Facelift (Rhytidectomy)

A facelift is a surgical procedure that contours the lower face and neck, resulting in a more defined and youthful jawline. With the natural decline of collagen production as patients get older, the facial skin and musculature can relax and lose its supportive structure. This often causes mid-facial volume loss and descending cheeks, as well as the formation and deepening of creases. Facelift surgery can correct sagging skin, jowls, and “turkey neck,” generally serving as an excellent technique to reverse signs of aging as naturally as possible. A good facelift should allow you to appear refreshed and rejuvenated while still maintaining the natural character of your face. Philadelphia plastic surgeon David Bottger, MD has many years of experience performing facelift procedures and knows how to create optimal results for each patient while taking their unique goals and facial anatomy into account.

If you are interested in a facelift procedure, contact Dr. Bottger at 610-227-6114 today to schedule your initial consultation. We serve patients in Newtown Square, Philadelphia, and nearby areas of Pennsylvania.

Facelift Terms to Know

At our practice, we believe thorough patient education is critical to achieving a mutually satisfactory outcome and to maximizing the overall success of the facelift procedure. We encourage you to familiarize yourself with common terminology you may come across as you research the facelift procedure:

• Jowls — Sagging skin or soft tissue that typically hangs along the cheeks or jawline. Often caused by thinning skin and a loss of elasticity, jowls are a telltale sign of facial aging and can be exacerbated by lifestyle factors such as smoking, poor skin care, sun exposure, and weight loss.
• SMAS facelift — An approach to facelift surgery that targets the underlying SMAS (superficial muscular aponeurotic system) layer rather than just the superficial skin. The SMAS provides essential internal support for the face, which is why rejuvenating this layer of tissue can refresh your appearance.
• Nasolabial folds — Creases that form from the base of the nose to the corners of the lips due to thinning facial skin. Also called “parentheses wrinkles” or “smile lines,” nasolabial folds may indicate a lack of facial volume or poor skin elasticity.
• Liquid facelift — A non-surgical treatment designed to create a younger-looking appearance using cosmetic injectables. Although the results do not compare to a surgical facelift, many patients consider it a minimally invasive way to restore lost volume and rejuvenate the face. This approach is limited in effectiveness if signs of aging are significant.

What are the Benefits of a Facelift?

A facelift can essentially turn back the clock on your face, allowing you to restore a more youthful appearance that should last for the foreseeable future. The benefits of a facelift generally include:

• A younger, refreshed appearance
• Long-lasting results
• Proven record of safety and effectiveness
• Increased confidence in your appearance

While there are non-invasive skin tightening devices available, a surgical facelift will always provide the best quality of results, as well as the most enduring outcome. If you have significant jowling or experience a “turkey neck,” a facelift can be the best option to achieve a clean and youthful jaw and neck contour.

If you are a smoker, you may still be able to undergo facelift surgery under the condition that you quit tobacco use for at least four to six weeks prior to and following your surgery. Smoking significantly increases the chances of complications during surgery, and it may also adversely impact your results and delay healing. For men and women trying to quit smoking, pursuing a facelift may actually help in this endeavor. Studies have shown that many smokers who undergo a facelift are able to either quit completely or significantly reduce their cigarette consumption following surgery.

Your Facelift Consultation

Your initial consultation is an opportunity for you to ask Dr. Bottger questions about a facelift or his experience performing facial procedures in general. You will have the chance to discuss your aesthetic goals and learn the most beneficial treatment options to resolve your concerns. Be prepared to discuss your medical history, as well as any previous history of facial plastic surgery you may have. Dr. Bottger will evaluate the anatomical structure of your face and neck to observe signs of facial aging and determine the best facelift technique for your needs. He will then explain the benefits, risks, limitations, and recovery period associated with a facelift. The goal of this consultation is to help you fully understand the facelift procedure so you can make a well-informed decision about whether to pursue surgery. You will never feel pressured or rushed during your consultation, and Dr. Bottger will be able to provide you with before-and-after photos so you have a good idea of what enhancements can be achieved.

How is the Facelift Procedure Performed?

Full Facelift

During the standard facelift procedure, the superficial muscles in the neck and face are tightened, and excess fat is removed. An incision is placed behind the hairline and follows the natural crease at the top of the ear before curving inside the ear, around the earlobe, and into the posterior ear crease. In some cases, the incision will extend into the hair bearing scalp.

After the tightening and contouring of the deeper tissues, the skin is pulled up and back while excess skin is removed. The skin is then sutured. Dr. Bottger is careful to avoid putting too much tension on the sutured incisions in order to facilitate smaller and cleaner scars.

Mini Facelift

Some patients may be candidates for a modified facelift procedure that utilizes shorter incisions. Referred to as a “mini facelift,” “S-Lift,” “mid-facelift,” or “cheek lift,” this is considered a less extensive version of traditional facelift surgery. The appearance of sagging skin, jowls, and wrinkles are still reduced with a mini facelift, but skin laxity in the neck is typically not addressed. With that said, a mini facelift has the benefit of a relatively shorter recovery period when compared to a full facelift. Dr. Bottger will discuss your options and which type of facelift would best achieve your aesthetic goals during your initial consultation.

Neck Lift

While a facelift can improve the appearance of the neck somewhat, a neck lift is a separate procedure designed to more extensively rejuvenate the aging neck. This is accomplished by addressing a number of issues, such as sagging skin, excess fat, and muscle banding. The surgery often involves the use of liposuction in combination with an incision under the chin, which allows the suturing of the platysma muscle bands of the neck. Skin removal may also be part of the procedure, depending on the degree of laxity. This procedure is directed at the neck only and does not address the jowls, mid-face, or cheek regions—to improve those concerns, a formal facelift would be required.

What are the Risks of a Facelift?

While facelifts are considered very safe when performed by a qualified and skilled plastic surgeon, the procedure still involves surgery; as such, there will always be some degree of risk involved. The potential risks of facelift surgery may include:

• Unfavorable scarring
• Infection
• Hematoma
• Skin necrosis
• Nerve injury

Significant complications—although possible—are uncommon. The risk of complication is much higher with patients who smoke, which is why it’s critical to refrain from smoking for at least four to six weeks before and after your procedure.

You should always choose an experienced, board-certified plastic surgeon for any cosmetic surgery procedure, including a facelift. This should greatly reduce your risk of possible complications. With dual board certification in both general surgery and plastic surgery, Dr. Bottger has performed enough facelift procedures to know how to reduce the risks involved with a facelift.

What is Recovery From a Facelift Like?

Depending on the extent of your facelift, whether you are combining it with other surgeries, and your general health, it may be recommended that you stay overnight in the hospital following surgery. However, in many cases, patients are able to undergo a facelift as an outpatient procedure and do not need to stay in the hospital overnight.

One of the most pressing questions patients have when considering a facelift is what the recovery process is like and how soon they can return to work. Facelift recovery is often easier than expected, with more discomfort than actual pain. Dr. Bottger will prescribe pain medications for use at home, but most patients find that they only need them for a few days.

Each patient heals differently, but we have generally found that most people are able to return to work within two weeks. During your recovery, you may experience:

• Bruising
• Swelling
• A feeling of tightness or discomfort
• Numbness

Most bruising and swelling should dissipate within the first few weeks and makeup can be used to cover up bruising or scars. The feeling of numbness may last longer, but full sensation should eventually return.

How Long Does a Facelift Last?

Unfortunately, no cosmetic surgery can stop gravity or the process of aging. However, a facelift can reset the clock and you will always look better than you would if you had never undergone the procedure. In addition, you can preserve your results by following a good skincare regimen and limiting your exposure to the sun. Most people who receive a facelift never feel the need to undergo another one, while others may decide they want to touch up their results with a second facelift or mini facelift 10 to 12 years later.

Will I Have Visible Facelift Scars?

Facelift scars are well-hidden and usually heal to resemble fine lines that are barely visible. Plus, as incisions are concealed within the hairline and along the natural contours of the ears, any post-surgical scarring is typically inconspicuous. The scars will be red at first, but they should soften and fade over the course of one year until they reach their final appearance. Following proper wound care measures according to Dr. Bottger’s recovery instructions can encourage optimal healing of your incisions and maximize the likelihood of a discreet scar appearance.

How Much Does a Facelift Cost?

The average cost of a facelift starts at $16,290 and depends on a patient’s needs and aesthetic goals. The details of your treatment plan will ultimately determine the price of a facelift. Factors that usually influence the cost of surgery include:

• The surgical technique used
• Whether you are undergoing a full facelift or mini facelift
• Fees for the surgical facility, anesthesia, post-operative care, and other associated expenses
• The complexity of the procedure

Once Dr. Bottger is able to assess your needs in a consultation, a member of our team will provide a personalized cost estimate of your facelift expenses. To help ensure the benefits of aesthetic enhancement are available to all who desire it, our practice works with one of the most trusted plastic surgery financing companies in the nation. CareCredit^® offers qualified applicants a range of payment plans with low monthly installments and low- to no-interest options, giving approved patients the opportunity to undergo their desired treatment while suiting their budgetary concerns. If you have any questions about the cost of a facelift, please contact our practice for more information.

Combining a Facelift With Other Cosmetic Procedures

A traditional facelift primarily addresses the lower face. A common misconception is that a facelift is designed to treat the entire face; however, separate procedures are necessary to address the eyes, brow, or cheeks.

It’s certainly possible to combine multiple surgeries and many patients opt to incorporate another facial rejuvenation procedure into their facelift treatment plan for more comprehensive results. Popular procedures to pursue in accordance with a facelift include:

• Brow Lift: Also referred to as a forehead lift, a brow lift is designed to raise the position of sagging brows and the upper eyelids. It can also improve “frown lines” between the brows.
• Eye Lift (Blepharoplasty): Eyelid surgery is intended to treat the upper third of the face by eliminating signs of age and exhaustion, such as drooping or puffy eyelids, excess skin, under-eye bags, and wrinkles.
• Liposuction: Liposuction is a popular procedure that can minimize a “double chin” appearance by removing excess fat from the neck to improve the contour under the chin.
• Fat Grafting: Fat grafting can be very effective at reducing the appearance of dark circles or under-eye bags, which can both have a great impact on how bright and awake you look. This technique can also be used to restore lost facial volume.

In addition to other surgical procedures, non-invasive treatments such as injectable fillers can also be performed at the same time. A facelift can address sagging skin but does not treat volume loss, so many patients find that a facelift to tighten the skin, as well as dermal filler injections to restore lost volume, creates beautiful results.

Can I Get a Facelift Without Surgery?

While some signs of premature facial aging can be reduced non-surgically, minimally invasive solutions generally aren’t as effective or long-lasting as a facelift procedure. Still, many patients can achieve moderate facial rejuvenation with injectable treatments, such as Restylane^®, Radiesse^®, and JUVÉDERM^®, among others. Depending on the product used, injectable fillers can be used to smooth nasolabial folds and marionette lines, lift loose or hanging skin, add volume to areas of the face that appear flat, or reestablish lost facial contours. Commonly referred to as a “liquid facelift,” a combination of these dermal fillers can be applied based on your concerns, allowing patients to achieve natural-looking enhancement without surgery or extensive downtime. Don’t hesitate to inquire about a liquid facelift to Dr. Bottger in a consultation. He can suggest the best treatment options to fulfill your aesthetic goals while accommodating your unique needs.

Facelift Alternatives

Flat, sunken, or hollow features can additionally be treated with autologous fat grafting — often shortened to facial fat transfer. Rather than utilize cosmetic injectables, facial fat grafting uses your own tissue as a natural filler to enhance volume in the tear troughs, cheeks, temples, or lips. Injections can also target nasolabial folds and marionette lines among other deep facial creases. The result is generally a fuller look in the area(s) of injection, as well as reduced wrinkles and more youthful facial contours.

To collect fat for re-injection, this procedure harvests excess fat cells from another region of the body — typically an area abundant in fatty tissue, such as the abdomen, thighs, flanks, or buttocks. Liposuction is performed on the harvesting site to extract fat cells, after which the fatty tissue is purified and prepared for facial rejuvenation. Small syringes are then used to inject small amounts of the filler into volume-depleted regions of the face. Results typically reveal themselves in the weeks following treatment and the final outcome is usually seen at the three-month mark. At this point, the rejuvenation achieved can be considered permanent. Fat transfer injections characteristically provide longer-lasting results when compared to dermal fillers, and the technique is often utilized in tandem with facelift and neck lift surgery to further enhance facial contours.

Choosing the Best Facelift Surgeon for Your Needs

Selecting the right plastic surgeon to perform your facelift is a major step in the treatment process, and can understandably be a little overwhelming. You should always meet with a prospective surgeon in person to gain a more personal understanding of their rapport and quality of care, but it’s generally advised to seek out a facelift surgeon who has:

• Experience: A qualified facelift surgeon should have a wealth of experience performing the procedure, as well as extensive training in facial plastic surgeries in general. Dr. Bottger not only has over 20 years of experience in aesthetic procedures, but he is also board-certified by ABPS and was named “Top Doctor” by Philadelphia magazine.
• Training Beyond the Bare Minimum: Cosmetic surgery is constantly evolving and it’s essential that your prospective plastic surgeon remain up-to-date with the latest techniques. Membership to professional organizations can demonstrate a surgeon’s dedication to newer, more efficient facelift techniques. While being involved in these organizations is not required to perform surgery, those who are active in ASPS and ASAPS have typically completed post-graduate courses that go beyond the minimum educational requirements necessary to practice.
• A Good Reputation: The levels of satisfaction enjoyed by previous patients can help you understand whether a plastic surgeon is able to provide personalized care for a diverse range of patient needs. Online reviews can be a good place to start assessing a plastic surgeon’s reputation, but also check if they have won any awards, recognitions, or honors.
• The Skills to Attain Elegant Results: A plastic surgeon’s photo gallery can show you the results possible with a given procedure, and allow you to make a decision about facelift surgery accordingly. Be sure the final outcomes displayed align with what you ultimately hope to gain from the procedure.

Dr. Bottger would be happy to meet with you and discuss your reasons for considering facelift surgery in person. During a consultation, he can answer all of your questions about the procedure, as well as give you insight into his training, experience, credentials, and the types of results achieved with previous patients.

Additional Facelift FAQs

Is a facelift painful?

Most patients experience discomfort rather than pain during recovery from a facelift. Swelling and feelings of numbness and tenderness are normal and usually managed well with the medication prescribed by Dr. Bottger. As healing progresses, facial swelling will naturally resolve and you should feel stronger every day. If you begin to feel pain, use your medication as necessary and never hesitate to contact Dr. Bottger if you have concerns. The majority of patients stop taking their medication after a few days and feel well enough to return to work within one to two weeks after their procedure.

Is a facelift different for men versus women?

While the treatment process will be the same for both male and female patients, certain techniques during the facelift procedure may differ. Men and women usually have distinctions in their facial shape, skin tissue, and goals for the outcome, so these characteristics will be taken into account to help ensure a natural-looking result. Also, the male beard pattern should be taken into consideration when designing incisions. The overall goal of a facelift is to achieve a younger-looking appearance with respect to the natural character of your face, so the anatomical differences between men and women will likely influence your facelift procedure.

What’s the best age for a facelift?

Age is less important in determining whether you could benefit from facelift surgery than the concerns you wish to improve. If you exhibit wrinkles, sagging skin, or jowls along the jawline, you are likely a good candidate for facelift surgery regardless of whether you are in your thirties or your fifties. Some patients develop signs of age relatively early, while others may retain good skin tone well into middle age. With this in mind, there is usually no “best age” for pursuing a facelift. Dr. Bottger has achieved beautiful results for younger and older patients alike.

Will my face appear “stretched” or “pulled” after facelift surgery?

Despite misconceptions about potential facelift results, you should simply look like a younger and more refreshed version of yourself after the procedure. A “tight” or “overly pulled” appearance is usually an indication of a poorly performed facelift in which a surgeon merely redrapes the overlying skin, rather than addressing the deeper facial tissues. Dr. Bottger is extensively experienced in performing facelift surgery and focuses on achieving a natural appearance while preserving the character of a patient’s face.

How many years younger will I look after a facelift?

A facelift can reverse the clock on your appearance by approximately ten years, sometimes longer. The difference can be made more dramatic by combining facelift surgery with other rejuvenation treatments that target additional signs of age, such as volume loss and drooping eyelids. Procedures like fat grafting and blepharoplasty can target each of these concerns respectively and renew the facial tissues from the inside out. Don’t hesitate to ask Dr. Bottger which treatment options can help get you closer to your aesthetic goals in a consultation.

How long does it take to look “normal” after a facelift?

According to the American Society of Plastic Surgeons (ASPS), patients are typically “presentable” to the public around 14 days after surgery. At this time, swelling should be substantially reduced and most individuals feel well enough to return to work and non-strenuous activities. However, every patient is unique in this regard.

How do you sleep after a facelift?

Dr. Bottger will provide you with extensive post-operative instructions detailing how to sleep and shower after facelift surgery. The best sleeping position is usually on your back with the head slightly elevated above heart level. This can increase blood flow and help facilitate the healing process.

Can you get a neck lift without a facelift?

Most patients who experience laxity around their neck and under their chin also have drooping skin along their lower face and jawline; therefore, the most optimal improvement is often achieved when both the face and the neck are addressed. That said, Dr. Bottger performs surgery according to your unique needs and desires. Together, you two will develop the best treatment plan to achieve your goals.

How do I prepare for a facelift?

Before your procedure, Dr. Bottger may instruct you to avoid taking aspirin, anti-inflammatory drugs, and certain other medications to help reduce bleeding and bruising after a facelift. You should also abstain from smoking for at least four weeks before and after surgery. Since a facelift is typically an outpatient procedure, you will also need to arrange for a friend or loved one to drive you home from our surgical facility.

How long does tightness last after a facelift?

Due to the time it takes for incisions to heal and swelling to subside after the procedure, it generally takes two to three months for the face to feel “back to normal” after facelift surgery. Tightness and soreness are normal during the initial healing period, but rest assured that your face should feel more relaxed as the weeks progress.

Schedule Your Facelift Consultation In Philadelphia

If you are thinking about a facelift or other cosmetic facial plastic surgery procedure in Philadelphia, don’t hesitate to contact Dr. Bottger at 610-227-6114 to schedule your consultation today.