Home/Surgical Cosmetic Procedures/Facial Plastic Surgery/Facelift Surgery
Facelift surgery is a cosmetic procedure designed to restore a more youthful appearance by smoothing wrinkles, eliminating sagging skin, and reducing other signs of aging in the face and upper neck area.
Over time, the effects of gravity, exposure to sun, dry air, and general stress take a toll on an individual’s face and neckline. Jowls can develop under the jawline with folds and fat deposits. Sometimes creases begin to form between the nose and the mouth. A facelift can considerably reduce these signs of aging by removing excess fat, tightening the underlying muscles, and redraping the skin around the neck and face. If your problem areas are limited to the neck, a more conservative approach, known as a “neck lift,” may be the procedure needed to achieve a more defined jawline.
Facelift surgery often includes techniques designed to tighten and contour the neck for comprehensive rejuvenation. In fact, many facelifts incorporate neck lift components to address visible signs of aging in the lower face and neck simultaneously. However, in some cases – such as a mini facelift or when the focus is primarily on the cheeks and jawline – neck lift techniques may not be necessary. Dr. DiBello will carefully evaluate your needs and goals to determine the most appropriate approach, ensuring your procedure is tailored to achieve optimally balanced results.
Facelift surgery can be done alone; however, it is also frequently performed in conjunction with other procedures, such as a neck lift, an endoscopic brow lift, eyelid surgery, or rhinoplasty. Alternatively, patients may wish to incorporate body or breast enhancement procedures (e.g. liposuction or breast augmentation) into their care.
When multiple cosmetic surgeries or non-surgical treatments are combined into one – especially in the interest of addressing age-related concerns – we often call it a “mommy makeover.” If you so desire, Dr. DiBello can work with you to develop a customized plan for your comprehensive aesthetic procedure.
Dr. DiBello has found that incorporating facial fat transfer at the time of a facelift can significantly enhance both early and long-term results. The procedure uses fat harvested from another area of the body and strategically injects it into targeted facial zones. By replenishing age-related volume loss in areas such as the cheeks, temples, and under the eyes, fat transfer can help achieve natural-looking facial rejuvenation.
In addition to being performed alongside a facelift, facial fat transfer can be an excellent option for individuals who are not yet ready for surgery or who have already undergone a facelift and wish to further refine their results.
Individuals who wish to rejuvenate their facial appearance and are in good general health are typically considered good candidates for facelift surgery. There is no upper age restriction for this procedure; women and men of varying ages seek to reduce signs of facial aging with a facelift.
A consultation with Dr. Joseph DiBello, our experienced plastic surgeon, will help you determine if you are a candidate for a facelift. At that time, Dr. DiBello will discuss his personalized approach to your surgery as well as important considerations involved in facelift surgery. If it is determined that you are not a candidate for facelift surgery, Dr. DiBello can recommend a more appropriate treatment that can adequately address your concerns, such as BOTOX® Cosmetic and/or dermal fillers.
Most facelift patients are in their 40s, 50s, or 60s, which is when signs of aging typically become more prominent. However, age is not a requirement to be considered a good candidate, and patients older or younger can be eligible for a mini or full facelift. Everyone ages at a different rate and, as a result, the ideal age for facelift surgery will different from patient to patient. In general, the best time to consider a facelift is when you are unhappy with fine lines, wrinkles, and sagging skin, and non-surgical treatments no longer help you achieve the results you desire.
Dr. DiBello offers three different techniques for the facelift procedure, as described below:
In the mini facelift procedure, tightening and lifting of the underlying muscular structures of the face, otherwise known as the SMAS layer, in the cheek areas is performed through small incisions placed discreetly in front of the ears. Ideal candidates for this procedure are looking for improvement in the cheek area above the neck, do not have a significant excess of loose skin, and have overall good tissue tone. The technique can often be performed in-office.
A modified mini facelift (sometimes erroneously called a “one-stitch facelift” on social media) focuses on lifting and tightening the cheek area with smaller incisions. Dr. DiBello generally administers modified mini facelifts in our office with local anesthesia, and can use the strategy to address mild to moderate signs of aging.
*”One-stitch” refers to the social media phenomena, but these are not the proper terms for these treatments (see this blog for more information).
SMAS, short for superficial musculoaponeurotic system, is a thin sheet of connective tissue and muscle in the mid and lower face, deep to the skin, and continuous with the platysma muscle of the neck. A SMAS flap facelift, or “deep plane” facelift, not only involves tightening of the skin of the face and neck, but also repositioning and lifting of the underlying SMAS and platysma muscles. This provides a profound, longer lasting, but natural improvement in the contours of the cheek and neck areas.
Your facelift journey begins with a one-on-one consultation with Dr. DiBello, during which he will take the time to understand your aesthetic concerns, medical history, and personal goals. He will carefully examine your facial structure, skin quality, and tissue laxity to determine which technique, whether it is a mini facelift, modified mini facelift, or full SMAS facelift, is best suited to your anatomy and desired outcome.
Dr. DiBello will walk you through your surgical options in detail, explain what to realistically expect from your results, outline the recovery process, and address any questions or concerns you may have. If additional procedures such as a brow lift, eyelid surgery, or facial fat transfer could enhance your outcome, he will discuss those possibilities as well. By the end of your consultation, you should have a clear, customized treatment plan along with a transparent cost estimate, allowing you to move forward with confidence and no surprises.
In the classic full SMAS facelift surgery, both the sagging skin and the underlying deeper tissues of the face and neck are targeted. Dr. DiBello will begin the incisions behind the hairline in the temple area that extend down in front of the ear (in front of the tragus in men, behind the tragus in women) and ultimately curve around the earlobe, blending into the hairline behind the ear. The SMAS layer is then tightened and lifted in the cheek area, eliminating the sagging along the sides of the mouth as well as the jowls. The removal of fat and smoothing of the structures of the neck and suspension of the neck is generally performed through a small incision beneath the chin as well as behind the ears. Excess, sagging skin is then trimmed and tightened until a natural contour is achieved. The full SMAS facelift surgery requires general anesthesia and is typically done at the hospital. In some cases, a facelift can reduce the outward signs of aging by ten or fifteen years.
As stated above, the mini, or MACS, facelift targets mainly the underlying deeper structures of the cheek (SMAS). Dr. DiBello accomplishes this by making a limited incision extending from the top of the ear at the hairline, passing down in front of the ear and ending at the earlobe. The skin is conservatively elevated and the underlying SMAS is then tightened. Limited trimming of the skin is then performed, if necessary. While this procedure could be done under local anesthesia, Dr. DiBello prefers to perform the procedure using IV sedation for improved comfort.
To see a visual representation of this procedure, please view our facelift 3D animation.
For patients seeking even less invasive correction (typically those with mild to moderate sagging in the midface or cheek area), Dr. DiBello may recommend a modified mini facelift. This technique involves smaller incisions and a more targeted lift to the cheeks and jawline. Often performed in-office under local anesthesia, the modified mini facelift can offer natural-looking improvements with minimal recovery time.
Patients with mild to moderate facial sagging, particularly in the cheeks or midface, who are in good general health and have reasonable skin elasticity are often well-suited for an in-office procedure. Those who prefer a quicker recovery, wish to avoid general anesthesia, or are not yet ready for a full surgical facelift may find the modified mini facelift to be an ideal starting point.
While full SMAS facelifts are typically performed at a hospital or accredited surgical facility, the modified mini facelift can be administered right here in Dr. DiBello’s office. This setting is convenient, familiar, and avoids the added logistics of a hospital visit without compromising quality of care.
One of the practical advantages of an in-office facelift is the use of local anesthesia rather than general anesthesia. Patients should remain comfortable throughout the procedure while avoiding the extended recovery period often associated with going under general anesthesia. This can translate to a smoother recovery experience and a quicker return to daily activities for many patients.
The price of an in-office modified mini facelift at our practice typically starts at $4,500; however, it is important to note that the price can vary among patients based on the customized treatment plan and other factors associated with care. The total cost will be presented to you once the treatment plan is developed and a member of our team will be happy to answer any questions.
During the initial consultation, Dr. DiBello will evaluate your needs and goals to determine whether an in-office modified mini facelift is right for you.
Most mini facelift procedures, and even full SMAS facelift procedures, typically do not require overnight stay. If your procedure is performed at the hospital, you may elect to stay overnight to ensure optimal comfort and safety. Either way, Dr. DiBello provides you with thorough instructions and recommendations to minimize swelling and discomfort. Drains are typically not required for mini facelifts, but while they are used frequently in full SMAS facelift procedures, they are usually removed three to four days in the office.
In the first few days after surgery, Dr. DiBello recommends resting with your head slightly elevated. Any discomfort can be managed well with Tylenol, Arnica Montana supplement, and a prescribed anti-inflammatory. Some swelling and bruising is normal, but should subside in the weeks following surgery. You will need to wear a support garment for the first week, and as needed thereafter.
Based on your individual case, Dr. DiBello will provide you with specific guidelines that can minimize the chance of complications and ensure proper healing. However, in general, most patients are able to return to their regular routine and other light activities after two weeks, whereas strenuous exercise and heavy lifting should be avoided for at least four to seven weeks.
In your follow-up appointments, Dr. DiBello will check your progress to make sure you achieve an ideal outcome.
The length and location of facelift scars can vary, depending on the technique employed—however, Dr. DiBello takes great care during all facelift procedures to ensure incisions are carefully placed in a way that results in scars that are typically unnoticeable.
In many cases, incisions are made within or along the hairline, making them easy to conceal, once healed. Some patients may also have a scar that extends down behind the ear, but this also typically remains inconspicuous by blending in with the natural crease of the ear. Regardless of your unique incision pattern, closely following Dr. DiBello’s aftercare instructions can help scars heal and fade successfully.
During your consultation, Dr. DiBello will determine which surgical approach can effectively address your concerns and yield the best possible results. He can then create a personalized treatment plan and discuss specific incision options with you.
Facelift results can be very long-lasting, but the longevity can vary from patient to patient, based on factors such as the surgical method used, as well as the patient’s skin quality and efforts to maintain optimal skin health.
Individuals who have skin that has not lost too much elasticity typically experience longer-lasting results—however, using a daily moisturizer and other skin care products, as well as refraining from smoking can also help extend the lifetime of your results. Additionally, drinking plenty of water and eating a healthy diet can stave off the need for touch-ups or revisional surgery.
The technique your surgeon uses can also affect the longevity of your results—methods that only address loose skin typically do not yield results that last as long as a facelift performed with a more comprehensive approach that tightens underlying structures, as well.
A full SMAS facelift (cheeks and neck) starts at about $14,000 at DiBello Plastic Surgery, but the cost of facelift surgery can vary significantly based on the details of your personalized treatment plan. Factors such as the type of facelift being performed, any additional procedures performed, the complexity of the procedure, anesthesia, surgical facility fees, and other associated expenses all play a role in determining the final price.
During your consultation, Dr. DiBello will assess your needs and goals to create a customized surgical plan. At that time, he will provide a detailed and transparent estimate tailored to your specific case.
While a facelift generally provides the most comprehensive and longest-lasting improvement for facial aging, not everyone needs or is interested in undergoing this surgical procedure. For those wanting a non-surgical facelift alternative, Dr. DiBello offers a variety of cosmetic injectables, such as dermal fillers and BOTOX® Cosmetic injections, which can help smooth wrinkles, restore lost volume, and subtly lift sagging skin for a less invasive method of rejuvenation.
These treatments can be highly effective for maintaining results after a facelift or for softening the earlier signs of aging, but it’s important to understand their limits: fillers and BOTOX injections work at the surface level, temporarily adding volume or relaxing muscle activity, rather than correcting the deeper structural changes that cause sagging in the first place. As a result, they cannot deliver the same lasting, transformative improvement as a surgical facelift.
With this in mind, Dr. DiBello has often found that autologous facial fat transfer is even more effective than cosmetic injections for the majority of patients, although this treatment will require liposuction surgery of another body area to harvest the excess fat for transfer to the face. Depending on your unique needs, Dr. DiBello can employ the use of microfat, nanofat, or a combination to deliver the smoothest, most natural-looking effects. Microfat is typically used for restoring lost volume and contouring the face, whereas nanofat can be used to smooth delicate areas and improve skin texture and tone. Together, these techniques can offer comprehensive rejuvenation with the benefit of using the patient’s own natural tissue, which contains their body’s own growth factors and stem cells.
Similarly, laser treatments and other energy-based devices are sometimes marketed as non-surgical facelift alternatives, and while they can improve skin tone, texture, and mild laxity, they, too, have real limitations. These technologies work by heating or stimulating the skin’s surface and upper layers, but they simply cannot reach deep enough to address the underlying muscle and connective tissue that lose strength and shift position with age. Because they aren’t able to actually tighten the SMAS layer or reposition sagging structures, energy-based devices tend to offer subtle, short-term refinement rather than the significant, long-lasting rejuvenation many patients are hoping to achieve.
This underlying principle applies across the board: no injectable, topical, or energy-based treatment can truly replicate the results of surgery, because none of them are able to tighten the deeper facial structures that give the face its youthful support. A facelift remains the only option capable of repositioning and securing the SMAS layer and underlying muscle, which is why it continues to offer the most meaningful and durable results for patients seeking significant facial rejuvenation.
Patients researching their options will often come across marketing that promises “surgical-level results” through minimally invasive treatments or devices, frequently paired with claims of minimal scarring and lower costs. While some of these treatments may certainly play a valuable role in a broader skincare or rejuvenation routine, it’s important to approach such claims with a healthy dose of skepticism. No non-surgical treatment, regardless of how it’s marketed, can reposition or tighten the SMAS layer and underlying facial muscles the way surgery can. Understanding this distinction upfront can help patients set realistic expectations and avoid investing in treatments that may not deliver the transformation they’re truly looking for.
Additionally, while those treatments may indeed be of “lower cost,” the results are likely temporary and require ongoing maintenance treatments to sustain, whereas the results of a well-performed facelift can last for years. Dr. DiBello encourages patients to think of it as an investment: weighing the cumulative cost and time of repeated non-surgical touch-ups against the more comprehensive, one-time investment of surgery, which can make a significant difference in overall long-term value and satisfaction.
If you would like to learn more about the most ideal treatment options to help you achieve a younger-looking appearance, Dr. DiBello can talk with you about your needs and preferences during your consultation.
To ensure your safety and the most natural-looking results from facelift surgery, it is essential that you choose a qualified plastic surgeon to perform your procedure. The most important quality to look for when selecting a facelift surgeon is board certification by the American Board of Plastic Surgery (ABPS). This indicates the surgeon has completed at least six years of specialty training after medical school, has completed the rigorous exam process, and participates in continuing education every year. In addition, board-certified plastic surgeons like Dr. DiBello operate out of an accredited medical facility and demonstrate a commitment to patient safety and high-quality care.
Other factors to consider when researching facelift surgeons include their experience with facelift techniques, if they have before-and-after pictures you can view, and what patients have said about them in online reviews. If you ever feel unsure about a surgeon and their surgical abilities, you should keep looking until you find a physician who makes you feel completely comfortable.
To discover if you are a candidate for facelift surgery, please contact our office today to schedule a consultation with Dr. DiBello.