Facelift in Virginia, Washington D.C., and Maryland

Are you looking to get rid of excess skin and volume loss in your face? The Naderi Center, a leading facial plastic clinic in Virginia, offers facelift surgery that can help restore the youthful appearance of your skin and soft tissue! With a commitment to excellence and safety, facelift surgery at the Naderi Center will help you look years younger without the risks associated with other procedures.

Facelift Benefits

A facelift offers numerous benefits that can enhance your appearance and boost your confidence. This procedure addresses signs of aging, revitalizing your facial features for a more youthful look. It tightens sagging skin, reduces wrinkles, and restores facial contours, helping you achieve a rejuvenated and vibrant appearance. Here are more benefits:

What Is a Facelift?

A facelift, which is also called rhytidectomy, is a type of facial plastic surgery focusing on addressing the natural aging effects on the face and neck. Aging causes a loss of skin volume, attributed to decreased collagen, elastin, and glycosaminoglycan production resulting in visible changes in facial appearance. This results in sagging skin, weakened muscles, and soft tissue descent, which can form jowls and blur the jawline. Volume loss in the cheeks and bone reduction can diminish facial support. The triangular facial focus in youth inverts into a squarer shape as jowls form and the midface volume decreases. Facelift surgery addresses these issues, restoring a more youthful appearance by tightening skin and muscles, and repositioning tissues.

Facelift Expected Results

• Lift excess loose skin on the lower face that causes jowl formation
• Improve the appearance of a “turkey neck” caused by sagging skin around the neck
• Tightens and lifts the underlying muscle and soft tissue to restore the cheeks, jawline, and neck area to a more healthy and youthful position and contour
• Diminishes appearance of deep wrinkles

Facelift Procedure Snapshot

PROCEDURE SUMMARY
What is the pain level after the surgery?	Minor discomfort
Anesthesia type (if applicable)	General anesthesia
Duration of Surgery	Up to 4 hours
Where is the scarring for this procedure?	Hidden incisions are camouflaged along the hairline and inside of the ear for women or in front of the ear for men
Timeframe to begin showing final results	1 to 6 months healing improves
When is the patient able to return to regular activities?	2 weeks
When is the patient able to resume exercise?	2-3 weeks
Cost of surgeon’s fee	$20,000+, Revision Facelift $30,000+

The goal of a facelift surgery is not to make everything tight, but to return the face to a natural, refreshed, more youthful, and overall better look.” —Dr. Jessica Kulak, Aging Face Surgeon

Ideal Candidates for Facelift

A Good Candidate for Facelift Surgery:

• Wants to improve appearance of jowls along the jaw and cheeks
• Has loose skin and excess tissue along the neck causing a double chin
• Has deep nasolabial folds or lines between the nose and corner of the mouth
• Has no medical conditions that will hinder surgical healing 
• Is a non-smoker
• Has a positive outlook and realistic goals for what can be achieved
• Is in overall good health

Ideal Age for Facelift Procedure

Facelift surgery is typically associated with people in their 40s to 70s, although it can be performed on those outside this bracket. Facial aging can begin in the late 30s due to genetic and external factors like stress, sun exposure, and weight loss. Loose facial tissue can result from these influences. Candidates for facelifts include individuals of any age experiencing tissue descent, skin loss, or changes in the jowls, cheeks, and neckline. The shift in cosmetic surgery is toward early intervention for gradual, natural results. Mini-facelifts, thread lifts, and non-invasive treatments like Ultherapy™ and SkinTyte™ help maintain youthful contours without immediate surgery.

Male Facelift surgery

A good facial plastic surgeon knows to address gender differences when performing facelift surgery. The aging concerns that males have are different from women’s concerns. Women are often looking to get rid of fine lines and wrinkles while men are generally more bothered by the loss of jawline definition. Furthermore, men often look for improvement to the lower face and neck rather than the full face. Another important difference between men and women for surgeons is where to hide incision lines. This is an important aspect of surgery for both men and women. Since men tend to wear shorter hairstyles and have more facial hair than women, plastic surgeons will have a slightly modified approach for their incisions when performing facelifts on men due to increased importance of hairline preservation.

Additionally, men experience a loss of muscle and skin laxity in the neck, sometimes paired with a fat deposit under the chin. Men with a weaker jaw and chin structure tend to develop these fat deposits at an earlier age, making them a great candidate for additional procedures such as submental liposuction and/or a chin implant.

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Facelift Surgical Techniques

Facelift techniques vary based on the incision approach, target areas, and level of invasiveness. Surgeons make incisions along the ear contours and hairline, undermining the skin from fascia. The surgeon will tighten the cheeks, jawline, and neck, redrape the skin, and remove the excess skin. Thus, precise incision placement ensures natural-looking results.

Cutaneous Lift

A “skin-only” lift tightens only the skin, leaving the muscles and tissues untouched. It involves separating, stretching, and removing excess skin, and it has a lower risk for complications. This type of lift is suitable for older patients with medical limitations. However, the results will not last as long, the scars will be more noticeable, and it only addresses surface skin laxity. Thicker scarring might occur due to the layer of skin that holds the incision. The results of a cutaneous lift do not last as long as other facelift techniques because of collagen loss.

Although a cutaneous lift or what most people know these days as a thread lift, has gained in popularity because of less cost as well as less downtime. I am personally not a fan because the results are not as impressive and long lasting as I would like them to be for my patients.” —Dr. Jessica Kulak, Aging Face Specialist

SMAS Plication

The word “plication” means to fold or the action of folding. The “SMAS,” or “superficial muscular aponeurotic system,” is composed of deeper tissues of the face including the ligaments, fat, and musculature of the cheek. Unlike a skin-only facelift, SMAS plication consists of tightening the skin as well as its underlying tissues. The surgeon will often elevate and reposition the SMAS and platysma muscle to restore the youthful contours of the face and neck. Once the surgeon has tightened this deeper tissue has been tightened, the surgeon will redrape the overlying skin and trim the excess skin to close the incision with minimal tension. Minimal tension at the closure of the skin is key to a thin and well-healed scar that is barely visible. This technique has longer lasting results, restores the SMAS to a more youthful position on the face, and better corrects the effects of aging. When done properly by a qualified facial plastic surgeon, the youthful results may last for 8-10 years.

Composite Facelift

The composite facelift is an advancement of the SMAS plication technique. This facelift is considered to be composite because it incorporates several elements of the face to reestablish true youthful characteristics of the face. Composite facelifts reposition the deep tissue layers of the SMAS. However, the key component of the composite facelift, which sets it apart from earlier techniques, is the addition of the orbicularis oculi muscle. This addresses the cheeks, jowls, and neck areas, and it includes a lift and tightening of the eye area as well.

Unlike more traditional facelift techniques that mainly focus on the horizontal repositioning of the facial skin and/or tissues, the composite facelift also takes into account the vertically descending effects of gravity on the face, giving an upward and horizontal tightening to facial tissues. The composite facelift typically has increased downtime and swelling. It is more invasive and has increased risk of complications.

Deep Plane Facelift

A deep plane facelift is a more developed and invasive form of the traditional facelift. The deep plane facelift can better improve the nasolabial folds because it dissects deeper than the SMAS tissue layers, down to the underlying muscles. Since this procedure is dissecting underneath deep tissues of the face, it causes less tension on the more superficial layers of the skin, which can be beneficial for patients with thick skin and a heavier face.

Due to the depth of this procedure, it is important to go to a board-certified facial plastic surgeon who is experienced and regularly performs this technique. A deep plane facelift requires skillful and meticulous dissection of deeper tissue layers, which even in cases where experienced hands are performing the procedure, there is a much higher risk of permanent nerve damage than with other facelift techniques. One commonly seen complication is damage to the mandibular branch of the facial nerve, which can lead to permanent one-sided or bilateral lower facial droop. Due to the increased risk of complications with deep plane facelifts, many experienced surgeons as well educated patients decide to pursue a slightly less invasive facelift approach to minimize the incidence of potential complications.

Subperiosteal Facelift

A subperiosteal facelift is considered to be more invasive than a traditional SMAS lift. A subperiosteal lift separates all fat and muscle from the underlying bony structures of the face. A subperiosteal lift is a good choice for patients who also want facial implants. Since all facial tissues are lifted from the facial bones, the implants are nicely placed between them.

The most profound results of a subperiosteal lift are most noticeable on the upper two-thirds of the face, as this procedure involves a vertical lifting process. Since a subperiosteal facelift dissects down to the facial bones, this procedure typically has more involved downtime and lengthier recovery. Swelling can be quite significant, lasting weeks to several months.

Mid Facelift

The midface is commonly known as the area surrounding the nose, eyes, and even the corners of the mouth (the middle areas of the face). As we age and lose skin laxity, it is normal to experience sagging or descent in these areas. Some may find sagging of the eye, cheek, and mouth areas only, without experiencing sagging of the neck or jawline. In cases where there is very focused facial sagging, a mid-facelift could give a more youthful appearance, without the need to undergo a full facelift. The results of a mid-facelift are often subtle, and not long lasting. Therefore, Dr. Kulak rarely performs this procedure on its own. A mid-face lift is usually paired with additional procedures to attain more optimal results. Often an upper and lower blepharoplasty (eyelid lift) complements the results of a mid-facelift by also refreshing the eyes to a more open and well-rested appearance.

Mini Facelift

A mini-facelift surgery is essentially a less intense and less invasive version of a traditional facelift. It is a great option for patients who are experiencing mild signs of aging and facial sagging in the lower areas of the face. A mini facelift is typically done on patients in their 30s to young 50s who do not yet need a full facelift but could still receive improvement to their facial contours. Many people know the mini-facelift by other names such as the “s-lift” or the “weekend lift” for its incisional technique and speedy downtime. Incisions for a mini-facelift are typically from the ear around to the hairline, well hidden in natural contours. The term mini-facelift is also often loosely used for partial facelifts such as lower face only, midface only, etc. Some may even refer to a mini-facelift as a procedure that primarily corrects the face with minimal correction to the neck, or as a procedure that primarily corrects sagging of the neck but not much of the face. The way the term is used may vary, so it is important to be very clear about which areas you are hoping to correct when going for a mini-facelift consultation. This will help the surgeon evaluate your specific anatomy and determine which kind of lift will give you optimal results.

Facelift Incision Lines

In plastic surgery, discreet scar placement is vital for a natural appearance. Patients want youthful results without obvious signs of surgery. A skilled surgeon will strategically make incisions within ear and hairline creases, preserving their position. Dr. Jessica Kulak, our facial plastic surgeon, elevates deeper facial tissues to reduce skin tension, yielding cleaner incisions and better scarring. She addresses concerns about hair loss near incisions by beveling incisions for regrowth. This preserves hairlines, enabling versatile hairstyles without visible scars. The aim is for patients to confidently wear their hair up or back without worrying about revealing surgical marks.

Not every surgeon takes the same approach to incision line placement for facelifts and neck lifts. Dr. Jessica Kulak meticulously places her incisions along the edges of the ear and behind the tragus cartilage. This allows for optimal camouflage rather than placing incisions directly in front of the ear and leaving more evidence of surgery. When closing the back edges of the tragus, the surgeon must use the correct techniques to minimize tension so that the tragus is not pulled forward. Repositioning the newly tightened skin over the tragus requires the removal of fat and sometimes the placement of deep sutures under the skin to minimize the potential tension on the cartilage.

Dr. Jessica Kulak has an artistic eye for natural contours and facial rejuvenation. Patients are always pleased with their natural results that simply restore them to a more youthful appearance without showing signs of any procedures. Below are examples of Dr. Jessica Kulak’s surgical results from two of her many patients who achieved amazing results with no signs of facelift surgery.

Surgical Procedures Commonly Combined with Facelifts

For most individuals, the aging process affects a variety of different areas of the face at the same time.

Other common effects of facial aging may include:

• Drooping of the eyebrows
• Sagging, puffing, and/or heaviness of the eyelids
• Volume loss in the cheeks and temples
• Laxity of the neck
• Worsening skin texture, tone, and overall quality
• Enlargement of the nose and increase nasal droopiness

If any of these additional effects of aging are a concern, the surgeon can correct them at the same time as a facelift. Our facial plastic surgeon regularly performs multiple facial procedures during one surgery. She does this to reach a more complete youthfulness of the face so that no major signs of aging are left. For example, if a patient needs a facelift but is also experiencing significant heaviness and sagging of the eyelids that is contributing to a tired and aged appearance, it would be beneficial to correct this as well. During a thorough analysis and consultation, our board-certified facial plastic surgeon will discuss these topics and provide recommendations.

Procedures commonly combined with a facelift:

• Upper Blepharoplasty
• Lower Blepharoplasty
• Neck Lift
• Chin Implant Placement
• Fat Grafting
• Laser Resurfacing
• Brow lift Surgery
• Neck Liposuction
• Laser Resurfacing

Liquid Facelift

A liquid, or non-surgical, facelift is the restoration of a more youthful facial contour through the use of injectable dermal fillers and Botox. The injectable fillers can replace volume loss, lessen skin sagging by filling volume from within, and smooth fine lines, wrinkles, and folds. The liquid facelift is the latest trend of a non-surgical, non-invasive procedure with minimal downtime and low risk.

A liquid facelift is an in-office procedure in which the provider will inject fillers and Botox into specific areas to reduce the signs of aging. At The Naderi Center, we offer a topical numbing cream to ensure our patient’s comfort during the procedure. Downtime typically consists of minor swelling and bruising, but with the use of makeup, most patients can go about their daily routine per usual.

A liquid facelift may seem reasonable due to its low downtime, risk, and avoidance of an invasive procedure. However, it does come with drawbacks. A major drawback is the longevity of facelift results. Although dermal fillers may last 1-2 years depending on the placement and quantity injected, our surgeons suggest routine dermal filler injections every 6-9 months to maintain the look. Furthermore, to maintain the results from Botox or Dysport, patients should come in for routine injections every 3-4 months. Patients should be aware of the continued maintenance required when opting for a liquid facelift.

Despite the ability of liquid facelifts to achieve great improvement, if your degree of skin laxity and facial aging is too severe, you may need more than just fillers and Botox to achieve the desired youthful look. An experienced facial plastic surgeon will assess your degree of aging and help determine which procedure will be most beneficial to you.

Surgical Facelift vs. Liquid Facelift

PROCEDURE SUMMARY
SURGICAL FACELIFT	LIQUID FACELIFT
Longevity of results (~10yrs)	Longevity of results  (6-9 months for dermal fillers, 3-4 months for Botox/Dysport)
More corrected result	Partially corrected result
Surgically invasive	Non-invasive
Higher risk	Low risk
Extended downtime	Little to no downtime

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Before and After Photos

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Cost of Facelift

A variety of factors determine the overall cost of your facelift procedure.

For more detailed pricing information visit here.

1. Surgeons fee: $20,000+, Revision Facelift $30,000+
2. Anesthesia Fee: depends on length of procedure
3. Hospital and Surgical Facility Fees: depends on length of procedure
4. Post-Surgery Garments and Recovery Device: included with surgeon’s fee at The Naderi Center
5. Pre-Surgical Medical Clearance and Lab Tests: usually covered by medical insurance
6. Medication Costs: usually covered by medical insurance
7. Follow-Up Visits: Included with surgeon’s fee at The Naderi Center

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Preparation for Facelift Surgery

At The Naderi Center, we believe we can improve the success of your facelift surgery with proper preparation. We go above and beyond to make sure that our patients are medically, emotionally, and physically ready for surgery.

Download and print our preop and post-operative facelift instructions here.

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Recovery After a Facelift

We will perform surgery at INOVA Fair Oaks Hospital, an ambulatory surgical center in Fairfax, Virginia, or Suburban Hospital and surgical center in Bethesda, Maryland. Patients will typically be discharged home from the hospital after a few hours in recovery to rest and relax. Many patients report little pain after facelift surgery. Minor discomfort is easily controlled with pain medication.

On average, recovery after a facelift takes about 10 days. The provider will remove bandages placed after surgery in the office the following day and will remove sutures after the first week. Swelling and bruising after a facelift are common and can take around 2 weeks to resolve. While the majority of the swelling will be gone by one month, swelling and incisions will continue to improve over the next 6 months. Most patients return to work after 2 weeks of recovery and can begin light exercise 3 weeks after surgery.

AQUECOOL RAPID RECOVERY SYSTEM

Post-operative healing and care are of upmost importance when it comes to staying comfortable and safe, and ensuring a good result. This is why our surgeon, Dr. Kulak, uses the Aquecool Rapid Recovery System for every one of her facelift/neck lift patients. Aqueduct Medical has a top-of-the-line recovery system for patients during their post-operative healing to expedite downtime, reduce swelling and bruising, and manage discomfort. It is an advanced FDA-approved device that delivers safe and controlled compression and cooling to the operated areas.

There are two parts to the Aquecool Rapid Recovery System: the Aquecool Masque and the Aquecool Device. The Aquecool Device is a portable and easy-to-use electric water cooling machine that maintains a water temperature between 50-65 degrees Fahrenheit (temperature may be specifically adjusted by the user). The Aquecool Device stays at its set temperature and is time-regulated to go on and off at appropriate increments to prevent tissue damage that can occur from over-icing. This device is then hooked up to the Aquecool Masque. The Aquecool Masque is a custom-fit, splint-like masque that is placed around the patient’s face and neck. When it is hooked up to the Aquecool Device, it circulates the temperature-controlled water through the masque to provide compression, comfort, and cooling.

Without this device, the recovering patient would have to rely on ice packs for post-operative facial cooling. Ice packs can be uncomfortably cold, melt quickly, and require routine changing to maintain the cooling effects. Having this cooling system automatically lessens the burden and maintenance of your post-operative facial cooling. You will not need to wake up throughout the day or night to change out messy, dripping ice packs. You can sleep comfortably throughout the night knowing that you are getting the proper care that you need.

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Possible Dangers, Safety Measures, and Potential Issues of Facelift Surgery.

When undergoing any surgical procedure, there are always risks of complications. Although the chances of encountering a complication are low, patients should be aware of the possible complications that may come from a facelift surgery.

Some possible risks of facelift surgery include:

• Hematoma – A hematoma is blood collection under the skin, which leaks from the blood vessels. This is one of the most common complications of facelift surgery and typically arises in the first 24 hours after surgery. Hematomas require medical attention and most often a surgical drainage of the blood collection.
• Scarring and Hair Loss – Most often scars from a facelift are concealed within the hairline and natural creases or folds of the ear. However, scars may become hypertrophic leading to a thickening and pigmentation of the incision line. Furthermore, this can cause either temporary or permanent hair loss along the incision lines. Routine steroid injections may improve hypertrophic scars and follicle transplantation may improve hair loss.
• Nerve Injury – Damage to underlying structures, such as nerves, may cause numbness, tingling, and weakened or even paralyzed movements of the face. Most of these side effects are temporary and resolve as the nerve endings reform. However, in rare cases permanent damage may occur.
• Skin Necrosis – Skin necrosis occurs when there is impaired blood supply to a certain region of tissues, which causes that region of tissues to die. Skin necrosis is a very rare but serious complication that requires medical attention. The risk of this complication is severely increased in smokers.
• Infection – Infection is always a possible complication of surgical procedures, as incision sites may become an entry point for bacteria. Signs of infection may include redness, swelling, drainage from the incision site, and fever. Infections may be treated with a course of antibiotics.

Many of the complications that may come from a facelift surgery can be controlled and treated with proper care, medication, or surgical correction. It is important to speak to your plastic surgeon about all possible complications that can occur before deciding on surgery. Strictly following your surgeons pre and post-operative care is imperative to achieving best results with the lowest risk of complications.

Pixie Ear Deformity

A previously common side effect of facelift surgery was an unnatural look of the earlobe, commonly known as the “pixie” ear deformity. This deformity usually comes about from improper reattachment of the earlobe after repositioning of the skin or too much tension put on the earlobe. This causes the earlobe to stretch and elongate down toward the jawline. The “pixie” ear deformity was a largely known sign of facelift surgery because of its unnatural appearance. A well-experienced facial plastic surgeon is aware of this complication and will properly perform a facelift to reduce the chance of this after-effect.

Revision Facelift

A revision facelift, or secondary facelift, is a surgical facelift procedure performed after one has already undergone a primary facelift. There are many different reasons to choose to undergo a revision facelift. However, the decision is typically very personal and based on one’s own satisfaction with the results from their first facelift. Longevity of results is a top reason some may undergo another facelift procedure. No matter how successful and satisfied a patient is with their first facelift results, a facelift does not stop time. Facelift results can last up to 10-15 years. But some patients may be unsatisfied with their facelift results after about 5 years. Aging is a natural process that continues to affect our bodies and face, and the rate of aging from one person to another is always varied. The natural aging process is largely a reason why some may opt for a secondary facelift. The proper time for this procedure is up to the patient’s personal discretion.

Other reasons to opt for a secondary facelift:

• Noticeable scarring
• Asymmetric results
• Original use of outdated techniques
• Major weight loss after initial surgery
• “Pulled back” look
• Irregular contour with dimpling or ridges
• Not enough lift

A secondary facelift is often more complicated than a primary facelift because underlying tissues have been repositioned in new areas and scar tissue may have formed. Going through with a revision facelift can be worrisome for many patients. When choosing to opt for secondary surgery, it is important to have an initial consultation with a board-certified facial plastic surgeon who is truly an expert in facial anatomy and specializes in facelift procedures. A skillful and experienced surgeon can correct any previous issues and restore you to a more symmetric, natural, and youthful appearance.

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Facelift Specialist, Dr. Jessica Kulak

Dr. Kulak approaches each patient as an individual and tries to develop a treatment plan that fits each patient’s goals and lifestyle. Everyone ages in a different way and at a different pace depending on a variety of factors. There is no set age that should guide your decision about when to pursue a facelift surgery. Dr. Kulak specializes in many non-invasive treatment options that she can offer her patients to reverse early signs of an aging face, such as fillers to replace volume loss or skin resurfacing to improve skin texture. However, surgery is the only true way to correct loose neck and cheek tissue in the face that cause the formation of jowls and the sagging skin appearance along the jawline.

Dr.Kulak utilizes conservative but effective facelift surgery techniques to achieve a natural, long lasting, and refreshed appearance to the face. Her goal is to restore a more youthful contour to the face without giving an overly tightened or “pulled-back” look. Dr. Kulak works with every patient to understand all of their individual goals and concerns in order to decide which procedures will give them the optimal outcome they hope for.

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Schedule your Facelift Consultation

Known as a leader in cosmetic and plastic surgery procedures, The Naderi Center has been serving patients in the Virginia, Maryland, and Washington D.C. area for more than 10 years, with patients visiting from Virginia Beach and other parts of the country. The Naderi Center is known for being the source of physicians and surgeons that are specialized in their realm and scope of practice. Patient’s come to The Naderi Center when they want an expert on the procedure or condition they are trying to improve. Contact one of The Naderi Center’s two offices for more information, or to schedule your facelift consultation. A patient coordinator can be reached at our Reston, Virginia office at 703-481-0002 and at our Chevy Chase, Maryland office at 301-222-2020.

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Facelift Questions to Ask