David H. Harley, MD

I am 40 and I know that sounds quite young to be getting a neck lift/lower face lift. I've never had a great jawline. But a few years ago I got liposuction under my chin. It really didn't do much. Then I lost 30lbs. My neck is just as bad or worse than before. I'll never know if the lipo made the skin sag or if it would have been just as bad with losing weight. Either way, here I am at 40 with this sagging neck and jowls.
Part of it is the fact that I have a very bad overbite. I know it doesn't see so bad from these side pics bc I have a "compensating chin". Think underdeveloped jaw with a long chin bone lol. Not having much jaw structure there makes thinks look more saggy, plus makes me have a very round face. I've considered orthognathic surgery or even a lengthening genioplasty, but I figured I would try this first. It actually seems to be the less invasive choice.

Updated on 25 Jul 2023:
My surgery is now scheduled for sep 6, 2023. That’s about 6 weeks away! I will update my progress along the way. I will be traveling from out of state to get it done and leaving the day after or maybe 2 days after bc I have young children at home.

Updated on 7 Sep 2023:
Hello, I got the surgery done yesterday and I am very happy with it already I’m too tired to write a long review so I just wanted to drop a couple of pics.

Updated on 9 Sep 2023:
Hello I thought I would do an update and share how it’s going. So far today I haven’t used any prescription painkillers, just Tylenol. My face feels pretty stiff, my ears feel clogged. My neck is tender. I can’t open my mouth very wide when eating.
My only concern at this point is that my lower lip is paralyzed on one side. I’ve heard that this is rarely permanent so I’m hoping this goes away soon. I’d really like to be looking pretty normal when I go back to work in another week. I’ve had very little bruising. I am pretty swollen though. I made a video to show what I look like now.

Updated on 9 Sep 2023:
Smile on day 3

Updated on 11 Sep 2023:
I’ve attached some pics to show my progress. My smile is getting a little bit better every. My neck is showing some yellow bruising. My face is still swollen, mostly around my temples/cheek bone area. My cheeks are still swollen too but I can feel that more than I can see it. My glasses actually help hide the worst part of my face which is around the temple area.

Updated on 11 Sep 2023:
Smile from before through day 5.

Updated on 14 Mar 2025:
Still very happy with my results. Smile is totally back to normal. There is a very small white scar near my temples. Doesn’t bother me at all.

Dr. Harley did a deep plane facelift with upper & lower blepharoplasty and Juvederm lip injections.
I had several friends that went to Dr. Harley for their face life 4-5 years ago and they looked absolutely beautiful and the way he performs his facelifts it’s nearly impossible to even see whatsoever around the ear where he cut.
Dr. Harley is far above any plastic surgeons before & after pictures and his reviews are the highest I could find so it was a no brainer for me.
I had my procedure just done on 6/13/23 and still healing and did have a few medical concerns as my b.p. got way out of control and Dr. Harley addressed and handled a highly stressful situation with the utmost professionalism and has consistently checked up on me every few days and the office staff was also top notch.
I just cannot say enough about how I feel my face looks just 2 weeks out .. I cannot imagine how fantastic it’s going to look in 6 months.
I will be sure to add my before 0ics, right after my procedure and once I’m fully healed so you have a frame of reference as to what you too can expect.
I did also hear that many celebrities have gone to Dr. Harley so that speaks volumes about his work as well.
He may not be the cheapest facial plastic surgeon but as the old adage always goes., you get what you pay for and my face is not alone place I choose to skimp on and neither should you.
Trust me you will NOT regret your decision having him do anything with your face.
All the best!

Excellent. Very kind. Set nerves at ease. Easily healed. Follow instructions in order to heal quickly. When I had the bandage and drain’s removed there was little to no swelling and absolutely no pain. Tylenol was enough for the pain.

I turned 60 and started to think about getting some sort of surgery to reduce the amount of wrinkles and sagging I was seeing in the mirror. I searched and researched my best options thoroughly. Honestly, I almost went to CA to a well known doctor there. I reached out to Dr. Harley's office as well. I am certainly happy that I decided to trust in Dr. Harley to take on the task of making me look younger.

I’m two weeks out and the results are stunning. High cheekbones are back, saggy jawline has been pulled up, neck is more defined than it ever was.

Still swollen and waiting for that to go down over a few months, but just… WOW. My skin and muscles look healthy and are correctly in place again.

My stitches were so small and Dr. Harley carefully hid incisions on the edges of earlobes and tight against the hairline. It seems unbelievable, but the scars are flat and difficult to see with nothing concealing them after only two weeks.

If you are afraid of scars, just let Dr. Harley know so he can take a close look at how he can help you in that area.

My plan is to post pics in a few months when I can show y’all how things look after swelling goes down.

I’d also like to mention how awesome and compassionate Team Harley is. Dr. Harley is a top doctor and artist, but he has somehow managed to check his ego at the door and show up with empathy and this is also reflected in his team. Wonderful people.

Updated on 26 Feb 2023:
In retrospect, I should have realized this would happen, but…

As I’ve grown older, one of my brows was becoming lower than the other. I had eye & brow surgery to correct this before getting a DP, but restoring brow symmetry was one part that didn’t work out so well.

After getting the DP, my brows are lifted and symmetrical. I wondered how this could be as I did not get a another brow lift during the DP procedure. I think this has to do with ligaments that were pulling on each other no longer doing so and this resulted on my brow no longer being pulled down by other ligaments. On one side of my face (the side with droopy brow), things had fallen more than the other side. Now, with ligaments & muscle moved to the original location, everything has just snapped back to where they would have been naturally before age pulled things down.

I think if you also need eyelid & brow surgery it might be better to do it with the DP than before because of the connected nature between what is below and above.

Other than that, still healing but things are looking great.

Updated on 5 May 2023:
I still don’t feel comfortable uploading pictures, but the results of this surgery are nothing short of stunning. I look like me at least 10-15 years ago, except more symmetrical with a defined and elegant jawline.

How people treat me has noticeably changed. People want to linger and talk. People are nicer, both men and women. Very attractive younger men out of a demographic I feel comfortable with have tried to ask me out.

It’s a bittersweet reminder that while many may not want to admit it, we are a species drawn to attractive things, and that includes a pretty, symmetrical face. It’s bizarre and appreciated to feel seen again.

The scars around my hairline are something I need to do something about. They are small, but I expect them to turn white (it’s how I heal) and I’ll need to get a follicle transplant to cover them later this summer.

Being in my mid 40’s, I started noticing a sagging jawline and cheeks. I also lost about 80+ lbs and knew that a defined jawline was not going to be in my future without modern medicine helping me out. So I began researching facial plastic surgeons about two years ago and finally decided on Dr Harley due to his consistent results that span over several years. While I was losing the last bit of weight to get to my goal, my mother decided to see him herself and had fantastic results. If that wasn’t enough, meeting him in person made me even more sure of my decision. He has a great bedside manner being both confident but also very approachable. He is easily reachable and gives patients his personal number to reach him with any questions or concerns. I’m just one day post op and just had the dressings removed and I am very happy! Looking forward to seeing the final results

Updated on 29 Jan 2023:
Still having some swelling in cheeks and jawline but improving everyday. Pictures do no capture the difference you see in real life. I tried to recreate same lighting and no makeup for comparison but forgot about pulling hair back. Incisions around front of my ears are healed and look good and are currently pink in nature ( that is how I scar: pink for 4-5 months then pretty much disappear). I’m very happy with everything.

Updated on 4 Feb 2023:
Things continue to improve as swelling gets better. My neck measurement has lost one full inch in circumference and now looks longer. Incisions in front of ears are very flat. I tend to have pink scars for a few months before they fade- these are doing really well. I’m very happy with my decision to go with Dr. Harley.

I’ve never been a fan of cosmetic surgery. I turned 56 and all of a sudden began to notice loose skin around my neck and upper eyelids. I tried creams, as well as several broadband light therapies, but nothing really worked. I began to consider surgery. I found this site and read review after review. I read someone’s who stated she wished she had gone with her first choice which was Dr. Harley. After reading her post, I searched up Dr. Harley. His before and afters were extremely impressive because they looked natural and refreshed, which is the look I was searching for. I sent an email requesting a consultation. After speaking with Doctor Harley I knew he would be the one.

I had my Biltmore Lift along with an upper Bleph yesterday. My experience was much like others described. Meet the doctor at his office, signed paperwork, was given a crushed cocktail of meds under my tongue. My husband walked me to his surgical area, the rest is a complete blur.

I slept all day after I got home. Mind you we are Floridians, but luckily we own a home in Maggie Valley, so my husband is my nurse and made it incredibly convenient. My husband drove me to Dr. Harleys office early in the morning. Doctor removed my compression bandaging and drain. I’m swollen, specially around my eyes. I’ve been icing my face and will continue to do so. But I already love what I see.

I’ll be sharing pictures in order to help anyone that’s doing their research. I was terrified, mostly due to not knowing what to expect. However, I’m only one day post op and here I am completing a review. Like someone else said “do it for yourself” and don’t be afraid.

I’ll continue to post pictures as I heal.

Updated on 29 Dec 2022:
I’m currently 48 hrs post op and so far so good. Hardly any bruising other than my eyelids, which is expected. I’m sleeping through the night. No issues chewing anything. I also added some pre-op picture I had taken in order to have a good baseline.

Updated on 30 Dec 2022:
It’s been 72 hours since my surgery and I’m feeling like a million bucks. I showered and washed my hair making me feel human. I have no bruises, swelling has gone down. Still slightly swollen under my eyes and my neck. I haven’t had issues chewing nor sleeping. Sleeping in a wedge pillow on my back isn’t my idea of comfort, but I can still sleep. No pain meds are needed just Tylenol. No pain other than the feeling of tightness, which is expected. Wanted to provide updates so anyone that’s considering this type of surgery and is apprehensive can have a guide on what to expect. I went in knowing that everyone’s experience differs, mine has definitely been pretty easy so far.

Updated on 1 Jan 2023:
It’s been 5 days and I’m healing. I am thrilled and can say it’s been much easier than I thought it would be. Never had issues chewing or sleeping. Haven’t had a pain med since day 3. Went out with my husband and the kids for New Years Eve and I’m feeling great. I’ll continue to post updates until I’m fully healed.

Updated on 1 Jan 2023:
Here’s a comparison of my upper kids pre op and 5 days post op. I noticed I hadn’t provided an eyelid comparison of my eyelid surgery. Eye swelling has improved a lot today. Having stitches removed tomorrow.

Updated on 6 Jan 2023:
9 days post and feeling great. Minimal swelling. All I have on is a little mascara. I wanted to see how it looked with actual eyelids, which I have now. Neck a tiny bit swollen in the right side, but very minimal. It’s amazing it’s only been 9 days.

Updated on 14 Jan 2023:
18 days post and healing well. Healing quicker on my left side but both sides look really good. This was my first time wearing makeup. Photos were taken with iPhone on portrait mode and no filters.

It gets better everyday.

Updated on 8 Feb 2023:
So far so good! Scars looks almost invisible and swelling is almost gone. I wake up slightly swollen, but once I start moving around it seems to dissipate. No black and blues and im finally able to sleep on my side!! I’m very happy with my results.

Updated on 22 Feb 2023:
It’s been 8 weeks and I’m pretty much healed. Swelling is non existent and scars are looking good. I still feel a little tight when I wake up and still feel tingling on both sides of my face every so often. I’ve waited to color my hair until now because I wanted to the incisions to be flat and not irritated. So far so good. Couldn’t have asked for more.

Updated on 30 Nov 2023:
Came back to add a long term update. I’m 11 months post op and I’ve lost 32 lbs. My results are still AMAZING!!!! I can not believe it’s held up with my weight loss, but it has. I know that a lot of people don’t come back to post long term results, but I wanted anyone thinking about it to know it holds up!!!

Updated on 19 Feb 2025:
2 year update.

It’s been 2 years and two months since my procedures. I wanted to jump on here and post how it’s held up. I also lost about 30 lbs since my surgery and everything still looks great. No scars and the definition is still there. Someone asked about the scars from the upper bleph and I’m posting three photos here with zero makeup on. I’m 58 and I could not ask for more.

This was my second surgery with Dr. Hartley. The first was a Biltmore lift 7 years ago at age 59. I don't live in North Carolina but travel there for the surgeries. I suppose it would be a lot less expensive if I had them done in my home state, but honestly never even considered it. Not that I'm rich or anything, but I figure it's the only face I'm going to get so why trust it to someone else. You see Dr. Hartley is the best of the best in my opinion. But I'll let you judge for yourself.
I don't know if I've just been lucky but both surgeries have been so painless, easy to recover from and successful, that I can't believe my good fortune. I'll post some pictures and let you guys ask me questions if you want. I'll answer as honestly as I can because this is about helping other people to make a good decision.

Updated on 2 May 2023:
I'm a year out from an upper Blepharoplasty. The after picture was taken today. I did not have a lower Blepharoplasty, maybe in my future. I love how my eye's look even without makeup. Restored to how they looked in my 30's. This was a painless procedure for me, and I healed very quickly. About a week for most of the bruising to subside. I took it easy for the first couple of days, then back to my normal on the go life. Dr Harley is fantastic!

After a successful Mommy Makeover in my mid-40s, time started taking a toll on my face. When I started researching procedures and providers, Dr. Harley's practice popped up in a Google search, and I was struck by the transformational before and after photos of patients on his website. I made an appointment for a consult, with the next available more than one year later. This gave me time to think hard about the risks of having a knife sliced into my face for the sake of a more youthful appearance. In the meantime, the price for the procedure had increased quite a bit, but my mind was made up, and when I caught an accidental selfie at work of my face at age 56, just one week before the procedure (deep plane lift with platysmaplasty), I knew I was making the right decision. We live 2 hours away from the practice, so my husband and I stayed at a nearby hotel on the night before and the night of the procedure. All went as planned, and we were on our way home by noon the day after the procedure, after Dr. Harley removed my surgical dressing and drain. Pain, bruising, and swelling have been minimal, so it seems the recommended dietary additions of pineapple and blueberries one week prior to the procedure really make a difference. Just two days after the procedure, I was working remotely from home. I do have some numbness around my mouth and ears, so smiling and talking are awkward now, although this gets better every day. Also, I exercise regularly and vigorously, so the hardest part for me is having to put that off for a while, but it's well worth the wait. I expect this investment to last a long time!

I know the title sounds hyperbolic, but I can't think of any other way to describe Dr Harley. He is SO talented and kind -- it's clear that his calling is to help people reclaim their beauty and confidence!!! His work is a prime example of what plastic surgery *can* and *should* do. It's truly life changing (in the best possible way)!!
Also, Dr Harley's prices are very (VERY) reasonable -- especially compared to other surgeons. He could easily charge double or triple what he currently does. But instead, he keeps his rates on the lower side -- meaning his services are that much more accessible to patients (myself included) who normally wouldn't have the means.
For background about me: I'm in my early thirties, but I'd been feeling insecure about my face for YEARS. I'd gotten Kybella in 2017, but it only made things worse (the swelling never went back down AND it left me with scar tissue). I'd also been dabbling with filler, but it never did much for me -- it was hardly detectable under all my skin and muscle.
Anyway, at the time, I thought a face lift would be too expensive/too complicated a procedure. I was also terrified at the thought of going under. But when I chanced upon Dr Harley's profile on here, I immediately knew that I'd found my answer. I was blown away by the before and after pics -- AND even more excited to find out he did everything with local!
When we had a phone consult a couple weeks later, I felt even more reassured that he was my guy. I booked my procedure, and the rest is history!!!
It's now almost two years later, and I continue to be THRILLED with my results. I look and feel so much better, and I still can't believe it was as easy and inexpensive as it was (all things considered)!!!! I should mention, I had a slight complication with my healing, but it had nothing to do with Dr Harley or the procedure itself -- basically, the Kybella from years ago made me more prone to hypertrophic scarring, so I ended up developing a lump under my chin. But Dr Harley went above and beyond to make sure I got the best result, and removed it for me -- completely free of charge!!! THAT is how much he cares bout his patients. Most other surgeons would have either ignored my concerns or charged me all over again!!
I now have such a wonderful result, and I'm here to tell you -- if you're on the fence: Don't be. You will be in the best, most capable hands. And in the occasion anything were to go wrong (while highly unlikely) Dr Harley will 10000% be there for you, and will make you feel safe and supported. I can speak to that first hand!!!!
Let me know if you have any questions, and feel free to reach out if you'd like to see pictures :) Best of luck!!!!