Facial Rejuvenation

Facial rejuvenation refers to the combination of cosmetic procedures used to restore your facial features to their previous youthful appearance. While a facelift is often the anchor or foundation for many facial rejuvenations, other procedures can complement and enhance the result. Surgical procedures such as eyelid surgery, brow lift and facial implants can help correct specific problem areas on the face. Nonsurgical treatments including fillers, neurotoxins (botulinum toxins) and fat injections can be used for volume enhancement and wrinkle and fold eradication. Laser skin resurfacing or other light modalities can be utilized to improve skin texture and correct skin blemishes or age spots.

When to Consider Facial Rejuvenation

  • If you want to reverse the signs of aging and restore a more youthful appearance
  • If your face and neck are sagging, or if you are losing volume in your cheekbones and contour along your jawline
  • If there are crow’s feet at the corners of your eyes, fine lines and folds around your mouth, and frown lines and furrows in your forehead
  • If there is drooping skin and wrinkling changes in your upper eyelids, upper and lower eyelid bags, and dark circles under your eyes

Considerations

Pros

  • When facelift and shaping with fillers, implants or surgery are combined, you get the joint benefits of skin tightening and lifting along with volume enhancement.
  • When laser resurfacing is added to the mix, you benefit from smoother skin, with elimination of skin imperfections and superficial wrinkling.
  • Using fillers and botulinum toxins after facial surgery can help maintain your results, improve the look of deep lines and prevent the development of new ones.

Cons

  • The greater the number of procedures performed, the greater the potential for complications.
  • You may need to have repeated toxin or filler injections over time to receive the full benefit of these treatments.
  • Adding additional procedures will also increase the cost of the total rejuvenative process and expected time for recovery.

These are the top three pros and cons to weigh when considering facial rejuvenation. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for facial rejuvenation?

The following are some common reasons why you may want to consider facial rejuvenation:

  • You want to look younger and more refreshed
  • You seek the most natural result
  • You have a number of aging signs that cannot be adequately treated with only one surgical procedure

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

A

B

C

D

  1. Balancing facial features may require multiple procedures to address loose skin, loss of volume and uneven skin tone.
  2. Facelift or brow lift, eyelid surgery and skin rejuvenation can give you a brighter look that is not only younger, but more revitalized.
  3. Facial rejuvenation also addresses structure and definition in the face, which can affect overall appearance.
  4. Injectable fillers and implants can improve facial contours and define cheekbones and the jawline.

Detailed Procedural Info

How is a facial rejuvenation procedure performed?

Careful planning and sequencing of procedures is necessary for facial rejuvenation. Your aesthetic plastic surgeon will determine the best order of procedures in your particular case.

  • If volume enhancement using fat transfer is desired for facial rejuvenation, it is typically performed first with fat grafting to deficient regions. The fat is harvested from other areas of the body and then transferred into the desired regions.
  • Depending on the degree of skin laxity (looseness) in the face, either a limited incision (for minimal to moderate laxity) or a more extensive facelift is performed. Eyelid surgery, brow lift or facial implants can also be performed.
  • For facelift, the skin flaps are lifted and trimmed or undermined as needed, then the flaps are moved to remove excess skin and secured with sutures.
  • Once the incisions are closed, laser resurfacing can be used to improve the quality of the skin surface, erasing wrinkles around the mouth and the eyes, eliminating blotchy pigmentation, diminishing the appearance of bags under the eyes, and helping to reverse skin damage as result of sun exposure.

After healing from the surgical component of facial rejuvenation, additional refinements can be performed during follow-up office visits.

  • Neurotoxins can be injected in the muscles of the forehead to smooth it, eradicate wrinkles, and provide a brow-lift effect.
  • Fillers can be injected to erase the fine lines around the mouth, to add volume to the lips, and to fill the folds extending from the nose to the mouth.
  • Fat can also be used at this point to add volume to the lips and to camouflage the deep line that runs from the corner of the lip to the jawline (often called the marionette lines).

What are my options?

There are multiple treatments that can be combined to give you a more youthful appearance. The procedures chosen will be tailored to your specific aging problems and concerns so that they provide you with optimal treatment.

What are the brand names for products used in treatments for facial rejuvenation?

  • There are a number of fillers and neurotoxins that your surgeon can choose from. For an explanation about some of the popular products visit our section on injectables.
  • Laser skin resurfacing also has many different brands and types to choose from, depending on your skin issues. For more information visit our section on laser skin resurfacing.

What will my facial rejuvenation incisions and scars be like?

The facelift incisions will vary, depending on the type of facelift performed. Likewise, eyelid surgery, brow lift, and facial implant surgery come with their own set of incisions. For a detailed explanation, visit these sections.

A

B

  1. The endoscopic brow lift uses several small incisions within the hairline. Incisions and placement vary.
  2. The incision line usually runs along hairline and within the natural contours in front and behind the ears.

Selecting a Surgeon

Select a surgeon you can trust

It’s important to choose your surgeon based on:

  • Education, training, and certification
  • Experience with facial rejuvenation surgery
  • Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.

After finding a board-certified plastic surgeon in your area who is experienced in performing facial rejuvenation procedures, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for facial rejuvenation and clarify what facial rejuvenation can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered. (See related procedures).

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

  • Previous surgeries
  • Past and present medical conditions
  • Allergies and current medications

Your treatment plan

Based on your goals, physical characteristics and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:

  • An approach to your surgery, including the type of procedure of combination of procedures
  • The outcomes that you can anticipate
  • Your financial investment for the procedure
  • Associated risks and complications
  • Options for anesthesia and surgery location
  • What you need to prepare for your surgery
  • What you can expect to experience after surgery
  • Show before and after photos of cases similar to yours and answer any questions

Questions to ask your aesthetic plastic surgeon

For a general list of questions to ask your surgeon about his or her background, find out about plastic surgery safety, and to plan your procedure visit the Planning Toolkit.

To get the most benefits from your initial consultation, here is a list of questions to ask your surgeon. We developed these questions to help you:

  • Make the most informed and intelligent decisions about your procedure
  • Confirm that you have the right surgeon for your procedure
  • Make your initial consultation as rewarding as possible
  • Understand your options, potential outcomes, and risks

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for facial rejuvenation?
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • Will my scars be visible? Where will my scars be located?
  • What kind of anesthesia do you recommend for me?
  • What will be the costs associated with my surgery?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect, and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing for Your Procedure

How do I prepare for a facial rejuvenation procedure?

Before treatment, you may be placed on a pretreatment program during which you will apply special creams, lotions, or gels to your skin for a few weeks or longer. You may also be given certain oral medications that you should begin taking prior to your treatment. Your surgeon will provide you with pretreatment instructions, answer any questions that you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery.

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking at least six weeks before undergoing surgery to promote better healing.
  • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding.
  • Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

Facial rejuvenation procedures are usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

What can I expect on the day of my facial rejuvenation surgery?
Your facial rejuvenation procedures may be performed in an accredited hospital, free-standing ambulatory facility, or office-based surgical suite. Most facelift procedures take at least two to three hours to complete but may take longer.

  • Medications are administered for your comfort during the surgical procedure.
  • General anesthesia is commonly used during your procedure, although local anesthesia or intravenous sedation may be desirable in some instances.
  • For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse, and the amount of oxygen circulating in your blood.
  • Your surgeon will follow the surgical plan discussed with you before surgery.
  • After your combined procedures are completed, you will be taken into a recovery area where you will continue to be closely monitored. You may have drainage tubes in place.
You will likely be allowed to go home after a short observation period unless you and your plastic surgeon have agreed on an overnight stay.

Aftercare and Recovery

Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:

  • Drains, if they have been placed
  • Skin care after laser resurfacing
  • Normal symptoms you will experience
  • Potential signs of complication.

See options for short-term recovery locations in Aftercare and Recovery (Planning Toolkit).

Immediately after facial rejuvenation
Your appearance immediately after facial rejuvenation will depend on the type of facelift performed and the number of associated treatments that are added. Your resurfaced skin may be covered with petroleum jelly or other protective ointment, and in some cases, dressings, tape or a bandage may be applied. If facelift, fat grafting, and laser surgery are combined, your face will be swollen and bruised initially but these signs of surgery will resolve over the next week to ten days and you will be able to fully appreciate the improvements that have been achieved. After neurotoxin or filler injections, the results are obvious after a few days and the associated pain is related to the specific products used.

When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact your physician. If you are concerned, contact your surgeon to find out if your pain, redness, or swelling is normal or a sign of a problem.

Recovery time frame
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about care of drains, taking an antibiotic if prescribed, and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

How Long Will the Results Last?

Although it is impossible to totally reverse the pull of gravity and the natural aging process, the results of facial rejuvenation will be long lasting. The complementary procedures, filler and toxin injections, which can be repeated periodically, will help you to maintain your youthful appearance. The fat grafts are permanent and will age as you age. Laser resurfacing will have a permanent effect.

Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon's office for follow-up evaluation at prescribed times and whenever you notice any changes in your face. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs

The cost of facial rejuvenation varies from doctor to doctor and from one geographic area to another. It also depends on the number of different treatments that are combined.

See the national average for physician fees per procedure.

These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments or other miscellaneous costs related to this procedure.

Because facial rejuvenation procedures are considered elective, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.

Choose your surgeon based on quality, training, and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.

Limitations and Risks

Fortunately, significant complications from facial rejuvenation are infrequent. Your specific risks for facial rejuvenation will be discussed during your consultation.

All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures

Other risks specific to rejuvenation are outlined below:

  • Reabsorption of fat grafts
  • Possible skin breakdown
  • Return of wrinkles and folds over time may require subsequent treatments

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your facial rejuvenation surgery.

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