Dr. Kolstad doesn’t believe in a one-size-fits-all approach to his facelift procedures. There are a variety of methods that he uses, depending on your unique facial aging. Rather than stretching the skin, Dr. Kolstad usually seeks to elevate the underlying superficial muscular aponeurotic system (SMAS). This approach creates the most natural-looking results for his patients.

These are a few possible facelift methods that could be right for your facial aging.

• • Traditional facelift — This is the “full” facelift for rejuvenating the face, jowls, and neck. A full facelift involves lifting and repositioning the muscles and deeper tissues and removing certain attachments. Dr. Kolstad usually sculpts the fat to avoid creating a hollow look that you see on failed facelifts. Excess skin is trimmed and then re-draped. The incisions with a traditional lift start at the temples, run downward in front of the ear, wrap around the earlobe, and terminate in the hairline of the lower scalp. If the patient has particular issues in the neck area, a second incision is made under the chin to lift, tighten, and trim excess skin on the upper neck.
  • Limited-incision/mini facelift — The goals of this facelift aren’t as widespread, instead providing limited rejuvenation around the eyes and mouth, including nasolabial folds and other deep creases. Shorter incisions are made at the temples, around the ears, and if needed, in the lower eyelids and/or under the upper lip. These mini lifts have become the most popular choice.
  • Mid-face lift — As the name implies, this lift focuses on the mid-face, lifting the cheeks and removing lines. Mid-face lifts can reduce puffiness under the eyes, correct nasolabial folds, and improve the cheeks. Incisions are small, usually in the lower eyelids or mouth.
  • S lift — These lifts focus mainly on the jowls without tightening the neck. Dr. Kolstad calls them S lifts because they involve only short incisions, creating very minimal scarring. The incision is made around the earlobe and behind the ear to the lower scalp. An incision can also be made under the chin.

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The process of removing your sutures is a progression. Depending on the method of facelift you had, the location of your sutures can vary. Here’s the timeframe. External sutures placed in front of the ears are removed in 4-5 days. At 7 days, sutures around the earlobes are removed and those behind the ears are loosened. By day 10 after your facelift, all remaining sutures are removed.

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Dr. Kolstad uses general anesthesia for more intensive facelift procedures for patients in San Diego and surrounding areas. Short-scar (S) lifts and occasionally mini facelifts can be performed in the La Jolla office using local anesthesia. Of course, if the patient would prefer general anesthesia, that can always be provided instead.

Most people take about 10 days off of work to recover. By the tenth day, all sutures and clips have been removed, the majority of the swelling has resolved and any residual bruising can be camouflaged with make-up.

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With a traditional facelift, most patients can return to work in 10-14 days. Endoscopic lifts and mini facelifts may be able to return to work in just a few days. Depending on your unique procedure, Dr. Kolstad will discuss your timeframes with you during your consultation and then afterwards when he sees how your healing is progressing.

After major surgery such as a facelift, most patients want to get their blood moving again and get back to their exercise routine. But you need to be patient — exercising too soon after a facelift can lead to complications and lead to a longer recovery period.

For the first few days of your recovery, you should take short, light walks to encourage blood circulation. But you don’t want to increase your heart rate or blood pressure, as this can cause the tiny blood vessels beneath the skin of the face to bleed.

For the remainder of the first month, activity levels can increase, but heavy lifting, weight training, and any strenuous exercise needs to be avoided. You need to keep your facial blood pressure down.

Four weeks after surgery, you can add light cardio exercise back to your routine, things like slowly pedaling a stationary bike or light aerobics. At six weeks, you can usually return to all exercise, including weight training and strenuous exercise. This can vary by the patient, however.

Although you often hear certain practices promising an equal amount of rejuvenation from a liquid facelift, where dermal fillers are used in lieu of surgery, there really isn’t any comparison in the level of rejuvenation between these two procedures. Yes, dermal fillers are excellent for addressing sagging around the mouth, and they can be effective for returning volume to the cheeks. But for patients will real issues with sagging skin, jowls, and neck banding, a surgical facelift is really the only answer.

Liquid facelifts are best for patients with only limited sagging. They last about one year and then another session is necessary to maintain your results.

Thanks to Dr. Kolstad’s extensive knowledge of facial anatomy and experience with these procedures, these are pretty low-risk procedures. Of course, this is surgery, so patients are at risk for excessive bleeding, infection, reaction to anesthesia, and poor wound healing.

Specific to facelift procedures, these are the risks:

• • • Injury to the nerves that control facial muscles (usually temporary)
    • Numbness or tingling around the incision areas (temporary)
    • Hair loss at the incision sites
    • Skin discoloration (rare but can continue for several months)
    • Skin healing issues (more common with smokers)

A frequent concern of our patients is looking plastic after facelift surgery. There are limitless examples of unnatural, operated results. When surgeons pull too tight, the corners of the mouth can change, the neck looks stretched and the skin can lose some of their natural contours.

It is very important to choose a plastic surgeon in San Diego that specializes in operating on the face and is comfortable with the challenging anatomy and procedures.

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The most powerful surgery to lift the jowls and tighten loose neck skin is a full lower facelift. Dr. Kolstad’s Natural Lift takes him 4-5.5 hours to complete depending on the complexity of the surgery and the persons anatomy.

This type of procedure is most commonly performed in a plastic surgery center using general anesthesia. Full lower facelifts cost range from $13,000 to upwards of $30,000 depending if combined with complimentary procedures. This price is inclusive of the plastic surgery center facility fees and anesthesia costs for a 4-5.5 hour surgery.

One of our most common procedures is a mini face lift. This procedure can be completed in the office using a combination of local anesthesia and oral sedation. Many of our patients prefer to have this surgery performed in a plastic surgery center using full anesthesia as well.

Mini face lifts cost range from $11,000 to upwards of $20,000 depending if combined with complimentary procedures. The price includes the plastic surgery center facility fees and anesthesia costs for a 3-4 hour surgery.

A neck lift is designed for someone with loose neck skin without a prominent jowl. It is common for someone who had a facelift in the past to need a neck lift without having to redrape the facial skin. This procedure can be completed in the office using a combination of local anesthesia and oral sedation. Many of our patients prefer to have this surgery performed in a plastic surgery center using full anesthesia as well.

Neck lifts cost range from $6,000 to upwards of $12,000 depending if combined with complimentary procedures. . The price includes the plastic surgery center facility fees and anesthesia costs for a 2-3 hour surgery.

A short incision facelift elevates the jowl and improves the jawline. A “S” lift is designed for someone who does not have significant signs of aging and does not require lifting loose neck skin. This procedure can be completed in the office using a combination of local anesthesia and oral sedation. Many of our patients prefer to have this surgery performed in a plastic surgery center using full anesthesia as well.

Short incision facelifts cost range from $5,000 to $10,000.

Revision facelifts require more time to complete and more surgical expertise to perform. Scar tissue from previous surgeries makes dissection more difficult. Improving scars from previous facelift surgeries is a frequent concern of our patients.

Revision facelifts are performed in a plastic surgery center using general anesthesia. Revision lower facelifts cost range from $15,000 or more depending on complexity and scar tissue. The price includes the plastic surgery center facility fees and anesthesia costs for a 4.5-5.5 hour surgery.

Because facelifts are considered to be elective surgery, they are generally not covered by insurance. The only time that would change would be in the case of traumatic facial injury.

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Absolutely! Many of our patients choose to enhance their facelifts with the addition of smaller procedures. For results to look perfectly natural sometimes adjunctive treatments are required to create balance.
Submental (Under the Chin) & Neck Liposuction:

Removing unwanted fat can dramatically improve the jaw and neckline. The fat underneath the chin can prove resistant to weight loss and creates a blunting of the neckline. Even after redraping loose neck skin if the submental fat is not adequately treated the results will be limited. No additional incisions or scars are required for neck liposuction.

View examples of Neck Liposuction.
Facial Fat Transfer:

As we age our face loses volume similar to a water balloon becoming deflated. Many surgeons rely on pulling the skin tighter and tighter to address loose skin created by facial volume loss. Simply pulling the skin tighter is a common cause of the unnatural, plastic looking facelift results. The most natural way of restoring your youthful cheek contours is through fat grafting. Facial fat transfer is the process of removing unwanted fat from the belly or hips and transferring it to the deep folds around the nose and mouth, tear troughs, and cheeks.

Find out more about Facial Fat Transfer.

Chin Implant or Prejowl Implant:

As we age we lose bone density. Many people are familiar with osteoporosis of the arms and legs. A similar process occurring in the face leads to loss of chin and facial skeletal volume. An anatomical chin implant can be used to augment lost volume in the jaw. No additional incisions are required for chin implant augmentation.

Read more about Chin Implant Surgery.