What Is a Facelift — and Is It Right for You?
A facelift (also called a rhytidectomy) is a surgical procedure that lifts and firms sagging facial tissue to restore a more youthful appearance in the lower face and neck.
Here’s what you need to know at a glance:
- What it treats: Jowls, loose neck skin, deep nasolabial folds, sagging cheeks, and loss of jawline definition
- What it does NOT treat: Fine lines, skin texture, sun damage, or the upper face (brows and eyelids need separate procedures)
- Procedure time: Typically 3–6 hours
- Recovery: Most people return to work in 1–2 weeks; full recovery takes 4–6 weeks
- Results: Long-lasting — often 10 or more years depending on technique and lifestyle
- Starting cost: $8,000 or more
Gravity is relentless. Over time, skin loses elasticity, facial fat shifts downward, and muscles loosen. The result? Jowls form, the neck softens, and the face starts to look tired — even when you feel anything but.
For many people in New Jersey, that gap between how they look and how they feel is exactly what brings them to consider a facelift.
It’s one of the most impactful procedures in facial rejuvenation — and one of the most misunderstood. Done well, results look natural and last for years. Done poorly, or chosen for the wrong reasons, the outcome can fall short of expectations.
This guide covers everything you need to make a confident, informed decision: the anatomy behind the surgery, the techniques surgeons use, who is a good candidate, what recovery actually looks like, and what results are realistic.
I’m Dr. John A. Cece, a fellowship-trained plastic surgeon who completed my Aesthetic Surgery Fellowship at Manhattan Eye, Ear, and Throat Hospital, where I trained under world-renowned leaders in facelift and facial rejuvenation surgery. I bring that advanced expertise to every facelift consultation and procedure here at The Plastic Surgery Group of New Jersey.
What is a Facelift (Rhytidectomy)?
To understand what a facelift can do, we must first look at how the face ages. Facial aging is not a single-layer issue. It is a complex, multi-dimensional process involving the skin, subcutaneous fat, underlying musculature, and even bone structure.
As we age, our skin loses collagen and elastin, leading to progressive skin laxity. Concurrently, the deep fat pads of the face — particularly the malar (cheek) fat pad — begin to descend. This descent accentuates the nasolabial folds (the lines running from the nose to the corners of the mouth) and leads to the formation of jowls along the jawline. In the neck, the platysma muscle loses its tone, resulting in vertical bands and a loss of the youthful, sharp cervicomental angle.
A rhytidectomy is designed to surgically address these structural changes. According to the Mayo Clinic Guide to Face-lifts, the procedure focuses on reducing sagging skin and smoothing folds of skin on the cheeks and jawline. Rather than simply pulling the skin tight — which can lead to a windswept, unnatural appearance — a modern facelift targets the deeper tissues to lift, reposition, and secure them in a more youthful anatomical position.
As detailed in the Facelift Overview on MedlinePlus, a traditional surgical approach involves lifting the underlying muscle and connective tissue layer, removing excess fat, and trimming away redundant skin.
It is equally important to understand what a facelift cannot do. As outlined in the Facelift Surgery Guide by ASPS, a rhytidectomy cannot halt the biological aging process, nor can it alter your fundamental skeletal structure. It does not address fine surface wrinkles, sun damage, or pigmentary changes. For those concerns, we often recommend adjunctive treatments like medical-grade skincare, chemical peels, or laser resurfacing.
Key Anatomical Landmarks and Surgical Techniques
A successful, safe, and natural-looking facelift requires an intimate, microscopic understanding of facial anatomy. The face is a dense network of nerves, blood vessels, and muscles, all organized into distinct layers.
When we perform a rhytidectomy, we must navigate several critical anatomical landmarks:
- The SMAS (Superficial Musculoaponeurotic System): First defined in 1976, the SMAS is a continuous, fibrous, and muscular layer that envelops the deeper structures of the face and neck. It is the anatomical “anchor” of a modern facelift. By lifting and tightening the SMAS, we can restore the midface and jawline without putting tension on the skin.
- The Facial Nerve: This is the most critical motor nerve in facial surgery. It exits the skull and branches out across the face to control facial expressions. To avoid injury, we use specific surgical landmarks. For example, we reference Pitanguy’s line — a line drawn from 0.5 cm below the tragus of the ear to 1.5 cm superior to the lateral brow — to map the precise path of the temporal/frontal branch of the facial nerve.
- The Great Auricular Nerve: This sensory nerve provides feeling to the lower earlobe and surrounding skin. To protect it, we identify McKinney’s point, located one-third of the distance from the mastoid tip to the clavicular head of the sternocleidomastoid (SCM) muscle.
- Retaining Ligaments: The zygomaticocutaneous and massetericic ligaments act as anchor points, pinning the facial tissues to the underlying bone. To achieve a comprehensive lift, these ligaments must be carefully released.
For a deeper dive into these anatomical relationships, you can consult the Cervicofacial Rhytidectomy Anatomy on StatPearls.
To tailor the procedure to each patient’s unique anatomy, we utilize several distinct surgical approaches. Below is a comparison of the primary techniques we use, which are also detailed in our Facelift 101 Guide to 7 Types.
Surgical Techniques Comparison
| Technique | Target Area | Dissection Depth | Ideal Candidate | Recovery Time |
|---|---|---|---|---|
| Traditional SMAS Lift | Lower face, jawline, and neck | Sub-SMAS or SMAS plication | Moderate facial sagging and jowling | 2–3 weeks |
| Deep-Plane Facelift | Midface, cheeks, jowls, and neck | Sub-SMAS beneath the retaining ligaments | Moderate to severe laxity, midface descent | 2–3 weeks |
| MACS / Mini Facelift | Lower face and early jowls | Limited subcutaneous dissection | Mild aging signs, younger patients | 1–2 weeks |
| Skin-Only Facelift | Skin envelope only | Subcutaneous (above SMAS) | Rarely performed; short-lived results | 1 week |
The Deep-Plane Facelift Technique
The deep-plane facelift is widely regarded as the gold standard for comprehensive, natural-looking facial rejuvenation. Unlike traditional techniques that lift the skin and the SMAS layer separately, the deep-plane approach enters the space beneath the SMAS muscle layer directly.
By operating in this deeper plane, we can release the retaining ligaments that bind the facial tissues to the bone. Once these ligaments are released, the entire composite unit of muscle, fat, and skin can be repositioned vertically as a single, tension-free layer.
This technique offers several distinct advantages:
- No “Pulled” Look: Because the skin remains attached to the underlying muscle layer, there is zero tension on the skin itself, avoiding the telltale “windswept” appearance.
- Midface Restoration: It effectively lifts the fallen malar fat pad, restoring youthful volume to the cheeks without the need for excessive dermal fillers.
- Exceptional Longevity: Repositioning the deep muscular structure provides results that typically last 10 to 15 years.
Many patients seeking the Best Deep Plane Facelift Surgeons travel to our Montclair, NJ facility, selecting this technique for its unparalleled, natural elegance.
The Mini Facelift and Short-Scar Options
For patients exhibiting earlier signs of aging, a full deep-plane procedure may not be necessary. In these cases, we often recommend a mini facelift or a Minimal Access Cranial Suspension (MACS) lift.
The MACS lift utilizes a shorter incision that starts in front of the ear and does not extend behind the earlobe. Using specialized purse-string sutures, we suspend the sagging deeper tissues vertically. This technique is highly effective for correcting mild jowling and restoring jawline definition with minimal downtime.
To learn more about how these limited-incision options compare, you can read our S Lift Mini Facelift Overview.
However, we always remind our patients: “mini” procedures generally produce “mini” results. If you have significant neck laxity or deep facial folds, a comprehensive SMAS or deep-plane approach will yield a far more satisfying and durable outcome.
Candidacy, Preparation, and Surgical Risks
The best candidates for a facelift are individuals who are in good overall health, do not smoke, and have realistic expectations. While most patients are in their 40s, 50s, or 60s, we successfully perform this procedure on patients well into their 70s and 80s, provided they are medically cleared. The key physical requirement is that the face and neck have begun to sag, but the skin still retains some degree of natural elasticity.
Contraindications and Risks
A thorough preoperative evaluation is essential to minimize risks. Certain medical conditions serve as temporary or absolute contraindications:
- Smoking and Nicotine Use: Nicotine is a potent vasoconstrictor. It severely restricts blood flow to the healing skin flaps, drastically increasing the risk of skin necrosis (tissue death) and severe scarring. We require absolute cessation of all nicotine products (including vapes and patches) for at least 4 to 6 weeks before and after surgery.
- Uncontrolled Hypertension: High blood pressure is the primary risk factor for a postoperative hematoma (a collection of blood under the skin). If a hematoma forms, it usually occurs within the first 24 hours and may require a quick surgical drainage to protect the skin flap.
- Blood-Thinning Medications: Aspirin, NSAIDs, fish oil, and certain herbal supplements increase bleeding risks and must be discontinued at least two weeks prior to surgery.
During your consultation at our office in Montclair, New Jersey, we will carefully review your medical history to ensure your safety.
Pre-Operative Preparation Checklist
To ensure an optimal outcome and a smooth recovery, we ask our patients to follow these essential steps:
- Medical Clearance: Obtain a physical exam, blood work, and an EKG (if indicated) from your primary care physician.
- Medication Adjustment: Stop taking aspirin, ibuprofen, vitamin E, and herbal supplements 14 days before surgery.
- Nicotine Cessation: Maintain strict avoidance of all nicotine and tobacco products.
- Skin and Hair Care: Wash your face and hair with a germ-killing, chlorhexidine soap the night before and the morning of surgery. Do not color or perm your hair for at least one week before surgery (as you must wait 4 to 6 weeks post-op to do so again).
- Post-Op Support: Arrange for a responsible adult to drive you home and stay with you for the first 24 hours after your procedure.
Recovery Timeline and Long-Term Results
Healing after a facelift is a gradual process that requires patience. While every patient heals at their own pace, we prepare our patients with a standard recovery roadmap.
The First 14 Days: Managing the Peak Phase
- Days 1–2: You will wear a supportive facial wrap. Swelling and bruising will begin to peak. Pain is typically mild to moderate and is easily managed with prescribed medication.
- Days 3–5: The initial dressings are removed in our office. You can gently wash your hair with mild baby shampoo. Swelling may look asymmetrical; this is entirely normal.
- Days 7–10: Sutures are carefully removed. Bruising will begin to fade, often shifting from purple to yellow, and can be easily camouflaged with mineral makeup.
- Days 10–14: Most patients feel comfortable returning to work and light social activities.
Weeks 3–6: Returning to Normalcy
- Weeks 3–4: Light cardiovascular exercise (such as walking) can be resumed. Swelling will continue to diminish, and your facial contours will begin to refine.
- Weeks 4–6: You can resume strenuous exercise, heavy lifting, and normal styling of your hair. Residual numbness around the ears and cheeks will gradually resolve over the coming months.
To see what realistic healing looks like, we encourage you to view our Before and After Facelift gallery.
Scar Management and Longevity
Our surgeons place incisions with meticulous precision, hiding them within the natural contours of the hairline, around the curves of the ear, and beneath the chin. Over time, these scars fade into thin, nearly imperceptible lines.
To optimize healing, we provide detailed instructions on Facelift Scars After Surgery, which includes using medical-grade silicone gel and practicing strict sun protection.
While a facelift cannot stop the clock, it effectively resets it. You can realistically expect to look 10 to 15 years younger. Your face will continue to age naturally, but you will always look significantly refreshed compared to if you had never had the procedure.
Frequently Asked Questions about Rhytidectomy
What is the typical cost of the procedure?
The price of a facelift can vary widely based on the complexity of the surgery, the technique chosen, and whether it is combined with other procedures. Generally, the price range starts at $8,000 or more. This total typically includes the surgeon’s fee, anesthesia fees, and state-of-the-art surgical facility costs. During your personalized consultation, we will provide an exact, all-inclusive quote.
Can this surgery be combined with other facial procedures?
Absolutely. In fact, most patients achieve their most harmonious, natural results by combining a facelift with complementary procedures.
Because a rhytidectomy primarily addresses the lower two-thirds of the face, patients often choose to combine it with a Services Facial Procedures Forehead Lift to address a heavy brow, or blepharoplasty (eyelid surgery) to refresh tired-looking eyes.
Additionally, a Services Facial Procedures Neck Lift is almost always integrated into the procedure to ensure a seamless, youthful transition from the jawline to the collarbone. We also frequently utilize facial fat grafting (fat transfer) to restore youthful volume to hollow cheeks and temples.
How long do surgical results typically last?
The longevity of your results depends heavily on the surgical technique used and your lifestyle. A deep-plane or comprehensive SMAS facelift typically lasts 10 to 12 years, and often longer.
To maximize the longevity of your results, we recommend maintaining a stable weight, adhering to a medical-grade skincare regimen, avoiding smoking, and wearing daily broad-spectrum sun protection.
Your Next Step Toward a Naturally Refreshed Look
Gravity may be constant, but you do not have to let it dictate how you look and feel. A beautifully executed facelift can restore your natural, youthful contours, helping you project the energy and vitality you feel on the inside.
At The Plastic Surgery Group of New Jersey, our highly regarded, board-certified plastic surgeons — including Dr. Rosen and Dr. Ablaza — specialize in delivering elegant, natural-looking results. We operate out of a state-of-the-art facility in Montclair, NJ, offering our patients from New Jersey and the greater Manhattan, New York area an unparalleled, safe, and transformative experience.
To meet our exceptional team, please visit Our Team Doctors page, or learn more About Us.
Are you ready to take the next step toward a refreshed, confident you? We invite you to Contact Us today or Schedule a Facelift Consultation to discuss your personalized rejuvenation plan.
