Facelift FAQ

An office examination with a facial plastic surgeon can provide further information specific for you regarding facelift surgery. Continue doing your research before speaking with a specialist and bring your questions to the office. Schedule a consultation today!

Generally, a minimum of 2 weeks are allowed from the consultation to prepare for surgery. Select procedures may be performed earlier. Nonsurgical procedures may be performed at the same time as the initial consultation.

Combined brow lift, eyelid lift, and facelift surgery is referred to as a “full facelift.” Facial plastic surgery is tailored to the unique needs of each patient, based on several factors such as individual anatomy, degree of facial aging, medical conditions, and patient personal preferences. While a brow lift, eyelid lift, and/or facelift are commonly performed together, these procedures don’t have to be performed at the same time.

Yes, it’s generally preferred to combine procedures such as facelift surgery with a brow lift, eyelid surgery, or another complementary treatment. First, by combining surgeries, you may save money on some fees. Secondly, tissue modified from one area may be used for another surgical area. Lastly, by combining the recovery processes, you minimize downtime from work, school and physical activities. Commonly combined procedures with facelift surgery include the following:

• Eyelid Surgery
• Brow Lift
• Fat Transfer
• BOTOX® Cosmetic

Strenuous activities or exercise after plastic surgery will increase the risk of bleeding, swelling, and bruising. Activity restriction during the recovery period varies based on the operation performed and patient’s medical condition. Light activities, such as slow walking, may be performed soon after anesthesia. Heavy activity, such as aerobics, yoga, cycling, running, heavy lifting, or similar vigorous activities are allowed 2 weeks after the procedure. Contact sports are generally allowed after 6 weeks.

Patients can go to work or school the next day or work from home, if desired. Most patients, however, plan at least one week off from work or school after plastic surgery. A longer period of recovery may be necessary for combined procedures.

Surgical facelifts vary depending on the specific needs of the patient and surgery. Limited incision facelifts, such as mini lifts or direct neck lifts, are quick, while traditional or full face lifts may take a few hours of precision surgery. However, the length of surgery depends on the complexity and number of procedures performed. Dr. Chaboki will discuss the length of your individual procedure with you prior to the date of the facelift surgery.

Patients should remain in the area at least the first day after plastic surgery. Regional travel by car is allowed the following day after surgery. Patients should wait at least 1 week before air travel after plastic surgery, but waiting 2 weeks is preferred. The risks associated with travel reduce with time.

Makeup should not be used around the operated area for the first week after surgery. Shaving is usually allowed the first week after facelift surgery. As healing is monitored, Dr. Chaboki will help determine an appropriate time to resume makeup and shaving on or near operated areas.

Dissolving sutures may be used for facelift surgery. Skin sutures usually dissolve or are removed within the first couple weeks after surgery.

Dr. Chaboki performs a medical history and physical on all patients prior to undergoing cosmetic treatments. Facelift surgery may be safely performed on many chronic, stable medical conditions. However, facelift surgery may be delayed or cancelled as needed for patient safety. Dr. Chaboki will work with his cosmetic patients to help find a safe, appropriate aesthetic option if facelift surgery cannot be performed.

Smoking adversely affects health and recovery after plastic surgery. Treated areas are at a greater risk of poor healing, scarring and infection. Blood vessels that supply oxygen and nutrients to the tissues shrink up and subsequently prevent optimal healing.

Patients must stop smoking for a minimum of 2 weeks prior to surgery to decrease the risk of these complications and continue smoking cessation after the procedure. Cosmetic surgery is an opportunity to quit smoking all together.

Any plastic surgery procedure (surgical or nonsurgical) may result in bruising and swelling, which may peak in the first day before improving. In addition, the bruising generally fades away faster than swelling. Lastly, surgical procedures tend to swell or bruise more, as compared to nonsurgical treatments performed in the office.

To ensure the best outcomes after facelift, make sure to read and follow our plastic surgery care instructions and the following guidelines below:

Avoid Blood Thinners
Some normal medications or herbs may worsen bruising. Stop all ibuprofen, aspirin and aspirin-like products for at least 2 weeks prior to your procedure. Avoid any herbal teas, supplements, or medications that thin the blood, such as St. John’s wort, ginkgo, ginger, garlic, ginseng, kava, vitamin C, and vitamin E.

Elevate Your Head
Let gravity play a role in the recovery process. Positioning your head on top of a few pillows, or elevated mattress top, will help reduce bruising and swelling in the treated area. Avoid bending over as much as possible, too.

Apply Ice
In addition to reducing swelling, a cool compress helps constrict blood vessels, which may decrease the extent of bruising. Ice, however, should not be placed directly on the skin. A soft cloth helps spread the cooling effects. Ice is the most important during the first 2 days after cosmetic treatments.

Avoid Heavy Activity
Heavy or strenuous activity that increases the heart rate or blood pressure can increase bruising and delay recovery. Heavy activities to avoid include, but are not limited to, all types of exercise and sex. Even lighter activity, such as yoga, should be avoided. This restriction on activity is for the first 2 weeks after plastic surgery.

Try Arnica Montana and Bromelain
Herbal supplements that help some patients reduce bruising and swelling include Arnica montana and bromelain. Both of these are available over-the-counter without prescription. You should look for these supplements in a tablet form. Bromelain is also found in pineapples.

Bruising improves faster than swelling after plastic surgery. On average, most bruising resolves within the first 1 to 2 weeks in the early phase of healing.

Lumps, bumps, or nodules, if present, are often temporary and fade with time. These issues are usually due to swelling. Small blood clots, stitches, or scar tissue are other possible causes, which also resolve gradually.

The immediate swelling after facelift surgery may last approximately a week or 2, depending on several factors. After this initial healing period, swelling is still present, but usually only noticeable by the patient. The very last tiny bit of swelling takes several months to gradually dissolve.

It’s possible to have swelling in areas of the face and eyes adjacent to the surgery site even though plastic surgery was not necessarily performed in those areas. This extension of facial swelling is due to gravity and the natural movement of fluid in the tissues. In addition, keep in mind that the eyelids, face, and nose are very sensitive to swelling from other factors, such as allergies, diet, hormones, gravity, sleep, etc.

Patients are comfortable during surgery, whether the procedure is performed in the office via local anesthesia or in a surgical facility with IV sedation. Patients may experience a very brief, mild sting from the initial numbing medication.

A certain level of discomfort is normal and expected after plastic surgery. Patients often describe sensations as tightness, soreness, or discomfort that is easily managed by oral pain medication (e.g., acetaminophen, codeine). Many patients have reported not requiring prescription pain medication after the first several days or so.

Severe pain, which is unusual, should always be reported immediately to your plastic surgeon.

Every patient will recover at a unique rate. There are 3 general phases of healing after any plastic surgery: early (days/weeks), intermediate (weeks/months), and late (months/years). The phases of recovery don’t have distinct transitions between them. The early phase of healing occurs within the first days and weeks after plastic surgery. Most of bruising and swelling resolves during this early phase, including stitches dissolving or being removed. Generally, patients report not requiring prescription pain medication after the first several days or so after facelift surgery.

On average, patients are “back to normal” approximately 2 weeks after plastic surgery. Exercise may be resumed after 2 weeks, around the time when the intermediate phase of healing begins. During the first couple months after plastic surgery, skin continues to tighten and swelling continues to resolve. Patients have already returned to work or school by this intermediate healing time frame. Any residual swelling is usually noticeable by the patient only.

The last phase of healing really takes several months to years, as gradual changes continue to occur in the skin and tissue. Any external scars and residual mild swelling continue to fade. Patients should continue healthy habits to maintain their aesthetic results, such as eating a healthy diet, routinely exercising, avoiding excess salt or processed foods, using consistent sun protection, avoiding smoking, and getting adequate sleep.

Downtime after cosmetic procedures varies from a few hours to several days, depending on the specific procedure and areas treated. Office procedures are performed under local anesthesia, if any anesthesia is required. Surgical procedures are performed with either IV (twilight) sedation or general anesthesia and require a longer recovery period. Anesthesia normally wears off within the first 24 hours after surgery.

Patients wear a gentle, elastic neck wrap to minimize swelling for a several days after surgery. Many patients wear a scarf and glasses to run quick errands outside, until they feel more comfortable in public.

Driving is generally avoided during the first week after facelift surgery because your neck may feel stiff or tight while turning your head initially. Numbness, especially around the ears, is common and normally resolves with time.

General instructions for before and after plastic surgery can be found on our Care Instructions page. Dr. Chaboki may provide specific instructions for individual patients personalized to their procedure. This will be discussed extensively both before and after the procedure.

Safety is our primary concern, and perioperative instructions can help reduce the risks associated with plastic surgery and anesthesia. In addition, preparation before facelift surgery helps maximize recovery after plastic surgery. Each patient and procedure is unique, so variations will occur and be specific for each patient. Patients must read the care instructions before any procedure.

Common preparation tips prior to or after any plastic surgery procedure:

• Avoid blood-thinning medications or supplements, such as ibuprofen, aspirin, herbal supplements.
• Stay hydrated and drink plenty of water.
• Avoid excess salts in your diet, including processed and fast food.
• Strictly avoid smoking.

All plastic surgery procedures require some form of anesthesia, even if minimal. The minimal amount of anesthesia is referred to as local anesthesia, where ice, vibration, numbing cream, and/or local injection is used to numb the treated area. Only the treated area is numbed, and the patient remains awake, alert, and comfortable. Nonsurgical office treatments (e.g., BOTOX® or Restylane®) are often performed via local anesthesia. Most facelift surgery, especially when combined with other procedures, is performed with either IV (twilight) sedation or general anesthesia.

Nonsurgical facial procedures (e.g., BOTOX®, Restylane®, KYBELLA®) are performed in the office with local anesthesia. Minor surgery (e.g., mini lift) may also normally performed with local anesthesia. Facelift surgery may be performed with either IV (twilight) sedation or general anesthesia at accredited facilities with a licensed anesthetist.

Patients are safe and comfortable during their procedures. The decision on the type of anesthesia used during plastic surgery depends on the extent of surgery, additional cosmetic surgery procedures along with the eyelid surgery, patient factors and preference, and surgeon factors and preference. After an evaluation, the plastic surgeon and patient decide together the appropriate anesthesia type for plastic surgery.

Dr. Chaboki practices facial plastic surgery at several DC-area surgical facilities to accommodate his patients:

• Georgetown University Medical Center
• MedStar Surgery Center

Minor procedures with local anesthesia are performed in the DC office. Surgical procedures with IV (twilight) sedation or general anesthesia are performed at accredited facilities with a board-certified anesthetist.

After facelift surgery, you should look better than nature intended for the remainder of your life. The aging process continues, however, so wrinkles and sagging skin will reappear years after facial surgery. You can always expect to look better than if you had not had the procedure in the first place. Patients may consider nonsurgical treatments to help maintain a rejuvenated appearance after cosmetic surgery.

No other aspect of facial cosmetic surgery has received more marketing terms than the facelift. Many plastic surgeons have trademarked or branded their facelift techniques, but in reality these names are only for marketing.

The best facelift surgeons tailor each surgery to the specific needs of each patient without any specific branded name. One facelift surgery is not necessarily better than another. Be cautious when speaking to a branded or trademarked cosmetic surgeon. Keep in mind that safe and reliable facelift surgery techniques are used by the entire community of plastic surgeons and are not associated with trademarked or branded names.

Facelift surgery candidates generally have the following qualities, which may vary for each person:

• Good general health
• Over 18 years old
• Excess skin and/or fat of the lower face and neck
• Droopy or sagging tissue

As a facial plastic surgeon, Dr. Chaboki will tailor the facelift surgery as appropriate for you. Facelift surgery is customized to your degree of facial aging, underlying anatomy, and most importantly, your personal goals. Some patients require a limited lift, while other patients would benefit from extensive procedures. A nonsurgical lift may be appropriate for some patients too, especially those with very limited time for recovery. Only after a comprehensive evaluation can Dr. Chaboki help determine appropriate options customized for you.

Patients with some medical conditions or medications may not be good plastic surgery candidates. In addition, those with unrealistic expectations should not have treatments.

Patients may start considering cosmetic facelift surgery at a younger age, for those who were born with excess skin or fat. Neck liposuction and chin augmentation with an implant are more often performed for these younger patients. Many patients start considering cosmetic facelift surgery (e.g., mini lift or S lift) after age 40.

Nonsurgical alternatives to facelift surgery include BOTOX or Dysport injections around the eyes and forehead to reduce wrinkles and improve brow position. Facial fillers such as Restylane® or BELOTERO® as a “liquid facelift” may reduce wrinkles and creases. KYBELLA® injections can reduce excess neck fat.

For optimal outcomes in patients with significant excess or loose skin, facelift surgery is required.

Education is the best method to reduce risks. Learning about the procedure and risks, including a discussion with your plastic surgeon helps promote safety.

Follow the preoperative and postoperative care instructions of your plastic surgeon. These care instructions are meant as a guide and don’t replace specific instructions for you. Preparation reduces risks both before surgery and during your recovery after cosmetic surgery.

A patient’s safety is always our primary concern. Any plastic surgery has inherent risks, but facelift surgery is considered a safe surgery in healthy patients.

Dr. Chaboki will review your medical history and medications, in addition to an appropriate examination to evaluate not only the aesthetic plan, but also to perform plastic surgery safely. Some patients may also need testing and/or preoperative medical evaluation by their primary care physician before surgery.

The skin and tissue near incisions may appear puffy and pink initially. This puffiness will improve with time. Topical petroleum jelly (such as Vaseline® or Aquaphor®) applied to external incisions helps the skin appear its best and reduces scars. Keep incisions moist with petrolatum ointment at all times during the initial healing period. Do not use any other hair products, creams, or lotions, until advised otherwise. In addition, take extra care when combing, brushing, or styling the hair in the early recovery period.

Other methods to maximize skin health include not smoking, staying adequately hydrated, maintaining a healthy diet, sleeping well, and using sun protection.

Incisions for many facelift techniques, including mini lift and S lifts, are hidden within the natural contours around the ear. The facelift incision may be anywhere from the temple, sideburns, around the ear, and/or upper neck. The incision location and length vary largely based on the age of the patient and how much lift he or she needs. Dr. Chaboki will minimize the incision but maximize the lift, without creating an unnatural appearance. The facelift incision, regardless of exact location, fades from view over time.

Most facelift and neck lift surgeries also have a supplemental incision under the chin. This chin incision is well hidden in a natural crease and is used largely to access fat in the neck for liposuction, chin augmentation, or neck muscle tightening.

For more information, read our blog post on facelift incisions.

Hair loss (alopecia) may occur with any procedure involving the scalp region. Some facelift surgeries involve incisions hidden within the hair. That being said, patients generally do not have hair loss with facelift surgery. Hair loss that might occur is normally temporary. Hair follicles are “hibernating” and re-grow with time. Lastly, hair is not shaved during surgery.

Sagging skin may occur after massive weight loss, such as after bariatric surgery. As a result, a facelift is commonly considered following significant weight loss. While some skin tightening may occur naturally, there is often the concern of excess skin. In addition to abdominoplasty (i.e. tummy tuck) to improve the waistline, a facelift can help improve the jawline and neck.

Facelift surgeons typically advise waiting a year after bariatric surgery before considering a facelift. Your body weight should be stable before proceeding with any plastic surgery.

Some have argued that facial exercises or electric stimulation of the facial muscles can help tighten the face and reduce the sagging appearance common with aging. However, there isn’t scientific research that shows it being worthwhile for cosmetic improvement. In addition, most plastic surgeons and dermatologists have not seen long-term, predictable results from such nonsurgical treatments. Any cosmetic results, if present, tend to be very short term and subtle.

Facial exercises and electric stimulation are not a replacement for a surgical facelift or neck lift. Patients with significant neck fat or sagging skin will typically require facelift surgery.

The newer techniques of facelift surgery, such the S lift or SMAS lift, are generally considered “mini” lifts when compared to older facelift methods. Mini facelifts generally have shorter incisions and quicker recovery time.

Nonsurgical facelifts can be performed with wrinkle relaxers such as BOTOX Cosmetic or Dysport®. By relaxing the muscles that pull down the jowls (i.e., platysma), BOTOX can provide a temporary neck lift. This type of nonsurgical lift may be referred to as a Nefertiti lift. Results with a BOTOX nonsurgical facelift are subtle as compared to surgery and are temporary.

A liquid facelift, also called a nonsurgical facelift, refers to nonsurgical methods of rejuvenating the face with injections. These cosmetic injections include facial fillers (such as JUVÉDERM® or Restylane®), fat injections, and relaxer injections (such as BOTOX® Cosmetic). Liquid facelifts are better to enhance the cheeks, midface, lower eyelid, temples, chin, jawline, and lips; these procedures generally do not focus on the neck.

The face ages in a multidimensional manner. Gravity is only one aspect of appearing older. We all also gradually lose facial volume with age and sun damage. Fat and bone loss contribute to this facial shrinking and thinning. A combination of lifting with a facelift and filling with fat transfer, also called fat injection, provides a more natural, comprehensive rejuvenation.

Patients may assume that facial plastic surgeons only recommend plastic surgery. The best plastic surgeons, however, provide a variety of options (including nonsurgical), with a preferred option given a patient’s personal goals, underlying anatomy, and degree of facial aging.

Submental fullness is another term for a double chin. A double chin can be due to many factors, including excess neck fat, loose skin, sagging muscle, or weak chin bone. For patients with excess skin laxity contributing to submental fullness, a facelift is usually required.

For more information, read our blog post on submental fullness treatment.

Those patients with significantly more skin laxity and neck fat will generally require more surgery. Older patients usually require more surgery as compared to younger patients. Generally, ideal patients for mini lifts or S lifts are typically younger with more moderate signs of facial aging.

Less invasive plastic surgery procedures sound appealing, but may not give desired results in some patients. Each patient is unique, and an appropriate facelift procedure can only be determined by a comprehensive evaluation by a cosmetic surgeon. A consultation with a facelift surgeon will help determine which factors are contributing to your appearance — and which procedures are appropriate to rejuvenate the face and neck.

There is overlap with neck lift and facelift procedures. Unless it’s a full facelift, a limited incision facelift (e.g., mini lift, S lift) improves the lower face, jawline, and neck primarily. A neck lift improves the neck only. Facelift surgery involves incisions around the ear, while a neck lift typically has an incision only under the chin. A facelift is more likely required when loose skin is present that needs to be lifted, while a neck lift is more likely required when there is loose neck muscle (i.e., platysma) which creates bands. A neck lift can be performed with liposuction or chin implant too.

A consultation with a facelift surgeon will help determine what factors are contributing to one’s appearance, and subsequently what procedures are appropriate to rejuvenate the face and neck.

Normally, a facelift focuses on modifying the skin, fat, and muscle tissue of the lower face and neck. Some patients may have a double chin (also referred to as submental fullness) from a weak chin bone. If desired, chin augmentation may be performed at the same time as facelift surgery.

The SMAS, which stands for superficial musculo-aponeurotic system, is a layer of fat and muscle tissue just under the surface of the skin on the face. Modification of the SMAS is the main component of most facelift surgery, not just the skin. Long-lasting facelift results are obtained by lifting and tightening the SMAS through a variety of techniques.

Some asymmetry might be improved with facelift surgery. As a result, Dr. Chaboki may make modifications on facelift surgery to improve symmetry.

Keep in mind that a certain degree of asymmetry will still persist and cannot be corrected. For example, patients with asymmetric jowls commonly also have asymmetry of the eyes, ears, and face.

Thread lifts were once considered a possible solution to tighten the face and neck without surgery. However, there isn’t clinical evidence that shows it being worthwhile for cosmetic improvement. In addition, plastic surgeons and dermatologists have not seen long-term, predictable results from such nonsurgical treatments. Any cosmetic results, if present, tend to be very short term. Thread lifts are not worth it.

A thread lift is not a replacement for a surgical facelift or neck lift. Patients with significant neck fat or sagging skin will typically require facelift surgery.

A facelift focuses on the lower face, neck, and jowls. A mid facelift focuses on the cheeks and mid facial area, including the lower eyelids. A mid facelift can be combined with other facelift types, or performed on its own.

For more information, read our Mid Facelift FAQ.

There are several types of facelift surgery. Dr. Chaboki performs a variety of methods of surgery to rejuvenate the appearance of the face and neck. The variation largely depends on where incisions are placed and what tissue is modified during the lift. One facelift type is not appropriate for all patients. Facelift surgery is tailored for the individual patient.

• Limited incision: smaller incision(s) are placed in front and/or behind the ear. Also known as a mini lift, S lift, short scar lift, or MACS lift. Quickest recovery to minimize disruption to a patient’s lifestyle, as compared to other facelifts. Primary facelift method utilized.
• Traditional: longer incisions and more tissue reshaping with enhanced lifting, for patients with advanced aging.
• Mid facelift: a procedure that improves the tightness and tone of the cheeks and lower eyelids rather than the lowermost portion of the face.
• Deep plane: deeper tissue modifications and longer incisions. Limited for more advanced aging. It’s the most invasive method of facial surgery, requiring a longer recovery, but can give the most dramatic results.
• Full: any facelift combined with plastic surgery of the eyes (blepharoplasty) and eyebrow (brow lift).
• Secondary: any facelift performed on a patient who has previously had a facelift, even if it was years prior. A secondary facelift can be performed to correct an irregularity left behind by the previous surgery or simply to maintain and “freshen up” results.

A facelift is plastic surgery that improves the appearance of the lower face, jawline, cheeks, neck, and chin areas. Technically referred to as rhytidectomy, facelift is also known by many other names (such as SMAS, mini lift, short scar lift, S lift).

Facelift surgery is commonly performed with other facial procedures, but may also be performed on its own. All facelift types involve an incision in front of the ear, with varying extension of this incision toward the temple or behind the ear. The amount of tissue lifted depends on the exact surgical approach and the particular needs of each patient.

Facelift surgery is one of the most common aesthetic procedures for both men and women to rejuvenate the face. Patients appear more rested and refreshed by reducing wrinkles, tightening and lifting the neck tissue.

Plastic surgery covers a broad area of medicine, which includes both reconstructive procedures and cosmetic procedures. If your procedure is medically indicated, some portion of the cost may be covered by your insurance plan. Insurance coverage varies greatly for patients, and patients are ultimately responsible for fees.

Your facelift is priced according to your individual needs, and Dr. Chaboki offers you an estimate during your consultation. The cost of most facelift procedures can range from $6,500 to $20,000. *