Common visits in the office are patients in their early 50’s to late 60’s who meet with me to discuss ways they could enhance their facial appearance. They consider themselves healthy and have made an effort to take care of their faces by washing, moisturizing and using sunscreen regularly. But they still look tired and are unable to do anything about the lines around the eyes, the sagging cheeks, the deep wrinkles or lack of jawline definition. Patients feel unhappy with their looks and frustrated. “How can I change myself to look as good and as healthy as I feel on the inside?”
As we reach our 40’s, facial aging starts to take its toll and becomes more visible, mainly around the eyes, mouth and neck. Skin on the face and neck loses its laxity and the tissues holding the skin droop down to worsen the problem. We also loose facial volume and the beautiful high cheek bones or sharp jawline we once had.
I tell all my patients about the facial rejuvenation choices we have today with surgical procedures which yield wonderful results. By lifting and repositioning facial muscles, adding lost fat to the cheeks, temples, jawline, hollowed eyelids, removing wrinkles around the eyes and neck – and so many other combinations of small improvements of the face – patients get beautiful, noticeable improvements and a refreshed look.
One of my favorite surgeries to perform is the facelift. It is the right procedure for many, the most cost-effective long-term facial rejuvenation surgery and it can produce stunning, natural results.
Our facelift surgery is one of the most effective single procedures for aging.
How are your facelifts performed?
A facelift is a comprehensive surgery to improve the signs of aging of the face, including procedures to lift the cheeks, sharpen the jawline and treat aged skin. The modern facelift successfully addresses all the areas of the face, making it look rejuvenated without the telltale signs of plastic surgery. Our facelift surgery is one of the most effective single procedures for facial aging because we treat the deep structures of the face, lifting the areas around the muscles and the connective tissues and repositioning them to where they used to be.
Is there an alternative to facelift surgery?
Yes. Sometimes when the facial laxity is mild, meaning less droopiness, we can do smaller procedures such as fat grafting and replace the fat tissue lost with aging to recreate facial contours and highlights. Liposuction of the neck can be used to remove the double chin, but would not tighten the skin. We also offer skin resurfacing treatments to improve the skin quality, fine wrinkles, and hyperpigmentation. Dermal fillers can also be used to reshape the face and create beautiful facial contouring and wrinkle treatment. Small surgical procedures for facial rejuvenation such as buccal fat pad removal, liposuction, fat grafting to the face, lip lift, eyelid lift can be done under a local anesthesia if small and gradual improvements are preferred by the patients.
Will others see my facelift incisions?
No, the facelift incisions should not be visible. When the closure is made correctly and with attention to detail, the incisions are hidden in the hairline, under the chin and around the ear. Scars will be virtually invisible six months after surgery.
How much time will I need to recover after facelift surgery?
The average downtime is about 2 weeks after surgery for procedures done under general anesthesia. Some patients have more swelling or bruising than others, so it may take about 3 weeks for the most visible signs of surgery to be gone. No heavy weight-lifting or intense exercise for 2-3 weeks. We recommend patients do not schedule any major social event for at least 8 weeks after surgery.
Is it better to have a complete facelift? Or a mini-facelift?
Whether you decide to have a mini or complete facelift is dependent on how much visible facial aging you have and what results you would like to achieve. If we only want to improve the lines around the jawline and a reduce the wrinkles around your neck, a neck lift can be done by itself.
A mini-facelift is usually a more limited facelift with smaller incisions. It needs to be done for the right candidate, otherwise the results are also “mini” and temporary. The face ages as a whole and it should be completely evaluated. We are also different individuals that age differently, needing individual surgical approaches.
If you are not happy with your face and neck as a whole, a facelift, combined with improvements to the neck, nose, eyelids and lips, may be the best choice for you to feel fully satisfied. A complete facelift includes:
- Facelift to lift the cheeks, the corners of the mouth, improve deep wrinkles in the face
- Neck lift and platysmaplasty to neck bands
- Fat grafting to the face to improve facial highlights and loss of volume
After surgery what should I do to keep my heathy glow?
A facelift does not stop the aging process, but it is a “reset” in time. We offer a number of skin treatments and products to help maintain the results long term, including maintaining and improving the texture of the skin, the pores and dynamic wrinkles. A healthy lifestyle is also a part of the maintenance of the facelift procedure.
How can I get started to learn more?
If you are interested in discussing a facelift, a mini-facelift, a neck lift, or any other facial rejuvenation procedure it would be my pleasure to see you in the office for an in-person consultation. We can talk about what you want to achieve, go over the specific areas you are looking to improve and I will answer any questions you have.
Plastic surgery through a woman’s eye
Dr. Gabriele Miotto, Atlanta plastic surgeon has been recognized in the top 10% of doctors at Emory Healthcare in patient satisfaction.
Surgery and Recovery Information
After the procedure
Facelift and neck lift is an outpatient surgery done under general anesthesia. After the procedure, there will be visible fine skin sutures in the incisions, some bruising and swelling.
Facelift or neck lift surgery is not a painful procedure, but mild discomfort and feeling of tightness in the face and neck areas are expected for a few days to a few weeks after surgery. Bruising and swelling are usually the cause of the discomfort. However, it can be treated with preoperative and postoperative medication and supplementation, ice and anti-inflammatories. Swelling can be minimal or more intense depending on how many procedures need to be done in surgery to make the results the most beautiful and natural possible. Frequently combined procedures with a facelift or neck lift are a blepharoplasty or eyelid lift, fat grafting to the eyelids or to the face, browlift or lateral brow lift, laser resurfacing or resurfacing with a chemical peel to treat the skin aging, lip lift and others. There are many options for us to use to achieve the best results.
Sutures are removed between 7-10 days after the surgery. Return to normal daily activities between 2-3 weeks. Expect at least 8 weeks for committing to major social events as residual swelling can remain for some patients after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising.
General preoperative recommendations for facelift, neck lift and mini-facelift surgery:
What to avoid before surgery:
- DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
- Discontinue Vitamin E 10 days before surgery.
- Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
- Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
- Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.
What to take before surgery:
- Vitamin C may aid in preventing bruising and speeding healing. Consider taking 2000 mg per day 1 week before surgery (this can be split into two 1000 mg doses per day).
- The supplement HealFast® may speed up recovery after surgery. If you choose to take these supplements, please begin taking them five days before surgery as instructed on the packaging. They can be purchased online at www.healfastproducts.com or on websites like Amazon.
- Before a chemical peel or laser treatment, Dr Miotto will instruct you to begin using tretinoin (retin-a) and hydroquinone 2 weeks before your procedure to speed up the healing process. We carry these products at our Spa for your convenience.
General postoperative recommendations after facelift, neck lift and mini-facelift surgery:
- You MUST have a responsible adult to transport you home and stay with you for a full twenty-four hours after your surgery. If general anesthesia is used, the medications used during the procedure directly affect the nervous system, and for your safety, we will not allow you to drive or be home alone immediately after surgery.
- You will be unable to drive if you are taking narcotics.
- It is common to feel sluggish for a few days as the anesthesia works its way out of your system.
- It is recommended to elevate the head with two to three pillows after all facial procedures.
- Your initial post-operative appointment will be scheduled by your Patient Care Coordinator; please make arrangements to have reliable transportation for these appointments as you will not be permitted to drive until twenty-four hours after your surgery and when you are no longer taking narcotic pain medications.
- For your safety, we require that you have a responsible adult stay with you for twenty-four hours after your surgery for general help, as you may find your balance and judgement impaired.
- Please refrain from physical activity that will increase your heart rate or blood pressure for 2 weeks after surgery. However, bed rest is NOT recommended, and you should be walking at normal pace after the procedure.
- Frequent walking will decrease the risk of post-operative blood clots (mostly after general anesthesia).
- Sexual activity can safely be resumed 2 weeks following surgery. Please discuss with Dr Miotto as needed.
- You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
- Do not submerge yourself into a tub/pool until all wounds have healed (usually in 3 weeks).
- Do not scrub the surgical sites, however you can allow soapy water to run over them.
- Avoid lotions on the surgical sites for 2 weeks, but you can moisturize any other areas as desired.
Returning to Work:
- Recovery time will vary; however, most patients return to work within one to 2 weeks after the procedure, within one week you will have a feel for your specific limitations and will be able to determine how comfortable you will be with resuming your daily activities and workload.
- Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
- Eat a few bites of food before taking pain medications as these can cause nausea.
- A diet low in sodium will help minimize swelling and water retention.
- Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.
- Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
- It can take months for the very final results of your surgery be apparent. After 12 weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing (including the appearance of scarring) to continue to appear for up to twelve months.
- It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.
GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, breast and liposuction.
Call 404-850-5851 for your consultation.