In general, a facelift removes excess skin, lifts and tightens underlying tissues, and redrapes the skin on both the face and neck, decreasing or eliminating signs of aging. These procedures can correct midface sagging, droopy or prominent nasolabial folds, deep nasolabial creases, “marionette” lines, and jowls. A facelift includes a neck lift most of the time unless a limited “short scar” or “mini facelift” is performed. Even a “short-scar” facelift can improve the neck by indirectly recruiting some of the skin of the neck into the face; nevertheless, the results on the neck can be limited. A neck lift is included when a full or traditional facelift is performed.  This will dramatically improve the results in the neck, eliminating creases, removing excess fat, and creating sharper neck angles.

In general, a facelift removes excess skin, lifts and tightens underlying tissues, and redrapes the skin on both the face and neck, decreasing or eliminating signs of aging. These procedures can correct midface sagging, droopy or prominent nasolabial folds, deep nasolabial creases, “marionette” lines, and jowls. A facelift includes a neck lift most of the time unless a limited “short scar” or “mini facelift” is performed. Even a “short-scar” facelift can improve the neck by indirectly recruiting some of the skin of the neck into the face; nevertheless, the results on the neck can be limited. A neck lift is included when a full or traditional facelift is performed.  This will dramatically improve the results in the neck, eliminating creases, removing excess fat, and creating sharper neck angles.

Dr. Rivera uses deep SMAS techniques, primarily utilizing a Deep Plane technique. However, he may also use a SMAS flap, SMASectomy, or SMAS plication depending on individual anatomy, tissue thickness, or surgical history.

The SMAS (Superficial Musculo-Aponeurotic System) is a layer of tissue beneath the skin that provides structural support to the face and covers the facial muscles.

A facelift is still considered the ‘gold standard’ for facial rejuvenation.  Despite misleading claims by some companies or people providing these services, there are no minimally or non-invasive procedures in the market or coming into the market that can even remotely achieve close to the facelift results.

Recovery duration varies individually; typically, it spans 1-3 weeks. After one week, many resume Zoom meetings, though some may experience residual swelling or bruising. Exercise is advised against for the initial 3 weeks. Larger social events or red carpet appearances are suitable after 6 weeks, adjusted based on individual healing and procedure extent.

Overall, a well-performed facelift using modern techniques should not make you look different. Dr. Rivera-Serrano knows this, and his focus is to make you look like yourself, only younger. Please look at all the before and after pictures in the photo gallery as examples. Occasionally, in addition to facial rejuvenation, some patients want a few additional procedures to make certain features more attractive or improve the facial harmony, such as nose surgery or chin augmentation. In combination with a facelift, these procedures can make the results of a facelift not only rejuvenate in nature but also make a face more attractive, proportioned, and balanced.

Some situations to consider a facelift: You feel that your face (and neck) do not reflect your energy levels, youthful character, or spirit. You show signs of facial aging that do not match your age. You believe that your facial aging, excess skin, and sagginess are a career, professional, or social handicap. You look aged but want to look refreshed.

There is a common fear among facelift patients to look like celebrities with botched plastic surgery jobs. The reality is that most of these poor plastic surgery outcomes result from older facelift techniques that rely on the skin to lift and tighten. This leads to unsupported deep tissues that create folds and creases (“Joker” lines) on the skin. Modern and well-executed facelift techniques like the ones performed by Dr. Rivera-Serrano rely on a solid foundation by lifting the deep tissues first, thus avoiding using the skin to lift and almost eliminating the risks of any such problems. These contemporary techniques are more technically demanding and time-consuming, resulting in longer operative times as compared to older ones. In Dr. Rivera-Serrano’s philosophy, the excess skin should be eliminated as much as possible. The skin should not be used to hold to the face but only to cover it as biologically and evolutionary intended. Any skin that is made to hold anything will unavoidably stretch rapidly, leading to short-lasting results and potential deformities.

It is important to understand that a facelift does not “lift” or improve the entire face. The word “facelift” is a misnomer to a degree. The only areas that a “facelift” lifts are the lateral middle and lower thirds of the face. In other words, the lateral cheeks and lower face (including the jowls and the jawline). A facelift does not rejuvenate the center of the face from top to bottom, the eyelids, or the forehead. For instance, if your lip is long or you have abundant lip wrinkles, very deep nasolabial creases, eyelid bags, saggy eyelids, saggy eyebrows, or forehead creases, a facelift will not improve them. Additional procedures will be needed to rejuvenate those areas, including lip lifts, blepharoplasty, brow lift, and others. Dr. Rivera-Serrano’s preference is to do these procedures at the same time as the facelift.  Sometimes these procedures need to be done as a different operation (staged) to decrease anesthesia time during surgery. If you have advanced signs of aging, it is ideal (but not mandatory) to have these additional procedures so your rejuvenation does not look patchy and your refreshed jawline and cheeks match with the rest of the face.

A good quality facelift is not a one size fits all type of procedure. The type of facelift, duration of the operation, and complexity depend on the treatment goals, the areas of the face that need to be treated, and the severity of each individual aging signs, which vary greatly among individuals. Therefore, each surgery is tailored. A personal consultation will determine what is best for you.

Some situations to consider a facelift: You feel that your face (and neck) do not reflect your energy levels, youthful character, or spirit. You show signs of facial aging that do not match your age. You believe that your facial aging, excess skin, and sagginess are a career, professional, or social handicap. You look aged but want to look refreshed.