Dr. Steven Fagien & Dr. Elbert Vaca

Facelift & Necklift Surgery

Face Procedures

Every face is unique and can age differently. Therefore, face and necklift surgery must be individually tailored to achieve a natural result. Dr. Vaca has published extensively on facial aesthetics in the premier plastic surgery journals including Plastic and Reconstructive Surgery & Aesthetic Surgery Journal. Dr. Vaca’s elite training and his keen eye to detail can help you attain a more revitalized and youthful facial appearance.

In many ways the term “facelift” is a misnomer, as it is not as simple as tightening and removing loose facial skin – tightening skin alone can result in a tight and unnatural appearance. Dr. Vaca individually analyzes each face and discusses each patient’s goals to optimize their result. With age, the face can lose volume in the cheeks, temples, and around the eyes and lips, and gain extra fat deposits in the neck and jowls. A modern facelift involves restoring a youthful facial fat distribution via selective removal and addition of volume. In addition, a facelift involves tightening the deeper layer of the face (known as the SMAS & platysma muscle), followed by judicious removal of excess skin to achieve a beautiful and natural appearing result.

What is the difference between a facelift and necklift?

There is no straightforward answer to this question as there is significant overlap between both procedures (facelift & necklift). The surgical approach should be individualized to each patient’s needs and goals. In general, a facelift should also rejuvenate the neck, as the neck is one of the first areas to demonstrate aging changes. The key to an excellent result is a balanced result that avoids unnatural appearing and harsh transition between the face and neck. However, in the properly selected patient, a necklift alone may be appropriate if the patient’s aging pattern is mainly in the neck.

Am I a candidate for a facelift/necklift? Are there Alternatives?

During consultation and discussion of your individual goals, Dr. Vaca can help assess if you are a good candidate for a facelift and/or necklift. For earlier signs of facial aging or localized issues (submental fat – i.e. extra fat below the jawline), liposuction, facial fat grafting, dermal fillers, Botox® Cosmetic, and skin resurfacing including chemical peels and laser treatments can provide improvement. Of note, the above treatments can also be used in conjunction with a facelift for an improved result. Importantly, however, a facelift remains the most effective means to treat more significant lower facial and neck aging changes.

Facelift Incisions

Facelift incisions are concealed along the borders of the ear and lower hairline. For a full face & necklift, these incisions are placed along the sideburn, in front of the ear, behind the ear, and beneath the chin. Depending on your individual goals and aging pattern, the length of these incisions may be different.

How long do the results of a facelift last?

This is variable between patients and can depend on many factors including genetics, skin quality and tone, sun damage, smoking, weight changes after surgery, and how the deeper structures of the face are treated during surgery. Dr. Vaca uses a SMAS and Platysma flap technique for the deeper structures of the face which, in his opinion, improves the longevity of facelift & necklift results.

Does a facelift correct all facial wrinkles?

A facelift is very effective at improving jowls, creating a sharper neckline, and improving many of the wrinkles of the neck and cheeks. A facelift generally does not improve fine facial lines – particularly fine lines around the mouth. Skin resurfacing procedures, including laser and chemical peels, can improve fine facial lines and be used to compliment the result of your facelift procedure.

Can a facelift/necklift be combined with other surgical procedures?

Yes, absolutely! Procedures including browlift, blepharoplasty (eyelid lift), lip lift, chin augmentation, facial fat grafting, and skin resurfacing can be performed at the same time as a facelift to complement your overall result. If you are interested in other procedures, you should discuss these during your consultation with Dr. Vaca. The main factor determining the number of potential combined procedures is limiting the length of surgery and avoiding too much time under anesthesia.

What are the risks of Facelift and Necklift surgery?

All surgical procedures carry a degree of uncertainty and risk. Thankfully, the risk of any major complication is rare. While the majority of facelift scars heal extremely well, scars may be more visible in some patients. Poor healing can occur – this is more common in smokers. Unfavorable scarring is more common in patients who experience poor healing.

Infection and bleeding are rare but can occur. It is important to avoid strenuous activity, blood thinning medications, and that your blood pressure is well controlled after surgery to decrease the risk of bleeding.

Injury to the nerves that control the muscles of the face is rare but can occur. If this occurs, it is temporary the vast majority of the time.

After surgery, there will be a change in sensation over the area of the cheeks, ears, and neck. Sensation recovers over time in most patients; however, loss or decreased sensation can be permanent in some areas. In addition, there may be some temporary asymmetry in the movement of the face after surgery, but this recovers in the vast majority of patients.

We all have natural asymmetries between each side of our face – some people more than others. After a facelift, asymmetries will still exist. After surgery, patients tend to scrutinize their face more intently and may notice some asymmetries for the first time.

Before and After Photos

Facelift – Case 1

Facelift – Case 2

Facelift- Case 3

Meet Dr. Vaca

Dr. Vaca

Dr. Elbert E. Vaca is a Plastic & Reconstructive Surgeon who completed his medical training at The Johns Hopkins University School of Medicine and Northwestern Memorial Hospital.
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Meet Dr. Fagien

Dr. Fagien

Dr. Steven Fagien is one of the foremost oculoplastic surgeons in the United States and the world. He completed his medical training at the University of Florida and a fellowship in oculoplastic surgery at the University of Illinois Eye and Ear Infirmary.
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