Restore youthful contours with the gold standard in facial rejuvenation.
A facelift repositions deeper facial tissue to restore the jawline, cheeks, and neck. Unlike traditional facelifts that simply pull the skin, this procedure releases and repositions the deeper muscle layers (SMAS) and fat pads. The result is a natural, tension-free restoration of the midface, jawline, and neck: avoiding a tightened look. By focusing on the underlying architecture of the face, we achieve results that are not only more natural but also significantly more durable.
InquireA facelift at our practice centers on release and repositioning of the superficial musculoaponeurotic system (SMAS) rather than simple skin excision. Incisions are placed within the temporal scalp, pre-auricular crease, around the lobule, and in the retroauricular sulcus extending into the posterior hairline. Skin flaps are elevated in the sub-SMAS plane over the malar eminence and lateral neck. The SMAS is released at its ligamentous attachments and repositioned vertically, not obliquely, to restore the malar fat pad to its original anatomical position and recreate a defined jawline. Platysmal banding in the neck is addressed through a submental incision with corset platysmaplasty when indicated. Skin is redraped without tension; excess is trimmed and wounds are closed with absorbable sutures.
A facelift is a good fit for adults with jowls, lower-face laxity, and neck aging that non-surgical treatments will not meaningfully correct. Candidates must be non-smokers or willing to cease smoking at least four weeks before and after surgery, as nicotine severely compromises skin flap perfusion. Psychologically stable patients with clear goals and an understanding that a facelift restores rather than transforms are best suited for this procedure.
The first week involves the most notable swelling, bruising, and tightness. Drains, when used, are removed on postoperative day one to two. A surgical compression wrap is worn for the first week. Most patients are comfortable in social settings at two to three weeks, though residual swelling and mild sensory changes in the cheek and ear may persist for six to twelve weeks. Final results, including full softening of the tissue and complete scar maturation, are appreciated at six to twelve months.
Compression wrap worn. Drains removed day 1–2. Swelling and bruising most pronounced. Head kept elevated.
Swelling substantially reduced. Bruising resolved or easily concealed. Most return to social activities.
Residual firmness and sensory changes continue to resolve. Light exercise may resume. Scar management ongoing.
Full result visible. Scars mature to near imperceptibility. Refreshed, natural appearance sustained.
Hematoma is the most common facelift complication, occurring in approximately one to three percent of patients, and is more prevalent in men and hypertensive patients. Facial nerve injury leading to motor weakness is rare but the most feared complication; meticulous surgical technique and anatomical knowledge minimize this risk. Skin flap necrosis can occur, particularly in smokers. Other risks include prolonged swelling, asymmetry, widened scarring, earlobe distortion, and hair loss in hairline incision areas.
Non-surgical treatments such as thread lifts, radiofrequency, and HIFU devices can provide modest tissue tightening with no downtime but cannot replicate the structural restoration and longevity of a surgical facelift. Dermal fillers address volume loss and can camouflage mild jowling but are insufficient for significant skin and SMAS laxity. For patients with isolated lower face and jowl concerns without significant neck laxity, a limited-incision mini-lift may be appropriate.
Performed by Dr. Ruben Castro in Newport Beach, California