Facelift

A facelift can allow you to turn back the hands of time and better reflect your youthful spirit. This popular treatment can help both women and men address common signs of age such as wrinkles, jowls, and inelastic skin on the face and neck. Our Orange County plastic surgeon, Daniel C. Mills, MD, FACS, performs many variations of facelift surgery and has helped numerous patients who desire to reverse the visible effects of age and attain a more youthful and refreshed appearance. He is experienced with state-of-the-art techniques designed to smooth out the loose skin of the face and neck, tighten the underlying tissues and muscles, and remove any excess skin. With a customized treatment plan designed to address your unique needs, Dr. Mills can rejuvenate your appearance with natural-looking results.

What Is a Facelift?
Facelift Benefits
Facelift Candidates
Facelift Options
Facial Fat Grafting
Complementary Procedures to Facelift Surgery
Facelift Procedure
Facelift Recovery
Facelift Results
Facelift Scars
Facelift Alternatives
Facelift Cost
Choosing the Best Facelift Surgeon
Additional Facelift FAQs

Quick Facts About Facelift Procedures

Sedation: General anesthesia
Procedure Length: Anywhere from 2 to 6 hours, depending on techniques utilized
Potential Benefits: Youthful, revitalized facial aesthetic (particularly in the lower third of the face); significant reduction of age-related cosmetic concerns
Recovery: Normal activities can usually be resumed within 10-14 days; strenuous exercise can typically be continued after about six weeks
Cost: Varies upon specifics of procedure

What Is a Facelift?

Medically referred to as a rhytidectomy, the facelift procedure is an aesthetic enhancement option that can tighten underlying facial muscles, reduce excess skin, and create a firmer and smoother appearance in the middle to lower facial areas and the neck. Facelift surgery can be performed utilizing an array of advanced techniques. The procedure is customized for each patient based on their unique needs and goals, and can be combined with other facial procedures for more comprehensive rejuvenation.

What Are the Benefits of a Facelift?

Many often think that a facelift procedure addresses the whole face; however, a facelift actually only focuses on the lower two-thirds of the face, addressing areas such as the jowls and the neck. If you have loose skin around your neck and/or some jowling around your mouth, then you are a likely candidate for a traditional facelift. The potential benefits of a facelift include reduction in the appearance of wrinkles and folds, the removal of excess skin, and the tightening of remaining skin for a smoother, firmer appearance. Dr. Mills utilizes advanced facelift techniques and is extensively experienced with this procedure. He will create a personalized treatment plan designed to meet your expectations with results that look natural.

Am I a Candidate for a Facelift?

The best candidates for facelift surgery are typically individuals who are experiencing signs of facial aging and sagging, inelastic skin in the mid- to lower areas of the face, as well as the neck. Both women and men who have moderate to severe degrees of loose skin, jowling, and other signs of age in the areas for which facelift is designed to treat can often achieve excellent, long-lasting aesthetic results from this procedure.

Generally, ideal candidates are in good overall health, are able to refrain from smoking, and do not suffer from any medical condition that may increase the risks of surgery or prevent the smoothest recovery possible. Dr. Mills will evaluate your skin and talk with you about your medical history and treatment goals to determine whether you are a good candidate for facelift surgery. If this is the best option for your needs, our plastic surgeon can develop a customized treatment plan designed to renew your appearance with natural-looking results.

What Are My Facelift Options?

There are several surgical options that Dr. Mills performs and each addresses a different area of the face:

Sub-Muscular Aponeurotic System (SMAS) Facelift

The SMAS facelift, or “SMASectomy,” is often the most effective and longest-lasting means of addressing jowling, facial wrinkling, and excess skin on the face and neck. This procedure is especially effective in addressing the issue of what’s sometimes referred to as a “turkey-gobbler” neck. Time can cause the facial skin to sag and lose its elasticity. Dr. Mills uses the SMAS facelift to lift and secure the sagging skin and underlying muscle structure to a firmer and smoother position across the face and neck. The incisions are inconspicuously hidden in the natural contour of the ear and extend around the earlobe and back into the hairline. There is also a tiny incision under the chin.

Midface Suspension Facelift

If you are experiencing a flattening out of the mid-portion of the face, Dr. Mills will likely suggest a midface suspension. This type of facelift literally repositions the cheek fat pads, which over time become low and less prominent. The midface suspension also reduces and smoothes out prominent nasolabial folds. Dr. Mills places small incisions in the hairline and at the lower eyelash line. Of all the facial rejuvenation procedures, the midface suspension generally yields the most dramatic results. This procedure will actually change your look a bit. Dr. Mills can perform the SMAS and midface suspension either individually, together, or in conjunction with other facial procedures that will enhance the entire face.

View our facelift before-and-after photo gallery to see our results. If you would like more information about the facial rejuvenation procedures that we offer, please contact Aesthetic Plastic Surgical Institute.

Facial Fat Grafting

Facial fat grafting, also known as “fat transfer” or “fat injections,” can address some of the aesthetic concerns that cannot be improved with a facelift alone. Facial fat transfer can be particularly useful for enhancing areas exhibiting a lack of volume and contour, such as the lips, cheeks, under-eye regions, and the temples. In addition, fat injections can reduce signs of “marionette lines” running between the nose and mouth, as well as smooth away wrinkles and fine lines in other facial areas. Facial fat grafting involves harvesting excess fat cells from another region of the body via liposuction, then injecting them into facial areas targeted for rejuvenation. This process essentially gives patients a double-benefit: removal of excess fat in one body area in order to rejuvenate another. Another advantage of utilizing fat transfer for facial enhancement is the technique’s ability to produce long-term results. In fact, the effects of facial fat grafting typically last much longer than what can be achieved with dermal fillers. Fat transfer to the face is so effective that Dr. Mills utilizes it as an adjunctive treatment in approximately 80 to 90% of facelift procedures.

Learn more about fat transfer to the face.

Complementary Procedures to Facelift Surgery

In many facelift surgeries, Dr. Mills uses submental liposuction to sculpt and define the jawline and neck. He can also combine facelifts with other procedures, such as blepharoplasty (eyelid surgery) to address droopy or puffy eyelids; fat transfer to restore volume to the face; brow lift surgery to correct sagging forehead skin; or even dermal fillers to smooth out the fine lines around the mouth. Just let Dr. Mills know what facial enhancements you are looking to achieve and he will tailor a surgical plan to give you the rejuvenated look that you desire.

What Does Facelift Surgery Involve?

During the consultation and other preoperative visits, Dr. Mills will walk you through your particular facelift design. Dr. Mills places high importance on your goals, physical examination, and medical history. During your physical examination, Dr. Mills will assess your facial bone and underlying tissue structure, skin thickness, texture, and elasticity, and the extent of facial wrinkles and folds. Dr. Mills will use all of this information to tailor a surgical plan that best suits your features.

Before Surgery

Typically two weeks prior to surgery, you will meet with our preoperative coordinator and Dr. Mills to finalize all of your surgical details. Your preoperative coordinator will review all of your preoperative instructions and make sure that you complete all the necessary laboratory tests and health screenings. If you have not done so within six months prior to your surgery date, you will need to have a medical evaluation (EKG, etc.) If you are a smoker, you will be advised to quit smoking at least one month prior to surgery and not to resume for at least one month after your surgery. Additionally, there are certain medications, herbs, and potions that your preoperative coordinator will advise you to cease taking from several weeks prior to several weeks after your surgery. We have vitamins and medications that will aid in your recovery by minimizing inflammation and swelling. These supplements are completely optional, but are available for purchase should you desire. It is really important that you follow all Dr. Mills’ instructions diligently to optimize your surgical results and recovery period. Your preoperative appointment will also be a time for you to ask any final questions, so that you are physically and mentally prepared for your surgery and recovery period.

Surgery

On your day of surgery, you will be cared for by an experienced surgical team that includes Dr. Mills, a nurse anesthetist, a registered nurse, and a surgical technician. Dr. Mills has been with some members of his surgical team since the beginning of his practice. Each person has a unique role in your surgery, but each individual shares in Dr. Mills’ philosophy and commitment to superior patient care standards.

Your surgical time will depend on the combination of procedures that you elect. You will likely be required to stay at an overnight facility, under the supervision of a specialized and experienced aftercare nurse. As her only patient, she will change and refresh your facial ice packs, administer medications and oxygen, and assist you with your snacks and walking. After a night of constant monitoring, you will be discharged the following morning. At this time, you will need someone to pick you up and care for you for the next 48 hours.

Prior to your discharge, your bandages will be changed from a full head wrap to a lighter wrap. Dr. Mills will remove the light head wrap on your second day postoperatively. Additionally, we will assist you in washing your hair at this visit.

What Is Recovery from Facelift Surgery Like?

Dr. Mills believes that oxygen therapy significantly promotes healing. As such, Dr. Mills sends his facelift patients directly to hyperbaric treatment following their overnight stay in the Oceanview Ambulatory Surgery Center and recommends five hyperbaric sessions following a facelift. There are several hyperbaric facilities located in the Orange County area, including a location that claustrophobic patients find comfortable.

For the first week after surgery, Dr. Mills recommends an extra dose of rest and relaxation. You will need to keep your activity levels very light and sleep with your head elevated. You may shower once the bandages are removed, but you will want to be extremely careful with washing your hair. Dr. Mills will ask that you not comb or brush over your suture areas. You will likely see the swelling reach its peak and then begin to subside within the first week. Dr. Mills will have you come in for routine follow-up visits, including removal of your stitches at 7, 10, and 14 days postoperatively.

After a couple of weeks, most of your bruising and swelling should subside and you may resume your normal activities, including non-strenuous work. You can generally expect that you can exercise after several weeks, but Dr. Mills advises that you avoid direct sun exposure. You should always wear a hat and high SPF sunblock to protect your skin. (Dr. Mills recommends that you consistently cover your face from sun exposure beyond the postoperative period to protect your skin and maintain your results.)

We understand it can be emotionally uncomfortable to be seen in public during the first couple of weeks after your surgery. While we know the healing will be worth the wait, we want to make this period as comfortable as possible for you. Our in-house aesthetician will apply some camouflage makeup to cover any bruising and show you how to do this on your own. Additionally, she will set up an appointment for a complementary facial and review a regime to keep your skin looking radiant and beautiful.

We encourage you to come to our office for routine postoperative visits for the first six months so that Dr. Mills can evaluate your progress and healing. Between these checkups, we want you to call us with any questions, needs, or just to keep in touch. Dr. Mills wants to build a long-term relationship with his patients, so we always welcome ongoing communication.

With facial surgery, potential complications may include hematoma, delayed wound healing, infection, numbness, and wide or depressed scars. It is crucial that you attend all follow-up visits and maintain a restful postoperative period to minimize the occurrence of any potential complications.

Dr. Mills understands that this is likely a very significant decision in your life. He looks forward to meeting you to hear your specific needs and discuss how he can refresh your appearance. We would also happily connect you with past patients so that you can ask them questions about their experience. In the meantime, we welcome any questions that you might have via email or phone. You can call our office or contact our patient coordinator through our contact us page. It is our practice philosophy to strive to provide every patient and prospective patient with the best service and care possible, so please let us know how we can best serve you.

After facelift surgery you can expect:

To require assistance for the first two to seven days following your surgery.
To drive after 7–10 days.
To resume normal activities after about 10–14 days.
To resume any light aerobic activity after one month.
To see bruising and swelling subside after about two to four weeks.
To take approximately 10-14 days off from work.
To feel a bit “down” for two to three weeks postoperatively.
To visit our office postoperatively at 3, 7, 10, and 14 days and one, three, and six months postoperatively. (We also recommend annual follow-up visits.)
To wear support stockings for at least two weeks after your surgery (or until you are moving normally).
To be on oxygen therapy for six hours per day for the first week postoperatively.
To see your final results in about three months after surgery, consistently improving
To feel tightness for the first two weeks (or until the swelling subsides).

How Long Does a Facelift Last?

Facelift surgery typically provides results that last for many years; however, it is important to remember that the face will continue to age as time goes on, and eventually the skin will once again develop inelasticity. With that in mind, taking good care of your health and your skin can keep the results of the initial facelift surgery going for as long as possible.

How Noticeable Are Facelift Scars?

Dr. Mills prides himself on his ability to minimize the appearance of residual scarring. Since the incisions for this procedure are typically made behind the ear, within the hairline, or in other inconspicuous locations, scars from facelift surgery can be well-concealed and virtually unnoticeable to others. Within a few months, the scars will most likely only be found by your hairdresser!

Are There Alternatives to Facelift Surgery?

Depending on your specific needs, the severity of your aesthetic concerns, and your ultimate goals for treatment, there are alternatives to facelift surgery that may be worthy of exploration. Some individuals would like to consider options that do not involve surgery or lengthy recovery times, while others simply have cosmetic goals that may be better achieved with another kind of treatment. For patients who have mild to moderate cosmetic concerns and are looking to essentially obtain a “facelift without surgery,” Dr. Mills offers an advanced treatment called Ultherapy® that may be an ideal choice. Ultherapy® utilizes a special device applied to the facial skin that delivers ultrasonic energy deep within the dermal layers. The technique is designed to reduce signs of wrinkles and inelastic skin to produce a firmer, “lifted” appearance. Ultherapy® typically does not require an extensive recovery period, and good results can often be seen after just one treatment. Another popular facelift alternative is what’s known as a “liquid facelift.” This option rejuvenates the face by utilizing a collection of injectable dermal fillers to enhance the skin. A liquid facelift can address signs of age and volume loss in a variety of facial areas, and does not require surgical intervention. In some cases, patients may benefit from laser skin resurfacing or other non-surgical medical spa options that can address their concerns. These alternatives will not be able to achieve results that last as long as facelift surgery; however, they can be very effective treatments for the right candidate.

It is also important to note that some individuals seek rejuvenation that may be better addressed by a different surgical procedure. For instance, a browlift or an eyelid surgery procedure can address concerns in the upper areas of the face, which are regions that a facelift is not designed to improve.

During your consultation with Dr. Mills, he will be happy to answer any questions you may have about facelift surgery or alternatives that may be more ideal for your goals. Regardless of the procedure you choose, all treatments at our practice are completely customized to create the best possible results for your specific needs.

How Much Does a Facelift Cost?

Because facelift procedures at Aesthetic Plastic Surgical Institute are customized for each patient, the total cost will be based on factors unique to each individual’s treatment plan and will not be the same for everyone. Some of the factors that will be taken into account include the surgeon’s fee, facility and anesthesia fees, the facelift technique utilized, whether additional aesthetic enhancement procedures are part of the overall treatment plan, and other components. After your facelift treatment program is developed during your initial consultation with Dr. Mills, one of our patient care coordinators will produce a total price estimate that includes all expenses associated with your facelift procedure. We will be happy to answer any questions you may have, and to go over the many various payment methods we accept. These include plastic surgery financing options available through a reputable agency that offers an array of affordable monthly payment plans for qualified applicants. Our practice can assist you with finding the way to pay for your facelift surgery that most conveniently fits your budget.

How to Choose the Best Facelift Surgeon

Choosing the plastic surgeon who may ultimately perform your facelift surgery is one of the most important steps of the process. As you research your options, there are a few specific things to look for that can be helpful in narrowing down your selection. First, it is a good idea to explore the prospective surgeon’s website to learn more about their experience and credentials. It is often preferable to consider plastic surgeons who are certified by the American Board of Plastic Surgery. Board-certified plastic surgeons have undergone rigorous testing requirements and must meet criteria that prove their experience and skills with plastic surgery procedures. Additionally, membership in The Aesthetic Society® (formerly known as the American Society for Aesthetic Plastic Surgery) and other respected medical organizations can be good indications of a plastic surgeon’s knowledge and experience. Taking a look at before-and-after photos and reading patient reviews of the surgeon can also help you formulate an idea of the results the doctor is capable of achieving and of other individuals’ experiences at the practice.

Here are some questions to ask and things to consider while researching your options:

Is the surgeon certified by the American Board of Plastic Surgery?
How many facelift surgeries does your prospective surgeon perform in a year?
Where will the surgery be performed?
Are you able to view before-and-after photos of previous facelift patients? If photos are not available on the website, you can ask if there are any available at the office that you can review.

There are numerous factors to consider when searching for the plastic surgeon who can successfully help you accomplish your aesthetic goals. You must feel comfortable in their care and confident in their abilities, and you should always feel that they are truly listening to you and communicating honestly and thoroughly.

You can find more tips on how to select the best plastic surgeon for your needs here.

Learn More

Additional Frequently Asked Questions About Facelift

Will my face look pulled or tight after facelift surgery?

Some patients express concern that they will experience the “tight” or “windswept” effect that is sometimes associated with lower-quality facelifts. Rest assured that Dr. Mills’ goal – be it facelift surgery or any other procedure – is to accentuate the natural features of each patient rather than produce inauthentic, “plastic” results. For this reason, he employs only proven techniques and safe surgical methods when performing facelift surgery. During your consultation, he will familiarize himself with your facial anatomy and create a plan to enhance its unique beauty.

How many years younger will I look after a facelift?

Many patients report looking roughly 10 years younger after their facelift surgery; however, keep in mind that this may vary based on your age, your skin laxity, the nature of your aesthetic concerns, and several other factors.

Do I have to stay overnight?

Dr. Mills prefers that our patients stay overnight in a facility after a facelift. A nurse will stay with you to administer pain and nausea shots or pills, change your icepacks, and monitor your overall recovery. Our nurse is also helpful in keeping you calm that first night, as the head dressing is bulky and can make some people feel claustrophobic.

Will I be in pain after surgery?

Most of our patients would say that the procedure is not painful, but there is a lot of anxiety. Some patients do complain of some ear pain, but this can be treated with medication.

Will I be really bruised?

Most of our patients experience bruising for about one to two weeks. We do recommend an anti-bruising agent prior to surgery and will provide you with complementary camouflage makeup to minimize the appearance of bruising.

How should I sleep after facelift surgery?

During your facelift recovery, you will be advised to sleep with your head elevated to mitigate swelling and limit contact with the surgical area. If you are not used to sleeping in this position, you may find it helpful to prop yourself up with pillows for extra comfort.

How much time should I take off work?

You should plan on taking about two weeks off. If you have a more strenuous job, we recommend that you take a month off to fully recover from surgery and minimize any potential post-surgical complications.

How can I reduce swelling after a facelift?

During the first two weeks after your facelift procedure, you will experience a significant degree of swelling. This is a normal response and should fade as the healing process continues. Swelling can often be effectively controlled by ensuring that you regularly maintain your head in an elevated position—even while sleeping, if possible. By taking this step, you can limit the amount of fluid that accumulates in the facial areas that have been treated. We can also talk with you about vitamin supplementation or medications that may be helpful to reduce swelling after facelift surgery. Some dietary adjustments may also be a useful way to manage inflammation. Eating foods that are high in protein, vitamins, and antioxidants—and low in salt—can be advantageous for controlling the effects of swelling after surgery.

Is facelift surgery different for men versus women?

There are some differences when it comes to the overall surgical approach of a facelift depending on a patient’s gender. The fact is that women and men have different anatomical characteristics and distinct preferences as to how they would like to enhance those characteristics. Men typically strive to achieve a more defined jawline and sharper contours. Women are also often interested in achieving these outcomes, but with softer results. Other distinctions include the precise locations where the incisions will be created. Some male patients who have receding hairlines may require the incisions to be made in a different area in order to produce less conspicuous scarring.

With all of this in mind, the fundamental goal of facelift surgery is the same for both women and men: to rejuvenate the face and achieve an appearance that looks smoother, more youthful, and more vibrant for years to come.

Is there an ideal age for facelift surgery?

The qualities of your skin, your aesthetic desires, and your current health status are the major indicators as to whether a facelift is an ideal treatment option. Age is not usually a deciding factor. Facelift surgery is most frequently performed for individuals in the 40s to 70s age range; however, patients who are both younger and older than that range have been successfully treated with this procedure.

When will I look “normal” after facelift surgery?

Provided you follow your personalized care instructions, attend follow-up visits, and rest sufficiently during your recovery, the final results of your facelift surgery should be apparent within six months. With that in mind, the majority of swelling should fade approximately two weeks after the procedure, and the initial results should start becoming noticeable by that time.

Schedule Your Consultation

We look forward to meeting you in consultation to develop a surgical plan that best suits your needs. Please contact our patient coordinator to schedule your one-one-one consultation. Dr. Mills wants this to be a great experience for you, and his staff will do everything we can to serve you.

Medical References*

University of Utah Health