Q: What are the pros and cons of a lower facelift?

Pros A lower facelift rejuvenates the bottom third of the face, contouring the jawline, chin, and (frequently) the neck. This surgical procedure is typically less invasive than a full facelift, so you may have shorter incisions and less scarring. Recovery time also tends to be shorter—usually a week to 10 days of downtime (though some patients do need two weeks of recovery time). Results from this facial plastic surgery procedure can last up to 10 years. Even as you continue to age, you’ll always look younger than if you hadn’t had the procedure. Cons As you heal, you can expect some swelling for up to 3 months and numbness in the treated areas for 6 months or longer. A lower facelift doesn’t usually treat the upper cheeks, midface, or brow. If your concerns extend to those areas, you may need to consider a mid facelift, full facelift, fat transfer, and/or a brow lift. It also doesn’t address textural issues or uneven pigmentation from sun damage, though it can be combined with nonsurgical skin rejuvenation procedures to improve skin tone and texture. While the procedure can turn back the clock, your face and neck will continue to age, and you may want to opt for another procedure after about 10 years. Like all surgery, this one comes with risks, including infection, hematoma, poor scarring, and (very rarely) infection or facial nerve damage. Related: Why I’m So Happy I Got a Lower Facelift

Question 1

What is a lower facelift?

Accepted Answer

A lower facelift is a surgical procedure that rejuvenates the lower half or third of the face—everything below the corners of the mouth, including the jawline and often the neck.

Sometimes called a “mini lift,” a lower facelift lifts and tightens the underlying facial structures that slacken with age and removes excess loose skin to eliminate jowls, better define the jawline, and lessen deep wrinkles and folds. The procedure also addresses the area under the chin and often removes excess neck fat.

Compared to a full facelift (rhytidectomy), lower facelift techniques are less invasive and require smaller incisions. An upper facelift (aka a forehead lift or brow lift) focuses on everything above the eyes, including your brow line and forehead.

Lower facelifts may also have a shorter recovery time of seven to 10 days, compared to the two weeks of recovery time that’s often needed after a SMAS or deep plane facelift.

Related: Mini Facelift vs. Full Facelift: What’s the Difference?

Facial plastic surgery terms are used differently by different plastic surgeons, so be sure that you and the surgeons you consult are clear on your specific areas of concern, what will be done to address them, and the expected results. “What a full facelift means to one surgeon may not be the same for all surgeons,” says Dr. Sam Naficy, a facial plastic surgeon in Bellevue, Washington.

If you’re looking for more complete facial rejuvenation, your surgeon may recommend combining a lower facelift with another cosmetic procedure. This could include a brow lift, rhinoplasty, laser skin resurfacing, injectable dermal fillers, or a facial fat transfer (using fat harvested from other body areas via liposuction).

Question 2

Does a lower facelift include the neck?

Accepted Answer

Yes, a lower facelift procedure is usually combined with a neck lift (aka platysmaplasty), to achieve the best results. “Because the lower face and neck are part of the same anatomic unit, they are typically lifted together, and the procedure is generally called a lower face and neck lift,” says Dr. Naficy.

According to Dr. Allen Gabriel, a plastic surgeon in Vancouver, Washington, “it’s rare to do a lower facelift only.”

Performing these procedures at the same time has both practical and aesthetic benefits. “The platysma is a broad sheet of muscle that covers the neck and extends to the lower face,” Dr. Gabriel explains. This muscle can separate and sag over time, and tightening it as a complete unit provides a more balanced, transformative result.

A neck lift also lifts and smooths sagging neck skin and removes excess fat, to eliminate issues like a double chin, horizontal banding, and the laxity that’s commonly called “turkey neck.” These changes can give your entire neck and jawline a more youthful appearance.

Related: Lower Facelift vs. Neck Lift: What’s the Difference?

Question 3

What are the pros and cons of a lower facelift?

Accepted Answer

Pros

A lower facelift rejuvenates the bottom third of the face, contouring the jawline, chin, and (frequently) the neck.
This surgical procedure is typically less invasive than a full facelift, so you may have shorter incisions and less scarring.
Recovery time also tends to be shorter—usually a week to 10 days of downtime (though some patients do need two weeks of recovery time).
Results from this facial plastic surgery procedure can last up to 10 years. Even as you continue to age, you’ll always look younger than if you hadn’t had the procedure.

Cons

As you heal, you can expect some swelling for up to 3 months and numbness in the treated areas for 6 months or longer.
A lower facelift doesn’t usually treat the upper cheeks, midface, or brow. If your concerns extend to those areas, you may need to consider a mid facelift, full facelift, fat transfer, and/or a brow lift.
It also doesn’t address textural issues or uneven pigmentation from sun damage, though it can be combined with nonsurgical skin rejuvenation procedures to improve skin tone and texture.
While the procedure can turn back the clock, your face and neck will continue to age, and you may want to opt for another procedure after about 10 years.
Like all surgery, this one comes with risks, including infection, hematoma, poor scarring, and (very rarely) infection or facial nerve damage.

Related: Why I’m So Happy I Got a Lower Facelift

Question 4

How much does a lower facelift cost?

Accepted Answer

The average cost of a lower facelift is type: embedded-entry-inline id: 6aTOuvi443nRPfQzwP6tIP, but some RealSelf members say they’ve paid as much as type: embedded-entry-inline id: 3TqRgTEUtEO0futq5cEvbi in recent years. Today, Dr. Naficy says it’s not uncommon for prices to range up to $40,000, and sometimes more.

Your lower facelift cost will depend on factors like your plastic surgeon’s level of experience, their practice location, and the complexity of your procedure.

It’s a significant investment, but it can also be a more cost-effective option in the long run than nonsurgical facial rejuvenation treatments that may not work as well and require ongoing maintenance treatments.

This is cosmetic surgery, so insurance won’t cover it, but most surgeons accept plastic surgery financing options or offer monthly payment plans. You can also finance your treatment with CareCredit.

See our complete guide to lower facelift costs

Question 5

Lower facelift before and after pictures

Accepted Answer

The lower facelift photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 6

Who's a good candidate for a lower facelift?

Accepted Answer

Good candidates are healthy nonsmokers in their late 40s or 50s who are beginning to see sagging around their mouth, jawline, and under the chin.

You'll also need to have at least one centimeter of pinchable, lax skin on your lower face.

“In your 40s, a lower face and neck lift will allow you to achieve the best version of yourself while still being at an age for optimal healing,” says Dr. Kian Karimi, a facial plastic surgeon in Los Angeles. “The best part is that you will be able to enjoy this refreshed look for many years to come, as we typically expect the results to last 8–10 years.”

Recently, more 30-year-olds have also started opting for lower facelift surgery, to address early jowling and laxity. Some also view it as a form of aging prevention (sometimes called “prejuvenation”).

Related: 30-Year-Olds Are Getting Facelifts. Here’s Why.

Question 7

What happens during lower facelift surgery?

Accepted Answer

A lower facelift procedure takes 2 to 4 hours (depending on your provider’s technique and skill level), but it may take longer if it’s being combined with other cosmetic procedures.

Here’s what to expect.

First, you’ll be given general anesthesia or local anesthesia with sedation, so you’ll either be fully asleep or drowsy and relaxed.
Your plastic surgeon will make incisions near the front of the ears, extending from the earlobes to the hairline. Another short incision just under the chin may be necessary to suction out excess fat and/or tighten the sagging neck muscles. The length of the incisions and their exact locations will depend on your doctor’s surgical technique, your facial anatomy, and your goals for the procedure.
Your surgeon will then lift the skin and underlying tissues, elevating the facial muscles (the SMAS) and suturing them into their lifted position.
They will then trim any excess skin to eliminate sagging and improve your jawline definition.
Finally, they’ll close your incisions with fine sutures.

Lower facelift surgery is an outpatient procedure, so you’ll return home the same day with aftercare instructions.

You’ll be groggy from the anesthesia, so make sure you have someone you trust there to get you home safely and stay with you for the first night.

Question 8

How long does lower facelift recovery take?

Accepted Answer

Patients don’t heal in exactly the same way, but you can expect your recovery timeline to go something like this.

One day post-op

Your surgeon will monitor your recovery at follow-up appointments starting the day after your surgery.
“Recovery has different phases after a lower facelift, starting at the first week where sutures and staples are present and you look ‘procedural,’” says Dr. Stephen Prendiville, a facial plastic surgeon in Fort Myers, Florida.
You can expect some discomfort, redness, sensitivity, bruising, and swelling.
Pain meds are usually only necessary for a few days. Your plastic surgeon may also ask you to use light ice compresses to reduce swelling.
It’s also common to experience a tightening sensation as your skin adjusts to the changes, as well as a temporary loss of sensation around the incisions.

One week post-op

Most people hide out at home for one or even two weeks post-op, says Dr. Ben Lee, a plastic surgeon in Los Angeles.
Many surgeons use dissolving sutures, but if regular sutures are used, they may be taken out during a follow-up appointment at the one-week mark.

Two weeks post-op

At this point, you should be beyond the worst of the swelling.
Your surgeon may give you the go-ahead to resume light exercise.
“I allow most of my patients to apply makeup between 10–14 days, which will conceal bruising, swelling, and other aspects to the uninitiated eye,” says Dr. Prendiville.

One month post-op

By this time, your plastic surgeon will probably give you the green light to resume your regular exercise routine.
According to Dr. Lee, after four weeks “most people can function socially without anyone noticing anything other than the fact that you look perhaps 10 years younger.”

Two months to a year

“Firmness and swelling in the neck to the touch can last 2–3 months,” says Dr. Prendiville. “Numbness of the neck and lateral face typically lasts 6 months or more.”
You may feel like you’re completely healed much earlier in the process, but “it takes an entire year for all swelling to be gone,” says Dr. Richard Balikian, a facial plastic surgeon in Murrieta, California. “That’s when ‘after’ photos are usually taken.”

Question 9

How soon will you see lower facelift results?

Accepted Answer

Patients report seeing an improvement within a week, as soon as the swelling starts to go down.

However, it can take six months to a full year to subside completely. The changes you see will be more dramatic during the first six months, but you’ll notice subtle improvements over a full year.

It’s not uncommon for lower facelift patients to be disappointed early on with their results, when their face doesn't look quite as good as they expected, according to doctors on RealSelf.

“Getting a facelift can be a very stressful experience, and it’s only natural to expect the results to be immediately obvious,” says Dr. Konstantin Vasyukevich, a facial plastic surgeon in New York City. “However, one has to remember that there is quite a bit of healing happening, and this healing will take time. As the healing process continues, the swelling goes down and the soft tissue settles into its new position, all the positive changes become a lot more apparent.”

Dr. Vasyukevich advises trying to reserve judgment for at least three months before critically evaluating your lower facelift results.

See lower facelift before and after photos

Question 10

How long does a lower facelift last?

Accepted Answer

Lower facelift results tend to last 8 to 10 years, but your age, lifestyle choices, bone structure, skin type, sun exposure, and heredity all play a role in how long your results will last.

Younger patients tend to enjoy longer-lasting results, so if you're in your 40s, the effects may last beyond 10 years.

Nonsurgical procedures that stimulate new collagen formation, such as Thermage FLX, are very helpful in improving skin quality and further enhancing the results of a lower face lift.

“My patients who look the best and maintain their results the longest are those who combine surgery with collagen-stimulating treatments, along with fat grafting or filler injections,” says Dr. Naficy. “Aging has multiple facets, and the components related to volume loss and reduction of skin elasticity shouldn’t be ignored. A surgical lift can help reposition sagging tissue, but it can’t restore elasticity or volume.”

Question 11

What are the risks of lower facelift surgery?

Accepted Answer

Most people don’t experience complications from this procedure, but like all surgery, it’s not without risks. The most common side effects include:

Hematoma, a collection of blood under the skin that needs to be drained
Infection (possible but extremely rare)
Some numbness in the lower face and neck for up to six months post-op, as the nerves repair themselves

Rarely, patients have facial nerve injury that causes muscle weakness and palsy. Thankfully, the chance is extremely low, and it’s not usually permanent.

People who smoke or use other forms of nicotine products (vaping, gums, patches) are at a significantly increased risk of complications resulting from poor healing, Dr. Naficy tells us. “Nicotine reduces the circulation of blood to skin and can have serious wound healing consequences, including scarring,” he says.

To help ensure that your recovery goes as smoothly as possible and that your results meet, or even exceed your expectations, be sure to attend all of your follow-up appointments and follow all of your surgeon’s recommended instructions.

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Sam Naficy, MD, FACS

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Sam Naficy, MD, FACS

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