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Facelift & Necklift

What is the best age for a Facelift & Necklift?

The short answer is: it depends. We all age in 3 ways…

  1. Our skin begins to have surface changes (sun spots), 
  2. We lose volume (mostly fat)
  3. 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). The factors will determine the optimal time for a face or necklift.

Facelift San Francisco

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.

Facelift Walnut Creek, CA
Facelift Marin County
Facelift Before and After Tiburon, CA

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

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Dr. Rankin is one of the most intelligent and caring doctors I have ever had. He is a renowned surgeon and I’m so thankful for his work. Dr. Rankin goes above and beyond to care for his patients, answer questions, and ensure the best outcome. He is incredible! I would recommend him to absolutely everyone!

Breast Reconstruction

Dr Rankin was a referral from a good friend. From the start his knowledge and bedside manner was impeccable. He took all the time needed to explain the procedures I was going to have and assured me that he could get the results I was looking for. What was so encouraging to me is his understanding and patience of how long I had been wanting to do this. After the procedure he was there 24/7 for any questions. He called in additional scripts when needed and even went above and beyond to get some in home therapy services to provide hydration and vitamin therapy! All I can say is Wow! The results are coming, but he has made my journey so much easier and healthier. His knowledge is so expansive not only in surgery but also very resourceful in every aspect of your recovery. Thank you Dr. Rankin!

360 Liposuction

Dr. Rankin is a brilliant surgeon coupled with the most professional comforting bedside manner -a rare combination! Dr. Rankin did the most amazing job closing A three month open wound in my stomach that would not heal. I feel human again - four weeks postop my scar looks amazing! I will definitely refer Dr. Rankin to anyone looking for an excellent plastic surgeon!

Breast Surgery

I had a cancer on my face and he removed it completely and there is hardly any visual or other signs of it whatsoever; he was super in consultation and post operative; needless to say, I'm one happy, very happy patient; I would use him again and recommend him highly.

Mohs Reconstruction

The procedure went great and I’m very happy, excellent work. I had a Asian Rhinoplasty done as well as a Forehead Reduction.

Asian Rhinoplasty and Forehead Reduction

Very knowledgeable and interested in my needs and letting me know how what he suggest and what I need can work together. He was very easy to understand and made me very comfortable


The office staff and Dr. Rankin were all very attentive, took their time, and were very personable. Both the patient care coordinator and Dr. Rankin sat in the office and answered all the questions I had, plus offered other information about the procedures and recovery I had not thought about. They were very transparent about what would and would not give me the best outcome for the areas I was concerned about. They were organized, efficient, and very welcoming

Mommy Makeover

I love Dr.Rankin, he made my experience so comfortable, he knows just what you want, and his Patient Care Coordinator Inger Fredricks is amazing too! I have already recommended him to my friends as they see my., results unfold, and they seem pretty excited to meet him as well! I had a breast augmentation, with a lift. I also had liposuction with Renuvion. I also had a abdominoplasty.

Mommy Makeover

Absolutely excellent. I couldn’t be happier with the results I’m getting and with Dr. Rankin and his staff. The physical result is wonderful - as good or better than I envisioned.

Fantastic Experience and Results

Dr Rankin (and Dr Aycock) have provided a level of expertise and sensitivity to my queries that is unparalleled. They spend as much time and care with their patients and go above and beyond educating and making sure the procedures are perfectly matched to their patients needs and desires. The clinical staff in Ingrid is 24/7 always there and available to support in the kindest way possible! I feel so well taken care of, thank you!


”Dr. Rankin is a highly professional plastic surgeon. My after surgery results are the best ones I have ever seen! Great before and after care and during healing. He is there every step of the way to answer and help with all the questions and concerns.”

Best Breast lift

K.T. Patient
”Dr. Rankin is one of the best young surgeons! He is very caring - listens - just a fantastic personality! Highly Recommended. Dr. Timothy Rankin!!”

Dr. Rankin is Caring

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...

Alan B. Physician/ Patient

Want to Read More?

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