Facelifts Explained With Dr. Josh Waltzman

What is a Facelift?

A facelift is a generalized term for rejuvenating aspects of the face. Generally speaking, a facelift either involves a procedure to tighten from the cheeks and jawbone up or from the cheeks or jawline down into the neck.

What is the Difference Between a “Mini" and Standard Facelift?

A “mini-facelift" is a procedure designed to stay in front of the ear. The scar will run into the sideburn, down the front of the ear and hook around the bottom of the ear. That procedure is not as significant as a lower/full facelift and does not involve the neck. It can be good for early signs of aging. However, it is not as powerful as a complete lower facelift, which includes the deeper tissues in the cheek and neck.

Who Is a Good Candidate for a Facelift?

The best candidates are people who are already experiencing some signs of facial aging including nasal-labial folding, frown lines, early jowling, fullness behind the chin, some laxity in the neck, or muscle banding. Patients must be healthy, non-smokers.

Who is Not a Good Candidate for a Facelift?

Patients who are not in good health, are smokers or have heart conditions, are not good candidates for a facelift. However, extensive medical workups are involved in qualifying for these surgeries. People with unrealistic expectations of how they'd like to look postoperatively may not be great candidates, either, and need to know that they may not get the results they're looking for. Also, people who have already had multiple cosmetic procedures to the face already may not be good candidates.

What is the Average Cost of a Facelift?

Depending on what procedures are done, for example, adding fat grafting, liposuction, or other skin tightening in conjunction with the lift, a general ballpark is between $12,000 and $15,000, including anesthesia and possible surgery center stay.

What Should You Look for in a Surgeon?

Board certification is very important, but it's also necessary to find someone you can relate to and feel comfortable with. You will not only spend time with this surgeon in pre-op and consultation, but in all the ensuing follow-up which may take months and years. While price is important, it's important to consider your relationship with the surgeon over the least expensive price.

What is the Difference Between a Cosmetic Surgeon and a Plastic Surgeon?

Plastic surgeons undergo a rigorous residency after medical school and then an accredited fellowship program with a minimum of six years plus fellowship. A plastic surgeon has been trained in all aspects of plastic surgery, including cosmetic. Cosmetic surgeons have less rigor and standardization in their training and don't have to go through a plastic/reconstructive surgery residency in the U.S.

What Questions Should You Ask in Consultation?

Ask your surgeon about their approach to facelifts, such as what are their goals for you. Ask to see some before/after pictures of their other patients, with the caveat that everyone is different, and procedures will have varying results. Bring a photo of yourself in your younger years, as well. It's also good to ask how often the surgeon does this procedure—is it once a year, or several times a month, etc? You can also ask for referrals to patients your surgeon has treated.

What Are the Risks and Complications of Facelifts?

Scarring is a concern, and a reality of facelifts. There will be scars, but if the surgeon does their job right, they should be hidden. Typical facelift scars run in front of the ear, loop up behind, and come into the hairline.

More serious risks include a loss of sensation and potential nerve damage. Some numbness is normal right after surgery but it should come back to all or nearly full sensation within about four to six weeks, or sometimes longer.

Nerve damage to nerves that control the motions of the face is a more serious complication that can result in a very small percentage of patients. Your surgeon should be able to talk about their procedures to minimize this outcome.

What Can You Do To Prepare for a Facelift at Home?

The most important action to take is to not smoke for four to six weeks prior to a facelift. There can be disastrous complications for an active smoker, particularly in healing incisions. It is also necessary to eat a healthy diet, with good protein intake. Stay physically active and maintain an appropriate weight.

How is a Facelift Performed?

Patients are typically put under general anesthesia, in an accredited surgery center, with a board-certified anesthesiologist. A breathing tube is inserted after the patient is put to sleep.

Then, the surgeon makes a small incision in the subcutaneous tissue, just below the skin, that creates a flap. Next, the surgeon makes an incision in the superficial musculoaponeurotic system, or SMAS, a layer of neck muscle that fans up to face. This allows the surgeon to tighten the deeper structures of the face and then redrape the skin under minimal tension to give the best appearing scars and remove any excess skin.

For facelifts that involve the neck, surgeons access the neck through a tiny incision at the back of the chin, then sculpt and dissect the fat under the chin. They may then tighten the platysma muscles with sutures to create a more youthful neck contour.

What is Recovery from a Facelift Like?

Recovery is surprisingly easy. Most patients don't even need to take pain medication any stronger than Tylenol. You may experience some bruising and tightness, but pain is usually minimal.

Most importantly, you must relax for two solid weeks. This means no exercise or vigorous activity. Ideally, you should also be off work and avoid social engagements. You will return to your surgeon's office several times within the first week after your lift. After two weeks, you will be socially passable, and may just need minimal cover-up.

How Much Follow Up Is Involved?

Ideally, your surgeon will see you back the very next morning to check any drains and incisions. Stitches and drains may be removed at days four or five, and another set of stitches may come out at day seven. Ideally, your surgeon will schedule a consult for one month, three months, six months, and one year. Full recovery, however, can take up to three months for small things to settle, such as fat grafting in the cheeks.

How Long Does a Facelift Last?

A well-done facelift should last 10 to 12 years. However, within that time you'll see some recurrent jowling and laxity of the neck again. A facelift does not stop the aging clock, it just turns it back.

Are There Different Considerations for Men and Women?

The most common patients to get facelifts are women, aged 50 and up. However, men do get facelifts. Since many men wear their hair short, and have facial hair, there is more to consider about where the facelift scar will be, and how it will affect the beard line. Men with more space between ear and beardline will have better results.

CareCredit Credit Card Financing for Facelifts

Ready to revitalize your appearance and boost your confidence? The CareCredit credit card makes it easy to pay for facelifts and related expenses not covered by health insurance.** Apply today and use our Acceptance Locator to find a doctor or cosmetic surgeon near you that accepts CareCredit so you can stop dreaming and start living your best life. Continue your wellness journey by downloading the CareCredit Mobile App to manage your CareCredit account, find a provider on the go, and easily access the Well U hub for more great articles, podcasts, and videos.

Author Bio

Jordan Rosenfeld has been freelance writing for 21 years about finances, health, education and more, and is the author of 9 books. Her work has appeared in The Atlantic, The Billfold, GoBanking Rates, Daily Worth, Quartz, Medical Economics, The New York Times, Paypal, The Washington Post and more.

Meet the Expert

Dr. Josh Waltzman is a board-certified plastic surgeon and founder of The Waltzman Plastic and Reconstructive Surgery in Long Beach, CA.