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Introduction

Are you looking older than you feel? Starting in the mid 40’s, signs of facial aging may start to accelerate. You may see deepening smile lines, formation of creases at the corners of the mouth, the beginning of jowls, drooping neck skin, and general sagging of the face and neck. If you are experiencing some of these changes and want to correct them, Facelift surgery with Board-Certified Plastic Surgeon Dr. Lawrence Tong may be the solution for you.

A Facelift is a facial plastic surgery procedure performed to improve the appearance of aging in the neck and face. Also called a rhytidectomy, this procedure lifts sagging skin, diminishes wrinkles, removes excess fat, and tightens the underlying musculature in the face and neck regions. Dr. Tong has extensive experience performing Facelifts, and can help you enjoy rejuvenation of the face and neck that looks natural, never too tight or “pulled.”

What are the Benefits of a Facelift?

The Facelift is the foundation for rejuvenation of the aging face and neck. Although the name might imply otherwise, a Facelift helps to restore a more youthful appearance to not only the face, but the neck as well. In fact, the benefits of a Facelift can be categorized into facial and neck improvements.1

Facial improvements:

  • Lifts and tightens the facial skin
  • Elevates the jowls (for a clean, sleek jawline)
  • Elevates descended cheek fat (for healthy, youthful cheek fullness)
  • Helps to smooth the folds in the corners of the mouth (marionette lines) and smile lines (nasolabial folds)

Neck improvements:

  • Loose neck skin is removed and tightened
  • Fat in the neck and under the chin is removed
  • The vertical ‘neck bands’ that are caused by neck muscle laxity are corrected
  • We encourage you to explore examples of Dr. Tong’s work in our facelift before-and-after photos.

Who is a Candidate for Facelift?

Men and women with visible signs of aging to the face and neck who want to look younger are typical candidates for Facelift surgery.

Those who can benefit from a Facelift include:

  • Patients that have moderate to advanced signs of aging in the face and neck
  • Younger patients with significant excess neck skin and/or fat, who may also have moderate facial aging
  • Patients who have lost significant weight and have substantial sagging of the face and neck

Additional criteria:

  • Patients should be healthy and relatively fit
  • Smoking must be stopped at least 2 weeks prior to surgery and not restarted afterwards
  • Dr. Tong will evaluate your overall health status to make sure surgery is appropriate for you

Additional Facial Rejuvenation Options

A Facelift can provide significant rejuvenation of the face and neck, but may not address all areas of concern for certain patients. For a more dramatically refreshed appearance, Dr. Tong may recommend additional plastic surgery procedures to further enhance the results of a Facelift. Some common additional procedures are described below.

Rejuvenation of the Eyes, Brows, and Forehead

While a Facelift is an important component of facial rejuvenation, some patients incorrectly assume the procedure will also lift the brow and forehead (in addition to the face and neck). Although the forehead is part of the face, it is not affected by a Facelift procedure. A Brow Lift is a separate procedure that is commonly performed in conjunction with a Facelift.2

Likewise, neither the upper or lower eyelids are affected by a Facelift. Upper and lower eyelids may be lifted and rejuvenated with a Blepharoplasty procedure.3

As a person ages, facial volume (in the form of fat) typically diminishes. With these changes, the cheeks may sink, the eyes look hollow, and the overall youthfull plumpness of the face morphs to a more gaunt and aged appearance. Facial volume is an important factor in achieving a youthful appearance, and carries an almost equal importance to facial sagging. While a facelift mostly addresses facial sagging, Fat Transfer (or Fat Grafting) is another procedure that is performed in conjunction with a Facelift to provide a more complete rejuvenation.

Other options for Rejuvenation of the Neck

A Facelift performed by Dr. Tong is designed to improve the contour of the neck in conjunction with the face by tightening skin, removing a modest amount of fat, and correcting muscle laxity. If a patient wishes to solely focus on the neck (and not on the face), a Neck Lift procedure can be considered. A Neck Lift is most appropriate when there is , excess neck skin or inelasticity (sagging or loose neck skin). If loose skin is not a major concern but instead, redundant fat or extensive muscle banding are the major concerns, a Mini Neck Lift may be a more suitable treatment option to smooth the neck. Alternatively, redundant fat under the chin that is unaccompanied by skin or muscle laxity can simply be resolved with Chin and Neck Liposuction.

Mini Facelift

A Mini Facelift is an abbreviated form of a standard Facelift. It improves the appearance of the face from the jawline (including the jowls) to the upper cheeks at the level of the eyes. The rejuvenation consists of the correction of sagging skin (through removal of excess skin), trimming of jowl fat, and tightening of the underlying muscle layer. Unlike a standard Facelift, the Mini Facelift does not improve the appearance of the neck.

Dr. Tong understands that it can be easy for patients to feel overwhelmed by the range of facial plastic surgery options available to them. During your private consultation, he will take time to understand your unique goals and lifestyle before helping you arrive at the ideal treatment plan to meet your needs.

Non-Surgical Facial Rejuvenation

A Facelift is a powerful procedure that addresses the underlying causes of facial aging sby removing excess skin and tightening the remaining tissue. This improvement cannot be accomplished in an equivalent manner with minimally invasive enhancement options. While there are multiple surgical and non-surgical procedures to improve the appearance of aging in the face and neck, they do not produce the same results as a Facelift.

Non-surgical options, including injectables and dermal fillers, generally work well for younger patients or patients with lesser signs of aging. Patients who would like to restore facial volume can also benefit from these medical-grade spa treatments. From an anatomical perspective, these non-surgical procedures are most effective when there is minimal to no sagging or excess skin.

Details of the Facelift Procedure

Dr. Tong usually performs the Facelift procedure under general anesthesia or deep IV sedation. During the time you are under general anesthesia, you will be asleep and completely unaware of your surroundings. With IV sedation (‘twilight’) anesthesia, you may be aware from time to time, but should feel no discomfort.

Facelift surgery is performed in our CPSO-accredited surgical centre. To begin the Facelift procedure, incisions are made to expose the underlying muscle layer of the neck and cheeks. Dr. Tong tightens this underlying muscle layer, which elevates the descended cheek and jowl tissues. In the neck, he tightens the lax neck muscles to eliminate vertical banding and create a deeper angle under the chin. He also removes excess tissue from under the chin. The facial and neck skin is then re-draped to achieve a natural, non-operated look, and the incisions are meticulously stitched back together. Dr. Tong then places the last stitches, a Facelift dressing is applied, and the patient is gently awakened from anesthesia.4

Facelift Incisions

Depending on the nature of a patient’s unique treatment plan and aesthetic goals, the incision for a Facelift generally:

  • Starts at the earlobe, and travels upward along the natural curves of the edge of the ear
  • The incision continues into the hair of the temple for approximately 4 cm
  • An alternate incision that travels along the edge of the sideburns (following the hairline) may be used instead of one that goes into the hair
  • The incision may also travel along the back of the ear, near the fold where the ear meets the side of the head and slightly along the posterior hairline
  • A small incision is also made in the ‘double chin’ fold to access the fat and lax neck muscles at the midline of the neck

Any scars from Facelift surgery hide well because they blend into the natural curves and lines of the skin. Once the incisions have matured, the majority of patients are not concerned with visible Facelift scars.

Recovery After Facelift Surgery

Patients are strongly encouraged to stay in our overnight suites following a Facelift procedure. After the effects of anesthesia have largely worn off, the nurses will transfer you to our overnight stay centre. There, you will stay the night while being monitored by our registered nurses. They will ensure that you are comfortable, safe, and have your needs attended to.

The next morning, Dr. Tong will visit you to remove the dressings. Afterwards, he will allow you to be picked up by your family/friend(s) to go home. At home, you should rest and relax as much as possible. You may do non-strenuous activities, such as watching television, reading, and making small meals. It is best to sleep in a reclining chair or use multiple pillows to keep your head elevated when you sleep. This helps decrease facial swelling.

Pain following Facelift surgery is typically mild. Dr. Tong will prescribe pain medication, which can be used during this time. You will have some bruising that lasts 1-2 weeks. The majority of patients return to (non-strenuous) work at 10-14 days.

You will have an appointment with Dr. Tong at one week after surgery to have stitches removed. He will likely allow you to start light exercise (e.g. walking) at 1-2 weeks after surgery. Avoid strenuous activity until 4-6 weeks after surgery. After the initial post-op visit, you will follow up with Dr. Tong at six weeks, six months, and one year after surgery. Post-operative photos are taken at these visits.

As with any surgery, there are risks involved with having a Facelift. Although the procedure has a low risk profile, Dr. Tong will make sure to go over the potential problems associated with Facelift surgery at the time of your consultation.

How to Choose the Best Facelift Surgeon For You

There are a few important factors to consider when choosing a qualified surgeon to perform your Facelift:

  1. Choose a plastic surgeon who is certified by the American Board of Plastic Surgery. The equivalent Canadian designation is board-certification from the Royal College of Surgeons and Physicians of Canada in Plastic Surgery. These certifications indicate that the physician has undergone the required training and passed the appropriate examinations to be called a “plastic surgeon.” Dr. Tong is certified by both the Royal College of Surgeons and Physicians of Canada and the American Board of Plastic Surgery.
  2. Ensure your plastic surgeon has substantial experience. As with any profession, a surgeon’s work tends to improve with experience and continued refinement of their skills and technique. This is particularly relevant for cosmetic surgery.
  3. Select a plastic surgeon who performs Facelifts regularly. Most plastic surgeons perform Facelifts. However, a surgeon who performs this procedure frequently will have enhanced familiarity with different facial anatomy, advanced techniques, and any complications that may arise. A highly-experienced Facelift surgeon is also more experienced in minimizing the appearance of any scars.
  4. Choose a surgeon who makes you feel at ease. It is very important that you feel comfortable expressing your goals and reservations to your plastic surgeon. You should also feel confident in receiving exemplary care at every stage of your treatment.

Facelift FAQs

What is the best age for a facelift?

Patients of varying ages can benefit from a Facelift (or related procedures). Individuals as young as their thirties to those nearing middle age and beyond may be candidates. One primary myth about Facelift surgery is that a ‘best age’ exists for facial rejuvenation. Candidacy for a Facelift largely depends on whether a patient exhibits the signs of aging appropriate for the procedure in question, such as jowls, sagging facial tissue, deep wrinkles, and lax musculature in the face and neck. These concerns develop at different ages for each individual based on their genetic makeup, skin quality, lifestyle habits, diet, and propensity for sun exposure, among other factors. f you would like to find out whether a Facelift could refresh your appearance, the best way to determine candidacy is to consult with a board-certified Facelift surgeon you trust.

Is a Facelift different for men versus women?

Although Facelift surgery aims to achieve the same goals for both men and women, there are certain aesthetic conventions distinctive to male and female patients that may inform the procedure. While women typically exhibit a narrow facial shape with softer features, men usually have a broader, oblong-shaped face with a more defined chin and jawline. Dr. Tong takes great care to perform a Facelift with consideration of masculine and feminine characteristics that can yield a natural-looking result for men and women alike.

Additionally, there are some technical differences between male and female Facelifts due to male beard-growth patterns, and the shorter hair length typical of men when compared to women. Depending on beard growth density, the incision in front of the ear may be modified to prevent beard growth in certain areas. Facelift procedures can have the effect of shifting the sideburn, which is potentially more significant in male patients. The incisions in front of the ear and temple region must be planned carefully to minimize these effects.

Finally, depending on the degree of neck skin laxity and a patient’s beard-growth pattern, men may have some facial hair displaced behind the ear as a result of neck and Facelift procedures. The goal of a Facelift is to achieve a more youthful version of yourself, and Dr. Tong will utilize the appropriate techniques to produce an outcome that preserves the natural character of your face.

How long before I can exercise again after a Facelift?

Light exercises that do not significantly raise the blood pressure, such as walking and non-strenuous yoga, can usually be resumed one to two weeks after your Facelift procedure. Intensive workouts and aerobic activity should be avoided for a while longer, approximately four to six weeks.

While Dr. Tong understands the eagerness of some patients to resume their normal routines as quickly as possible, pushing the body before it is fully healed can cause a number of complications, including bleeding (hematoma), fluid buildup (seroma), potential infection, the opening of incisions (dehiscence), and prolonged swelling (edema). It is generally best to gradually build to more and more demanding workouts, depending on your body’s response to increasing activity. If you have a question about whether it’s safe to perform a certain exercise, don’t hesitate to contact Dr. Tong for personalized medical advice.

Will I Have Visible Facelift Scars?

With any surgical procedure, there will be some trace of a mark or scar following your Facelift. However, Dr. Tong takes every measure to minimize the appearance of scarring by hiding scars in discrete locations, such as the back of the ear, the hairline, or under the chin. This careful placement can allow surgical marks to blend in with the natural contours and curvatures of the face and neck for inconspicuous post-surgical scarring.

As time passes and your healing progresses, it is typical for incision marks to fade significantly. After several months, the scars will begin to diminish as the normal maturation process begins, usually between 6 and 18 months. The final scar appearance is fairly difficult to notice once the scars are well-healed.

While Dr. Tong will take great care to make scarring virtually undetectable, your role in properly treating and caring for your incision scars can further camouflage their appearance. In the days following surgery, you can help your scars heal correctly by:

  • Keeping the wound clean and dressed: Never remove surgical bandages without clearance from Dr. Tong.
  • Avoiding touch and unnecessary contact with the scar: Do not mess with, pick, or scratch incision marks. This will interfere with your body’s natural healing process.
  • Only use surgeon-approved antibiotic creams, if provided: Immediately after surgery, using creams and moisturizers that Dr. Tong did not directly advise can impede the scar’s ability to heal.

How Long Do Facelift Results Last?

The results of a Facelift generally last between 7-10 years; if the procedure is repeated before the end of that time period, it is unlikely that another Facelift would provide significant improvement. Continued sun exposure, cigarette smoking, significant weight changes, and genetic factors could reduce the longevity of the result. The vast majority of patients who undergo a Facelift procedure never have a second Facelift procedure.

How Much Does a Facelift Cost?

The cost of a Facelift is determined by the complexity of a patient’s unique treatment plan, as well as the geographic location where the procedure is performed. Other factors that generally affect the cost estimate for a Facelift include:

  • The expertise of your plastic surgeon
  • The type of anesthetic used
  • Whether the surgery is being combined with other procedures
  • The amount of surgical work performed

With fees for the operating room, pre- and post-operative care, and anesthesia included, the general price range for a Facelift at Yorkville Institute of Plastic Surgery ranges from $15,100 -$16,500 + HST. Of course, the true cost will vary according to each patient’s needs. After your consultation, our office will be able to provide you with a personalized quote to help you make a well-informed decision about your procedure.

Our office accepts a variety of payment methods—including a credit card, certified cheque, money order, bank draft, and cash— and we offer a financing option through Medicard®, a plastic surgery financing company serving patients in Canada.

Please contact our practice for any additional questions or concerns you may have about the cost of a Facelift.

Your Facelift Consultation

At Yorkville Institute of Plastic Surgery, our entire team is dedicated to ensuring our patients are fully educated so that they are empowered to make confident decisions about their cosmetic options. To this end, Dr. Tong is careful to allot significant time for patient consultations—usually one hour or more.

During your Facelift consultation at our offices in Toronto, Dr. Tong will grant his undivided attention as you discuss your goals, reservations, and lifestyle factors that may influence your decision to undergo plastic surgery. He realizes that you’ll have a great deal of information to digest, and will take all the time necessary to be sure that you understand all aspects of your treatment plan and surgical process.

To learn more about how Toronto Facelift surgeon Lawrence Tong, MD can help you achieve your desired facial rejuvenation, please schedule a Facelift consultation by giving us a call at (416) 972-0999. Otherwise, let us give you a call; just fill out our contact form and we will call you on the same or the next business day. No doctor’s referral is needed.

Facelift at a Glance

What the procedure does
Restores youthful facial features by elevating the jowls and cheeks, softening the marionette lines and nasolabial folds. Also makes the neck more youthful by removing fat and elevating the skin.
Duration of the result
7-10 years
Face gradually may sag with weight gain, aging, smoking, sun exposure.
Length of time to perform the procedure
3.5-4.5 hours
Overnight stay recommended
Type of anesthetic most commonly used
IV sedation or general anesthesia
Length of time off of work
7-10 days
Time to get back to exercise
2 weeks light exercise, 4-6 weeks heavy exercise
Pitfalls your Plastic Surgeon should avoid
  • Unnatural ‘pulled’ look
  • Unnatural (pixie) ears
  • Unnatural hair shifts
  • Poor scars

1 American Society of Plastic Surgeons. Facelift. Available: https://www.plasticsurgery.org/cosmetic-procedures/facelift. Accessed May 14, 2020.
2 American Society of Plastic Surgeons. Brow Lift. Available: https://www.plasticsurgery.org/cosmetic-procedures/brow-lift. Accessed May 14, 2020.
3 American Society of Plastic Surgeons. Eyelid Surgery. Available: https://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery. Accessed May 14, 2020.
4 Mayo Clinic. Facelift. Available: https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059. Accessed May 14, 2020.

Dr. Lawrence Tong has either authored or reviewed and approved this content.

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