Dr. Jason specializes in natural looking facelift surgeries to restore your youthful appearance. Unfortunately, no matter how well we take care of our skin, facial aging is inevitable. A combination of gravity, sun exposure, toxins, environmental factors, and the stresses of everyday life take their toll on your appearance over time. Some of the earliest signs of aging occur in the face and patients begin to feel a mismatch between their youthful energy and their appearance.
Facial Rejuvenation procedures can not necessarily stop the clock and the ongoing aging process but they can turn back the clock to achieve a more youthful and refreshed appearance that you once had. Therefore, the goal of facial rejuvenation is not just to tighten skin and make someone look “pulled” or “operated” but rather to regain their youthful appearance.
It is important to remember that the different areas of the face, such as the eyes, cheeks, and neck all age together and should “match” each other. It is, therefore, typically advisable to surgically correct more than one area of the face for a natural look that maintains “facial harmony”.
Facial aging is more than just skin deep. All the layers of the face including the underlying fat, and even the bone also change with age. Facial rejuvenation procedures aimed at simply removing excess skin often result in a “pulled”, “stretched,” or obviously “lifted” appearance that not only looks unnatural but also quickly worsens over time given the elastic properties of skin, which allow it to stretch and loosen.
Dr. Jason’s goal with natural looking facelifts is to make patients look younger by shifting more of the facial tissue than just superficial layers. Surgically rejuvenating approach is to reposition the deeper layers of the face, and to utilize the deeper fibrous layers beneath the skin for support. This technique allows him to avoid pulling on the skin which allows for less visible scars and longer lasting results that are more natural in appearance.
+ Length Of Facelift Surgery: Three to four hours.
+ Anesthesia: Typically general anesthesia. Local anesthesia with IV sedation is also possible.
+ Length Of Stay: A single overnight stay is highly recommended. The Surgery Center at UCLA is the only place in Los Angeles that allows you to have your surgery followed by a monitored overnight stay with a registered nurse (R.N.) in the same facility. Not to mention, that UCLA’s world class hospital ranked “Best in the West” according to the U.S. News and World Report for the last 2 decades, is next door in the rare event of an emergency. This allows for a safer surgical experience which is one of the main reasons Dr. Jason is proud to be on faculty at UCLA.
+ Facelift Recovery: Initial mild to moderate discomfort; up and about within by the next day; wash hair in one to two days; stitches removed at 1 week; swelling, bruising mostly gone by two weeks; back to work with makeup, two weeks; avoid any exercise or significant increase in your heart rate for 2 weeks. Full effect and return to full activity at 3 months.
+ Facelift Scars: Inconspicuous scarring, mostly concealed in the hair, behind the ear, or in natural facial creases.
+ Facelift Risks/Possible Complications: Serious complications, while possible, are unlikely. Some potential complications can be avoided by carefully following your surgeon’s instructions. In addition to the usual risks associated with anesthesia, other risks include: Hematoma, Skin necrosis, Facial weakness or paralysis, Infection (Risk less than one percent), Ear numbness (Rare), Hair loss (Usually temporary), and Pulmonary emboli (Extremely rare).
Facelift Before & After Photos
Top 10 Facelift Questions
1. I am only 45 years old, can I be a good candidate for a facelift? 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.
2. What should I ask during my consultation to find the right doctor for me? You should look at the doctors before and after photos critically and decide whether you like their sense of aesthetic. Cosmetic surgery is an art and therefore you want to find a doctor that matches your taste so to speak.
3. What kind of facelift is best? What are the different types of Facelifts? What is the difference between facelifts, mini-lifts, upper and lower facelifts, and neck lifts? 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. You can refer to my facelift chapter in The Second edition of Plastic Surgery Essentials if you are really interested in the medical details. 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.
4. If I plan to lose weight, should I wait to have my facelift? If you plan to lose a significant amount of weight in the near future it is best to wait to have your facelift 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.
5. How long will the effects of a facelift last vs. fillers? 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.
6. I have been considering additional procedures (rhinoplasty, fillers, breast augmentation, etc.). Can I have multiple procedures done at the same time? 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.
7. How can I control swelling after facelift surgery? 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.
8. How long will it take to heal (aka when will I be ready for a special engagement)? 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.
9. When can I start working out again? 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.
10. When can I go back to work after a facelift? It really depends on what you do for work. If you have a desk job you can typically return to work after 1 week. If your profession is more physically demanding, Dr. Jason recommends to wait at least 2-3 weeks before returning to work. Remember, you do not want to strain or lift anything that weighs more than five pounds for the first 2-3 weeks.
UCLA Facelift Consultation
If you are considering facial rejuvenation, please come in for a consultation with Dr. Jason at UCLA or his Beverly Hills Office. Click here to book a consultation.
At the consultation Dr. Jason will listen closely to what you are looking for and what you are trying achieve. He can also make recommendations as to what you may or may not want to consider in terms of ancillary procedures. You will also have the opportunity to thoroughly review Dr. Jason Roostaeian’s work and see whether the results of his natural looking facelifts are what you are looking for.
About Your Facelift Surgery
Dr. Jason’s Pre-Operative Facelift Do’s and Dont’s:Avoid smoking cigarettes, wearing a nicotine patch or using nicotine gum three weeks prior and three weeks after surgery. All nicotine products inhibits circulation and slows your healing process.
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 than 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.
What To Expect After FaceliftYour 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)!
If you are not ready for facelift surgery then there are some nonsurgical options available in order to pause the so called “clock”. If you are looking to prevent new wrinkles from forming then one solution would be to start receiving Botox injections. If you would like to see more volume in your lips and cheeks then a great option would be to see Dr. Jason for either Juvederm and/or Voluma (for cheeks). Juvederm can also help fill in wrinkles around your mouth, such as smile lines. To read more about Botox and Filler please visit Dr. Jason’s article Top Questions About Botox and Filler Injectable Treatments.
If you suffer from excess fat in your neck & want to find a solution to get rid of your double chin then call or contact Dr. Jason Roostaeian’s office today to inquire about a new FDA approved injectable called Kybella. Kybella is the first FDA approved injectable drug to improve the appearance of the jaw line by dissolving excess fat underneath the jawline, often referred to as a “double chin”. For more in depth information about Kybella please Dr. Jason’s article What is Kybella? New Nonsurgical Treatment to Get Rid of “Double Chin”
During your appointment, Dr. Jason will thoroughly discuss the different treatment options you are a candidate for, both surgical and non-surgical, and answer any questions you may have.