Facelift Surgery in New York / NYC
Cosmetic plastic surgery of the face can “turn back time” by reducing the appearance of wrinkles and lines, sun damage and sagging skin that can make you look angry, sad or tired.
Dr. Rizk is highly specialized in Facelift and Necklift surgery and is a double board certified facial plastic surgeon who does not perform body plastic surgery.
Dr. Rizk performs many different types of facelifts and customizes the lift for each patient to achieve a natural, long lasting result with the most rapid recovery. As we age, muscles become loose and drop underneath the skin. Dr. Rizk's Lift differs because it addresses the deeper tissue by going under the muscle sliding it backwards into its original youthful position. This technique results in less bruising and swelling since he lifts deeper beneath the muscle. Skin scars heal better because there is no tension on superficial layers and skin. Once the deeper tissue is lifted, the excess skin is trimmed.
Rhytidectomy results in a natural, softer look and creates definition along the jawline and neck, without tightness. Dr. Rizk takes special care to hide scars inside the ear which allows wearing hair up after surgery with no visible scarring. Most patients are able to resume their normal routines within 7-10 days after surgery. Dr. Rizk also performs other types of shorter lifts for younger patients with lesser degrees of aging.
Dr. Rizk's "Rapid Recovery Neck Lift," featured on Fox 5, incorporates the use of the Endotine Ribbon and tissue glues which results in a rapid recovery and creates a more natural lift with longer lasting results. Dr. Rizk was the first surgeon to use this ribbon device in the deep plane face lift and neck lift, and he incorporates the use of tissue glues to expedite the healing process and decrease bruising and swelling. In addition, Dr. Rizk incorporates use of various vitamins and herbal supplements to expedite recovery.
Facelift Before and After Patient 31: 50 year old female patient receive a facelift and necklift surgery in combination with upper and lower eyelid surgery, endoscopic partial browlift surgery and Fraxel CO2 laser treatment. Photos are shown 6 weeks after surgery with minimal swelling and improved definition on the jawline and cheek area.
The key to Dr. Rizk's rhytidectomy surgery is best expressed by former Miss California, Francine Newton, who stated in a New York Times featured article, "No one knows I had a facelift - I had to tell them. My friends have never seen anything like what he's done for me."
Does Dr. Rizk do these Media-Advertised lifts, like the Nonsurgical Y lift, Lifestyle lift, or Liquid Lift? What are they?
There are many short-lived lifts, most of which are not even lifts, but are just filler injections hyped by catchy names like Y lift or Liquid lift (merely filler injections in the face). Of course, most filler injections will make patients look better, but fillers are used in conjunction with a real lift which lasts 10 years or more, makes patients look natural, and the recovery is rapid. Fillers may be used alone or in conjunction with real lifts and do help with the nasolabial folds, but do not lift the neck or jowl. Too many fillers, especially in the lower face and around the mouth can look UNNATURAL. Dr. Rizk does not tout his lifts with NAMES, only giving his patients NATURAL RESULTS and LONGEVITY.
What are face and neck changes that occur with age and how should a facelift, neck lift or both address these changes?
As we age, gravity, sun-exposure, genetic factors, smoking, pollution, and life stresses all combine to loosen and sag our facial tissues (muscles, fat and skin). These aging changes may deepen the folds between the nose and mouth (nasolabial fold) and result in jowl formation around jaw line where definition is lost. Additionally, accumulation of fat under the chin may produce a double chin. Loosening of the neck muscles (named platysma) may produce appearance of hanging cords (particularly visible in thin patients). It is important to note that any facelift or neck lift or both must address the muscle layer, fat and skin in order to look natural and achieve longevity.
Definition is the key to beauty, not tightness.
Lifting skin alone will result in an unnatural tight look, will loosen quickly and will result in a stretched scar. This is an important point because many rhytidectomy procedures advertised on broadcast or print media taunt the consumer into believing that there are these magical “weekend lifts”, short lifts, with 2 day recovery times and long lasting results. My advise to patients is “if it sound too good to be true, it usually is “. My facelift or neck lift surgery looks natural, lasts over 10 years and patients may be socially presentable in a week. I have presented extensively at scientific plastic surgery meetings and published my techniques in peer reviewed journals. These techniques are tested over time and incorporate the latest technology and advances. I refer you to my textbooks and articles in ‘in the news section’ for more information. To summarize some important concepts, I perform my face lift and neck lift deep to muscle and fat layer and lift in a natural vector of elevation. By doing so, I am able to reestablish youthful look by repositioning drooping tissue to its original youthful home. The cheek fat pad in the midface is important for a beautiful face. I reposition this fat pad over its youthful home right under the cheekbone and eliminate the hollowed area created by aging under the cheekbones. Injecting fat in this region is unpredictable and I do not believe fat injections work as they clump and create deformities over time. It is better to reposition you own tissue. By lifting sagging, deeper tissue it result in natural definition along jaw line, rather than unnatural tightness evident with more superficial lifts advertised all over today’s media. By lifting deeper, the superficial tissue and skin is merely trimmed away and closed with no tension, thus resulting in the thinnest best healing scars. Additionally, lifting deeper results in less bruising and a more rapid recovery since most bruising is linked to more superficial blood vessels under the skin.
Facelift Before and After Patient 30: A female patient underwent facelift and necklift surgery to improve definition in the jawline and cheek bones. Fat injection treatment was performed to increase volume in her chin to balance the face and chin. Photos are shown 2 weeks after treatment with minimal swelling and improvement in overall facial definition.
How do face lift/neck lift techniques differ and how do Dr. Rizk’s techniques differ?
To put it simply all face lift and/or neck lift techniques differ by length of incision and depth of lift. Dr. Rizk performs many types of lifts, with some partial shorter scar lifts for younger patients addressing a specific region, either lower face, neck or midface separately or together, and customizes the lift to the patient’s degree of aging. His signature lift is the modified deep plane rhytidectomy which addresses the midface, lower face and neck. He has pioneered the use of high definition 3-D telescopes from the facelift or neck lift incisions around ear or under chin to visualize face and neck structures and increase surgical precision and safety (featured as lead clinical story in face section of Plastic Surgery Products Magazine, December, 2008) Dr Rizk has developed a graded customized approach to facelift/neck lift surgery which means that a younger patient in his/her 40’s may only need an isolated neck lift. An older patient with jowl formation in lower face may be a candidate for a partial lower facelift/neck lift and some patients may require the full rhytidectomy. The full facelift addresses the mid-face as well as lower face, jowls, and neck. The brow is not part of a facelift and is addressed separately with a browlift. This graded approach to facelifts allows for shorter scars depending on the lift. A neck lift scar alone is behind the ear and under the chin. A rhytidectomy scar is tucked away inside the ear and hair to hid the scar and allow hair to be placed up without scar visibility. Dr.Rizk has added certain technology/medications such as tissue glues and herbal medicines to expedite recovery. The use of high definition telescope technology (high definition camera systems) through the facelift incisions around the ears allows better visualization to maximize safety. Facelifts/neck lifts very often are performed together in one procedure but an isolated neck lift may be performed in a younger patient without a facelift or visa versa. Some heavy necks and most male necks require a midline tuck of the muscle done through a small scar under the chin with this telescope system, in addition to the lift sideways behind the ear, to achieve a better result. Various herbal medications are added pre/post-operatively such as arnica Montana, bromelin, and tissue glues to expedite recovery. A moratorium is placed on use of aspirin and other NSAID’s such as ibuprofen, Alieve, Excedrin which cause bleeding and bruising as well as fish oil, and herbal supplements which may increase bleeding and bruising for 2 weeks before and 2 weeks after surgery.
What is typical age of face lift and neck lift patient?
Typically, patients in their early 40’s may be a candidate for a neck lift alone and later in their 40’s for a partial face lift and neck lift. Patients in their 50’s or 60’s usually require a full face lift/neck lift. Age range for face lift/neck lift is 40’s-70’s with some exceptions below age 40 in patients with weak chin structure and increased fat deposition under chin. Face lifts can also be successful in patients in their 80’s.
How long does it last?
Because Dr. Rizk addresses the deeper tissues and fat layers in face and neck, facelift typically lasts 10 years. Face continues to age but the clock is turned back and benefits of rhytidectomy and neck lift surgery will last even beyond 10 years as patients will look much better thereafter as compared to not having the procedure done. Another rhytidectomy may be performed after 10 years. Dr. Rizk has successfully performed third or fourth facelift procedures on older patients.
Facelift Before and After Patient 29: 56 year old female patient received a facelift, necklift endoscopic partial browlift, rhinoplasty and eyelift procedure for an overall improved facial aesthetic. Photos shown after full recovery.
What are differences in male versus female facelift and neck lift surgery?
Male skin is thicker and heavier with more blood supply because of the beard. In all male facelift/neck lift patients, Dr Rizk performs the midline muscle tuck (midline playsmaplasty or submentalplasty) done from a small incision under the chin with the high definition telescope system. This is done in addition to the lateral (sideways) pull of the platysma muscle in the neck. Male patients tend to be concerned more about their necks than their faces as compared with female patients. Some female patients with neck cords or significant fat under the chin also benefit from this midline muscle tuck in addition to the lateral pull to the side behind the ears. Male patients show a particular advantage in a more rapid recovery with the use of tissue glue (see section on “in the news” and view Dr Rizk’s peer reviewed articles published in Archives of Facial plastic Surgery on deep plane rhytidectomy with tissue glue).
What is a weekend lift?
There are many facelift/neck lift techniques advertised in the media daily with many claims. Dr. Rizk does not believe that there is a weekend lift that can result in natural, long-lasting outcome. It has never been addressed in scientific plastic surgery meetings and it is just a catchy media phrase.
What is typical recovery? How about pain?
Typically, patients can be socially presentable in 1 week after rhytidectomy or neck lift surgery. However, there is still some swelling which will subside with time. The patient undergoes procedure as an outpatient either in Dr. Rizk’s JACHO certified surgical facility on Park Avenue or at Manhattan Eye, Ear and Throat Hospital or Lenox Hill Hospital. Dressing is removed the day following the surgery. Dr. Rizk does not use drains after surgery so the pain of having drain is eliminated. The tissue glue used at end of procedure replaces having a drain in your face after procedure. The pain, in general, is minimal. Some tightness in the neck and face is expected for first two weeks after rhytidectomy and neck lift surgery. Most stitches are removed in 7-10 days. Makeup may be worn in 7 days. It is recommended hair be dyed before surgery.
Facelift Before and After Patient 28: 45 year old female patient underwent a facelift, necklift, endoscopic eyelid and subtle rhinoplasty. Photos are shown 2 weeks after surgery with minimal swelling and noticeable overall rejuvenation of the face.
What anesthesia is used for facelift/neck lift surgery?
Anesthesia is provided by board certified anesthesiologists with many years of training in ambulatory anesthesia (not nurse anesthetists). Either twilight (sedation) anesthesia or general anesthesia can be used. General anesthesia has become very safe and same medications are used for sedation as general. The patient breaths on his own in both types of anesthesia. The difference is in General anesthesia; a breathing tube is employed to establish a safe airway for breathing. The anesthesiologist will speak to the patient beforehand and discuss all options and make recommendations accordingly.
What new innovations are employed?
- Dr. Rizk’s innovations include high definition telescopic assisted visualization of facial anatomy resulting in precision and increased safety. Imagine the difference between a regular TV and a high definition TV and then add the 3d concept to that to just give you an idea of the immense advantage of this technology. (featured in Plastic Surgery Products article in ‘in the news section’)
- Dr. Rizk is the first surgeon to use endotines (absorbable devices which can replace stitches that raise and hold deep tissue in face) in the deep plane so they are non-palpable. Because of their multiple securing areas, they provide a longer lasting lift and secure tissue better in a more natural method. Dr. Rizk also modified the device to use it in the deep plane and this is currently being modified by the company for Dr. Rizk.
- Addition of tissue glue eliminates need for drains. Tissue glues have been employed in medicine for many years in open heart surgery to seal blood vessels and in other types of surgery. These glues (see extensive publications in textbooks and peer-reviewed articles in ‘in the news’ section) have immense benefits. They are used inside face after surgery and dissolve over a period of a week. They seal small blood vessels which cause bruising and oozing. They are meant to replace drains and expedite recovery. They do not replace using stitches. Drains are an old guard method which can increase infection rates, malfunction, cause more scarring and are painful upon removal (see peer reviewed articles on my website). I have been teaching for many years about these glues when they were first introduced to plastic surgery for burn victims to attach the graft tissue. More surgeons are starting to use them all over the country.
- Deeper tissue surgery is the key-Dr Rizk has modified the deep plane facelift by using the endotines and shortening the incision to improve longevity and result in a much more rapid recovery. His signature lift is the modified deep plane facelift/neck lift.
- Herbal medications used before and after surgery also expedite recovery
What procedures can be performed at the same time as a facelift/neck lift surgery?
- Lasers - sometimes lasers are used in conjunction with a rhytidectomy or neck lift to improve skin texture, eliminate fine wrinkles around the eye or remove sun damage. The latest and most advanced laser I use is the fraxel-co2 combination laser. This is not a fraxel laser or a co2 laser but a combination which results in a much more dramatic improvement than a fraxel laser alone and a much quicker recovery than a co2 laser alone. Typically, face looks good in 1 week after this laser. This laser is the latest and most advanced buzz in skin rejuvenation. I have and still occasionally use the erbium laser and co2 lasers but the recovery from this new laser is far quicker and far superior to the erbium or co2.
- Implants- sometimes I may add a chin implant to support a weak chin or a cheek implant to augment a flat cheek. The bone is the support of the face and weaknesses in certain bony regions may result in the face dropping quicker so this improves my facelift/neck lift results. As much as 25 percent of facelift/neck lift patients also undergo concomitant chin implant and/or cheek implants.
- Rhinoplasty- sometimes a very subtle improvement in a long drooping aging nose can make a dramatic difference and really improve overall facial harmony. Sometimes patients notice their noses more after rhytidectomy and/or neck lift surgery and opt to undergo a rhinoplasty in a later procedure so i will sometime discuss a minor lift of millimeters in the nasal tip to improve overall facial balance and harmony. It really can enhance the facelift with no additional recovery or pain. I will perform this procedure in about 10 percent of facelift/neck lift patients.
- Browlift- a complete or partial browlift may enhance the youthful look. Though I only occasionally recommend a browlift, I am very conservative in lifting the brow and only recommend it if the eyebrow is below the bony region of the eye. I offer many partial browlifts which lift only the corner of the eye (the lateral hood) and not the complete brow. I will perform a browlift with a facelift/neck lift procedure less than 10 percent of the time.
- Eyelids- surgery (either upper or lower eyelids) is the most common procedure performed with rhytidectomy and neck lift surgery. Approximately 60 percent of facelift/neck lift patients also undergo an eyelift procedure to enhance their youthful look.
What is the cost of a facelift/neck lift?
There is a range of fees and it depends on whether it is a full rhytidectomy or a partial facelift or isolated neck lift. It also depends on size of face and extent of work. In general, there are 3 fees: operating room fees (time dependent), anesthesia fees (time dependent) and surgical fee. To obtain an estimate of the surgical fee, either pictures have to be seen from front view and side view or after a consultation. For more information, you may call the office to inquire about fee ranges.