Surgical Incision
Individuals considering a facelift often express concern about the planned surgical incision and associated scar. However, following surgery, the scar is rarely a concern.

With proper planning, careful placement of incisions, meticulous technique and appropriate aftercare, facelift incisions heal reliably well. Patients are routinely satisfied with the imperceptible nature of their incisions sites, and consider the subtle scars to be a very reasonable tradeoff to obtain the improvement sought in terms of facial and neck laxity.

The surgical incision typically begins in front of the ear, where it follows the natural skin crease separating the cartilage part of the upper ear from the facial skin.
The incision then follows the curvature of the ear, behind the tragus which is situated just in front of the ear canal. The incision then follows the natural crease around the earlobe and in the crease behind the ear. Depending upon the need for neck lifting, the incision may course into the hairline behind the ear.

Before, Planned incision site, Appearance at weeks 1, 2, 4, 8.

Dr. Pearson's Technique - Treatment of the Neck

As part of a facelift, the neck is usually treated as well. The platysma muscle is responsible for the appearance of neck laxity. Treatment of the platysma improves the neck contour. Treatment of the platyma muscle imparts a more significant, natural, and long-lasting result. This is typically performed through a discreet skin incision concealed within the natural crease behind the chin.

Complementary Procedures
Liposuction and fat sculpting of the area underneath the chin is often performed during a facelift. In addition facial sagging and jowling, facial volume is diminished during the aging process.

Fat transfer (also called fat grafting) may be performed at the same time as facelift surgery. This technique uses your own living fat cells from another body site to restore regions of facial volume loss to more youthful proportions. When appropriate, fat can be transferred from the abdomen, buttocks, or thighs.

Upper Facial Rejuvenation may be undertaken at the same time. A lateral Brow Lift (also called "Temporal Lift") may complement a Facelift by improving lateral brow sagging and 'hooding' apparent at the outer upper eyes.

A Lip Lift may be considered to improve the peri-oral appearance and balance in the lip region. In many individuals, by the time a facelift is indicated, some degree of apparent upper lip elongation accompanies the age-related facial changes.

Skin resurfacing is often coupled with a Facelift, intended to improve skin surface irregularities such as fine lines, sallow skin appearance, uneven skin tone, or to improve the appearance of so-called 'age spots.' Laser Resurfacing, Chemical Peel and/or Dermabrasion may be considered.

Possible Non-surgical Alternative Treatments
Subtle signs of aging may be amenable to minimally invasive methods to rejuvenate the lower face. Dr. Pearson offers a full range of nonsurgical procedures including facial skin resurfacing, Botox treatments, and volume replacement with a variety of injectable fillers, such as Juvederm, Restylane and/or Sculptra.

Caution is advised regarding 'Energy-Based Treatments'
Caution is advised for those considering energy-based 'lifting' or 'tightening' facial rejuvenation procedures. Understandably, there is a strong demand for non-surgical options to improve the appearance of sagging facial skin. There are multiple FDA-approved devices which are heavily marketed as providing 'non-surgical' alternatives to a Facelift. These devices use laser, radiofrequency, or ultrasound energy in an attempt to 'lift' sagging facial skin. Often, patients are left disappointed because the results that they had expected are generally not consistent with the results they experience. Most of these non-surgical options are relatively expensive, performed by non-physicians, and deliver results that are typically so subtle that they are often difficult to discern.

Dr. Pearson does not offer or endorse any of these treatment modalities.

If you are considering one of these options, do your homework. Speak with individuals who have themselves undergone the treatment that you are considering. Ask to see photos which depict the average result obtained by the practice offering the treatment. Are results guaranteed? Ask about how you will be handled if no result or an unsatisfactory result is obtained. We have met many, many patients who have undergone such non-surgical, energy-based treaments, who then experienced disappointing results, and who were then told that they should undergo the treatment a second time or to wait for many months for a result to appear.

Ultimately, those patients desiring a discernible result typically undergo a traditional Facelift after all, but not before much frustration, wasted expense and lost time.

Recovery after Facelift Surgery
Following a facelift, you can expect a few days of swelling and soreness which is well controlled with oral pain medications. Most sutures are typically removed between days 5 and 7. Makeup can be used at this point to camouflage any bruising or scars. Swelling and bruising generally subside by 7-10 days. You can resume most normal activities after a couple of days, except for intense exercise, which may be resumed at about 3 weeks. Most people are able to return to work with confidence in 10-14 days. Facelift scars are usually not noticeable after enough time has passed for them to mature (see below). In any case, they are easily disguised in natural skin creases and by one's hairstyle.

A Customized Approach
Dr. Pearson's technique is to customize the Facelift procedure to each individual. In our practice, there is no 'cookie-cutter' approach to facial rejuvenation. Each patient's starting appearance including skin laxity, fat accumulation, volume loss, jowling, neck laxity, neck banding, and preferences are considered carefully and factored in to a plan for rejuvenation.

Results Matter Achieving an outstanding result for your facelift is our highest priority. Dr. Pearson has a long track record of achieving oustanding, natural results. View our Facelift patients' reviews and Review our Photo Gallery of Dr. Pearson's Facelift results.

The Aging Process

As part of the normal aging process, the face undergoes several changes concurrently. There are skin changes including loss of elasticity, development of fine lines and wrinkles, and age-related skin color irregularities. Separately, there is loss of the youthful fullness and gentle convex contour that accompanies youth. In other areas, there is an accumulation of fat. This is especially common in the submental area underneath the chin.

In addition, there is an apparent deepening of facial creases including those around the mouth. Jowls appear along the jawline, so that a formerly smooth jawline is replaced with sagging tissue at the mid-jaw. Overall, the heart-shaped face reminiscent of youth, defined by an oval-shaped jawline on frontal view, is replaced by a more bottom-heavy, square-shaped lower face reminicent of aging.

Some of these changes can be addressed at their early stages with non- or minimally-invasive procedures. For a more lasting or definitive result, a Facelift may be considered.

What is a Facelift?

The term Facelift may have multiple meanings. In general, a Facelift implies surgical treatment of lower facial and neck laxity which involves an incision around the ears, and which enables tightening of the lower facial and neck muscles and often removal of excess skin.

Similar terms for a Facelift include: 'Lower Facelift', 'Face and Neck Lift'.

Modifications of a typical facelift may include:

• Full Facelift = usually means a Facelift and upper facial rejuvenation such as a Brow Lift.
• Mini Facelift = usually means skin tightening without muscle tightening. Although, some people use the term 'Mini' to denote a Facelift in situations when minimal laxity is present.

What types of Facelifts does Dr. Pearson perform?

Dr. Pearson does not perform one type of facelift. Dr. Pearson's Facelift is customized for each person depending on their age, skin type, degree of laxity and preferences. Dr. Pearson performs: mini-Facelift, SMAS Facelift, deep-plane Facelift, among other types. During your consultation, Dr. Pearson will explain which approach may be preferable for your situation.

Which Facelift technique is Dr. Pearson's preferred and most-commonly employed method for the Facelift?

Dr. Pearson prefers and most commonly uses the 'Extended Deep Plane Facelift' technique. The Deep Plane Facelift affords more significant improvement in the appearance of facial laxity, a more natural appearance, and greater longevity than most other approaches.
The Deep Plane Facelift technique involves release of those facial ligaments which tether the facial muscles in an unfavorable position, thus allowing re-draping of the facial soft tissues in a natural-appearing and lasting manner.
The 'Extended' Deep Plane Facelift approach extends into the neck the same ligament-releasing and muscle-tightening approach.

Does Dr. Pearson tighten the muscle during the Facelift?

In most cases, yes. Muscle tightening imparts greater longevity, more substantial improvement of facial and neck laxity, less skin tension, and improved surgical scarring among other benefits.

Where is the Facelift performed?

When IV sedation is used, Dr. Pearson performs Facelifts in an accredited Ambulatory Surgery Center (ASC). Compared with a hospital setting, an ASC offers the advantages of lower cost, improved privacy and personalized attention.

What type of Anesthesia is used for a Facelift?

Several options are available for anesthesia during your Facelift. Most patients choose to have deep sedation (twilight) or general anesthesia. However, options including local anesthesia alone and light sedation are available. The advantages of deeper anesthesia include improved comfort, decreased operative time and enhanced ability to achieve a superior result.

Where are surgical incisions placed?

In general, Facelift incision placement is planned for in front of and behind the ear, then adjacent to the hairline behind the ear. A small incision is also planned for placement in the crease between your chin and neck. The particulars of your incision will depend on your anatomy and surgical goals. Dr. Pearson will customize the incision site placement to your face. See the graphic on this page for a more detailed explanation of Dr. Pearson's Facelift incision.

What type of surgical scar may I expect?

When surgical incision sites are carefully planned, meticulously performed, and appropriately cared for, Dr. Pearson's Facelift scarring is typically inconspicuous. Once sutures are removed, temporary pink discoloration of the incision sites may be concealed using makeup and / or hair styling. Once healed, scars are concealed within natural skin creases and the hairline rendering them usually imperceptible in social situations. Scarring depends on your own intrinsic healing, which Dr. Pearson will discuss with you.

Is the neck included in a Facelift?

In most cases, the neck is part of the Facelift procedure. Dr. Pearson will explain this in person during your consultation.

Can a Neck Lift be performed alone, without a Facelift?

Yes. However, in most cases, laxity of the lower face develops simultaneously as neck laxity. As a result, most Neck Lift candidates are usually also candidates for a Facelift. In addition, including the lower face during a Neck Lift usually helps to minimize 'bunching' of skin near the ears. There are several advantages associated with combining a Neck Lift with a Facelift. During your consultation, Dr. Pearson will explain how this may apply in your particular case.

Are there risks involved with Facelift surgery?

Yes. During your consultation, Dr. Pearson will discuss with you the potential risks of surgery. Precautions are taken to minimize risks. Most patients do not experience complications. As a Board-Certified Facial Plastic Surgeon, Dr. Pearson's surgical practice is limited to the Face and Neck. We believe that our high level of sub-specialization and practice focus enables us to minimize risks associated with Facial Plastic Surgery.

Am I a candidate for a Facelift ?

If you are concerned with the appearance of facial and/or neck laxity, you may be a candidate for a Facelift. Several factors are considered as to an individual's candidacy for a Facelift.

Ideal candidates for facial plastic surgery demonstrate the following characteristics:

• Are generally healthy
• Do not smoke or use tobacco
• Have a positive outlook
• Have reasonable expectations about what can be accomplished with surgery
• Understand and accept the risks and limitations of surgery

RESULTS

How will I look after my Facelift? How much of an improvement may I reasonably expect?

During your consultation, Dr. Pearson will demonstrate to you in the mirror what you can expect from a Facelift.

Will I look like I had cosmetic surgery?

This is a common concern among individuals considering a Facelift. In short, once the early swelling and skin discoloration has resolved, onlookers typically cannot tell that our patients underwent cosmetic surgery. Dr. Pearson is sought after specifically for his ability to achieve natural results.

How a Facelift is performed makes a world of difference as to the results achieved. Careful incision site planning, meticulous surgical technique and avoidance of tell-tale signs of surgery are crucial. A natural appearing Facelift cannot be overdone; there should be no pulling, or windswept appearance. View our Photo Gallery to see a sampling of Dr. Pearson's Facelift Results.

How Long Will My Facelift Last?

Dr. Pearson will discuss this with you at the time of your consultation. The results of your Facelift are permanent. However, no surgical procedure can stop the aging process. Dr. Pearson's technique includes tightening of the facial muscle layer, which adds substantial longevity to the lift. For most people with normal skin elasticity, our patients enjoy a period of 7-10 years before they notice enough recurrent skin laxity to warrant further surgical treatment.

PREPARATION

How can I prepare for my Facelift?

During your pre-operative visit, detailed instructions for pre operative preparation are provided and discussed. Prescriptions and supplies are also provided at that time.

What type of pre-operative testing is requested?

Pre operative testing is performed within about 30 days of one's surgery date. Depending on one's age and medical history, such testing may include blood work, EKG and medical clearance by your doctor. If your doctor is unavailable, we have a trusted team of doctors and cardiologists who are available for medical and/or cardiac clearance.

How far out should I plan to schedule surgery?

In general, we schedule Facelift surgery 6 or more weeks in advance. During certain times of the year, more advance notice is needed. If you know your preferred time and availability, we can schedule months in advance to reserve your appointment.

RECOVERY AND HEALING

What may I expect following my Facelift? (First 24 hours)

• During your pre-operative visit, detailed instructions for aftercare are provided and discussed.
• On the day and evening of surgery, a caretaker should be available to assist with home care. This person does not need medical training.
• All Facelift patients are seen by Dr. Pearson on the morning after surgery. Dr. Pearson will demonstrate aftercare measures to be performed at home.

Will I have drains? Why?

In many cases, Dr. Pearson uses small drains which exit the skin within the hairline behind the ears. Those are removed on the morning after surgery. Removal takes a few seconds and is not painful. The benefits drains use include diminished bruising and faster resolution of swelling.

Recovery (after 24 hours)

• A bulky dressing is used for the first night only, and is removed on the morning after surgery. After that, a light elastic wrap is then used for a few days.
• Most patients use prescription pain medications for only a few days.
• Resume light activity at home the day after surgery. That includes caring for oneself, preparing food, and 10 minute walking sessions.
• You are advised to avoid exertion and straining activities during early recovery period.
• Most patients resume driving after 5-7 days once they are comfortable with their range of motion (head turning) and have discontinued prescription pain medications.
• By day 7, there is significant improvement in the expected peri-operative bruising and swelling.
• Sutures are removed between days 7-10
• By day 10-14, most patients feel that their appearance is acceptable to return to social appearances and work. Any residual swelling and/or skin discoloration may be concealed with makeup and hair styling.
• By 3 weeks, full exertion including exercise is resumed.
• By 4-6 weeks, most patients are pleased with the improvement in their appearance.

When can I return to work / Resume social appearances?

Most patients feel ready to return to work once they feel that their appearance is socially acceptable by day 10-14 (see above). By 4-6 weeks, most patients are pleased with the improvement in their appearance.

When can I resume exercise?

More intense exercise is typically resumed by 3 weeks. Depending on your swelling and healing progress, Dr. Pearson will advise you when exercise may be resumed in your case.

FINANCIAL CONSIDERATIONS

How much does a Facelift cost?

This is an individualized question. Each Facelift and/or Neck lift procedure is customized by Dr. Pearson to the individual's needs and preferences. Some cases require additional work and/or time to achieve optimal results. Consequently, the cost estimate varies accordingly. Following your consultation with Dr. Pearson, a customized quote will be provided.

The cost of a Facelift is substantial. However, people concerned with a diminished facial appearance related to facial and/or neck laxity consider the cost to be very worthwhile. Dr. Pearson's patients report a very high rate of satisfaction with their results and the positive impact on their lives. See some of our Facelift Reviews here.

How do the finances work for cosmetic facial surgery?

If you choose to proceed with surgery, we will work with you to find an acceptable date for your procedure. A deposit is requested at that time to hold your date. Our office begins the pre-operative planning at that time, including pre operative testing, pre operative meeting with Dr. Pearson to discuss specifics and logistics of your procedure, etc. Final payment is due a few weeks prior to surgery.