As the saying goes, “age is but a number” and facial aging is no different. There are many factors involved with how your face ages, both your genetics and environmental exposures play a crucial role. Therefore, there is no particular age that one should wait before considering a facelift. The procedure is effective for anyone who feels as though they have excess fullness and skin laxity in their face/neck.

At youth, the facial shape is more  heart shaped with fullness in the upper face. With age the face becomes more pear-shaped with the formation of “jowls” (fat that hangs below the jawline”) and increasing heaviness in the neck. A facelift can help restore the more youthful fullness in the cheeks, re-elevate facial fat that has descended below the jawline, and give a  sharper contour to the neck.

In addition, Dr. Jason will only perform a facelift on patients who meet the following criteria:

• Are in good health
• Do not smoke
• Are able to avoid any blood-thinning medications for several weeks
• Have been cleared for surgery by a primary care physician
• Have reasonable expectations and aesthetic goals

The result of a facelift is considered by most to last approximately 10 years, versus a filler (Juvederm, Voluma) that on average lasts 1 year. A facelift, does not stop the aging clock but is a great way to set that ever ticking clock back. It is rare for patients to request another facelift procedure before 10 years. This can vary with the type of facelift procedure performed. For instance, a skin only facelift, as explained above, will have a more temporary result compared to lifts that involve deeper tissues.

There exist a vast array of facelift techniques, which can make it confusing for the patient.  What’s the difference between the deep plane, high SMAS, MACS lift, lateral SMASectomy, short scar, skin only facelift really? The differences mostly have to do with how and what part of the deep tissues of the face are manipulated.

The topic of which type of facelift is best has been studied, and the conclusion thus far has been that it has more to do with the surgeon than the specific surgical technique used. In short, you should decide whether the results of a particular surgeon are in line with the kind of result you would be happy with.

When searching for the best facelift surgeon to perform your rhytidectomy, Dr. Roostaeian advises you to consider several key factors:

1. Credentials and Certifications: Research your prospective face surgeon online – not just on their website, but on industry credentialing sites such as www.surgery.org, which lists board certified plastic surgeons. Do not choose a cosmetic surgeon who is a member of the ABCS – they do not receive the extensive training and oversight that plastic surgeons do. Look for plastic/cosmetic surgeons like Dr. Roostaeian, who are ABPS and ASAPS members.
2. Before and After Photos: The doctor you choose to perform your facelift should be happy to show you an extensive array of standardized before and after photographs. Scrutinize them carefully, making sure the lighting is consistent and the various views are shown with detail. View enough facelift pictures to determine whether or not the work is of high quality, with an aesthetic that matches your personal goals. Dr. Jason strives to provide patients with the highest quality of standardized facelift photographs so you can feel confident in your choice. Click here to view Dr. Jason’s gallery of before and after facelift photos. [LINK]
3. Office and Surgery Facility: Before choosing an aesthetic surgeon to perform your rhytidectomy, closely evaluate the office staff, as well as the surgery facility. All of the staff should be helpful and friendly, and pleased to provide you with detailed information about their operating rooms and equipment. Dr. Jason and his staff are proud to be affiliated with UCLA, world renowned for state-of-the-art surgical facilities and patient care. Click to learn more about our top-ranked hospital.[LINK]
4. Personal Connection: Seeing eye to eye with your facelift surgeon is just as important as assessing their operating skills. Plastic surgery is a very personal endeavor, and Dr. Jason strongly believes in creating a connection with all of his patients prior to heading into the OR. 

Click to read Dr. Jason’s blog post How to Find the Best Plastic Surgeon.

Facelift costs vary considerably from patient to patient. The exact cost of facelift surgery will depend on the complexity of your procedure, and you will receive a written quote following your consultation.

It is possible to have multiple procedures done at the same time. For instance, including a brow lift and/or eyelid procedure (blepharoplasty) to a facelift is very common. However, it is important to keep the planned operating time to less than 8 hours in order to optimize your safety. Increased operative times have been shown to increase the risk for complications such as infections and risk for deep vein  clots that can lead to pulmonary emboli.

If you plan to lose a significant amount of weight in the near future it is best to wait to have your facelift with Dr. Jason until your weight has been stable for 6 months. Patients with massive weight loss are common candidates for facelift as their once very full face deflates and leaves behind a lot of excess skin. Smaller changes in weight (<25 lbs), however, will likely not effect the result.

When preparing for a facelift procedure, follow all instructions issued by Dr. Roostaeian, his office, and the staff at the UCLA Surgery Center. These guidelines include, but are not limited to:

TWO WEEKS BEFORE SURGERY

• Do not take aspirin or any aspirin products. These medications cause bleeding which can lead to complications. You may only use Tylenol.
• If you are using Retin-A, discontinue use two weeks prior to surgery date. Do not recieve a dermabrasion, chemical peel, or laser, within five days prior to your surgery date.
• Do not take Vitamin E  (it will cause you to bleed more).
• Surface skin breakouts (rash, fever blisters, pustules, etc.) on your face or body may cause your surgery to be cancelled.  Call us immediately so you can be treated and avoid surgery cancellation.  Also, call if you develop a fever or any illness.
• Do not cut your hair (even your bangs) two weeks prior to surgery.  Longer hair helps hide fresh incisions.  Also, longer hair is easier to manage in surgery (we braid it to keep it out of the way).
• Do not color, perm, or chemically treat your hair during the 2-week period before and after surgery. Failure to do so may result in hair breakage and hair loss.
• Make arrangements for someone to drive you home after the doctor sees you the day following surgery.
• It is extremely important that we are informed about any medications or supplements that you are currently taking such as diet pills, mega doses of vitamins, prescriptions for depression, etc., Dr. Roostaeian and your anesthesiologist need to know every medication that is in your system.

 THE DAY BEFORE + THE DAY OF SURGERY

• Shampoo your hair and body with an antiseptic soap the night before surgery. We prefer you to use Hibiclens (sold at most drug stores) to wash your hair, face, and body (avoid the eyes) the night before and/or morning of surgery.
• Do not eat or drink anything (not even water) after midnight.  The morning of surgery you may take your regular medications such as blood pressure, heart, thyroid, etc. with a small sip of water.
• Leave all your jewelry at home, including any body (pierced) jewelry.  Do not wear contact lenses- not even extended wear.   Remove all makeup.  Do not apply lotion or creams.   Bring a robe, gown (one that will slip easily over your head or one that buttons up the front) and slippers.
• DO NOT “WORKOUT” THE DAY BEFORE OR THE MORNING OF SURGERY.  This will dehydrate your body and you will not be able to replenish it with water. 

If you are scheduled for a facelift surgery with Dr. Roostaeian, here is a shopping list of what to buy or bring in order to have an optimal surgery experience.

• Button-up pajamas- to avoid pulling any clothes over your face after surgery.
• Handheld mirror to hold up behind your head and look into your bathroom mirror, so can see where to apply the ointments and peroxide to the areas behind your ears and neck, especially if you don’t have anyone helping you.
• At least four clamp hairpins, to hold your hair out of the way so you can see to apply ointments and peroxide.
• Hydrogen Peroxide and Q-tips – Dilute peroxide keeps your wounds clean, thereby reducing infections and helping the healing process. You will apply it using Q-tips around the ears and chin areas. (Avoid peroxide in the areas around your hair as it can cause bleaching).
• Witch Hazel – To use in the areas where the sutures are in the hair to avoid bleaching.
• Ziplock bags to make ice packs.
• Mild soap (ie Dove or Cetaphil) and Aquaphor lotion for washing your face after the first week. Your skin will become dry at first and this will help as you want to avoid any harsh soaps or lotions.
• Foods with Very Low Salt- you want to really minimize salt, ideally to less than 1-2 grams per day, as this will help reduce your swelling. You want to maintain the low salt diet for at least 6 weeks and ideally for 3-6 months.

Swelling is normal following a facelift surgery. Some measures to reduce the amount of swelling include:  a) Try to keep your head above the level of your heart at all times for the first 2 weeks. Do not sleep with your head resting on multiple pillows as this will flex your neck and cause bleeding and/or bunching of the neck skin. Dr. Roostaeian recommends a large wedge that elevates your back and your head.  b) Use cooling measures such ice water soaked gauze or ice water in a ziplock for the first 48 hours. Your skin should just feel cool to the touch. Avoid anything completely frozen such as gel packs as this can cause damage to your skin. c) Avoid activities that involve bending over or straining. You should also minimize your salt intake as much as possible after surgery. Ideally you should ingest no more than 2 grams per day for the first 3 months after surgery. d) Dr. Roostaeian also will also prescribe a Medrol dose pack to help reduce your inflammation and swelling from surgery.   All of these measures combined will help minimize the amount of swelling you encounter following surgery.

Although every patient is unique, here is a general idea of what to expect after facelift surgery with Dr. Jason Roostaeian.

Your head dressing and some of your eye stitches will be removed 24-48 hours after your surgery.  Follow-up appointments will be made at this time.

• Numbness in the cheek area and tension in the neck are normal and will disappear over the next few months. Some swelling and bruising are to be expected.  If you develop extreme redness, pain, fever, or sudden swelling in one area of the face or neck, please call the office.  If you have any problems or concerns, please call us.

• No food.  Occasional ice chips only the first 24 hours.

• The next day after your head dressing is removed, begin shampooing your hair daily in the shower using shampoo. (This instruction will not apply to you if you have also had nose surgery.)  Let the water and shampoo run down over your face.   One of your goals is to keep your face and all the sutures as clean as possible which will decrease the chances of bacterial formation.

• Keep your head elevated 30-45 degrees for at least 3 weeks to minimize swelling.  When laying back, use pillows between shoulders and neck to keep your chin extended out when resting.  Also, do not bend over.  It’s important to keep your head above your heart. In order to prevent a crease or fold under the chin or neck remember not to let your head bend forward at the neck. Don’t allow your chin to point down while reading, knitting, etc.

• Clean incisions (face, eyes, and/or neck) very gently with half strength peroxide (use tap water to dilute).  Q-Tips will work perfectly to remove crusts from suture lines.  Apply the ointment we provide 2-3x daily to suture lines – but not on stitches that are in your hair.

• Do not color, perm, or chemically treat your hair during the 3-week period before and after surgery. Failure to do so may result in hair breakage and hair loss.

• Do not twist your head side to side for 6 weeks after surgery.  Turn your head by turning your shoulders.  This protects your face and neck incisions.

• Keep animals away from your incisions.  Do not allow animals to sleep in your bed for 4 weeks.

• Do not operate heavy machinery (driving) for 2 weeks.

• Do not wear earrings for 4 weeks post surgery.

• A small, gentle infant-type toothbrush will be very helpful the first week after surgery when brushing your teeth.

• During the first week post surgery have a soft, very low-salt diet, no chewing and minimal amount of fluids.

• During week two up to 3 months, maintain a low-salt diet with minimal fluids.

• Do not consume aspirin or ibuprofen products within 2 weeks post surgery.

• No nicotine products within 4 weeks post surgery.

• Be very gentle when caring for your hair for 4 weeks.  No brushing, pulling, or rubbing on the hair around the sutures.

• Do not use any heat (curlers, curling iron, blow dryers, etc.) on your hair as your scalp and face can be burned very easily.

• No extreme temperatures on your face, neck or chest areas such as heating pads or ice packs.  Your nerve endings and blood supply in some areas have been temporarily disturbed and you can easily burn or freeze.

• Be careful when pulling clothing over your head to avoid pulling the ears.

• A concealer is available 1 week after surgery to help cover bruising if needed.  Apply very gently.

• Avoid vigorous activity for 6 weeks (and any exercise that raises your heart rate for 4 weeks) following surgery.  You may resume sexual activity 2 weeks after surgery.  (Increasing your heart rate can cause bleeding.)

• Avoid the direct sun or tanning spa for at least 12 weeks following surgery as fresh scars will permanently pigment (turn brown).

For the first few weeks, you will typically experience some bruising and swelling following facelift surgery with Dr. Jason Roostaeian. For a scar to fully heal it takes at least 6 months to a year. Over this time you will see your scars become less visible, they will lighten in color and become softer to the touch. Your final result will be apparent within several months in most cases.

For the first 2-3 weeks following surgery, you want to avoid straining (lifting anything more than 5 lbs), or getting your heart rate/blood pressure up as this can lead to bleeding. After 2-3 weeks you should avoid mechanical forces that will stress or put tension on your healing incisions for 3 months. This means you should avoid high impact activities that lead to excessive movement of your head and neck, such a running. If you feel up for it, after 2-3 weeks, Dr Jason Roostaeian recommends starting with the seated stationary bicycle which is low impact and minimizes movement of your head and neck.  modest exercises that do go back to working out three weeks after facelift surgery. Listen to what your body is telling you at all times, for instance stop the workout if you experience any new discomfort in your face or neck. Remember, getting plenty of rest and reducing your overall activity will give you time to heal and speed up your recovery.

As always, consult with Dr. Jason if you have any questions about your post-brow lift healing process.

Dr. Jason Roostaeian is extremely meticulous about the placement of his facelift scars. Typically, the scarring is inconspicuous, mostly concealed in the hair, behind the ear, or in natural facial creases.

The scar fades over time, remaining extremely inconspicuous and undetectable in most people.

For a scar to fully heal it takes at least 6 months to a year. Over this time you will see your scars become less visible, they will lighten in color and become softer to the touch. Most patients feel comfortable to attend any special engagements by 4-6 weeks as the majority of swelling has gone down and the scars can be easily concealed with make-up.

While everyone heals at a different pace, there are general guidelines to help determine how much work or school you’ll miss after a facelift. To promote proper healing, Dr. Roostaeian recommends taking at least 1 week off after facelift surgery. Most patients are able to work from home or do homework after a few days of rest. Most patients with non-strenous jobs can return to work after about one week. If your work requires significant physical activity (lifting more than 5 pounds) you want to wait at least 2-3 weeks to prevent any increases in your blood pressure that can lead to bleeding while your’re still in the early stages of healing.

Just as with any rejuvenation procedure with Dr. Roostaeian, we cannot prevent ongoing aging but we can set the clock back many years. Generally speaking, the results of a facelift last an average of 10 years.