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Facelift & Necklift

What is the best age for a Facelift & Necklift?

We all age in 3 ways. Our skin begins to have surface changes (sun spots), we lose volume (mostly fat), and we lose elasticity I our skin. The rate at which these occur depends on your heritage and your degree of exposure to the environment (sun, smoke, etc).

Systematic approach for optimum results

 Instead of thinking of a specific procedure, we find that it is much more useful to discuss what aspects of aging are bothering you. We can then discuss the best way to address those changes naturally. 

If you don’t like the skin along your jaw, then we need a procedure to address skin. 

If you don’t like the excess fat under your neck, then we need a procedure to address the fat. 

If you don’t like the sun spots and changes in skin tone…. you get it. This is a pragmatic way to find the right procedure for you. Note that none of those questions asked about your age.

Evolution of Facelift & Necklift surgery

 The word Facelift makes some people nervous given that historically, facelifts led to a “tight” or “windblown” appearance that was anything but natural. Older procedures that focused on simply pulling the skin tight were short sighted and failed to provide durable, natural rejuvenation. Newer procedures focus on rejuvenation and not augmentation. The goal is always to make you look like a younger version of yourself, not someone else. 

I hope that this page provides some useful information so that we can empower you to make the right decision. Think of us as a guide or partner.

Most of the patients that come to see us have concerns about facial aging. This begins to occur when there is discord between the image you see in the mirror and your own self perception. We believe that we can maximize your quality of life by rectifying this discord. 

Holistic Approach

I like to think of the face as a whole. Though we will discuss different areas of concern, it is usually critical to address neighboring areas of the face in order to ensure that we do not create a “surgical” appearance.  Imagine a smooth neck. As you begin to shift the skin on your neck and jaw up, it may appear to bunch on your cheeks, so we have to then lift the cheeks, and then the lower eyelids…. Etc. So while a more extensive procedure may sound intimidating or less natural, it is usually this holistic approach that gives us the most natural outcomes. 

 The Procedure

Lets start with the basic procedure. There are many techniques for rejuvenating the face. Each procedure is distinguished by 3 basic components: the incision, how the deeper layers (SMAS- superficial muscular aponeurotic system) of the face are lifted, and how the neck is refined. 

My preferred incision is hidden along the sideburn, along the edge of the ear and then wraps around behind the ear. The amount of extension behind the ear depends on the degree of excess skin, if any (many times there is very little excess and it need only be repositioned). In most of my patients I like to use a “High SMAS” facelift that is able to reposition the deeper layers of the face into a more youthful position without causing any distortion of the mouth or muscles of facial expression. 

Neck and jawline

The neck is refined by creating a smooth elegant foundation. The neck is composed of layers. The neck, just like the face, loses fat in the layer just under the skin (subcutaneous fat) as we age. Therefore, there are very few patients that benefit from liposuction of the neck even if you feel that you neck is “fat”. A youthful neck is smooth and free of lines or veins. An older appearing neck tends to have lines and veins and “bands”. The difference between the 2 is the amount of subcutaneous fat. So while neck liposuction can provide a temporary improvement for some patients, it can accelerate the aging process. My approach focuses on contouring the deeper structures of the neck (platysma muscle, submandibular glands, subplatysmal fat, and digastric muscles) while leaving the more superficial, “youthful” fat unharmed. I believe this creates a more natural, durable result.

Additional Procedures

Since a natural rejuvenation requires that all areas of the face appear to be the same age, many patients benefit from combining fat grafting, an eyelid lift (blepharoplasty), brow lift, or laser resurfacing with their facelift in order to create a “non-surgical” appearance. For example, a refined jawline and youthful cheeks may be noticeable if your forehead till appears wrinkled. The human eye is incredibly sensitive to small changes in facial configuration or expression. We have to ensure that there are no incongruencies. While you may decide to share the details of your procedure, no one should be able to tell that any surgical procedure has occurred. 


The typical downtime from a facelift is about 2 weeks. Luckily this is not due to discomfort as we use long acting local anesthetic to improve recovery and frankly facial surgery is not typically painful. Our post operative dressings are very minimal. The surgery can be performed as a same day surgery or you may opt to spend the night. There will be some bruising and swelling, but you will be presentable to a stranger after roughly 2 weeks. 

If you are preparing for an event (wedding, birthday, vacation, reunion, etc), we recommend facial rejuvenation no less than 8-12 weeks before your big day, in order to ensure appropriate healing and full activity.If you are interested in facial rejuvenation, I encourage you to reach out to us. We would be happy to answer your questions and schedule a complimentary consultation

Ask Dr. Rankin

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B.L. Patient
”Dr. Rankin transformed my neck from a severe triple chin to one that is well sculpted with appropriate muscles clearly visible. I highly recommend him.”

I had a Triple Chin...

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Want to Read More?

The American Society of Plastic Surgeons has compiled an excellent resource for patient education. 

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