Facelift

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Facelift Newport Beach

Facelifting is one of the most popular plastic surgery procedures in the US and internationally. There are numerous techniques to lifting the face. In skilled hands, most techniques involve at least several of the following principles:

  • Tightening the supporting layers of the face, particularly the 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 facelifts, midface lifts, endoscopic lifts, MACS lifts, and an alphabet soup of “x”-lifts that are trademarked and marketed broadly. Several cosmetic surgeons (some of whom are genuinely trained plastic surgeons and some who are self-appointed cosmetic ones) out there market these lifts under their initials or other such confusing terminology.

Dr. Sayed believes in a sophisticated yet simple approach. Each face is different and the above principles need to be analyzed and applied appropriately depending on the patient’s requirements, down time tolerance, incision preferences, and aging characteristics. For most 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 slight improvement of the jowls while others want a full facial rejuvenation.

As for incisions, here’s the real deal: the length of the incisions depends mostly on 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 the incision 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 when closing the face. Sometimes the wrinkling, bunching effect that pleating may cause will resolve on its own but in some patients it persists. 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. We’ve seen all sorts of challenging findings when we work at doing secondary facelifting on patients who have had surgery by others, and curious incision choices are some of them.

Facelift 101

The typical facelift incision starts along the hairline near the temple, 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, incisions are usually fairly faint and hard to detect by the average observer.

In most facelifts, 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. This is particularly notable near the jowls and the mid cheek areas. Other techniques used may 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 methods depending on your needs.

Facelift FAQ’s

1. How do I know if I am a candidate for facelift surgery?​

Some of our selection criteria to include you as a facelift candidate include:​

  • Enough 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 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 techniques

2. How long does facelift surgery usually take?​

Most facelift 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.

3. What is recovery from facelift surgery like?​

Most facelifts are performed on an outpatient basis in a AAAASF-certified operating room, meaning the facility is up to very high standards of accreditation. 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, 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 instructions while requiring a respectful number of face-to-face visits in the office.

Early postop recovery findings can include bruising and swelling, mild discomfort, slight eye irritation, a sense of facial fullness, and some mental adjustment to the process of healing which most patients undergo. Usually the swelling 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 and then return to light fitness routines after that. 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 recovery, which may include medications for pain, bruising, swelling, and dietary optimization.

4. How long do facelift results usually last?​

Look, 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 surgery. 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 facelift in 15 years or so, depending on the age at the time of first facelift. Primary facelift is most common for patients in their early to mid 50′s and early 60′s, although we have performed them on patients as young as mid-40′s and as old as late 80′s.

5. How can I prepare for my facelift surgery?

  • Have a reasonable expectation of what surgery 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 facelift.

6. How much does a facelift cost in Southern California or South Florida/Miami?

We don’t like to publish pricing as it is subject to market changes and dependent on the types of procedures you consider. We do have a fee schedule available in the office after your consultation, and we can give you an estimate through virtual consultation tools available on this site like our Zwivel® page. Feel free to contact us for a pre-consultation and we are happy to provide more information.