What is a facelift?

A facelift, or a lower face and neck lift, is a surgical procedure that repositions and removes excess and droopy face and neck tissue to produce a younger and more refreshed appearance.

The three areas that are generally improved by a facelift are:

– the jowls

– submental fat

– platysmal neck bands

What are the different types of facelift?

There are as many types of facelift as there are surgeons in the world, making information on this procedure confusing and difficult to find for patients when they do internet searches.

Being a specialized facial surgeon, Dr. Moubayed performs all types of facelift in Montreal. Moreover, Dr. Moubayed recently published a medical textbook on Facial Plastic Surgery. On this page we will try to explain all types of facelift to you:

  1. Skin-only facelift: removal of excess face and neck skin. This technique has a high rate of relapse and necrosis and is generally not performed.
  2. Mini-facelift: short incisions are practiced in front and behind the ear, with minimal dissection to reposition facial skin and muscles. Faster recovery but not all patients are good candidates.
  3. Repositioning face and neck lift (SMAS-plication or imbrication): incisions in front and behind the ear, as we all hairline incisions are practiced to reposition face and neck tissue in a position producing a younger and more refreshed look.
  4. Deep-plane facelift: considered by many as the most powerful facelifting technique. Similar to repositioning facelift, but an additional dissection is practiced under the muscles of facial expression to reposition them in a more durable and precise fashion. Technique that requires advanced knowledge of facial anatomy as it is performed right above the facial nerve that enables facial movement.
  5. Facelift with submental liposuction: Similar to previous techniques, but combines a small incision under the chin enabling removal of submental fat.
  6. Facelift with fat injections: In addition to the aging effects of gravity, patients also suffer from fat deflation in the face. Facelift with fat injections is similar to preior techniques, but combines fat injections (usually harvested in the abdomen) to restore facial volume in the aging face.
  7. Facelift with facial implants: The best facelift candidates are those with a strong facial structure. To optimize the results of facelifting, facial implants at the level of the cheeks and chin can sometimes be offered by Dr. Moubayed.
Facial nerve

The deep-plane facelift dissection resides right above the facial nerve that makes the face move
Source: Moubayed et al., Facial Plastic and Reconstructive Surgery: Concepts, Questions, Answers, 1st ed.

What types of facelift does Dr. Moubayed perform?

Dr. Moubayed performs six types of facelift: mini-facelift, repositioning neck andfacelift, deep-plane facelift, facelift with submental liposuction, facelift with fat injections, and facelift with facial implants.

What are the risks of a facelift?

Like any surgery, a facelift presents the universal (but minimal) risks of scarring, bleeding (and bruising), infection (superficial or deep), and pain (temporary or permanent).

However, the main risk of any cosmetic surgery is to not be satisfied with the result. After a proper consultation that includes a complete examination and photo evaluation, Dr. Moubayed can generally produce the results desired by the patient. However, we do not control the healing of tissues, and some patients heal in an unpredictable way producing asymmetries or irregularities that can sometimes require touch-ups.

Any facelift involves the risk of producing paralysis of a facial nerve branch, temporary (and sometimes permanent) numbness of the face or ear (via the great auricular nerve), hair loss, and changes in skin pigmentation.

Dr. Moubayed is a surgeon that is exclusively trained in facial surgery. He has a conservative and individualized approach with each patient. All patients are followed closely after surgery with very precise and very clear instructions. All of this is done in order to minimize the risks listed above.

What happens during a consultation?

A consultation starts with a complete history and physical examination. Photos are taken and analyzed with your surgeon. This is an essential communication tool as some patients want changes that are not always possible in surgery.

Then, we talk about surgery and recovery, and Dr. Moubayed answers any and all questions you may have.

Multiple consultations are sometimes necessary before deciding to proceed with surgery. Cosmetic facial surgery is an important decision to make and it is important that you are well informed before proceeding with it.

How do I prepare myself for a facelift consultation?

It is a good idea to prepare yourself for your consultation and this is easily done.

First, prepare to list in order of importance the elements you would like to improve in your face: jowling, submental fat, neck platysmal bands, among others. Do you find you have weak cheekbones or a weak chin ? Are there any other regions that bother you in your face such as your eyebrows, eyes, nose, or lips?

Finally, if you have had cosmetic soft tissue fillers to the face, try to find out which products were injected and when. If you have already had facial surgery, try to bring with you the operative report of your prior procedures if this is possible.

How long does it take to perform a facelift in Montreal?

Facelift surgery is synonymous with safety, finesse, and precision. When it is practiced using modern techniques that enable maximal control, it takes approximately between two and four hours.

Ideal face and neck proportions

Source: Moubayed et al., Facial Plastic and Reconstructive Surgery: Concepts, Questions, Answers, 1st ed.

What type of anesthesia do you use?

Facelift can be performed under local anesthesia, local anesthesia with sedation, or general anesthesia, depending on the extent of surgery and the patient’s wishes.

For general anesthesia, the type of anesthesia used is total intravenous anesthesia (without using anesthetic gases). This type of anesthesia is safe and helps reduce nausea and coughing after surgery. Our patients often report how positive their anesthesia experience was.

How long is recovery from a facelift?

Patients leave the surgical center the same day and recover at home with plastic drains (to prevent blood accumulations under the skin) and a big dressing around the face.

Your first appointment happens on the day after surgery where your surgeon removes your drains and examines your wound. Very precise and very clear wound care instructions are given and your stitches are removed 5 to 7 days later.

You should expect most bruising to disappear or be easily concealable after three weeks before returning to your daily activities.

Light physical activity can be resumed after a week, but for more vigorous activities like weightlifting, it is recommended to wait three weeks to minimize bleeding risk.

How long am I swollen after a facelift?

After three weeks, you will be presentable in society. Most of the swelling will disappear during the first three months, but minimal can swelling can persist up to a year.

How do I find the best surgeon for a facelift in Montreal?

It is important to look at multiple factors during your facelift surgeon choice:

1- Does your surgeon have specific expertise in facial surgery and anatomy to be able to protect your facial nerve and minimize complications?

2- Can your surgeon perform all types of facelift to be able to choose which one is most adapted to your needs?

3- Did you have a positive experience and feel comfortable during your consultation?

Are there non-surgical or minimally invasive alternatives to a facelift?

Certain carefully selected patients can benefit from minimally invasive injectable fillers or resurfacing procedures and obtain excellent rejuvenation results.

However, nothing replaces a consultation with a doctor that can offer the whole breadth of non-surgical and surgical facial rejuvenation procedures to be able to determine which one is best suited for your individual face.

Dr. Moubayed can counsel patients on the best individually-tailored type of procedure according to their facial aging profile.

Four ways to know if you’re a good candidate for a facelift

1- Your face shows signs of aging (jowling, submental fat, platysmal bands)

2- You have realisting expectations

3- You are in good health

4- You do not smoke

How do I contact Dr. Moubayed for a consultation?

  • Drop files here or