Most Common Facelift FAQs

So, jowls are a very common and frequent concern that patients have as they age. So, it’s basically excess skin and fat in this area of the jawline that starts building up. Depending on how tight the skin is, we can address jowls sometimes by disguising the jowl along the jawline by placing fillers before and after the jowls or even a PDO thread, which is a temporary solution to improve the contouring of the jawline. If there is already moderate laxity and the skin and muscles are also coming down, the best procedure is a lower face and neck lift. Or even a full facelift, depending on whether there are also changes in the cheeks. Depending on the solutions that the patient is looking for, we can try to do something temporary with fillers and threads or a surgical procedure.

Facelift scars can be very visible up to three months after surgery. Why? Because this is the time that the scar takes to become white or a lighter color. So, in the beginning, the scars are more visible because we have sutures and because the healing process makes the scar red. Then, over the first three to six months, the scars start softening and becoming white. But the most important thing is actually the way the incision was closed. So, we use very fine sutures and do not put tension on the skin, and that makes the scar heal very well and look very good from very early in the post-op period. But I would say that most scars would be white and non-red at about six to 12 months after surgery.

There is no particular age at which we will think about having a facelift. A facelift is basically decided, and the time for the surgery is decided when the patient starts seeing signs of aging. So, the age itself is not as important; what is important is what we see on the face. For example, we start seeing some loose skin or loose muscle and sometimes loss of volume in the face. So, there are several things we can think about to improve facial aging. But sometimes a facelift is the best, the most durable, and also the option that will give the patient what they are looking for. So, don’t pay much attention to the age; I pay attention to what the patient desires to achieve and what we can do with surgical or non-surgical procedures.

A PDO lift is a suture suspension lift that is done in the office, so it’s not a surgical procedure; it’s a non-surgical procedure that we use to create a mild lift mostly of the cheeks and of the jawline with these threads. So, PDO is an absorbable suture. It lasts for about a year, and it is usually placed under local anesthesia. So, we can get a little bit of lift in the cheek and a little bit of lift in the jawline. It’s not like a surgical facelift. It doesn’t give you the same effect as a surgical facelift, but it’s very good for younger patients with good skin quality, and they are seeing a little bit of loose skin. It's not to be compared with a facelift, so it’s a very mild thing done in the office under local anesthesia.

The treatment that works best for facelift scars are usually topical treatments that we, uh, recommend after the sutures, uh, come off. So, they include silicone creams with sunscreen because, uh, the sunlight or the UV light can pigment the scar, so we want to keep that light color protected. We can also sometimes use compression with tapes and silicone tapes, and if the scars stay red for a while or longer than we want, sometimes we can also do chemical peels or lasers to soften the color of the scar and make it look as good as possible.

A facelift is not the only way to address the jowls or the marionette lines. We can address these areas also with fillers or with a suture suspension, such as a PDO thread. It’s not as durable or a permanent solution as a facelift, but we can get very good results with injectables and with non-surgical treatments in the areas. It will always depend on how much aging the face has or the quality of the tissues. But we can have good results with other procedures, besides a facelift.

The longest-lasting and most effective procedure for lifting the jowls is still a lower face and neck lift, or a facelift associated with this. Why? Because during a facelift or even a lower facelift, we will address the deep tissues that are causing the jowls on the surface level, which is usually the muscle that falls and slides down, and even the soft tissue, the fat in the face. The skin is always attached to this area, so when we leave the deep tissues and the skin with it, we really reposition that jowl in a very stable way, and therefore this is a very long-lasting solution, so it’s years instead of months when we do something non-surgical.

So, after a facelift or lower facelift, we will reposition the tissue of the jowls in a more permanent way. However, a facelift or a lower facelift does not stop the patient from aging. If there is further aging, sometimes increases in weight, or a lot of sun damage to the skin, the jowls can return because they're part of the face and part of the body. So, we age as a whole. It’s very likely, though, that if it returns, it will be much more mild than it was before the first surgery. But no facelift or neck lift will stop the aging process. So, that will be the determinant in knowing if the jowls will return or not in the future.

Every time patients are thinking about having a facelift and they are losing or gaining weight, the best is to have a stable weight by the time of surgery. Why? Because when we gain weight, we will also increase the volume of the face. So, if you gain weight after a facelift, certain areas where you do not have fatty deposits may show up. Or, if you lose a lot of weight after a facelift, you will likely have skin laxity. So, there is loose skin after the facelift. So, ideally, the patient should be at a stable weight for at least three months. And will be able to maintain this weight after surgery. Those are always the best and most stable results after surgery.

I have a lot of patients in their 40s that start thinking about having a facelift. Why? There are many reasons; uh, some of them are really tired of just doing fillers and threads and having temporary solutions. They’re wanting a more permanent, more durable solution for skin laxity jowls, uh, and also fatty deposits under the neck, which are sometimes caused by muscle laxity, so we will offer patients a facelift in their 40s, and they are very, very pleased with the result because it really frees them for a long time, uh, from having to do constant injectables and other procedures that are non-surgical but require maintenance, so yes, it’s a common thing to have a facelift in your 40s.