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Over time, the skin loses its elasticity, and the volume in our face diminishes, leading to common signs of aging such as sagging and deflated cheeks, deepening wrinkles, and a less defined jawline. These changes are primarily caused by a combination of factors including reduced collagen production, environmental influences, genetics, and lifestyle choices. The Ponytail Lift is a novel surgical technique designed to counter these signs of aging with a minimally invasive approach. Dr. Lawrence Tong, based in Toronto, leverages this innovative technique to provide patients with a refreshed, youthful appearance that embodies the subtle yet impactful results today’s discerning patients seek.

What is a Ponytail Lift?

The Ponytail Lift is a minimally invasive facial rejuvenation procedure that elevates the aesthetics of facelifts to a new level. By sculpting and gently lifting the cheeks, brows, forehead, and jawline upwards, it mimics the youthful allure of a high, tight ponytail. This procedure stands out by incorporating soft tissue lifting along with fat transfer to plump out wrinkles and enhance facial contours, such as the cheeks, nasolabial folds and marionette lines, and jawline, offering rejuvenation from the inside out. As the name suggests, the procedure emphasizes rejuvenating and lifting the forehead, temples, brows, and midface mimicking the look of a high tight ponytail. It is not a procedure that can be utilized for all degrees of facial aging. However, when performed on a suitable candidate, its methodology ensures that a natural looking rejuvenation with incisions and any resultant scarring that are virtually invisible, hidden even when the hair is pulled back or styled into a ponytail.

Diverging from traditional facelift techniques, which often involve removing skin and making incisions around the ears that may lead to visible scars and a potential change in ear shape, the Ponytail Lift relies on minimal incisions within the scalp, hair, and temples. This approach avoids incisions around the ears altogether, preventing any scars from occurring on non-hair bearing skin. The outcome is a natural-looking rejuvenation, avoiding the overdone look and maintaining the essence of your natural beauty.

Benefits of a Ponytail Lift

For patients who are good candidates, the Ponytail Lift offers multiple benefits compared to the traditional facelift.

  • No Visible Scarring: Unlike a traditional facelift, all incisions for a Ponytail Lift are hidden within the hair.
  • Natural-Looking Results: During a Ponytail Lift, the forehead, midface, and jawline soft tissues are redraped vertically instead of laterally, resulting in an appearance that looks naturally refreshed. Fat transfer is utilized to restore the effects of volume loss due to aging, providing the third dimension vital for optimal facial rejuvenation.
  • Minimally Invasive: A Ponytail Lift is performed with very small incisions located in the hair, leading to less scarring and a shorter and more comfortable recovery period.
  • No Changes To Ear Appearance: In a traditional facelift, incisions made in front of or behind the tragus have the potential to alter the the appearance of ear or sideburns. Because Ponytail Lift incisions are not made along the ear, the anatomy along the ear is not affected.

Who is a Candidate for a Ponytail Lift

Dr. Lawrence Tong meticulously assesses each patient’s eligibility for the Ponytail Lift.

This procedure is ideal for male and female patients who are in good health and:

  • Desire subtle yet effective rejuvenation
  • Have moderate signs of aging (drooping, deflation, wrinkles) of the midface and forehead, with a relatively youthful neck
  • Have good skin elasticity
  • Do not have a significant degree of loose, sagging skin on the jawline, or neck (for patients with significant skin sagging in these areas, adding a neck lift or performing a facelift that utilizes more traditional incisions may be more appropriate)

The Ponytail Lift is excellent for patients seeking a step up from the temporary effects of Botox and fillers, offering more pronounced outcomes, yet it remains less invasive than traditional facelifts. However, individuals with very thin or short hair might find this technique less suitable, as the minimal incisions are hidden within the hairline, and visible scars could be a concern.

Preparing for Your Ponytail Lift

Preparation is key to ensuring the success and safety of your Ponytail Lift. Dr. Lawrence Tong and his team will guide you through a comprehensive preoperative process, tailored to optimize your health and outcome. Here are the essential steps you’ll need to follow:

  • Set Realistic Expectations: Understanding the achievable results is crucial. A detailed consultation with Dr. Tong will help align your expectations with what can realistically be accomplished.
  • Quit Smoking: To promote better healing, it’s advised to stop smoking at least a month or two before the surgery. Smoking can significantly hinder the healing process and increase the risk of complications.
  • Limit Alcohol Consumption: Reducing or stopping alcohol intake is recommended in the weeks leading up to your surgery. Alcohol can affect your recovery and overall health.
  • Review Medications: Certain medications and supplements can increase bleeding risk during and after the procedure. It’s important to avoid aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and specific supplements as advised by Dr. Tong.

By following these preparatory steps, you can help ensure a smoother procedure and recovery, leading to the best possible results from your Ponytail Lift.

The Ponytail Lift Procedure

Dr. Tong performs the Ponytail Lift procedure under sedation or general anesthesia. This procedure is fully customized, and may take between 2 to 3 hours depending on the patient’s unique anatomy and goals.

The Ponytail Lift procedure begins with strategically placed incisions within the scalp. These are carefully planned based on each patient’s specific anatomy and goals, allowing for the optimal vertical repositioning of facial tissues with minimal visibility of scars. Dr. Tong uses an endoscope (a slender instrument equipped with a camera) to precisely elevate the tissues of the forehead, brows, temples and midface.

A critical component of the Ponytail Lift is the transfer of fat to restore facial volume and the skin’s texture and tone. Fat grafting is performed in the cheeks, lower eyelids, nasolabial folds (smile lines) and marionette lines as appropriate to help improve the contours of the cheeks, chin, and jawline, and fill in wrinkles. This step ensures that the enhancements look natural and are in harmony with the rest of the face.

Ponytail Lift Recovery and Results

Recovering from a Ponytail Lift is generally quicker and less cumbersome than from traditional facelift procedures. Patients can expect bruising and swelling, which typically resolve to the point of presentability within 10 days to two weeks. You will be instructed to sleep in a slightly elevated position for the first week. You may shower the next day after surgery. The first follow up appointment occurs approximately one week after surgery at which time stitches will be removed. Dr. Tong provides detailed post-operative care instructions to ensure a smooth recovery. During the initial healing phase, it’s important to handle your hair gently—avoid vigorous brushing or combing until the sutures have dissolved and the incisions are fully healed. Additionally, using a mild shampoo is recommended, and it’s best to wait a few weeks before coloring your hair.

Most of Dr. Tong’s patients feel comfortable returning to work within 10-14 days of their Ponytail Lift. Dr. Tong asks that patients refrain from more strenuous activities including exercise for at least four weeks.

Patients who undergo a Ponytail Lift have the added benefit of enjoying the results much sooner than traditional facelift patients. You should appear naturally more refreshed and youthful in as little as one month, though it may take slightly longer to enjoy the full transformation after all swelling has abated.

Ponytail Lift FAQs

Can I combine my Ponytail Facelit with additional procedures?

Absolutely. For a more comprehensive transformation, some of Dr. Tong’s patients choose to combine their Ponytail Lift with an eyelid lift (blepharoplasty), chin and neck liposuction, mini neck lift, neck lift, lip augmentation, or a lip flip procedure.

What are the risks of a Ponytail Lift?

Any surgical procedure is associated with some risks and potential complications. Risks of a Ponytail Lift are similar to the risks associated with a traditional facelift and include:

  • Anesthesia risks
  • Bleeding
  • Nerve damage
  • Numbness
  • Hematoma
  • Scars
  • Hair loss at incision line1

How much does a Ponytail Lift cost?

The Ponytail Lift is a fully customized procedure, and the cost of Ponytail Lift is dependent on multiple factors unique to each patient. You will receive detailed information about the cost of your Ponytail Lift following your consultation with Dr. Tong.

Your Ponytail Lift Consultation

Dr. Tong and the entire team at Yorkville Institute of Plastic Surgery in Toronto are committed to providing each patient with the information they need to feel educated and able to make a confident decision about their plastic surgery treatment plan. Accordingly, Dr. Tong allots one hour or more for each patient consultation.

When you meet with Dr. Tong to discuss the Ponytail Lift, he will conduct a visual and physical examination of your face and review your medical history. He will then carefully listen to your cosmetic goals and concerns and educate you about the Ponytail Lift and potential alternative procedures and help you decide which type of facial rejuvenation treatment is best for you.

The Ponytail Lift is a relatively new facial plastic surgery technique, and as such, the results of the procedure are entirely dependent upon the plastic surgeon’s skill and artistry. To schedule your Ponytail Lift with a highly experienced and technically astute plastic surgeon, contact Dr. Lawrence Tong in Toronto.

Ponytail Lift at a Glance

What the procedure does
Refreshes and rejuvenates the appearance of the face, jawline, and neck
Duration of the result
5-10 years
Length of time to perform the procedure
2-3 hours
Type of anesthetic most commonly used
Deep Sedation or general anesthesia
Length of time off of work
10-14 days (sooner if working from home)
Time to get back to exercise
2 weeks light exercise (eg. calm walks)
Pitfalls your Plastic Surgeon should avoid
  • Limited effectiveness when the ponytail lift is performed on an inappropriate candidate (eg: excessive signs of aging)
  • Failure to control postoperative nausea (a common and potentially excruciating post operative complication)
  • Inappropriate and/or inadequate usage of fat grafting

1 American Society of Plastic Surgeons. What are the risks of facelift surgery? Available: https://www.plasticsurgery.org/cosmetic-procedures/facelift/safety. Accessed March 5, 2024.

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

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