Facelift and neck lift · New York and New Jersey
Facelift
A facelift lifts the cheeks, jowls, and neck by tightening the layer under the skin and removing the extra skin. Dr. Steven Ovadia is a board certified plastic surgeon with fellowship training in craniofacial surgery, with offices in New York City and New Jersey.
Overview
What a facelift is
A facelift, also called a rhytidectomy, is surgery that lifts the lower two thirds of the face and the neck. With age, the skin loosens, the fat of the cheeks moves downward, and the layer that supports them stretches. The cheeks flatten, folds deepen beside the nose and mouth, jowls form along the jawline, and the neck loosens.
A facelift corrects this where it starts. The supporting layer under the skin is tightened, the cheeks and jowls are lifted back toward where they used to sit, and the extra skin is removed. In most people the neck is treated at the same operation, which is why the names facelift and neck lift overlap.
The goal is that you look like yourself, rested and younger, with a face that still moves the way it always has.
What a facelift treats
- Jowls, and a jawline that has lost its definition
- Cheeks that have dropped or flattened
- Deep folds between the nose and the corners of the mouth
- Lines that run down from the corners of the mouth
- Loose skin and vertical bands in the neck
- Fullness under the chin
What a facelift does not do
- Lift the brows or the forehead. A brow lift does that
- Treat the eyelids. Blepharoplasty does that
- Remove fine lines, or change the quality of the skin itself
- Replace volume that has been lost. Fat grafting does that
- Stop the face from aging
Tell Dr. Ovadia about high blood pressure, blood thinners, aspirin, supplements, and any nicotine use, including vaping. These affect bleeding and healing, and they are planned for well before surgery.
Technique
How Dr. Ovadia performs a facelift
Under the skin of the face is a firm layer called the SMAS. It is connected to the muscles that move the face, and it continues into the neck as a thin, flat muscle called the platysma. As this layer loosens, the cheeks and jowls drop with it.
An operation that tightens only the skin does not last, and it can leave a face looking pulled. In a modern facelift the lift is carried by the SMAS, and the skin is laid back down without tension.
A technique Dr. Ovadia commonly uses is the SMASectomy. A strip of the SMAS is removed over the side of the cheek, and the two edges are stitched together. This tightens the layer and lifts the cheek, jowl, and neck upward and back.
The diagram shows the idea. It is not a prediction of an individual result.
How it is done
Incisions around the ear
The incisions are placed under the sideburn and in the natural lines around the ear, where they are hard to see once they have healed.
The skin is lifted
The skin of the cheek and neck is lifted off the layer under it, as far forward as is needed for your face.
The SMAS is tightened
In a SMASectomy, a strip of the SMAS is removed and the edges are stitched together. The direction of the lift is set for your face.
The skin is laid back down
The skin is laid back over the lifted face without tension. The extra skin is removed and the incisions are closed with fine stitches.
Facelift techniques compared
Facelift techniques differ mainly in what is done with the SMAS. These are the names you are most likely to come across.
SMAS plication
Folded
The SMAS is folded on itself and held with stitches. Nothing is removed.
SMASectomy
Commonly used by Dr. Ovadia
A strip of the SMAS is removed and the edges are stitched together, which tightens the layer and lifts it. The lift is done without working under the SMAS, where the nerves that move the face run.
Deep plane
Lifted from underneath
The surgeon works under the SMAS, releases it from the structures below, and lifts it together with the skin as one layer.
Dr. Ovadia commonly uses the SMASectomy because of how patients look afterward: the face looks natural and moves normally. The technique that is right for you is part of your surgical plan, and he goes over it with you at your consultation.
Incisions
Where the incisions are
A facelift incision usually starts under the sideburn, runs down in front of the ear following its natural lines, passes around the earlobe, and continues behind the ear into the hair.
When the neck needs more work, a short incision is added just below the chin. It runs side to side, in the natural crease under the chin.
The skin is closed without tension, which is what lets the scars heal as fine lines. Once healed, they are hidden by the hair, by the shape of the ear, and by the crease under the chin. Care is taken to keep the hairline and the earlobe in their natural position.
This is where the incisions are usually placed. They are not the same for everyone: the placement depends on your anatomy and on the amount of skin that needs to be removed, and other incisions are sometimes used. Dr. Ovadia shows you where your incisions will be when he goes over your surgical plan.
The neck
Neck lift
The neck ages together with the lower face. The skin loosens, fat collects under the chin, and the platysma, the thin muscle at the front of the neck, separates into the vertical bands that show when you talk or tense your neck.
A neck lift treats these. In most people it is done as part of a facelift, because the layer that is lifted in the face continues into the neck. It can also be done on its own when the neck is the main concern.
Tightening from the side
Through the facelift incisions, the platysma is lifted and secured behind the ear. This sharpens the jawline and the angle between the chin and the neck.
Tightening in the middle
Through a short side-to-side incision just below the chin, the two edges of the platysma are stitched together in the midline. This treats the vertical bands.
Fat under the chin
Fat under the chin is removed directly or with liposuction. When the skin is still firm and fat is the only concern, liposuction of the neck alone may be enough.
LiposuctionEvery surgery has risks. For a facelift and neck lift these include bleeding, infection, fluid collecting under the skin, slow healing or loss of skin near the incisions, weakness of part of the face from injury to a nerve, numbness or other changes in feeling, thinning of the hair along the incisions, scarring, differences between the two sides, and the need for revision surgery. Healing problems are more likely in people who use nicotine. Dr. Ovadia goes over the risks with you at your consultation.
Recovery
What to expect after a facelift
Swelling and bruising are normal and expected
The face and neck are swollen and bruised at first. Most people are comfortable being seen in public at 10 to 14 days. The last of the swelling takes a few months to settle.
Compression garment and an elevated head
A facial compression garment is important. Sleeping with the head of the bed elevated is important. Both help with swelling.
Dressings and drains
You go home with a dressing around the face and neck. Small drains may be placed under the skin for a short time after surgery to remove fluid.
Temporary numbness is common
The cheeks, the neck, and the skin around the ears can feel numb or tight. Feeling returns gradually over the following months.
Sutures and staples
Sutures typically come out at 5 to 7 days. Staples typically come out at 7 to 14 days.
Results come gradually
You see the change as the swelling and bruising clear. The scars start out pink and fade over the following months. The face feels like your own again at about 2 to 3 months.
Normal swelling comes on slowly. A rapid increase in swelling is something to watch for, and it should be brought to your physician's attention right away. The same is true of swelling that is much greater on one side than the other.
A general timeline
This is a general guide. Everyone heals differently. During your recovery, Dr. Ovadia will review your timeline with you.
Cost
Cost and insurance
A facelift is cosmetic surgery, and insurance is unlikely to cover it. The cost depends on whether the neck is included, whether it is done together with eyelid surgery or other procedures, where the surgery is done, and the anesthesia. You receive a quote after your consultation.
If you have questions about the cost of surgery, call or email us and we will go over it with you.
Your surgeon
Board certified and double fellowship-trained
Dr. Ovadia is board certified by the American Board of Plastic Surgery. After his plastic surgery training he completed two fellowships: gender-affirming surgery at Johns Hopkins, and craniofacial and pediatric plastic surgery at UT Austin / Dell Children's Hospital.
Craniofacial surgery is surgery of the bones and soft structures of the face and skull. He performs facelift and neck lift surgery on their own and together with other facial surgery, eyelid surgery, and facial feminization surgery. He sees patients in New York City and in Jersey City and Millburn, New Jersey.
Questions
Common questions about facelift surgery
What is a SMASectomy facelift?
The SMAS is the firm layer under the skin of the face. In a SMASectomy facelift, a strip of that layer is removed over the side of the cheek and the edges are stitched together. This tightens the layer and lifts the cheek, jowl, and neck. The skin is then laid back down without tension. It is a technique Dr. Ovadia commonly uses.
What is the difference between a SMASectomy and a deep plane facelift?
Both lift the layer under the skin, called the SMAS, and not only the skin. In a SMASectomy, a strip of the SMAS is removed and the edges are stitched together. In a deep plane facelift, the surgeon works under the SMAS, releases it, and lifts it together with the skin. Dr. Ovadia commonly uses the SMASectomy because of how patients look afterward: the face looks natural and moves normally. The technique for your surgery is part of your surgical plan.
Will I look pulled or different?
A pulled look comes from tightening the skin. In Dr. Ovadia's facelift the lift is carried by the layer under the skin, and the skin is laid back down without tension. The goal is that you look like yourself, rested and younger, with a face that moves normally.
What is the difference between a facelift and a neck lift?
A facelift lifts the cheeks, jowls, and jawline. A neck lift treats loose skin, bands, and fullness in the neck. The layer that is tightened in a facelift continues into the neck, so in most people the two are done together through the same incisions. A neck lift can also be done on its own when the neck is the main concern.
What is a mini facelift?
A mini facelift uses a shorter incision and lifts less. It can suit early jowls when the neck is still firm, and it does less for the neck. Dr. Ovadia tells you at your consultation whether a shorter incision would give you the change you are looking for.
Where are the scars?
Usually under the sideburn, in the natural lines in front of the ear, around the earlobe, and behind the ear into the hair. When the neck needs more work, there is also a short scar just below the chin that runs side to side. The placement depends on your anatomy and on the amount of skin that needs to be removed, and other incisions are sometimes used. Dr. Ovadia shows you where your incisions will be.
How long does a facelift last?
A facelift does not stop aging, but it sets the clock back. The face keeps aging from its new starting point, so you continue to look younger than you would have without surgery. Sun protection, a stable weight, and not smoking help the result last.
What is the best age for a facelift?
There is no single right age. What matters is what has changed in your face and neck, what you want to change, and your health. Dr. Ovadia goes over whether a facelift is the right operation for you now.
How long is the recovery?
Most people are comfortable being seen in public at 10 to 14 days, once the sutures and staples are out and most of the bruising has faded. The last of the swelling, tightness, and numbness takes a few months to settle. Everyone heals differently.
Why does nicotine matter?
Nicotine narrows the small blood vessels that keep the lifted skin healthy. It raises the risk of slow healing, loss of skin near the incisions, and worse scars. This includes cigarettes, vaping, patches, and gum. Dr. Ovadia tells you how long before and after surgery you need to be free of nicotine.
Can fillers or skin treatments do the same thing?
They do different things. Fillers add volume, and lasers and peels improve the surface of the skin. None of them removes loose skin or lifts jowls and a loose neck the way surgery does. They can be useful before a facelift is needed, or alongside one.
Can a facelift be combined with other surgery?
Yes. It is often done together with eyelid surgery, a brow lift, or fat grafting to the face. Whether it is safe to combine procedures depends on your health and how long the operation would be.
Does insurance cover a facelift?
A facelift is cosmetic surgery, and insurance is unlikely to cover it. You receive a quote after your consultation.
Can I have a consultation without coming to the office?
Yes. Phone and video consultations are available, in addition to in-person visits in New York City, Jersey City, and Millburn, New Jersey.
Next step
Start with a consultation
Dr. Ovadia will examine your face and neck, go over what you are hoping to change, and explain what a facelift, a neck lift, or a combination with other surgery would do for you.
225 Broadway, Suite 3100, New York, NY
377 Jersey Ave, Suite 440, Jersey City, NJ
90 Millburn Ave, Suite 206, Millburn, NJ
Phone and video consultations available · info@ovadiaps.com