Skip to content

Facial feminization: facelifts

facelift or rhytidectomy is a surgical procedure designed to improve the most visible signs of the aging process by eliminating excess fat, tightening the muscles beneath the skin of the neck, and removing sagging skin. It doesn’t stop the aging process but merely “sets the clock back”.

Those under 35-40 will have limited benefit from a facelift, although a brow lift often helps open up the face.

There are masculine and feminine patterns to aging, so a facelift can help you pass better. The older you are, the more dramatic the result will probably be. Some people, especially older patients, require a facelift to see the full result of bony facial work.

The Submusclar Aponeurotic System (SMAS) is a layer beneath the skin which invests the facial muscles. By tightening the SMAS, the jowls are lifted, the neck is tightened, the cheeks are elevated. This “deep” or “2-layer” facelift is an improvement over earlier skin-only techniques.

No one can say for sure how long the results will last. The clock is turned back, but keeps on running. Ten years later, you will look better than if you never had surgery. Many patients never have a second lift, while others may desire further surgery seven to 15 years later.

The scars from facelift surgery usually fade and are barely perceptible. They usually cut in the crease right behind the ears and back into the hairline.. The incision usually continues around to the front of the ear. The scar goes from under the lobe and behind that little flap you push down on to plug your ears (the tragus). In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.

Most patients are able to return to work in two to three weeks. You should allow four to eight weeks before major social engagements.

Your surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that you can use almost immediately to disguise them. Generally speaking, makeup techniques can be used soon after surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage cosmetics include three basic types of products: Concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin. Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel its well worth the effort.

It’s very hard to get rid of the deep cheek folds that extend from the corner of the nose to the corners of the mouth (nasolabial folds), but a facelift can help reduce this. This area seems to make a difference in passing.

The American Society of Plastic Surgery has a good overview with illustrations of the procedures. has a good gallery of photos from patients at varying ages.