Facelift and Neck Lift

What is a facelift and how will I know if it’s the right procedure for me?


Most doctors’ usual facelift incision. This incision raises the hairline in front of the ear.

Facelift surgery, or rhytidectomy, is the gold-standard for lower face and neck rejuvenation.  The procedure has undergone many refinements and advances over the past several decades.  There are many different facial techniques to tighten the skin, but none can boast the results that a contemporary facelift procedure can produce.   At Virginia Facial Surgery we warn that patients should beware of ‘miracle machines’ lofty promises, ‘the quick and easy, non-surgical facelift,’ or the, “facelift in a bottle.”   The results of these procedures are short-lived and leave many disappointed and with hard-earned money wasted. Also be wary of advertising gimmicks such as, ‘facelift in an hour while you are awake.’  These procedures are cook-book treatments provided by corporate franchises.  If it sounds too good to be true, it probably is.  These franchises have many unhappy customers…just search the company name and read the blogs.  Nothing can take the place of a contemporary facelift procedure.


Dr. Mueller’s hairline-preserving facelift incision.

At Virginia Facial Surgery, our facelift is not a one-size-fits-all procedure. The signs of aging are different during each decade of life and facial cosmetic procedures are now being sought out by people as young as in their twenties. This trend has been increasing, as people want to stay younger looking their entire life. Historically, facelift procedures were performed for people in their sixties or later. People now desire smaller procedures throughout their lives to continue to look young. We offer the weekend facelift, the mini-facelift, and the comprehensive facelift. We custom design your facelift procedure based on your aging and personal desires. Our procedures give you the results and longevity that you are looking for. Recent advances in procedures, anesthesia, instruments and technology make facelift surgery easier and more affordable. Our facelift procedures have you resting in your own home by the early afternoon. Naturally, as the face ages, the muscles lose tone and elasticity, begin to sag, and cause jowling. This also causes the skin to become lax and the neck muscle (platysma) begins to sag and form bands. Fat tissue may also collect under the chin. The skin may also be aged due to sun and environmental damage.

Male facelift scar to preserve the sideburn.

Male facelift scar to preserve the sideburn.

During your consultation, Dr. Mueller will first listen to your concerns, then will evaluate your bone structure, skin and muscle sagging, and skin damage. Based on the client’s concerns and Dr. Mueller’s examination, a personalized treatment plan will be recommended. Remember, these procedures are not needed but are desired. Dr. Mueller may suggest other procedures such as blepharoplasty (eye lid procedure), liposuction, chin implant or laser skin resurfacing in combination with a facelift, but understand, a facelift addresses the middle and lower face / neck only. Three main issues determine what type of facelift can be performed and if multiple procedures can be performed. They are: the patient’s general health, the amount of time the patient can take away from work, and the patient’s budget. We insist that our patient’s see their primary care physician to have a complete physical and blood tests to establish their overall health. A real facelift takes 10 – 14 days to heal. Promises of “no down-time,” “no scars,” “no bruising,” and “no anesthesia,” are promises that will not deliver results. The three types of facelifts that we offer, the weekend facelift (small), the mini-facelift (medium), and the comprehensive facelift (large) all address specific aging issues. A real facelift addresses issues such as jowling, platysmal neck bands, the deep layers of the face and the neck, again, depending on the degree of aging. Franchise and trendy micro-lifts do not address any of these issues and do not have longevity. Conservative facelift procedures do have a place, but only in our younger clients with minor aging. You would not want to waste your hard-earned money for a small lift when you really need a large procedure. A real facelift takes 10-14 days to recover. Don’t fall for high-priced television ads and advertised “miracle cures.”

The Weekend Facelift (small lift)

The weekend facelift is for those younger individuals who have minimal lower facial aging. 

There is at most mild jowling and mild aging of the neck.  The neck generally has a good drape with only mild laxity.  The incision is only made in front of the ear. It is a conservative procedure for those who desire to make mild or moderate changes with little down time.   It is called a weekend facelift because most of the healing occurs over the weekend.  The procedure can be performed on a Thursday or Friday and it is not uncommon to return to work by the following Tuesday or Wednesday.  The healing takes about 4 – 7 days.

The weekend facelift can be performed alone, or typically, it is done in combination with cheek or chin implants, eye lift, laser resurfacing and lip augmentation.

The Mini Lift (medium lift)

The mini lift is for those individuals with moderate signs of facial aging.

Typically, this is the facelift for those in their 40’s and 50’s.  Patients in this age range require more than those having a weekend facelift.  This is where patients have to beware of the one-size-fits-all facelift.  There is moderate jowling and neck laxity with platysma banding which is more advanced than the weekend facelift patient.  The incision is made both in front of and behind the ear.  90% of the incision is hidden either behind the ear or within the hairline.  The SMAS (Superficial musculo-aponeurotic system) layer is addressed in addition to a submentoplasty.  This allows both the deep layers and the skin to be tightened more effectively.  Just tightening the skin is not enough.  The jowling needs to be addressed in the deeper layers.

Healing of the mini lift takes one to two weeks.  Every patient is different.  Healing time is different for everybody, but most patients are out and about in 6 – 7 days with minimal makeup, hat and sunglasses.   Dr. Mueller tries to perform this procedure in the middle of the week so that you can have the weekend to recover as well.  Although you may be out and about in a week, it is emphasized that the healing takes up to two weeks.

The Comprehensive Facelift (large or composite lift)

The Comprehensive Facelift is for those individuals who require more lifting than the Mini Lift due to larger aging changes.

This face lift is also usually combined with other procedures such as eye lift and brow / forehead lifting due to the larger aging changes. The incision is made both in front of and behind the ear.  As with the Mini Lift, 90% of the incision is hidden either behind the ear or within the hairline.

The Comprehensive facelift involves a SMASectomy, submentoplasty, liposuction, facial implants, and laser skin resurfacing.  It takes about two weeks for recovery and Dr. Mueller schedules the procedure so that you can take a weekend in the middle of your recovery to minimize time away from work.  As with the Mini Lift, you can be out and about with a hat, sunglasses and some makeup after a week.  Dr. Mueller does encourage you to “take it easy” for about two weeks.  You deserve to relax after a comprehensive facelift.

Final thoughts

As discussed above, there are many new, trendy names for face lifting. The procedures are not new, just the names are. Beware of lofty promises and high-priced TV commercials touting how your life will be lifted with minimal down-time and a procedure that takes an hour under local anesthesia. These procedures do not address all the issues needed for a proper lift. The results don’t last and you end up wasting your money. Understand that these franchises have already spent upwards of $4000 in advertising to get one person in the door. Then, like a timeshare presentation, patients are up-sold on additional procedures. Procedures can therefore cost upwards of $14,000.00 or more. And, unlike the commercials that promised “in one hour,” these procedures take 3 – 6 hours WHILE AWAKE! At VIRGINIA FACIAL SURGERY, your procedure will be much less AND you can be ASLEEP. Clients do not even get to meet the doctor until the second or third visit – after the up-selling process is complete. Also pay attention to before and after pictures. The “before” pictures are taken using low light, high contrast to accentuate aging of the skin, and with the chin tucked in to the neck to exaggerate sagging. The “after” pictures use more light, are slightly out of focus or hazy, use less contrast, and the chins are tilted up to stretch and tighten the skin of the neck. Why is this? Simple! It is done to disguise their lack of results. You get what you pay for.