What does a facelift improve?

A facelift improves sagging in the cheeks and midface, jowls, jawline softening, and excess skin. It also improves nasolabial and marionette lines, though those lines are not completely eliminated.

What does a facelift not treat?

A facelift does not treat fine wrinkles or overall skin texture, upper or lower eyelids, brow position, or major facial volume loss. Those concerns may need separate procedures or skin treatments.

Why is a neck lift commonly done with a facelift?

The face and neck age together and share the same tissue planes. Treating the face without the neck can look unbalanced, so a combined face and neck lift is usually recommended.

What is the difference between a full facelift and a mini facelift?

A full facelift addresses moderate to significant aging by repositioning deeper facial tissues and removing excess skin for long-lasting improvement. A mini facelift uses shorter incisions and a limited lift, best for early, mild aging and typically lasts fewer years.

How long do facelift results last?

Facelift results typically last about 10 to 15 years. Aging continues naturally, but from a more youthful baseline.

What is recovery like after facelift surgery?

Most patients take 2 to 3 weeks off work. Bruising improves by 2 to 3 weeks, swelling steadily decreases, and most people feel comfortable in public within a few weeks. Final results settle over 3 to 6 months.

Is a “deep plane facelift” safer or better?

Deep plane techniques dissect closer to facial nerve branches. Dr. Freedland uses a safer surface-based SMAS and cheek-volume repositioning approach to achieve natural results while avoiding unnecessary nerve risk.

What are the main risks of facelift surgery?

Risks include hematoma, infection, fluid collection, delayed healing, temporary nerve weakness, scarring, asymmetry, and hairline changes. Serious complications are rare, and smoking significantly increases certain risks.

Can a facelift be combined with other procedures?

Yes. Facelift is often combined with neck lift, eyelid lift, brow lift, fat grafting, or skin resurfacing for a more balanced, complete rejuvenation and a single recovery period.

What does breast augmentation improve?

Breast augmentation increases breast volume, improves shape, enhances symmetry, restores fullness after pregnancy or weight loss, and helps balance overall body proportions.

What is the difference between saline and silicone implants?

Saline implants are filled with sterile salt water and deflate visibly if they rupture, but they may feel less natural and show more rippling. Silicone gel implants feel more like natural breast tissue and usually have less rippling, but rupture may be silent and monitored with imaging over time.

Are textured implants used in breast augmentation?

Textured implants are used less frequently due to their association with a rare lymphoma called BIA-ALCL. Dr. Freedland primarily uses smooth implants for most patients.

Should implants go over or under the muscle?

Under-the-muscle placement can reduce rippling and capsular contracture risk and often looks more natural in thinner patients, but recovery may be longer. Over-the-muscle placement can have a faster recovery and stronger cleavage, but may show more rippling in patients with thin tissue.

Where are the incisions placed for breast augmentation?

Common incision options include the breast crease (inframammary), around the areola (periareolar), or in the armpit (transaxillary). Dr. Freedland often prefers the breast crease because it gives the best control and heals discreetly.

How is implant size chosen?

Implant size is selected based on your chest width, breast tissue, skin quality, lifestyle, and aesthetic goals. Sizers in a surgical bra help visualize options, and Dr. Freedland recommends sizes that fit safely within your anatomy.

What is recovery like after breast augmentation?

Most patients wear a support bra for several weeks. Discomfort is normal, especially with under-the-muscle placement. Many patients return to work in about a week and avoid heavy lifting or strenuous exercise for 4 to 6 weeks.

Do breast implants last forever?

Implants are durable but not lifetime devices. Many last 10 to 20 years, but future surgery may be needed for rupture, capsular contracture, or cosmetic changes over time.

Why doesn’t Dr. Freedland recommend cosmetic fat injection to the breast?

Fat grafting to the breast can lead to fat necrosis and calcifications that may resemble or obscure breast cancer findings on mammograms. Because cosmetic augmentation is elective, Dr. Freedland avoids introducing long-term screening risks.

Can I still get mammograms with implants?

Yes. Implants do not prevent mammography. Technicians use special imaging views to visualize breast tissue effectively, and you should always tell your imaging center that you have implants.

What are common risks of breast augmentation?

Risks include capsular contracture, implant rupture or deflation, infection, bleeding or fluid collection, scarring, rippling, sensation changes, implant malposition, and the rare risk of BIA-ALCL. Dr. Freedland takes precautions to minimize these risks.

Freedland MD: Facelift Consultation in Bloomfield Hills

Facelift Consultation

We had an extensive discussion about facelift surgery, also known as rhytidectomy. This procedure improves aging changes in the midface and lower face by repositioning descended tissues, restoring a more youthful facial contour, and removing excess skin. When done well, a facelift creates natural, long-lasting rejuvenation. The goal is for you to look like a refreshed, younger version of yourself, not like a different person.

Understanding Facial Aging

Facial aging happens in predictable ways. Over time, the structures that once supported a youthful look naturally descend and lose volume.

Midface changes: The cheek fat pads settle lower, the cheeks lose fullness, and the nasolabial folds deepen.
Lower face changes: Jowls form along the jawline, jaw definition softens, and marionette lines become more noticeable.
Overall effect: The youthful triangular face shape (fuller cheeks tapering to a narrower jaw) becomes more rectangular as tissues descend.

A facelift reverses these changes by restoring the deeper tissues to a more youthful position.

What a Facelift Can Treat

Sagging cheeks and midface descent
Jowls and loss of jawline definition
Nasolabial folds (improved but not erased)
Marionette lines (improved)
Excess facial skin and laxity

What a Facelift Does Not Treat

Fine lines, wrinkles, or overall skin texture
Upper or lower eyelids (these are treated with an eyelid lift)
Brow heaviness (may benefit from a brow lift)
Significant volume loss (may require fat grafting or fillers)
The neck unless treated at the same time with a face and neck lift

Understanding these distinctions helps set clear expectations, and many patients benefit from combining procedures for comprehensive rejuvenation.

Full Facelift Technique

A full facelift provides the most comprehensive and long-lasting rejuvenation of the midface and lower face. It is designed to address both skin laxity and deeper structural descent.

Incision Pattern

The incision is carefully placed within natural contours and the hairline to make scars difficult to detect as they heal.

Begins in the temporal hairline above and slightly behind the ear, below the sideburn area
Continues downward in front of the ear and behind the tragus
Extends around the earlobe and into the crease behind the ear
Turns back into the hairline along the neck

Incisions in the hairline are cut on a slight angle so hair follicles can grow through the scar over time, helping camouflage it further.

Deep Tissue Elevation and Repositioning

The key to a natural, lasting facelift is lifting the deeper support structures, not simply pulling the skin. Dr. Freedland repositions the SMAS layer and cheek fat pads, which restores youthful volume and contour in a safe, controlled way.

SMAS: the support layer over the facial muscles that helps shape the lower face and jawline
Cheek fat pads: structures that descend with age and flatten midface contour

These tissues are elevated and secured with permanent sutures to restore cheek fullness, redefine the jawline, and provide support that does not rely on skin tension alone.

Why Dr. Freedland Avoids “Deep Plane” Facelifts

You may see marketing online for “deep plane facelifts.” This technique involves working in a deeper layer that is closer to branches of the facial nerve. While it can lift tissues, it carries a higher risk of nerve injury. Facial nerve injury can cause weakness or, very rarely, permanent paralysis.

Because facelift surgery is elective, permanent nerve injury is not an acceptable tradeoff. Dr. Freedland uses a safer technique that achieves strong lifting and volume restoration while avoiding the deeper area where facial nerve branches run. This preserves safety without compromising results.

Why Deep Support Matters

When deeper tissues are repositioned properly, the facelift:

Restores natural cheek fullness and midface contour
Recreates a youthful facial shape
Improves jawline definition without a “pulled” look
Lasts longer because the result is supported structurally

Skin-only lifts tend to look tight, wear off faster, and can create an unnatural appearance. Deep support creates a more durable and natural result.

Skin Redraping and Excision

After the deep tissues are repositioned, the skin is gently redraped without excessive tension. Only the necessary amount of skin is trimmed. This helps scars heal well and avoids a tight or over-corrected look.

Mini-Facelift

A mini-facelift is a smaller, less extensive procedure best suited for early, mild aging. It uses shorter incisions and a more limited lift of the deeper tissues.

Advantages

Shorter procedure
Faster recovery
Good for mild jowling and early facial aging

Limitations

Less dramatic improvement than a full facelift
Results are not as long-lasting
Limited ability to restore cheek fullness

Mini-facelifts are typically ideal for patients in their 40s to early 50s with mild signs of aging who want subtle improvement and a shorter recovery.

Facelift and Neck Lift

Facelift and neck rejuvenation are almost always performed together. The tissues and incisions overlap, and treating the face without the neck can create an imbalance. A face and neck lift addresses loose neck skin, platysmal banding, and submental fullness for a more harmonious result.

Recovery After Facelift

Facelift recovery is very manageable for most patients. You will see early improvement within weeks, with final results settling over several months.

Immediately After Surgery

Your head will be wrapped in a soft dressing or light compression garment
Discomfort is moderate and controlled with medication
You will sleep with your head elevated
Drains may be used and are removed early in recovery if placed

First Week

Most patients take about 2 to 3 weeks off work
Drains, if used, are removed within 1 to 3 days
Sutures are removed in stages from day 5 through day 14
Bruising and swelling peak early then steadily improve
Gentle showering and hair washing are usually allowed after a few days

Weeks 2 to 4

Bruising usually resolves by week 2 or 3
Swelling continues to improve
Most patients feel comfortable in public within 2 to 3 weeks
Strenuous exercise, heavy lifting, and bending are avoided for 3 to 4 weeks

Months 2 to 6

Residual swelling resolves gradually
Incisions fade and soften over time
Temporary numbness improves as nerves recover
Final results become clear between 3 and 6 months

Results typically last 10 to 15 years. Aging continues, but from a more youthful baseline.

Combining Facelift With Other Procedures

Many patients combine facelift surgery with other facial procedures for a more complete rejuvenation. Common combinations include:

Neck lift
Upper or lower eyelid lift
Brow lift
Fat grafting for additional volume restoration
Skin resurfacing to improve texture and fine lines

Combining procedures often creates the most balanced result and allows for one recovery period.

Setting Realistic Expectations

You will look like yourself, just refreshed
Natural asymmetries remain
Scars are permanent but fade significantly
A facelift improves structure, not skin texture
Results are long-lasting but not permanent
Numbness is common and usually temporary
Final results take several months to settle fully

Potential Complications

Facelift surgery carries risks, including hematoma, fluid collection, infection, delayed healing, unfavorable scarring, asymmetry, hairline changes, temporary nerve weakness, or prolonged numbness. Serious complications are rare. Smoking greatly increases healing risks, especially skin-related complications, so patients must stop smoking before and after surgery.

Making the Decision

Facial rejuvenation is a significant decision. The most important steps are identifying what bothers you most, understanding what each procedure can and cannot do, and choosing the approach that fits your goals and comfort with recovery. Dr. Freedland is here to answer your questions, review before-and-after photos with you, and help you make an informed choice.

Photos were obtained, a quote was given, and the patient will return in a week for further discussions if needed.

Related Procedures You May Want to Explore

If you would like to move forward or talk through options, you can request a consultation here: Contact FreedlandMD.

Rejuvenation Face Lift Consultation