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Our Approach to Surgery is Anything but Plastic

When patients come to us for a facelift, they typically say things like:

  • “Gravity has taken over my face, and now, jowls are forming.”
  • “It’s like my cheeks have flattened out.”
  • “My neck looks like it belongs to a much older person.”

If you want to restore your face to a smoother, tighter, more youthful appearance, a facelift (also called “rhytidectomy”) may be right for you.

The term “facelift” is misleading as it does not apply to the entire face. A facelift addresses the effects of gravity on the cheeks and neck area seen as jowls, turned down corners of the mouth, marionette lines, a double chin, neck bands, and overall loss of definition of the neck. These symptoms may be caused by accumulated fat tissue, excess neck skin, or both. Just by looking at yourself in the mirror and pulling back the cheek and neck skin, you can see how a facelift turns back the hands of time and makes you look eight to ten years younger. The goal is to make the end result appear natural and not “windswept” or fake.

What is a Facelift?

The facelift is the gold standard in cosmetic facial rejuvenation. Using a variety of techniques, it can lift and restore the deeper facial tissues, returning your appearance to the way it was ten years ago. Although many people think a facelift creates a “stretched” or unnatural look, today’s facelifts are more natural and undetectable than ever.

Facelift Benefits

The facelift has many benefits, including:

  • Smoother lines and folds
  • Lifted, fuller cheeks
  • Defined jawline
  • Reduced jowls
  • Less sagging skin

Good Candidates for Facelift

Depending on their needs, people of many different age groups can benefit from the facelift. For example, people in their late 30s and 40s can benefit from a mini facelift, while patients in their 50s and beyond can benefit from a more comprehensive traditional facelift. In any case, you should be in overall good health and able to undergo surgery. Dr. Coan will perform a detailed assessment and review your medical history to determine if the facelift fits you.

Why are facelifts difficult for other surgeons?

A well done and aesthetically pleasing facelift is more than just pulling back facial skin and removing fat. Because the face shows aging in numerous ways it’s important for your plastic surgeon to address all facial rejuvenation techniques, including:

  • Changes to the skin clarity, skin discoloration, and skin quality. Over time our skin quality changes due to sun damage over time and general loss of elasticity of the skin as we age. Skin care and laser therapy can greatly improve your skin before and after surgery.
  • Excess skin in the face and neck that has lost its elasticity. An important part of any facelift is resuspension of any sagging facial tissues and removal of extra skin.
  • Loss of volume and redistribution of fat. Older techniques of facelifting only removed skin and removed fat. This can work well in the neck but there is actually a loss of fat and facial volume in the jawline and cheeks. Resuspension of the sagging facial tissues and replenishing facial volume with fat grafts address this loss, reestablishing a more youthful appearance. It is also believed that the fat grafts contain “stem cells” that help rejuvenate the skin, improving its appearance and elasticity.
  • Loss of bone of the facial skeleton. This is more pronounced as you age and can be addressed with facial implants to the chin and cheek or fat grafting to restore lost volume.
  • Only a highly trained and experienced surgeon can assess and treat these multiple causes of facial aging. A combination of skillfully performed surgery, laser skin resurfacing, and skin care will restore a natural, more youthful appearance while delivering a more pleasant and balanced look. Dr. Coan located in Cary, NC is an expert in facial rejuvenation and will tailor your procedure to your individual needs.

How is a Facelift Performed?

Facelifts are performed with incisions that are hidden within the hairline behind the ear, within the natural creases of the ear, and sometimes underneath the chin. By placing incisions in these areas, plastic surgeons have found that the resulting scars are less noticeable. The facelift procedure is often combined with eyelid and forehead lift surgery for total facial rejuvenation. It is safe to combine all of these procedures in one surgery.

Recovery from a facelift requires one to two weeks off work. It is safe to be up and about after the first week but your bruising and swelling may limit your social interactions for the full two weeks. Within about a month, you will be able to resume vigorous exercise, sleeping on your stomach or sides, and lifting heavy objects. You can apply makeup after the first week, as long as you avoid the incision areas.

Preparing for Facelift

Dr. Coan and our team will provide detailed preparation instructions for your surgery date. The best thing you can do before your facelift surgery is practice good skincare (including sun protection) and eat a varied, nutrient-rich diet. Make sure to also get regular exercise and time outside. Dr. Coan may ask you to adjust certain medications, and you should do so with the help of your regular physician. We ask surgical patients to undergo blood testing to verify they won’t carry extra risk of complications during surgery, and these results will be due in the weeks leading up to surgery.

Facelift Recovery

The most important step of your facelift recovery is keeping your head elevated while resting. We recommend sleeping on a couple pillows or in a recliner – this helps prevent swelling and ensures your results heal as intended. You may experience a “tight” feeling in your face at first, but it will subside with time. Bruising and redness are also to be expected. Within one to two weeks, you’ll begin to feel like yourself again, but it may be an additional week before you feel confident returning to public – especially a public-facing job.

Results of Facelift

After healing from a facelift, you’ll see a noticeably younger version of yourself. Dr. Coan takes every step to ensure against visible incisions, but it may take up to a year for any scars to fade into their final appearance. Wearing sun protection daily is the best way to ensure a good result. With proper skincare and anti-aging treatments, your results can last a lifetime. Keep in mind that you’ll still age with time – you’ll simply look significantly younger for your age.

Alternatives/Combination Procedures

The facelift is often combined with a number of options. Dr. Coan can discuss the best combination procedure for you during a consultation.

Neck Lift

A neck lift can provide a more encompassing version of the facelift by ensuring the neck appears youthful and rejuvenated along with the face. Many people begin to age in the neck first, leading to an imbalance if only a facelift is performed. The neck lift is an excellent option if you have visible neck bands or sagging skin.

Brow Lift

The brow lift can address the upper face, lifting sagging brows and smoothing frown lines contributing to an angry or tired look. Whereas the facelift primarily addresses the mid and lower face, the brow lift can also rejuvenate the areas around the eyes and brows.

Eyelid Lift

The eyelid lift can smooth fine lines and wrinkles under the eyes while also getting rid of hooded or sagging upper eyelids. It’s also a great option for sagging undereye bags, smoothing the undereye area to give the appearance of a good night’s rest.


Botox is an excellent alternative for some patients, but for others, it’s a great way to maintain their facelift results. Although it may not be able to produce results on the level of a facelift, it can help smooth mild to moderate lines and wrinkles, especially combined with dermal fillers.

What to Expect From a Facelift Consultation

During a consultation with Dr. Coan, you’ll discuss your goals and concerns about the facelift. Dr. Coan recommends bringing a younger picture of yourself so he can see the specific ways your face has aged. You’ll also discuss the risks and rewards to make a completely informed decision. This is a great time to ask questions so you can feel confident in your decision to move forward with a facelift.

Frequently Asked Questions

Does a facelift make you look younger?

Yes, a facelift can produce facial rejuvenation, providing an overall more youthful appearance. In aesthetics, there are three types of facial aging: skin texture changes, volume loss, and shape changes. Skin texture changes are best addressed with quality skincare regimens that incorporate both products and resurfacing treatments. Volume loss is targeted with dermal fillers, and shape changes are addressed with more invasive procedures such as surgery. Facelift procedures serve to correct age-related shape changes, specifically in the lower third of the face where jowling occurs. Contrarily, skin treatments correct skin quality by addressing a multitude of concerns, including superficial wrinkles, age spots, pigmentation, sun damage, and more.

How can I tighten loose skin on my face?

There are various types of facial aging, including skin quality decline, shape changes, and volume changes. For example, facial shape changes are typically addressed and corrected with surgical intervention. Skin quality is best addressed with more conservative measures, such as proper skincare, resurfacing treatments, and consistent maintenance. However, there are a few surgical procedures that can address skin laxity. FaceTite is a procedure that utilizes radiofrequency heat energy to increase collagen production. This can serve to secondarily tighten the skin in the treated area (typically the jowls and jawline).

How do I get rid of my double chins?

Here at CARE Plastic Surgery, we offer a variety of services and treatments that can help address excess fat in the chin and submental area. Some patients may choose a surgical procedure, such as liposuction. Contrarily, if a patient is more concerned with loose skin in this region, appropriate treatments may include FaceTite and/or Morpheus (microneedling with radiofrequency energy).

How do I prepare for a facelift?

With a facelift or any other cosmetic surgery, we recommend consulting with a board-certified plastic surgeon to help ensure the best quality of care. We also recommend having a great support system during your recovery period.

How do I reduce swelling in my face?

Common methods to reduce post-procedural swelling include R.I.C.E. (rest, ice, compress, and elevate). Our post-operative protocol includes reclined sleeping, a facial compression sling, and limited activity levels. Additionally, avoiding certain medications prior to treatment and procedure can help minimize swelling. We recommend patients discontinue any use of NSAIDS or other blood-thinning agents (fish oil, vitamin E, red wine, etc.)

How do I tighten my jawline?

There are several options available to those seeking to tighten their jawline. One option most patients often overlook is injectables, particularly dermal fillers. With the appropriate product and treatment plan, fillers can be used to restore volume in facial regions to provide an overall rejuvenated appearance. Other minimally invasive treatments to tighten the facial skin include Morpheus and Forma, which both utilize radiofrequency energy to stimulate collagen production. Alternatively, FaceTite is a surgical procedure that utilizes radiofrequency heat energy to tighten the appearance of jowls.

How do you reduce swelling after a facelift?

In efforts to reduce overall swelling, we recommend our patients follow our standard post-operative instructions. These include limiting activity, increasing water intake, avoiding high sodium foods, and sleeping upright for the first two weeks after surgery.

How do you take care of your face after a facelift?

While patients can expect to continue to age, there are recommendations we encourage patients to implement into their day-to-day regimens. Proper skincare routines with medical-grade products serve to improve, maintain, and protect skin quality, further enhancing your facelift results. Oftentimes, taking care of yourself and maintaining good health secondarily benefits your skin. This can be done with simple habits such as staying hydrated, limiting sun exposure, and abstaining from smoking/nicotine use.

How long after a facelift can I exercise?

To reduce the risk of postoperative complications, we recommend our patients wait until 6 weeks after surgery before resuming normal exercise routines. We want to avoid any increase in heart rate or blood pressure to minimize complications.

How long do ears hurt after facelift?

Contrary to common belief, pain is not a commonly reported side effect of facelift procedures. Typical descriptions include discomfort similar to a headache. This type of discomfort is managed well with proper pain management protocol, and patients can expect it to resolve typically within the first 1-2 weeks after surgery.

How long does it take for bruising on the face to go away?

Every patient responds differently to major surgery. With most patients who receive a facelift, bruising tends to resolve by approximately two weeks after surgery.

How painful is a facelift?

Contrary to patient expectations, facelifts tend to be far less painful than expected. Pain control begins before the operation starts with local anesthesia and careful attention to local sensory nerves. Post-operatively, patients find they feel a sense of tightness but are quite comfortable with regard to pain. Postoperative pain control is usually managed with oral pain medication for approximately 2-5 days as needed.

What can I expect from a facelift?

Commonly misunderstood as a procedure to improve nasolabial folds, or the line between your lip and cheek, a facelift in fact is most useful in improving the jawline and correcting age-related jowls. Facelift procedures serve to address age-related changes primarily in the lower half of the face, such as jowling and other shape changes. This is the area where a patient can expect to see maximum improvement in their overall facial aesthetic from a facelift. The procedure can also, and is often, paired with other surgical procedures to address various aspects of the face. These procedures include a brow lift, neck lift, and more.

When should you get a facelift?

People age at different rates, and both skin laxity and early jowling can occur as early as in the 40s. Some patients prefer to wait longer until the jowls are extremely bothersome, while other patients prefer to intervene sooner. With limited jowling, a less invasive procedure may be available to sharpen the jawline and improve the early signs of aging without a full facelift. However, as the jowl becomes more noticeable, usually in the mid-50s to mid-60s, a facelift will likely be the appropriate procedure. The sagging jowl is lifted and the jawline tightened. Most importantly, the facelift corrects the lower third of the face and the cheeks. Additional procedures can be performed concurrently to address aging in the eyes and neck.

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I adore Dr. Coan & his whole staff. They are kind, warm, fun, & helpful. I trust Dr. Coan wholeheartedly. He is always honest with me, and would never sell or recommend a procedure that is not right for me. I love my office visits and look forward to going! Dr. Coan is my forever.

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Everyone here at Care plastic surgery are completely amazing people. They all made me feel very comfortable and safe in their hands. Dr. Coan is an amazing surgeon and does his absolute best to make sure you leave here looking and feeling amazing. -Mary John

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