Facelift

A good candidate for facelift surgery should be in good overall health, not use any nicotine products or able to abstain from nicotine products for at least 3 months before and 1 month after surgery. In addition, best candidate for surgery has realistic expectations regarding her or his result, stable emotional state, and good support system to allow seamless recovery after surgery. Ideally, the right candidate is at their stable weight as significant weight loss or gain can negatively impact long term results.

While there is no absolute right answer to this questions most people can benefit from a facelift starting in the early to mid-fifties. Some are ready for the procedure as early as mid to late forties.

A full facelift refers to a procedure that includes brow lift, midface lift, lower face and neck lift. In addition, many patients benefit from eyelid surgery such as upper blepharoplasty (removal of excess upper lid skin and fat), lower blepharoplasty (removal of excess lower lid fat and sometimes skin), and facial fat transfer. Lower facelift refers to elevation and tightening of the jowls and neck area. Lower facelift can also help with midface position and volume as well.

In general patients with excess skin in the neck achieve best results when lower facelift is combined with the neck lift. Younger patients who have minimal excess neck skin and mostly excess fullness in their necks can achieve good results with neck lift alone.

Facelift cost can range from eighteen thousand to over thirty thousand dollars depending on the combination of procedures required to achieve the best result. The cost includes surgeon, anesthesia, and facility (surgery center) fees. The cost covers all the pre-operative and post-operative care including postoperative visits.

Facelift recovery can differ depending on the combination of procedures performed, your healing capacity, and your tendency to swell and bruise. In addition, compliance with pre and postoperative instructions is critical to successful recovery. On average, it takes 3-4 weeks for majority of bruising and swelling to subside; however, this time frame can significantly vary depending on the patient. Improvements and changes can be appreciated up to 1 year postoperatively. For example, it is normal for skin numbness on the face and neck to take up to 1 year to resolve. Also, the incision sites, while nicely camouflaged, can look red for several months after surgery. Facelift sutures are dissolvable (except for upper eyelid sutures if upper eyelid surgery is being done at the same time), but most are trimmed and/or removed 1-week post-surgery.

Dr.Leyngold usually does not use surgical drains after surgery. Instead, he uses fibrin glue, a natural adhesive, to ensure the risks of fluid accumulation and bleeding are minimized. Some patients may require a “hemostatic net” sutures which are temporary stitches placed through the skin in the outer cheek and neck areas to prevent fluid accumulation. These sutures are usually removed within 2-3 days to prevent any scarring and suture tracks.

In the lower facelift the incisions are placed in the hidden creases in front of the ear and behind the ear. At the front, the incision also extends slightly upwards into the temporal hair tuft but stays behind the hairline. Behind the ear the incision runs in the crease where the ear meets the mastoid region and then transitions into the neck hairline with care to stay behind the hairline. Many patients also need a small and camouflaged incision underneath the chin for neck tightening. If patients are also undergoing eyelid and brow lift surgery the incisions are placed in the upper eyelid crease for upper lid skin removal (upper blepharoplasty), inside the lower lid (lower blepharoplasty), and a total of four small incisions (roughly 1 inch in length) at the frontal hairline and temple for brow lift surgery. If lip lift is being performed at the same time an additional incision is placed at the transition crease between the base of the nose and lip skin.

We require you stop ALL nicotine products at least 3 months prior to surgery. GLP-1 agonists such as Ozempic and Wegovy need to be stopped at least 2 weeks before surgery as they delay gastric emptying. Their intake within 2 weeks of surgery can result in anesthesia complications such as aspiration of gastric contents. We also require you stop all blood thinners such as Warfarin, Eliquis, aspirin, ibuprofen, herbal supplements that increasing bleeding, etc., prior to surgery. You will be provided with a list of blood thinners and recommendation for discontinuation time frame for your specific blood thinner(s). If you must take the medication(s) for a specific medical reason, we want you to obtain clearance from your doctor prior to stopping the medication(s).

Please abstain from physical exercise such as jogging, biking, high intensity training, racquet sports, resistance training, etc., for at least 3 weeks after your facelift surgery. We do not recommend lifting anything over 15 lbs. the first 3 weeks after your surgery. Walking is encouraged as soon as first postoperative day.

You will be prescribed medications for pain which include Celebrex (anti-inflammatory), gabapentin (for nerve pain), and oxycodone (narcotic). You can also take regular Tylenol. Most people do not require oxycodone for pain and feel comfortable with the other medications. Additional medications include a Medrol dose pack (short steroid taper) for swelling, Zofran (Ondansetron) for nausea and vomiting, and ophthalmic antibiotic ointment for upper eyelid incisions (if you are having simultaneous eyelid surgery).

We will provide you with a detailed written instruction. Some of the important highlights include sleeping flat on your back for the first couple of weeks after surgery, avoiding extensive neck rotation and extension for the first 4 weeks after surgery, avoiding emerging your head under water, swimming, hot tubs, pools, and baths for the first 4 weeks after surgery. You can shower and wash your hair the next day but avoid rubbing your incisions. If you are having simultaneous eyelid and/or brow lift surgery your vision maybe blurry for the first couple of weeks so appropriate arrangements for a driver must be made ahead of time.

Yes, we do require a responsible adult to stay with you after your facelift surgery including an overnight stay. You will also need someone to drive you to your first postoperative appointment which happens at our office the day after your surgery. After you first postoperative visit we recommend, but do not require, a caregiver.

While bruising and swelling can last 3-4 weeks, most people look presentable enough to appear in public without drawing attention after about 2 weeks.

While facelift surgery is very safe when performed by an experienced surgeon complications can occur just like in any other procedure. Luckily, majority of complications are temporary and resolve either on their own or with minor interventions. Dr.Leyngold will discuss the risks of surgery with you in detail during your consultation.

Most patients demonstrate final results between 3 to 6 months after surgery. However, improvements may still be noticed beyond this time frame.

Facelift result should last on average from 10-12 years. Determinants of result longevity include one’s age, with younger patients demonstrating slightly longer lasting results, skin and deeper tissue quality, genetics, smoking, unhealthy diet, and excessive sun exposure which can all affect the durability of results.

Yes, if you had previous facelift and now you notice recurrence of neck laxity and jowls your facelift procedure can be repeated.

Yes, Dr.Leyngold performs the most natural facelift surgery to ensure that your results make you look refreshed and rested without any stigma of having had surgery.

Dr.Leyngold uses state of the art extended deep plane preservation style facelift technique which releases the necessary ligaments to allow for appropriate repositioning of the descended facial and neck tissues. In addition, this approach allows for less skin undermining/dissection which decreases the risk of fluid accumulation (seroma), bleeding (hematoma), wound healing problems, and the use of drains. In turn, this results in the most natural and durable neck and facial rejuvenation results changing the facial shape from a “pear shape” to more of an “apple” shape configuration and provides a sharp neck line.

Dr.Leyngold uses state of the art extended deep plane preservation style facelift technique which releases the necessary ligaments to allow for appropriate repositioning of the descended facial and neck tissues. In addition, this approach allows for less skin undermining/dissection which decreases the risk of fluid accumulation (seroma), bleeding (hematoma), wound healing problems, and the use of drains. In turn, this results in the most natural and durable neck and facial rejuvenation results changing the facial shape from a “pear shape” to more of an “apple” shape configuration and provides a sharp neck line.

Dr.Leyngold is a board-certified oculofacial plastic surgeon with special interest in facelift and eyelid surgery. He completed medical school at The Johns Hopkins School of Medicine. After completing ophthalmology residency at The Johns Hopkins Hospital where he focused on eye, eyelid, and other facial surgery, he pursued a 2-year ASOPRS certified oculofacial plastic surgery fellowship where he had extensive training in facelift and eyelid procedures. He has subsequently taught and published on facial plastic surgery, lecturing nationally and internationally on the subject. He has also performed hundreds of successful facelifts with long-lasting and natural results.