and jaw. The different names are really just marketing tools, so the exact procedure may vary from surgeon to surgeon. A full facelift would not only tighten these areas but also remedy sagging in the cheeks. I hope this helps.

Q: Mini Face Lift or Blepharoplasty: Which to Do First? I’m planning a mini face lift and an upper eye blepharoplasty, but am looking at different doctors for each procedure. Which procedure should I do first?

A: There is no right answer to the question; either can be performed first. Once you have fully recovered, the next surgeon would modify his or her procedure based on the results from the first. However, I do wonder why you are looking at two separate surgeons for your blepharoplasty and mini lift. These can easily be accomplished in one procedure, saving you a second period of downtime and recovery. I would recommend continuing your search until you find one board-certified facial plastic surgeon who has expertise both in blepharoplasty and mini-lifts and get them both done at the same time. I hope this helps.

Q: Plastic Surgery to Remove Gobbler Under Chin?

A: Aging can be most dramatic on the neck, where the skin is thin and has a very loose connection to the underlying platysmal muscle. It is common to develop sagging skin under the chin – with or without fat. A lower rhytidectomy, or neck lift, can not only remove the excess skin but your facial plastic surgeon can actually tighten the underlying platysma as well. The result will be not only a clean chin, without a turkey neck or gobbler, but also a sleeker, more youthful jawline. You can see some before-and-after photos at the link below. In my practice, we offer the option of using local anesthesia, which means you can remain awake during the procedure and should have a shorter recovery time.

Q: How many times is it possible to have any form off eyebrow lift. I am a 26 year old female, and I have always had very droopy of hanging eyebrows and eyelids. Recently I have been considering undergoing a eyebrow lift. Have been reading a bit on it and it seems that it last for most patient for up to 5 years. So my question is how many eyebrow lifts can I person have done in a lifetime.

A: The short answer is that if you do not have a brow lift, in 5 years your sagging could be worse. The more detailed answer is that how many procedures you can have during one lifetime will be determined by the quality and elasticity of your skin. Certainly many people choose to do revision and “touch-up” surgeries after brow lifts, face lifts and blepharoplasties, among other procedures. It would be unusual for a patient to have more than 2 browlifts in their lifetime.  I hope this helps.

Q: 43 years old and tired of chicken neck. What is the best procedure for lower chin area with loose skin? At age 32 I had chin lipo with winged chin implant in 2004. In the last two years and three pregnancies later my lower chin area has sagging skin. I’m trying to avoid a lower face lift at my age. I wants something less invasive but I don’t believe Kybella helps loose skin.

A: There are a number of nonsurgical procedures that can help give neck skin more tone and lift. However, if the skin is lax and thin – as appears to be the case in the photos you provided – a necklift will probably give you the most satisfying results. Although it is a surgical procedure, it is less invasive than a facelift and requires fewer stitches. The results can be quite dramatic and will last up to 10 years, even as your skin continues to age.

Q: Does Neck Lift Help Improve the Jawline? Does a neck lift improve the look of the far edges of the jawline? Is there any procedure that lifts the jawline or do you need a full lower face lift?

A: When performing a neck lift, I first tighten the underlying platysmal muscle to angulate the jawline. I also tighten the deeper tissue around the lower part of the ear, which pulls up the lax skin underneath both the neck and the jawbone. If you have jowls or a double-chin, liposuction may be necessary to achieve optimal results. A well-performed necklift will make the entire jaw and neck area look smooth, toned, defined and youthful.

Q: Wondering what solution to fix turtle neck? I have some sagging skin, and no definition from chin and neck. What could be done?

A: The delicate skin on the neck is one of the first places where aging shows up. How much skin sagging and fat deposits you get in this area is partly determined by your genetics. Also, weight gain can permanently stretch the skin and, if followed by weight loss, may result in sags in the chin and neck.

A neck lift is less invasive than a facelift, and is the only other surgical procedure that can dramatically reverse turkey neck. (See my Before and After Photos below) The incisions are smaller and the recovery time less. Plus, the rest of the face is untouched. After surgery, you would be given recommendations to improve skin tone to keep the good results as long as possible. A consultation with a board-certified facial plastic surgeon will give you the answers you need to rectify this area of concern for you.

I hope this helps.

 

Q: What is the best procedure for sagging neck and loose skin under face/jaw line?

A: Depending on the quality of your skin, underlying musculature and bone structure, either a neck lift or a face lift would give you the most dramatic improvement for a sagging neck and jawline. The skin on the neck loses elasticity quickly and its tone can only be improved minimally by other methods, such as lasers and chemical peels. Those can be used in addition to a lift to keep your skin in top condition, but you will not get the results you want without undergoing some sort of surgery.

I hope this helps.

Q: What is the best and most successful non surgical procedure for sagging neckline and jowls? I’m 63 years old and lost 25 pounds.

A: While there are non-invasive options that can provide some benefit for candidates with mild skin laxity, the best results will only come from surgery. At 65 years old and having lost 25 pounds, it is unlikely that you will see significant results from a non-invasive procedure, unfortunately. I can understand having reservations about surgery.  This is normal.  I believe the best step would be to have a consultation to learn about your options and then make an educated decision at that time.  I believe patients are scared about the unknown.  If you become educated, you maybe more comfortable undergoing surgery.  If not, then surgery might not be for you.  Please visit a board-certified facial plastic surgeon for a consultation to see if non-invasive means will get you the results you want or if you should consider a lower facelift. I hope this helps.

Q: My neck runs straight to my chin, how can I get a more defined neck?

A: From your photo, it appears you have a heavy neck.  Liposuction may help, it may not create the best result.  For a heavy neck like you have, the best and longest lasting result is going to be with a neck lift.  Other options mentioned will give you an improvement and have less downtime.  It is going to depend which is more important, less downtime or a better result.   Please see a board-certified facial plastic surgeon to find the treatment option most appropriate for you.

Q: I’m 35 years old and I recently lost 73 pounds. I used to have a double chin, but now it’s just hanging loose skin. How can I get rid of this “turkey neck”?

A: Significant, rapid weight loss unfortunately does often result in loose, hanging skin as you describe. The best way to tighten and eliminate this excess skin is through a surgical neck lift. This procedure will tighten the skin along with the underlying muscle and remove excess, hanging skin in order to restore a smoother, more youthful look to the neck. I hope this helps.

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