There’s no stopping the inevitable signs of aging from appearing on the face. However, you can reset the clock with a facelift. This surgery not only tightens stretched-out skin, but also adjusts the underlying tissues for a naturally lifted, rejuvenated appearance that can be enjoyed for many years.
Dr. Steven Wallach is an experienced, board-certified, Upper East Side Manhattan-based plastic surgeon who uses his extensive knowledge and aesthetic surgical expertise to perform cosmetic procedures for the face, breasts, and body. He specializes in premium facial rejuvenation procedures that help his patients achieve a strikingly youthful, natural-looking visage.
Before and After Photos
Results May Vary
Signs of aging are unavoidable, and they affect everyone. Deep and superficial wrinkles and lines develop, while other tissues atrophy, resulting in lost volume.(1) At the same time, our skin becomes more lax, which can result in noticeable facial sagging that further ages our complexion. But that doesn’t mean that we don’t have options!
The goal of facelift surgery is to create a more youthful appearance by elevating sagging facial tissues to a more youthful position. In addition, some patients may benefit from facial fat grafting to fill in facial soft tissue deflation or volume loss. Facelift surgery procedures can accomplish this in one effective treatment.
Facelifts are commonly performed on patients from their 40s all the way into their 80s. Some patients may experience skin sagging due to weight loss, extensive sun exposure, and genetics, whereas others may simply wish to reduce or prevent further signs of aging. The best way to find out if you’re a good candidate is to consult with a board-certified plastic surgeon.
Good candidates for a facelift procedure in New York City are:
- Healthy men and women who have significant signs of facial aging
- Patients with cheek volume depletion, and facial fat pad loss
- People with deep jowling, and moderate to severe skin laxity in the lower face and upper neck.
- Free from serious underlying medical conditions that could affect treatment outcomes
Dr. Wallach will ensure you are well-informed about the procedure itself and the results you can expect to obtain by taking the time to get to know your concerns at a personal consultation at his office on the Upper East Side.
No two facelifts are alike, because no two people are alike. This is why Dr. Wallach uses a variety of techniques to tailor each surgery to the individual’s unique needs and desires, ensuring the lasting results are both seamless and beautiful.
With advances in research and knowledge in the 20th century, surgeons developed techniques that suspend the deeper tissues of the face in a lifted, more youthful position, rather than just tightening the overlying skin. This avoids the obvious “wind-swept” look, and allows patients to enjoy more refined results. This crucial layer of tissue is known as the SMAS: the superficial musculoaponeurotic system, a connective tissue layer below the skin and above the facial muscles. These techniques also enable optimal healing and longer-lasting results.(2)
During a SMAS facelift, discreet incisions are made, and the skin is separated from this deeper layer of tissue. This allows the surgeon access to the SMAS. They can then reposition this layer using strategic incisions and sutures to create a more youthful underlying structure for the face. Rather than just lifting and trimming away excess skin, this technique both preserves and reconnects key parts of the skin with the underlying structure of the SMAS, preventing the dreaded “pulled” appearance. In this way, Dr. Wallach is better able to adjust the overlying skin for the most natural-looking effect.
As the fat pads that give our cheeks their youthful fullness begin to atrophy and descend, they can also affect the appearance of the lower eyelid, “dragging” this area of tissue down and creating the appearance of sunken eyes, hollow cheeks, and jowls. The mid-facelift is a procedure that focuses on the cheek and lower eyelid junction. The goal is to elevate the cheek fat pad and treat the lower lid region, which lifts the entire middle region of the face, even helping to resolve the appearance of mild jowling. This can be done as an isolated procedure for patients without other areas of concern, or combined with other rejuvenating facial and neck procedures. Dr. Wallach can perform this kind of facelift using only a small incision at the corner of the lower eyelid. This gives him access to the tissues underlying the cheek. This soft tissue is then freed, and moved to a higher, more youthful position, and secured to the temporal fascia of the face with a series of strategic sutures. A support procedure for the lower lid is also performed at the same time to ensure a smooth, rejuvenated appearance for the entire area.
Mini facelifts address signs of aging like wrinkles and sagging skin on the lower face. They include removing excess skin from the chin and neck area and then tightening the remaining tissue, giving patients better chin and neck definition.
Compared to full facelift techniques, the mini facelift is less invasive and offers facelift patients natural-looking results with minimal scarring and a shorter recovery time. Since mini facelifts are less invasive and utilize shorter incisions, Dr. Wallach can perform this procedure under local anesthesia.
If you have excess or sagging skin in your lower face, you should schedule a consultation with Dr. Wallach to discuss whether a mini facelift procedure is right for you.
A common concern among facelift patients is whether the scars from the procedure will be visible long-term. And, for Manhattanites with demanding social and professional lives, the stakes are especially high. As an acclaimed surgeon who has published, taught, led panels, and presented extensively on a wide range of plastic and reconstructive surgical procedures, patients can be sure that they are in the very best of hands. Dr. Wallach is able to offer patients the option of multiple incision locations and techniques. These are all easily concealed in the hairline and around the ear while still allowing him the necessary access to analyze and adjust the facial tissues in your desired treatment area.
- Limited Incision – Otherwise known as the “short scar” approach, this incision is usually confined to the region from the base of the earlobe to the sideburn area. This is most commonly used by Dr. Wallach for mini facelift techniques in which the SMAS needs to be addressed. This incision does not permit adequate re-draping of loose neck skin, and so it is not a good technique to use for patients that require an extensive lower facelift or neck lift. However, it is a good choice for those patients in New York that need some jowl and cheek elevation with minimal need for neck work. In addition, it is a quicker facial plastic surgery procedure, so it may be better for patients who are not candidates for longer facial plastic procedures.
- Traditional Incision – The traditional facelift incision extends from the temples to behind the ear, and is carefully concealed along the curves of the ear and behind the hairline of the patient. This allows him the access necessary to reduce jowls, smooth nasolabial lines, elevate the cheeks, and create a smooth refreshed appearance for the midface, lower face, and jawline, Dr. Wallach ensures that these incisions are carefully camouflaged and that the hairline is preserved. This often includes a retrotragal incision, in which the incision travels from the sideburn down the ear along the inside of the tragus, the small notch of cartilage that protects the opening of the ear canal. Dr. Wallach carefully plans every incision pattern to achieve the best results and ensure any resulting scar will be practically invisible.
During your personal consultation with Dr. Wallach, you’ll have the opportunity to discuss your aesthetic goals face-to-face. This informative meeting will allow Dr. Wallach the chance to get to know more about you, and for you to get to know more about whether a facelift is right for you. Dr. Wallach will review your medical history and perform a thorough examination of your face, paying special attention to skin laxity and the underlying facial structure. This will allow him to recommend the best approach and design a surgical plan that achieves custom-tailored, natural-looking results. If you and Dr. Wallach agree that a facelift will be a rewarding procedure, your surgery will be scheduled and you’ll be given a detailed list of instructions so that you’re well prepared and have the best possible experience.
Your facelift procedure will be performed at Dr. Wallach’s onsite accredited surgical suite, or at one of several hospitals in Manhattan. The details of your procedure and your preferences will determine the type of anesthesia that is administered by a board-certified anesthesiologist. Nevertheless, you’ll need someone to escort or drive you home after your procedure, and to spend the next week resting. Over the next few weeks, you’ll return to Dr. Wallach’s offices for regularly scheduled follow-up appointments.
Many patients will have one or two drains that drain fluid from the face and neck region. These are often removed after a few days. Sutures are taken out over the first one to two weeks. Most patients will have some bruising and generalized swelling. Resting on your back with your head elevated and using cool compresses will help the swelling subside. The facial bruising usually goes away within a week to ten days but can last a bit longer for some. The facial swelling can last three to six weeks but may persist to a small extent for several months after that. If patients have had fat injections, the swelling may persist a bit longer. Most patients can go back to light desk work within seven to ten days. Many can start light aerobic activity within about three to four weeks and then advance to more strenuous activity within about six to eight weeks.
Following a facelift, minimally invasive facial rejuvenation procedures can be used to treat the concerns that a facelift does not treat. This can be accomplished with laser skin resurfacing, chemical peels, and skincare products that reduce the appearance of signs of aging. In some cases, facelift surgery is not required. As an alternative, some treatment plans can instead include a delicate balance of filler products, neuromodulators like Botox, and isolated facial surgical rejuvenation procedures such as a brow lift or cheek augmentation. Facial fat grafting is also an effective volume-boosting procedure that can add youthful shape to the face. Please speak to Dr. Wallach about whether a surgical or non-surgical intervention is right for you.
To learn more about the other services that Dr. Wallach provides and for more information about plastic surgery, follow his blog!
The price of your facelift will depend on your personal goals and the type of facelift you opt for. If you would like more information about Dr. Wallach and his success with New York City facelift surgery procedures, we invite you to contact us at our Manhattan office at (212) 861-6400 or by filling out our online contact form to request additional details.
- Park, D. M. (2015). Total Facelift: Forehead Lift, Midface Lift, and Neck Lift. Archives of Plastic Surgery, 42(2), 111. https://doi.org/10.5999/aps.2015.42.2.111
- Shauly, O., Stone, G. L., Shin, R., Grant Stevens, W., & Gould, D. J. (2021). Evaluating Facelift Complications and the Effectiveness of the SMASectomy Technique: A Single Center’s 15-Year Experience. Aesthetic Surgery Journal Open Forum, 3(4). https://doi.org/10.1093/asjof/ojab030
Does a facelift make you look younger?
I tell my patients that a facelift will refresh their looks and make them look better whatever their age is.
How do I reduce swelling in my face?
Swelling in the face after a facelift is normal. This usually takes a few weeks for the majority of the swelling to resolve but the residual swelling may last several months to completely resolve.
How can I tighten loose skin on my face?
If the skin of the face is very loose, then you might need a facelift. Sometimes for very mild laxity, lasers may help improve the laxity.
How do I get rid of my double chins?
A double chin may be caused by lax skin and/or fat. These can be treated with liposuction and/or a neck lift.
How do you reduce swelling after a facelift?
Usually time is the critical factor. Swelling will go away naturally as you heal.
How do I prepare for a facelift?
I tell my patients to eat healthy, exercise regularly, avoid smoking, and avoid medications or herbal supplements that can cause bleeding.
How do you take care of your face after a facelift?
I have patients try to sleep with the head slightly elevated, and also wear sunscreen after the stitches are removed. I also want them to limit their exertion for a few weeks after surgery.
How long after a facelift can I exercise?
I usually have patients avoid aerobics for about 3 weeks and heavy lifting or exertion for about 6 weeks.
How long does it take for bruising on the face to go away?
Most bruising will usually go away within 1-2 weeks.
How long do ears hurt after facelift?
The ears do not usually hurt after a facelift.
How long is recovery from a facelift?
The recovery can vary from patient to patient. This also depends upon the type of operation performed. In general, most facelifts are done in my accredited ambulatory surgery center and therefore go home the same day. I prefer that my patients go home with a nurse who can take care of them for a day or two if possible. Many of my patients have one or two drains that drain fluid from the face and neck region. These are often removed after a few days. Sutures are taken out over the first one to two weeks. Most patients will have some bruising and generalized swelling. The facial bruising usually goes away within a week to ten days but can last a bit longer for some. The facial swelling can last three to six weeks, but may persist to a small extent for several months after that. If patients have had fat injection, the swelling may persist a bit longer. Most patients can go back to light desk work within seven to ten days. Many can start light aerobic activity within about three to four weeks and then advance to more strenuous activity within about six to eight weeks.
How many times can you get a facelift?
There is not set amount of times a patient can undergo a facelift. I know of patients that have had 3 or more.
How much does a mid face lift cost?
The question is what is a mid-face lift procedure. There are many different kinds and so the fee will vary.
How much does laser face lift cost?
A laser face lift is a marketing tool name. There is no specific laser that can perform a face lift.
Is a facelift permanent?
A facelift result is permanent in the sense that there will always show some change. The quality of the result will vary from patient to patient based upon many factors.
How much is a face lift and neck lift?
A face and neck lift fee can vary from surgeon to surgeon. It can be as little as $5k and some charge more than $50K.
What can I expect from a facelift?
Usually a facelift improves the cheek, the jawline, and the neck.
How much is a facelift?
A face and neck lift fee can vary from surgeon to surgeon. It can be as little as $5k and some charge more than $50K.
What is a facelift called?
Another name for facelift is a rhytidectomy.
How painful is a facelift?
Facelifts are not usually very painful. It is more incisional discomfort that people have to deal with.
What is a mid face lift?
There are many different types of mid facelifts that will work to elevate the cheek soft tissue.
What is a neck lift called?
A neck lift is a neck lift. This is often done as a component of a facelift.
What is the average cost of a full facelift?
A face and neck lift fee can vary from surgeon to surgeon. It can be as little as $5k and some charge more than $50K.
What is a non surgical facelift?
A non-surgical facelift usually refers to facial filler product injection, botox injections, and laser treatments.
What is the difference between a deep plane and SMAS facelift?
A deep plane facelift is a facelift that elevates the SMAS and the skin usually as one component.
What is a thread lift?
A thread lift is a procedure incorporating either absorbable or non-absorbable sutures to lift the face through limited incisions.
When should you get a facelift?
A person is a candidate for a facelift when they have soft tissue descent of the cheeks, lax skin in the neck, and jowling.
What is best age for facelift?
There is no one best age for a facelift. It really is when the patient has signs of facial aging that warrant a facelift procedure.
What are the risks of getting a facelift?
In general, facelift surgery is safe. The most common issues that develop are prolonged skin numbness which often improves as the swelling goes down, and bruising which can last one to two weeks for most patients. Other less common risks include skin necrosis, fat necrosis, hematomas, fluid collections like seromas, infections, and contour irregularities as well as unfavorable scarring. While quite rare, there have been some reports of facial nerve injuries which can result in facial animation weakness. Many of these go on to heal without any sequelae or any need for further surgical intervention, and fortunately they are quite rare. Most of these procedures are performed under local anesthesia with sedation or general anesthesia, and of course there are some risks. Thanks to modern technology and advancements of anesthesia techniques, the risks of anesthesia are extremely low.
How do I know if I need a facelift?
Facelifts are commonly performed on patients from their 40’s all the way into their 80’s! Some patients who prematurely age due to weight loss, extensive sun exposure, and genetic variability have come in for facelifting in their mid-40’s, while, there are many that come in much later. It really varies in terms of age. Initially, people present with facial soft tissue sagging in their cheeks, jowl area, and necks. They notice loose skin as well. Some of these patients show early signs of aging and quite often can benefit from facial fillers to stave off surgical intervention. Eventually, facial rejuvenation surgery is warranted. I see many patients that have seen doctors that can not perform surgery that have overcompensated by overfilling patients’ faces, and these same patients can look a bit puffy. I always tell my patients that I have a full tool belt of potential treatments that I can offer. While I do not think that everyone needs surgery, I think many require a delicate balance of filler products, neuromodulators like Botox, and facial surgical rejuvenation procedures. Over the past several years, I have added facial fat grafting to many procedures because I think that facial aging is a combination of both deflation and sagging. I do not think that one specific procedure or non-surgical intervention is right for every patient. Many times it is a mix of both to get a very natural, long lasting result.
What is a limited scar facelift?
A limited scar facelift is one in which the incision used courses from the top of the ear or sideburn region superiorly, and extends to the base of the earlobe or just behind it. It is best in patients that do not have a lot of redundant skin who undergo a SMASectomy or a SMAS plication. SMAS stands for the superficial muscular aponeurotic system.
Is the skin pulled in a facelift?
Usually the deeper tissues of the face are repositioned as opposed to pulled. The skin should not be used to lift the tissues. The skin should be draped in a more perpendicular orientation to the incision so it does not potentially lead to telltale signs of a facelift, such as lateral swoops of skin.
Is the neck lifted at the same time as a facelift?
Quite often the neck is treated at the same time as the face. The two are strongly interconnected and to just treat the face would create an imbalance with the neck and it would look out of place.
Do you inject fat with a facelift?
Facial aging usually consists of two main problems. One is deflation or soft tissue atrophy, and the second is skin laxity or poor elasticity. For many patients, fat injection is a nice adjunct to provide volume to the face while elevating, draping the skin and removing the excess. However, too much of either one (skin excision or fat injection) may lead to unnatural results.
What is the recovery like from a facelift?
The recovery for a facelift is relatively easy for most patients. I like patients to go home with a light dressing and to keep their chin to neck angle about 90 degrees for the first week or so to avoid tension on the incision closures. Often if drains are used, they will be removed within a few days. I usually remove about half of the sutures within a week and the remainder by 10-14 days after surgery. Many patients can go back to work within a week to ten days but residual bruising might be present.
When can I go back to work after my facelift?
Many patients can return to work within about one to two weeks. There may still be some bruising after this time, but for women, make-up can be applied to camouflage any bruising.
Where are the incisions for a facelift?
The type of facelift performed and who is doing the procedure will determine where the incisions will be placed. Traditionally the incision starts in the temporal hairline and extends in front of the ear tragus and then goes behind the ear and back into the occipital hairline. I have found that these incisions are not always best in patients with severe skin laxity. This results in loss of good quality hair along the neck and the side-burn. Additionally, the pre-tragal incision can leave a very noticeable scar. I prefer in many cases, to place the upper portion in front of the hairline or sideburn to preserve the hair in this region. Typically, I will also place the incision behind the ear tragus, which is called a retrotragal position. In turn, this will better camouflage the incision in this area. When the incision goes behind the ear, I often like to keep it along the hairline as well to avoid loss of hair in this region. If performing a limited incision facelift, then the incision starts near the side-burn and ends at the base of the earlobe, or slightly behind it. My goal is to use the least amount of incisions and maintain a natural ear appearance and hairline to avoid telltale signs of a facelift.
Will I lose my hair by my sideburn or behind my ear after the facelift?
It was fairly common during a traditionally designed facelift that the hairline along the sideburn and behind the ear would sometimes be distorted. Patients would sometimes get the windswept appearance. In my opinion, the goal is to preserve the hairline and maintain a very natural look. Often I will set the incision along the border of the hairline so that the hairline is not distorted.
Why do some people look funny after a facelift?
Poor quality work is often related to unfortunate designed incisions, poor execution, and a lack of understanding the various techniques to improve the facial appearance. I think a good quality facelift is one that does not look strange or weird. The goal is to provide high quality work that maintains a very natural appearance while improving the facial aging.
Why are sweep lines caused by some facelifts?
Lateral sweep lines occur along the side of the face in some individuals after a facelift. This can be due to improper re positioning of the skin during a facelift. In my opinion, it happens more commonly in those patients when the surgeon pivots the skin in a superior fashion to lift the face. In general, I believe that the deeper tissues should be used to reposition the soft tissue, and the skin should be draped perpendicular to the incision in most cases. This should minimize the risk of sweep lines.
Why do some patients have their ears pulled after a facelift?
When ears are pulled down after a facelift onto the cheek, this is sometimes referred to as a pixie ear because of the pointed nature along the attachment of the earlobe to the face. This happens when there is too much tension on the face skin or when the earlobe is detached from its normal position. Patients have come to me with this problem from prior work done by others. I have fixed this by hitching up the skin underneath the ear and detaching the lobe from the cheek to allow it to properly dangle.
Will my nasolabial creases be improved with a facelift?
The nasolabial creases run alongside the mouth up to the nose, and often are accentuated with smiling. As a person ages, the soft tissues deflate and sag and the nasolabial folds often become deeper. Sometimes facial fillers like the hyaluronic acid products can help improve this area. Fat grafting can do the same, and may be a more permanent solution. Facelift techniques can be performed that will lift tissues around the cheek and will help soften the nasolabial folds. Effacing or completely flattening the folds can be performed but is not recommended. Nasolabial folds are part of the normal facial anatomy and should be present to some extent. Removing them completely causes patients to look a bit robotic.
Will the lines around my mouth be improved by a facelift?
Perioral rhytids or lip lines are not treated by a facelift per se. They can be treated at the same time as an ancillary procedure. Often laser procedures using Erbium, CO2, or Fraxel can help improve the quality of the lip lines. Dermabrasion is another method to soften the lines. Sometimes I will use a neuromodulator such as Botox/Dysport/Xeomin to weaken the muscle a bit. Fillers can be used to fill the lines as well.
How tight will my face be after the facelift?
A face after a lift should not feel too tight. Certainly the deeper tissues will be repositioned and so some internal tightness may be felt, but the patient should be able to turn their head back and forth and lift their chin upward. Over the ensuing few weeks post-op, as the swelling subsides, the tissues become softer and more mobile.
What is a composite facelift?
A composite facelift is a type of facelift that entails elevating the SMAS (the superficial muscular aponeurotic system) with the skin as one unit. This also includes repositioning the orbicularis oculi (the muscle around the eye in the same flap). It is different from the subperiosteal facelift.
What is a superiosteal facelift?
A subperiosteal facelift is a technique that works mainly on the upper two-thirds of the face. This procedure elevates the soft tissues of the cheeks and forehead below the level of the soft tissue just above the bone. Commonly this is performed with an endoscope, a small camera, to assist with the dissection. It does not treat the neck directly.
What is a MAC’s lift?
MAC’s lift refers to Minimal Access Cranial Suspension. A short scar facelift approach is performed, and looped sutures are used in the upper neck and cheek region to vertically raise the tissues. The advantage is a shorter operation using shorter incisions. However, it does not really treat the neck to any degree, and in someone who has severe laxity of the soft tissues, may be a better candidate for a more traditional approach.
What is a High extended SMAS lift?
SMAS refers to the superficial muscular aponeurotic system. This is a connective tissue layer superficial to the muscles but deep to the subcutaneous fat layer. When a high SMAS extended facelift is performed, the SMAS is released at or above the malar eminence and extended across the cheek region just past the region of the zygomaticus major muscle. This allows for elevation of the malar fat pad and enhancement of the cheek region. The soft tissue can be suspended in a superolateral vector and even imbricated to augment the cheek region. This is a very versatile procedure and I use it quite often on my patients.
What is a short scar facelift?
A short scar facelift is any one of a number of operations that refers in general to the length of the incision used to perform the facelift. It often runs from the side-burn extending downward by the ear and stopping just at the earlobe or slightly behind it. Various techniques to treat the deep tissue can be offered with this approach. It may not be appropriate for someone with severe skin laxity.
If I have a facelift, do I need to have my eyes and brow surgery as well?
In the analysis of all new patients, I always examine the entire face and discuss treatment options as indicated. The surgery is individualized for each patient and is not necessary in everyone. If the patient could benefit from eye surgery and/or brow surgery, it can be staged at a later time or not done at all. This really depends on the individual patient’s desires. Of course, if only the facelift is performed than a youthful lower two-thirds of the face will be out of sync with a tired looking upper one-third of the face. Nevertheless, the choices are always up to the patient.
How do I avoid elf ears from a facelift?
One way to avoid the removal of the sideburn and temporal hair is to properly design the incisions for a facelift. In addition, the ear can sometimes be distorted looking like an elf or pixie as well. I spend a lot of time designing and properly closing the incisions so that the risk of these deformities is minimized. This also adds a lot of time to the overall surgical procedure, but it is well worth the result!
How do I avoid that pulled look from a facelift?
The pulled look is commonly the result of actually pulling on the skin to give the lift and pulling it too tightly. Some surgeons use the skin to lift the face in a supero-lateral vector. The skin is pulled tightly to try to elevate the deeper soft tissues and as a result, distorts the face. I usually mobilize the deeper layers of the face to obtain the proper contour and then only remove the redundant skin as necessary.
How long does a facelift last?
A facelift results will vary based upon many different factors including a patients genetics, the quality of their skin, their age, etc.. It is hard to predict.
How long does a fat transfer to the face last?
Fat transfer is a procedure that can provide permanent results. I usually find that about 60-70% of the fat will survive, so additional procedures may be necessary. But this can vary from patient to patient.