Facelift (Rhytidectomy) – San Diego
The facelift is one of the most popular plastic surgery procedures in the US and internationally. Those looking for facial plastic surgery choose Dr. Tim Sayed, a board-certified specialist who has the extensive experience with facial procedures to offer patients personalized, natural rejuvenation.
Dr. Sayed applies numerous techniques to help patients attain long-lasting facial rejuvenation. In skilled hands, most facial surgery techniques involve at least several of the following elements:
- Tightening the supporting layers of the face, particularly the Superficial Musculoaponeurotic System (SMAS) layer
- Repositioning and restoring fat to its rightful locations and volume
- Removing excess skin
- Improving the complexion and texture of the skin
- Correcting a saggy or heavy appearing neck
- Lifting the jowls
- Maintaining a natural looking hairline and respecting anatomic landmarks
- Sculpting a shape that looks more youthful and takes gender aesthetics into consideration
You may have read about a number of facelift methods, including deep plane SMAS lifts, composite lifts, midface treatment, endoscopic lifts, MACS lifts, and an alphabet soup of “x”-lifts that are trademarked and marketed broadly. Some cosmetic surgeons are genuinely trained and board-certified, while others are self-appointed cosmetic surgeons without true plastic surgery training who market facial procedures under their initials of confusing terminology.
Dr. Sayed’s facelift offers a way to cut through the marketing and jargon; he believes in a sophisticated yet simple approach. Each patient is different, and the principles above need to be analyzed and applied appropriately depending on the patient’s requirements, down time tolerance, incision preferences, and aging characteristics. For most of his patients, Dr. Sayed will recommend a comprehensive approach that includes brow lifting, blepharoplasty (eyelid surgery), tightening and possibly removing excess SMAS tissue, fat grafting and repositioning, and an elegant redraping of the skin to achieve a smooth result. Patients with severely sun damaged skin, deep wrinkles or other texture and complexion problems may also benefit from laser resurfacing. Some patients may be satisfied with correction of the neck and a slight improvement of the jowls while others want a full facial rejuvenation. No matter what your unique concerns are, Dr. Sayed will meticulously plan and personalize your facelift so that your rejuvenation completely works for you.
As for incisions, here’s plain truth: the length of the incision depends on factors like how much extra skin there is to remove, regardless of which technique is chosen for other aspects of the procedure. Some surgeons try to keep their facelift incisions short by making certain decisions about how to tighten the skin, which in many cases involves pleating one side of the skin in order to make it match up to the other side of the incision. Sometimes the wrinkling, bunching effect that pleating may cause will resolve on its own, but in some patients, these complications persist. For this reason, Dr. Sayed expresses a preference for a smooth incision-even if it is slightly longer-in order to get the contour and elegance of the incision closure right. Dr. Sayed’s impeccable technique and respect for the facial tissues has allowed him to avoid the challenging results and bizarre incision choices he’s come across performing secondary facelift procedures. More importantly, Dr. Sayed strives to make sure your results never look overly-tight or overdone and that your rejuvenation looks as natural as possible.
View real patient before & after results in our photo gallery.
The typical incision starts along the hairline near the temple, goes down into the natural crevasses of the ear, climbs up behind the ear hidden in the crease, and then follows in a way that is somewhat camouflaged along the hairline behind the ear. When healed, the incisions are usually fairly faint and hard to detect by the average observer.
A sophisticated facelift does more than tighten the facial tissues—it addresses deeper layers like the SMAS, a layer of connective tissue and musculature that lie beneath the skin. In most procedures, sutures are used internally to pick up sagging fat and supporting layers like the SMAS and restore them to a higher and more youthful location. Treatment is particularly effective at rejuvenating the jowls and the mid cheek areas. Other techniques that could be used include grafting fat to areas of fat wasting or descent, removing and tightening a portion of the SMAS layer, supporting the face with internal grafts, and other procedures depending entirely on your needs.
Frequently Asked Questions About the Facelift
Some of our selection criteria to include you as a candidate include:
- Sufficient facial aging – fat atrophy, jowls, prominent nasolabial folds, cheek wasting, neck fullness, fat descent, skin looseness, neck sagging — to make it clear to Dr. Sayed that you will derive value from undergoing surgery
- Sufficient aging changes that fillers, Botox®, laser treatments and other options are unlikely to give you the result you seek
- General good health, meaning you do not have major uncorrected cardiovascular, respiratory, kidney or other major organ conditions and you are able to get medically cleared by your primary care doctor or a designated internal medicine physician who will perform a comprehensive physical examination and review preoperative laboratory studies
- Nonsmoker or willing to commit to NO NICOTINE IN ANY FORM for at least 3 weeks preop (before treatment) and for the duration of your recovery
- Available support system of friends, family, caregivers or others who can help you to keep your appointments, complete your preop and postop tasks, and emotionally bolster you through this exciting journey
- Reasonable expectations of how much youthful restoration is possible with specific surgical techniques
Because of genetics and environmental factors, people age at different rates and in different ways. Some patients begin to develop sagging skin on their lower face in their 50s and 60s, but some patients want to nip jowls and sagging skin in their 40s—sometimes, even in their 30s. As mentioned above, Dr. Sayed cares about one thing: making sure you derive value from treatment. To undergo a facelift, it’s necessary to have sufficient facial aging to qualify for the procedure, and that will mean different times for different people. The truth is that there is really no “best” time for everyone, which is why it’s important to talk to Dr. Sayed to see if you’re an ideal candidate.
Your facelift incisions will be strategically placed along the natural contours of the face to help conceal them; Dr. Sayed typically places his incisions along the hairline in the temples, around the contours in front of and behind the ear, and along the hairline behind the ear.
While you might see an immediate improvement after your facelift, the incisions made during the surgery might take some time to heal. During the first few weeks of your recovery your scars might appear red, then as time passes it should heal and finally mature, meaning it fades and softens in appearance. Regardless of your body’s ability to heal, Dr. Sayed will strategically place these incisions so that they won’t be easily visible to others; that way, you can enjoy going out in public without worrying about your scars looking too prominent.
It’s a common misconception that a facelift is done primarily to remove fine lines and wrinkles in the face; the truth is that treatment is provided to lift sagging skin in areas like the middle and lower areas of the face as well as the upper areas of the neck. While a facelift can ultimately soften the appearance of deep folds like jowls, it doesn’t directly address the quality of the skin or finer signs of aging. Your procedure can be easily combined with other treatments like laser resurfacing, blepharoplasty (eyelid lift), and more.
Most procedures are 3 to 6 hours in duration, depending on whether eyelids (blepharoplasty), brows (browlift), and skin treatment (laser resurfacing) and/or fat grafting are being done in the same procedure.
Our facelift is performed in an outpatient basis in a AAAASF-certified operating room, meaning our facility operates on the highest levels of safety. Patients usually spend up to a couple hours in the postoperative suite before being discharged in the care of a companion, family member or friend. Dr. Sayed gives a 24-hour phone number to all patients who can reach him for urgent questions about their facelift, and we also issue access to a patient engagement application that allows the patient or companion/caregiver to send SMS messages, photos, video and other content to our team in a secure, private digital format. This keeps us mutually informed on your recovery and allows us to update your facelift instructions while allowing you to have a respectful number of face-to-face visits in the office.
After your facelift, you might experience bruising and swelling, mild discomfort, slight eye irritation, a sense of facial fullness, and some mental adjustment to the process of healing (which is fairly typical of all patients who undergo surgery.) Usually the swelling from the facelift subsides within a couple of days and bruising is either resolved or easily concealed within 7-10 days. Most patients are advised to take 10-14 days out of social circulation and to give a good 3 weeks from surgery before expecting to be really in the public eye. Stitches are removed at 7 and 14 days depending on the location of the stitches (although we also use a lot of absorbable ones that don’t need removal!).
We ask that you abstain from exercise for 2 weeks after your facelift and then return to light fitness routines after that. To help with any swelling after the facelift, you may have drains in for 24 to 48 hours which are easily removed in the office. Dr. Sayed and his team provide close postop care in the office and with our remote engagement tools. You will be asked to take some supplement medications to aid in your facelift recovery, which may include medications for pain, bruising, swelling, and dietary optimization.
It’s perfectly normal to feel some tightness in the skin after your surgery—after all, the entire objective is to tighten the skin! That feeling of tightness tends to subside once the swelling of the skin goes down, so many of our patients experience some degree of tightness that lasts around 3 months. At that point, 90% of the feelings of tightness should go away.
It will take a few weeks before around 80% of the bruising and swelling dissipates, so it’s important to take it easy when it comes to returning to work or social events. Some residual swelling might persist for up to 6-12 months after your facelift, but when the swelling has completely subsided you should be able to see your full results. It’s probably a good idea to give at least 3-4 months before a major event like a wedding, gala, award show, or other public appearance where you may be photographed, in order for surgical changes look soft and natural.
No matter what, the process of aging will continue. You can’t stop the clock even with plastic surgery. What we aim to do is to help set the clock back (think of it like buying several years of daylight savings!) to make you look more youthful than you would have looked had you not had the facelift. In that sense, results are somewhat permanent, but you should not expect to look the same in 10 years, just as you would not expect to do so without surgery. It is not uncommon for patients to undergo a second procedure in 15 years or so, depending on the age at the time of first facelift. Primary treatment is most common for patients in their early to mid 50s and early 60s, although we have performed them on patients as young as mid-40′s and as old as late 80′s.
Have a reasonable expectation of what a facelift can accomplish
- Look at before and after photos and understand what kinds of techniques you are interested in
- Don’t smoke or take nicotine in any form for at least 3 weeks and ideally longer before (and after) surgery
- Stay well rested and well hydrated and eat a nutritious diet balanced with plenty of protein
- If your diet is lacking in vitamins, take vitamin C and zinc supplementation but ask Dr. Sayed about other supplements. We have a list of ingredients we ask you to avoid in the immediate preop phase to optimize healing and minimize bleeding risk.
- Designate a caretaker who can help you through the first 5 to 7 days after your surgery.
Review our Pricing page to build a “wishlist” and get estimated pricing on a facelift or a combination of procedures. We also have a fee schedule available in the office after your consultation. Feel free to contact our San Diego office for a pre-consultation and we are happy to provide more information.
Contact us today!
If you’re in the San Diego or Newport Beach areas and have any questions or wish to schedule a facelift consultation with Dr. Sayed, please contact our office.