Face Lift

Men and women in their 40s, 50s and 60s are the most common patients for a face lift in Maryland at our Frederick plastic surgery practice. Face lifts are a particularly popular choice because in this age range, it’s not uncommon to see signs of aging on areas the face including lines along side of the nose, grooves from the corners of the mouth, jowls, and redundant skin on the neck and lower face.

About the Procedure

Facelifts are performed in an outpatient setting under local anesthesia with sedation, or under general anesthesia.

The incisions vary significantly depending upon hairlines and facial features, but generally start in the hair above the ear, follow the front edge of the ear and curve around the lobe and back into the hairline behind the ear. After elevating the skin, the next deeper layer of the face (SMAS) with muscle attachments is then tightened for a more natural look. The facial skin is gently repositioned and lifted, with the removal of excess skin as well.

Facelifts are frequently accompanied by complementary procedures such as eyelid lifts or temple lifts.

An S-Lift is ideal for people who have heaviness along the jaw and particularly in their jowls. Evidence of a secondary aging characteristic known as the “marionette line,” crossing from the corner of the mouth to the jowl, also can be improved with this minimally-invasive procedure.  It is generally performed on an outpatient basis under general or local anesthesia, either in a free-standing surgical center or in the office.

With an S-Lift, the incision begins just above the ear lobe and continues around to the back of the ear with a small turn at the top, forming a rough “S” shape. Through this incision, Dr. Kress is able to tighten and re-balance the deep tissue layer to create a more natural look. Liposuction may be necessary for optimal facial contouring. The excess skin is tightened and trimmed. Drains are seldom necessary but may be used overnight at most.

Recovery Time

Most of our face lift patients are able to have their sutures removed within 10 days. Bruising and swelling decrease enough within 10 to 14 days for you to resume your work or regular activities. Final results are evident in 4 to 6 weeks or sooner with continued improvement for several months.


After your face lift at Plastic Surgery One, patients can enjoy a more youthful, rested appearance with a natural, balanced, and enhanced beauty.

Face Lift FAQs

What other types of face lifts are there?
The SMAS face lift is the workhorse of Plastic Surgery and continues to be an excellent procedure. There are—and there should be—minor variations in the position and size of the incisions based on individual facial features and patterns of aging, not based on a formula.Other types of face lifts that are being performed:

  • Sub-periosteal – this is a very deep face lift, which repositions the muscles in the face at the level of the skeleton. This has produced some fairly spectacular results. It is being done in very limited numbers because the period of swelling and recovery is substantially longer than for the standard SMAS face lift, and the return to work can be prolonged as well.
  • Extended SMAS lift – by going further towards the midline of the face and cutting several ligaments, an attempt is made to increase the durability of the face lift, but with questionable success.
  • Endoscopic face lift – although the scope is now the standard of care for dealing with the brow and the forehead, it has a far more limited application in the other portions of the face. The principle problem being that even though deep portions of the procedure can be done through the scope, there still is excess skin that needs to be managed. In some cases, the surgery time is significantly longer for similar results.
What if I have only minor areas of sagginess and wrinkling?

Instead of a full face lift, you may want to consider a “mini” face lift” from Dr. Kress. Variations include the temple lift, midface lift, S-lift, and G suture.

Can a face lift be repeated?
Face lifts are repeatable quite easily as long as the previous procedures were done correctly and in the correct plane. By that we mean there are several layers within the skin where the lift can be done. If these layers were correctly identified and respected during surgery, the face lift procedure can certainly be repeated.
If I have more that one face lift, will I look unnatural?
No. The face lifts, when correctly done, continue to maintain a very natural look and do not yield the stretched and taut look that is sometimes associated with the old face lifts or with a poorly done face lift.
How long does a face lift last?
That’s a very interesting question – actually forever. The simplest way to demonstrate is by comparing identical twins. One sister has the face lift procedure while the other does not. At the conclusion of the procedure the first sister looks ten years younger than the other. So even though both sisters will continue to age from that point, they’ll never again look exactly the same unless the second twin also has a face lift.So the answer to “How long does it last?” is FOREVER. Will you have it repeated? That becomes a social issue rather than an anatomical issue. In general, most of the people in the eastern part of the United States do not repeat their face lift. A single face lift is all that is accomplished in more than 75% of patients. On the west coast, the rate is somewhat higher, but then the acceptance of cosmetic surgery there is higher also.
What are the signs of a bad face lift?
  • Most serious is a stretched and taut, unnatural facial appearance. There can be a variety of reasons for this. The most common is the choice of incorrect vectors, which are the angles from which the skin and the SMAS tissue are moved. The skin and soft tissue is positioned toward the ear instead of toward the brows and the temple, which is the direction that the tissue originally migrated from. This is correctable, but far better avoided.
  • Loss of the earlobe – an amateurish face lift will sometimes cause the earlobe to disappear and create a stretched and very unnatural looking ear.
  • Loss of sideburns
  • An open ear canal – sometimes the incision in front of the ear sacrifices the little bump in front of the ear so that you can look directly into the ears. This is a very unnatural look.

“I never thought I’d have plastic surgery done—it seemed so superficial. But as I got older, I just didn’t like what time was doing to my face and my self-esteem. My face lift was one of the best things I’ve done for myself in a long time.” 

J.S. (Age 53)


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