Facelift / Necklift

Who Is a Candidate for a Facelift/Necklift?

The ideal candidate for a facelift is a person between ages 40 and 70 who is interested in improvement of the shape and structure of their face. It is rare that medical problems cannot be managed in a way that is safe for surgery. High blood pressure and diabetes must be under control. Nicotine is exceptionally bad for the results of a facelift and must be fully avoided for 4 weeks prior to surgery and 2 weeks after. Dr. Lewis will not perform a facelift on an active smoker or nicotine user.

Younger patients may be candidates for one of the mini-facelift options that Dr. Lewis offers such as the MACS lift. This allows a faster return to normal work schedule and work activity.

A facelift can have a rejuvenating effect on the lower two-thirds of the face. This can produce dramatic improvements, including:

• Increased jaw definition
• Decreased jowls
• Decrease sagging skin in the neck
• Decreased lines above the mouth (nasolabial folds)
• Decreased lines below the mouth (marionette lines)

Dr. Lewis works with you customize the procedure and to correct any concerns you have.

Cost in Richmond

The cost of facelift surgery at our practice starts at $16,850. During your initial consultation, we provide a breakdown of all costs related to your procedure. This includes:

• Dr. Lewis’ fee
• Operating room fee
• Anesthesia fee
• Fee for additional overnight stays

We make absolutely sure there are no hidden costs and no surprises.

Your Procedure

A facelift is one of the options Dr. Lewis offers to help address facial aging. It can restore a more youthful look to the lower and mid face and is nearly always done in a way to improve the contour of the neck as well. It can also be combined with other procedures to decrease the appearance of aging in the eyes and forehead.

Individualized Approach

Dr. Lewis is a facelift specialist and uses various surgical techniques to produce optimal results. He individualizes his approach based on which option he thinks is best for you.

This operation is much more than just removing some excess skin. The primary goal of a facelift is to tighten the structures underneath the skin (the SMAS or superficial muscular aponeurotic system) and to reposition the fatty structures of the face to their more natural position.

This involves making an incision around the ear in a position that heals very well. Through this incision, we can lift the skin over the cheeks and subsequently carefully lift and tighten the SMAS layer to a more youthful position. This lift and tightening can be performed in a variety of ways.  We will use sutures to expertly reposition this tissue to a higher and more natural location.

After the underlying SMAS has been tightened and repositioned, the overlying skin can be repositioned.  Now that the underlying tissue has been tightened, there is more skin than is needed and the excess is removed. The incision around the ear is very carefully repaired and the operation is finished.

A Note on Incisions

One of the tell-tale signs of a facelift is the incision around the ear. In all facelift-type surgeries (facelift, MACS lift, Lifestyle lift, mini-facelift, etc.) there is an incision at least in front of the ear.

Dr. Lewis is very skilled at making this scar blend in with the contours of the ear. Some surgeons will place this incision in the skin in front of the ear believing this scar heals well enough (it is also technically easier). Dr. Lewis believes this incision should be placed very close to the contours of the ear, and even within the ear in places. This makes for an incision that is usually nearly impossible to see without close examination.

The enables you to be able to wear your hair in any style you wish.

Recovery

This operation can provide a tremendous improvement for the look of your face, but it can have some moderate bruising and swelling as well. Some of Dr. Lewis’ patients have returned to work as early as a week after surgery, but we recommend taking 2 weeks off to fully recover.

The recovery from the mini-facelift or short-scar facelift techniques (such as a MACS lift) is shorter and most people are able to return to work after 5 to 7 days.

Immediately after surgery, you will have a bulky dressing in place to capture any drainage you’re your incisions. You will also have a small drain to collect fluid from underneath the skin. You will return to our office the day after your surgery to remove this bulky dressing and to make sure all is going well. This visit isn’t needed If you elect to spend the night at the hospital.

Your second visit after surgery, will be for the removal of the sutures. This is done usually 5 days after the surgery. If the drain was not removed on the first visit, it will be removed on this one. After your suture removal, you may start applying makeup, including concealer and your return to normal life can resume at your leisure.

Refrain from strenuous exercise for at least 3 weeks after surgery to avoid increasing your blood pressure, which can potentially increase swelling and bruising.

Reducing Risks & Complications

With any surgical procedure there are risks that you must be aware of. To minimize the risks, ensure your surgery is conducted in a safe and secure environment using the latest surgical techniques by checking the certifications and accreditation of your surgeon. Accreditation boards and bodies are there to protect you. Dr. Gordon Lewis is one of the top facelift surgeons in Richmond and has more than 10 years of surgical experience. He is affiliated with several important professional organizations, including:

• American Society of Plastic Surgeons (ASPS)
• Richmond Academy of Medicine
• Medical Society of Virginia
• American Society for Aesthetic Plastic Surgery (candidate member)
• American College of Surgeons (associate member)
• American Society for Surgery of the Hand (candidate member)

In general, this surgery is very safe and is well tolerated. It is rare that serious complications happen.  We will speak with you at length about these risks and answer all your questions.

These risks include, but are not limited to:

• Infection
• Bleeding
• Hematoma
• Asymmetry
• Nerve damage
• Unfavorable scars
• Skin loss
• Skin contour irregularities
• Pain
• Need for revision surgery
• Risks of anesthesia

Consultation Expectations

During your comprehensive 1-on-1 consultation, we cover several areas of discussion, including:

• Medical history and current medications
• Your aesthetic goals
• Your concerns about the surgery
• Options for surgically correcting these issues
• Risks associated with each option
• Estimated cost and financing options

Expect to spend close to an hour in our office for the consultation.

Location

Dr. Lewis performs surgical procedures at an accredited outpatient surgical center or a local hospital. He is affiliated with several local medical centers where his patients undergo surgery. He primarily operates at these locations:

Johnston-Willis Hospital
Stony Point Surgery Center

Initial consultations, follow up appointments and all non-surgical treatments and minor surgical procedures are performed at Lewis Plastic Surgery in Midlothian, VA.