Facelift Questions FAQ Youthful Reflections

Facelift Questions: FAQ

Call us today to schedule a free consultation ($300 value) where we will answer all of your facelift questions.

In the meantime, here are answers to a few of the most commonly asked questions.

What is a Facelift?
As we age, the effects of gravity, midface volume loss, and loss of skin elasticity leads to progressive laxity of the skin and soft tissues of the face, resulting in sagging along the jawline and in the neck, and deepening of the nasolabial folds and marionette lines around the mouth. A facelift, also called a rhytidectomy, is a surgical procedure intended to lift the skin and soft tissues of the face and neck, thereby restoring a more youthful contour to the neck and jawline, and softening the depth of the nasolabial folds and marionette lines. Therefore, a facelift primarily addresses aging changes of the lower face and neck. A facelift is commonly performed in combination with other facial rejuvenation procedures to address aging changes of the forehead, brow, eyes, midface, and skin. However, these additional procedures are not routinely considered part of a facelift.

What are the different types of facelift, and how do they differ?
This is a complex question, because there are so many different techniques that have been described for facelift, and the terminology is not always consistent in the literature. However, all properly performed facelifts employ some common basic principles. First, a variable length incision is made in the hairline in front of the ear, extending down along the natural creases around the front of the ear, and then possibly extending up along the backside of the ear and down along the hairline behind the ear for a variable length, depending on the needs of each individual patient. A separate small incision may be made in the natural crease under the chin to permit access to the midline of the neck, if needed. The skin of the face and neck is then elevated from the underlying soft tissues, called the SMAS in the face and the platysma muscle in the neck. This deeper layer of fascia and muscle is more resistant to stretch than the skin, and it is this deeper layer that is elevated and secured to re-contour the neck and jawline. Once the SMAS and platysma have been lifted and secured in a more youthful position, the excess redundant skin that comes back with the lift is trimmed along the incision lines and sutured back in place. Depending on the needs of the patient, liposuction of the jawline and neck, and tightening of the platysma muscle in the midline of the neck, may be performed through the incision under the chin for patients with significant fat accumulation or laxity in the neck. The thing that distinguishes different types of facelift procedures is the technique used for management of the SMAS and platysma. A SMAS plication involves folding the SMAS over onto itself as the tissues are lifted and suturing the layers together to support the lift. A SMAS imbrication procedure involves excising or removing a variable width strip of SMAS and platysma around the ear and approximating and securing the free edges together to support the lift. A deep plane facelift involves developing a separate plane of dissection underneath the SMAS layer to allow release of ligamentous attachments along the jawline and in the midface to allow additional mobilization of the SMAS during the lift. This is primarily to allow additional improvement in area of the nasolabial fold and midface. There are other variations related to suturing techniques and vectors of pull that distinguish facelift techniques. There are pros and cons to each facelift techniques, and the choice of facelift technique is dependent on the skill, experience, and preference of the operating surgeon. However, there has been no consistent evidence in the medical literature to demonstrate any advantage of one technique over another, in terms of outcome, complications, or longevity of results. Most experienced facelift surgeons have likely performed all of these techniques and utilize each to some degree based on the anatomy, concerns, and goals of each individual patient.

What is the difference between a mini-lift and a full facelift?
As described in a previous question, a facelift procedure is indicated for addressing aging changes of the lower face and neck. A facelift may be combined with other facial rejuvenation procedures, such as a brow lift or mid-face lift to address aging changes of the upper face and midface. However, these additional procedures are not routinely considered part of a facelift. A mini-lift is a very conservative facelift procedure that is best utilized for younger patients with mild to moderate laxity along the jawline and mild laxity in the neck, or for patient who have had a previous facelift and just need a little tuck-up. This procedure involves lifting a short skin flap around the ear to allow limited mobilization of the SMAS and platysma to tighten the jawline and neck. A full facelift is best utilized for patients with more advanced aging of the face and neck with moderate to severe laxity along the jawline and in the neck. This type of procedure involves more extensive skin flap elevation in the face and neck to allow more aggressive mobilization of the SMAS and platysma resulting in better tightening of the neck and jawline. This may also include liposuction in the neck and tightening of the platysma muscle in the midline of the neck to optimize results.

What is a Reflection Lift?
I am not a believer in a “one procedure fits all” approach to facial rejuvenation. Every patient is unique and different in their anatomy and the effects of aging. I have performed over 3,500 facelift procedures, and with that experience I have been able to develop techniques to optimize results for all of my patients. I tailor every procedure to the individual anatomy, concerns, and goals of each patient. The Reflection Lift utilizes my unique approach for lifting and securing the SMAS and platysma to optimize results and achieve a natural, more youthful look for my patients. The Reflection Lift can be performed in an office-based setting using light sedation and local anesthesia, thereby eliminating the risks and cost associated with general anesthesia. A Level I Reflection Lift is a conservative SMAS facelift approach for younger patients with mild to moderate laxity along the jawline and mild sagging in the neck. A Level II Reflection Lift involves a SMAS facelift, in addition to liposuction in the face and neck, to address mild to moderate laxity and fat accumulation in the jowls and neck. A Level III Reflection Lift is a more aggressive facelift approach for patients with moderate to severe laxity in the face and neck. This procedure involves more extensive skin flap elevation in the face and neck to allow tightening of the platysma muscle in the midline of the neck and more aggressive mobilization of the SMAS and platysma with the lift, in order to optimize results.

Can a facelift be performed without general anesthesia?
The simple answer is yes. A facelift can be performed very safely without the use of general anesthesia. I have performed thousands of facelift procedures in an office-based setting using light sedation and local anesthesia. I have a perfect, untarnished safety record utilizing these anesthesia techniques. I actually prefer to perform facial rejuvenation procedures without general anesthesia, because it reduces the risks and the cost for the patient. There are two alternatives to general anesthesia. One option is to use oral medication, such as valium taken by mouth, to relax the patient. The oral valium tends to relax most patients enough that they will doze off and sleep during the procedure. However, they may be awake or aware at times, and that is okay, because we use local anesthetic injections to numb the areas on which we are working so that the patient is not feeling pain during the procedure. Another option is to use IV sedation, which involves delivery of sedating medications to the patient through an IV to allow for more rapid titration of the level of sedation throughout the procedure. This is still not a general anesthesia, so there may still be times when the patient is awake or aware during the procedure. IV sedation also requires the use of an anesthesia provider to deliver the anesthesia, so there is an additional cost associated with IV sedation. I do also offer general anesthesia to my patients, but I feel that this unnecessarily increases the risk and the cost of the procedure for the patient.

What is the cost of a facelift?
The cost of a facelift can vary significantly, depending on multiple factors, including the region of the country, the experience of the surgeon, the complexity of the procedure performed, the location of the procedure (office, surgery center, hospital), and the type of anesthesia used. In general, the cost of a facelift includes the surgeon’s fee, the facility fee, and the anesthesia fee. The average facelift cost ranges from approximately $6000 to $15,000. However, cost should not be the primary consideration in determining the right surgeon to perform your procedure. The experience of the surgeon, his facelift results as indicated by review of before and after photos, and the satisfaction of his patients based on testimonials and reviews should be seriously taken into consideration. A low cost procedure performed by an inexperienced surgeon who delivers poor results is not a good combination. At Youthful Reflections, we try to make facial rejuvenation procedures more affordable for the average person by performing our procedures in an office based setting using light sedation and local anesthesia. The cost of a facelift in our practice ranges from $7000 - $10000, depending on the complexity of the procedure and the type of anesthesia used.

What are the risks of facelift?
The risk of complications with facial rejuvenation surgery is extremely low. However, as with all types of surgery, the risks include, but are not limited to, infection, bleeding, scarring, nerve injury, and unsatisfactory result. We take precautions to minimize the incidence of all of these potential complications. If a complication occurs, they can typically be managed with conservative measures and do not tend to affect the results of the procedure.

How long is the recovery from facelift?
As with all types of injury or surgery, there is a healing process that occurs over a period of 9 – 12 months during which time the body restores itself. Although it may take 9 – 12 months before the final results of a facelift are fully apparent, patients will look good and feel good long before the healing process is complete. Most patients want to know when they can get back out in public and others won’t be able to detect that they have had surgery. There are typically 2 visible signs of surgery: bruising and swelling, which can vary from one patient to another. It typically takes 1 – 2 weeks for the visible bruising and swelling that others can see to resolve to a point that others can’t tell. Some patients may take a little longer, if they bruise badly. However, the vast majority of patients can get back out in public within 2 weeks. That doesn’t mean that all of the swelling is gone or the healing is complete within that time. There will still be swelling that can be felt, but not seen that may take several weeks, or even months, to resolve. However, you will look good and feel good long before the healing is complete. It typically tell people to allow at least 3 – 4 weeks before any important event, such as a wedding, reunion, or speaking engagement where they want to look their best. In most patients, the majority of the soft tissue swelling has resolved by 6 – 8 weeks, but this can vary from one individual to the next. It is important that you be patient with the healing process and follow all postoperative care instructions to optimize healing and results.

Why do I look older than my friends who are the same age as me?
There are a number of factors that contribute to the differences in how people age, including genetics, sun exposure, skeletal structure, and lifestyle habits. Some of these you can control, but many you cannot. There are common things that happen to everyone as they age: wrinkles, drooping of the brow and upper eyelids, bags under the eyes, and sagging face and neck tissue. Facial rejuvenation can reverse these signs of aging and turn back the hands of time.

Will I still look like me?
We do not try to change the face that God gave you, but restore youthfulness that has been lost due to the effects of age and gravity. Dr. Boggess performs procedures to provide very natural looking results. Most people won’t be able to tell you had surgery; they may think you’ve changed your hair or lost weight. You’ll still look like yourself, just a few years younger.

How will I look different?
Dr. Boggess specializes in rejuvenation of the aging face and neck. Procedures are performed in a conservative manner to address the concerns and achieve the goals of each individual patient while providing natural appearing results. You will look refreshed and younger, not different or operated on.

Would a Reflection Lift work for me?
If you’re not happy with the reflection you see when you look in the mirror, a Reflection Lift could work for you. There is no standard age or profile for a Reflection Lift. Each Reflection Lift is customized to meet your individual needs and desires.

How long does it take to get a Reflection Lift?
Because each Reflection Lift is customized to suit each patient’s needs, the time will vary but typically it takes 1 – 3 hours.

How long will the effects of a Reflection Lift last?
As with all cosmetic procedures, the longevity of the results will vary from one person to the next. How you take care of your skin after the surgery will have an effect. We will give you tips for taking care of your skin post surgery.

All facial rejuvenation procedures are intended to turn back the hands of time for the individual patient and you will always have a more youthful appearance than you would have had if you had nothing done. However, you will continue to age in the way that you naturally age, which varies from person to person.


What can I do to get the best results?
Dr. Boggess and the Youthful Reflections team will provide detailed instructions for achieving the best results every step of the way. It is very important to follow all instructions, in order to optimize your results.

How much time do I need for recovery?
Patients’ recovery times differ. Some people are fine being out and about during the healing process. Typically, noticeable swelling will go down within 10 to 14 days. Most patients are ready to return to work in 1 – 2 weeks. If you’re hoping to look your best for a special occasion, you should schedule your Reflection Lift at least a month before the event.

Will I be in pain afterwards?
Pain and discomfort varies from one person to the next but after a procedure the pain is typically mild to moderate and easily controlled with pain medication. Most people take pain medication, as needed, during the first week, but we’ve had many patients tell us that they didn’t need anything stronger then Tylenol after the first night.

How much does a Reflection Lift cost?
Since your Reflection Lift is customized for you, costs vary for each patient.

Can I afford a Reflection Lift?
By eliminating the cost of general anesthesia and by performing our procedures in our office based operating room, we can significantly reduce the cost of most cosmetic procedures for our patients. We work individually with each patient to determine the best approach to achieve their goals within their budget. We can help you prioritize your goals to optimize your results within your budget to achieve the Youthful Reflection that you desire.

Am I too old or too young for facial rejuvenation?
People age in different ways and at different rates. Our patient population ranges in age from mid-30’s to early 80’s. Dr. Boggess will make a detailed assessment of your anatomy, goals, and physical health to determine if facial rejuvenation is right for you and what treatment will best achieve your goals.

Can a man get a Reflection Lift?
Yes, anyone can get a Reflection Lift. We’ve had many men who have had this procedure.

Do I have the option of having a Reflection Lift under general anesthesia?
Most of our procedures are performed in our office- based surgical suite using light sedation and local anesthesia. This eliminates the risks and cost of general anesthesia and is the preferred method for the majority of our patients. Dr. Boggess has performed thousands of procedures in this setting. However, we offer the option of procedures under general anesthesia for patients who prefer this method. There is an additional cost for an outpatient surgical facility and anesthesia provider in these circumstances.