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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, plastic surgeon Lawrence Tong, MD may have the solution for you.

What is a Facelift?

A facelift is a surgical procedure that is performed to improve the appearance of aging in the neck and face. Also called a rhytidectomy, the procedure lifts sagging skin, diminishes wrinkles, removes excess fat, and tightens the underlying musculature in the face and neck regions. Specific portions of the facelift procedure can be performed individually to address specific areas. These variations of facelift surgery include the mini facelift, neck lift, and extended neck lift.

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.

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?

For many potential plastic surgery patients in Toronto, facelift surgery is best suited for those who have concerns with both the face and neck appearance. Men and women with visible signs aging who want to look younger are typical candidates.

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

Considerations with a Facelift

A facelift is an important component of facial rejuvenation. Some patients incorrectly assume the procedure will also lift the brow (in addition to the face and neck). Although the brow and 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.

Likewise, the eyelids are not affected by having a Facelift. These are separate procedures that can be performed in conjunction with a Facelift, if desired. A very common combination of facial rejuvenation surgery would comprise of (i) Facelift, (ii) endoscopic brow lift, (iii) upper and lower Blepharoplasty.

During your facelift consultation, Dr. Tong will discuss these other procedures if applicable.
A facelift generally lasts between 7-10 years; if repeated before 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.

Facelift Incisions:
Depending on the nature of your unique treatment plan and your 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 fat and the lax neck muscles at the midline of the neck

These scars hide well because they blend into the natural curves and lines. Once the incisions have matured, the majority of women are not concerned with visible facelift scars.

How is a Facelift Performed?

Dr. Tong usually performs the 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.

Dr. Tong performs your surgery in the CAAASF accredited private surgery centre within the medical complex where his office is located, at 199 Avenue Road in Downtown Toronto. He starts the facelift by making the incisions, and then exposing 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 obtain a deep 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 you are gently awakened from anesthesia.

Mini Facelift

A mini facelift is an abbreviated form of a standard facelift that simply addresses the upper portion of the face. 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.

What is Recovery Like After a Facelift?

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 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 (non-strenuous) work at 10-14 days.

You will have an appointment with Dr. Tong at one week 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.

Become Educated about Facelift

Our first goal is to help you become an educated patient about facelifts. We feel that an educated patient will make better choices about their surgery and their surgeon. The initial consultation may take over an hour to complete. During your consult, you will have Dr. Tong’s undivided attention and you will never be rushed or pressured to make a decision about surgery. There is a great deal information to absorb during your initial consultation and Dr. Tong will make sure that you understand all important aspects of the surgery process.

Will I Have Visible Facelift Scars?

With any surgical procedure, there will be some trace of a mark or scar. However, Dr. Tong takes every measure to minimize the appearance of scarring by hiding them in discreet 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 process 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, the time for maturation ranging from 6 months to 18 months. The final scar appearance is fairly difficult to notice once the scars are well-healed.

Some key strategies to having an optimal scar outcome include: a) being able to place scars in well-hidden locations, b) careful handling of tissue (minimizing trauma to skin), c) stitching the skin together with meticulous surgical technique, d) appropriate degree of lifting, as to prevent distortion of the face (and minimize tension on incision lines), e) appropriate post-operative scar care.

The aforementioned factors are largely surgeon-dependent. The most important factor that is not surgeon-controlled is an individual’s unique ability for scar healing (determined by genetic indicators). Fortunately, with an experienced and competent surgeon, facelift scars tend to be very favourable.

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 would 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 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 $13,000 -$15,000. 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.

Is a Facelift Without Surgery Possible?

A facelift is a powerful procedure that addresses the underlying causes of facial aging such as increased skin laxity, by removing excess skin and tightening the remaining tissue. This improvement cannot be accomplished effectively 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 equivalent results to a facelift.

Non-surgical options, including injectables and dermal fillers, generally work well for younger patients or patients with lesser signs of aging. Patients that 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.

Surgery is utilized when non-surgical options are not effective enough to provide the improvement desired by the patient.

In summary, a facelift cannot be performed without surgery; if a patient wants to have their neck and/or face “lifted” or “tightened,” they are usually in need of a surgical procedure.

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 that 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 year after year as they hone their craft, skills, and technique. A surgeon’s work after a decade of practice is much better than it was in their first year of practice. This is particularly relevant for cosmetic surgery.
  3. Select a plastic surgeon who performs facelifts on a regular basis, as opposed to someone that only performs the surgery occasionally. Although any plastic surgeon can usually perform a facelift, a surgeon that performs facelifts frequently will have more familiarity in dealing with i) different types of faces, ii) different degrees of severity, iii) diverse anatomy, and iv) complications that could arise. Additionally, those who are well-versed in facelift surgery generally have more experience minimizing the visibility of incisions and scars.
  4. Choose a surgeon that communicates well, listens to your concerns, and makes you feel comfortable. During your consultation, you should feel confident that your surgeon understands your goals and wants what is best for you. He or she should provide exemplary care before, during, and after surgery. Although it is often assumed that you should feel comfortable with the person who will be operating on your face, it is surprising to hear from some patients who assume a rushed or even discourteous surgeon is just “part of the 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, cheeks, softening the marionette lines, nasolabial folds AND 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
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