It is natural to have some fears about facelift surgery. Facial Plastic Surgeon Anita Mandal, MD, is part of a small elite group of double board-certified facelift surgeons with expertise exclusively in the face and neck and over 25 years of experience in having performed thousands of facelifts to put you at ease. As one of the top facelift surgeons in Florida, she focuses on delivering elegant, natural, and youthful results without the pulled, “windblown,” or stretched look of more traditional facelifts. In technically skilled hands, a facelift can restore a youthful appearance with improved definition to your cheeks, jawline, and neck. Dr. Mandal strives to deliver the best facelift results in West Palm Beach & Palm Beach Gardens.

What is a Facelift?

With age, the tissues of the face and neck begin to sag due to the loss of collagen and elastin and the effects of gravity on the underlying muscles, fascia, and ligaments. Although each person ages differently, the cheeks and jowls migrate downwards towards the center of the face, resulting in a more pear-shaped, bottom-heavy appearance.

 In youth, the face is more of an upside-down triangular shape, with more volume in the upper half and a narrower, more defined jaw and neckline in the lower half. With age, the face begins to shift towards a triangular shape, appearing heavier in the lower half and narrower in the upper part. When combined with the gradual loss of bone and fat in the upper face, further loss of definition and youthful contours is seen, resulting in the development of jowls and turkey neck. 

 In the past, mainly patients who had lifestyles, were socially active, working, or in the public eye were most aware of the effects of aging on the face and desired to look as good on the outside as they felt inside. Nowadays, it is not uncommon for younger men as well as women in their early 40s to be proactive about facial rejuvenation, start the process earlier, and  undergo facelift surgery:

 If your cheeks, jawline, and/or neck are sagging, you may be a candidate for a facelift. Palm Beach Facial Plastic Surgeon Dr. Anita Mandal performs facelift surgery to restore a vibrant, youthful look that can also enhance your self-confidence.

What Is A Mini-Facelift

Also called a limited-incision facelift, this cosmetic surgery is a variation of the traditional lower facelift but a less invasive alternative that can address milder signs of aging. Patients who undergo a mini-facelift are typically younger and have less skin and soft tissue laxity. Thus, they require less soft tissue repositioning, less skin removal, and smaller incisions. 

 While mini-facelift incisions are typically smaller than those of a standard one, both types of facelifts, when performed with meticulous attention to detail, have discreet, well-hidden incisions made within the skin’s natural creases. Because a mini-facelift involves less dissection of the underlying tissues, recovery is faster than that of a traditional facelift. Dr. Mandal often performs both traditional facelifts and mini-facelifts under local anesthesia without the need for IVs.

What is a SMAS Facelift?

 Sometimes referred to as “the two-layer facelift,” an SMAS facelift is an effective technique to provide incredible results for patients with extreme skin laxity and soft-tissue descent. The SMAS (superficial muscular aponeurotic system) is a layer of tissue that lies deep within the facial skin, where it helps to support the structure of the face. As we age, the SMAS membrane weakens and loses its elasticity, which can result in sagging cheeks, exaggerated nasolabial folds, lax jowls, and a double chin. Dr. Mandal can correct these problems by focusing on the SMAS membrane, tightening the muscles, and removing excess fat and skin. 

During the procedure, Dr. Mandal will start by making a well-concealed incision near the temple within the hairline and will extend it downward, curving in front of and then behind the ears in very inconspicuous locations to hide the scars. Once the incision is created, she lifts the soft tissue and muscle under the skin to place it in a higher, more youthful position. Once the deeper tissues are resuspended, Dr. Mandal removes any excess skin, delicately pulls the remaining skin back over the face, and then closes the incisions with a meticulous suture technique. 

Procedure time is approximately three to four hours but will vary case by case.

What is a Vertical Facelift? 

A vertical restore facelift (VR facelift) is a newer and less invasive technique that focuses on fascial laxity to lift the entire face, including the outer brow, midface, jawline, and neck. It is performed under twilight sedation and uses inconspicuous incisions and sutures that are strategically placed within the hairline and hidden ear grooves. Dr. Mandal releases the facial ligaments to lift the tissues upwards (vertically) rather than horizontally. The procedure is finished by closing the incisions. 

Deep-Plane Facelift

 A deep-plane facelift requires dissection into the facial plane just below the midface’s superficial muscular aponeurotic system (SMAS). Dr. Mandal creates a tension-free skin closure with long-lasting results by choosing strategic points to place facial tension. In the deep plane, her focus is on releasing certain key facial retaining ligaments to maximize mobilization of the superficial soft tissue envelope and tightening the underlying muscle to lift the deeper tissues and address the buccal fat that can contribute to jowling. When performed properly, a deep plane facelift can produce dramatic and sustainable facial rejuvenation results in the midface and the lower portion of your face.

 What are Pixie Ears?

 Pixie ears refer to a development where the ear’s lobe merges with the skin on the face, creating a “pixie-like” appearance. This can be something you are born with, can be caused by wound contraction following a traumatic injury, or, more commonly, caused by a poorly performed facelift procedure.

 Various surgical techniques can be used to correct the pixie ear, and Dr. Mandal will assess your ears to determine the best approach. One of her more common minimally invasive approaches involves removing the existing scar from a previous facelift, which allows the earlobe to be repositioned. With this method, new incisions are made, leaving you with new scars that are more discreetly placed around the ear and cheek, making them virtually undetectable to the casual eye. 

 Pixie ear correction is performed as a “lunchtime” procedure, allowing you to leave after the surgery is complete.

What are the Benefits of a Facelift?

As a double-board-certified facial plastic surgeon at one of the leading facelift practices in Palm Beach, Dr. Mandal is one of the most experienced facial plastic surgeons in Florida. The advantages of this type of cosmetic plastic surgery are that a facelift can:

• Be combined with many other aesthetic procedures, including CO2 laser and facial fat grafting, brow lift, eyelid lift, and/or lip lift.
• Define the neck and jawline
• Improve the vertical platysmal neckbands
• Lift sagging jowls
• Have nearly invisible surgical scars
• Provide long-lasting results
• Give natural-looking results
• Recontour your neck and jawline 
• Reduce fat under the chin
• Target visible signs of facial aging
• Tighten loose skin

Who Are the Best Candidates for a Facelift?

Good candidates for Facelifts typically include patients with visible signs of facial and neck aging, such as sagging, skin laxity, and deep creases around the mouth. Ideal candidates are in overall good health and have realistic expectations about the outcome of the procedure. Other factors that make someone a suitable candidate for a facelift include:

• Age: The average age for a facelift is 55, but an increasing number of candidates are younger, in their 40s, but others are well into their 60s and 70s.
• Good skin elasticity 
• Non-smoker
• Having a clear and realistic understanding of what a Facelift can achieve

What Is Full Facelift

A full facelift is a marketing term, rather than an actual scientific term, that some surgeons often use to describe a combination of procedures that include lower facelift, neck lift, eyelid lid, and browlift to also sometimes include skin resurfacing and facial fat grafting. Unlike a lower facelift, which addresses the lower face and neck, a full facelift can address a broader range of aging concerns, including eyelids, brows, and poor skin texture. 

What a Facelift Won’t Do

Many patients falsely assume that facelift surgery corrects all facial and neck aging. It is important to understand that a facelift is not a substitute for injectable filler, BOTOX, laser, RF micro-needling, or other non-surgical facial rejuvenation treatments. The primary goal of facelift surgery is to tighten and lift sagging skin and soft tissues in the lower face and neck and, to some degree, in the cheek area. A facelift does not address the following concerns for which additional rejuvenation procedures are needed: 

• Lip lines 
• Other fine facial lines
• Frown lines between the brows, crowfeet or laugh lines, and forehead wrinkles
• Wrinkles, grooves, and creases of the lower face, such as the nasolabial smile lines and marionette or puppet lines
• Droopy or ptotic mouth corners
• Facial volume loss in temples 
• Heavy or sagging eyelids or eyebrows
• Poor skin texture 

 

What’s the First Step?

If you are interested in Facelift surgery in the West Palm Beach & Palm Beach Gardens areas, the first step is to schedule your consultation at Mandal Plastic Surgery. When you come in for your appointment, you will be able to meet with Dr. Anita Mandal directly, who will assess your face, listen to your aesthetic goals, and answer any questions you may have about the procedure. She will also ask you questions about your medical history, so it is important to be honest and clear about your cosmetic goals to help optimize your final outcome. 

Once you have decided on the best facelift technique for your unique anatomy and needs, Dr. Mandal will create your customized treatment plan. Your surgery can then be scheduled, and you will be provided with the appropriate information and directions to follow before, during, and after your procedure.

What to Expect on the Day of Facelift Surgery

During the procedure, Dr. Mandal typically performs facelift surgery under straight local anesthesia without IVs, intravenous sedation (“twilight sleep”), or, sometimes, general anesthesia. This outpatient surgical procedure, which takes 3-4 hours, typically allows patients to recover in the comfort of their homes the same night after surgery.

 Dr. Mandal camouflages the incisions in front of and behind the ears as well as underneath the chin. Incisions are made slightly differently in men vs. women. She addresses the muscle by excising and repositioning the SMAS, then using special sutures to secure the SMAS at specific anchor points to give a natural contour lift to the cheek and jowl area. She removes excess fat and tightens platysmal neck bands through a submental chin incision to further define the neck angle. The overlying face and neck skin is then re-draped over the new with created underlying facial contours, rather than stretched, with the trimming of excess skin. Incisions are then closed after placing a tiny drain under the tissues, and a head dressing is applied.

Sometimes, a brow lift and/or an eyelid lift are performed in conjunction with a facelift to rejuvenate the upper face and restore a balanced, more youthful look. When these procedures are combined, the operation is referred to as a full facelift.

Facelift Recovery

 After surgery, patients typically go home the same day with a pressure dressing around the head. For a few days, sleeping at a 40-degree angle, preferably in a reclining chair or bed, is essential to help reduce swelling. Dressings and drains are typically removed on the next postoperative day.

Prescription pain medications are taken until the discomfort subsides. Antibiotics may be prescribed to prevent infection. Any bruising and swelling can be covered with makeup. Sleeping with your head elevated during the first few weeks is best to accelerate swelling clearing. Sutures are removed in stages throughout the 7 to 14 days following surgery.

You may gradually return to routine activities over 2-6 weeks following surgery.

 Activities such as golf, yoga, aerobics, weight lifting, and pilates may require a longer waiting period. You may not color, perm, or chemically treat your hair for at least 4-6 weeks after surgery. You should also avoid wearing earrings for at least several months.

Once healed, the incisions are typically unnoticeable, enabling you to wear your hair short or pulled back confidently. Any visible scars are usually well hidden in your body’s creases and will eventually fade to the point where they are undetectable.

How much does a Facelift cost in Palm Beach?

 The cost of a Facelift in Palm Beach is determined by numerous factors, including Dr. Mandal’s facelift techniques and the degree of change required. The best way to find out how much your facelift surgery will cost is to come in for a consultation and have a detailed surgical plan created. With this information, our Patient Coordinator will be able to provide you with a complete breakdown of the costs.

Why Choose Dr. Mandal?

 Double-Board Certified Facial Plastic Surgeon Dr. Anita Mandal uses her expertise, clinical research, and over two decades of experience as a Facial Plastic Surgeon. Her open communication, sound judgment, and exceptional technical skills are the foundation for her long-term patient relationships. She is fellowship trained with the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS), and also has six years of residency in head and neck surgery.

Schedule Your Consultation

Dr. Mandal focuses on achieving satisfying results that are also very natural-looking. When it comes to the face, patients prefer quality and excellence over price. They seek her skills from throughout Palm Beach County, across Florida, and a range of national and international locations. To discover your options, request a consultation online or call 561-238-0040 at our Palm Beach Gardens office.

Facelift FAQs

Is a Facelift Painful?

Recovery from a facelift is most often without much pain. While patients may experience soreness, tightness, or discomfort in the early period, these sensations are very normal and go away over time. The first 1-2 days may require Percocet or Tylenol with codeine to help the discomfort, but thereafter, most patients take plain over-the-counter Tylenol or do not require any pain medications.

How Many Follow-up Appointments Will I Need?

The number of follow-up appointments you need after your Palm Beach Facelift starts with a dressing and surgical drain removal appointment the day after surgery. This appointment is approximately 24 hours after the procedure. You will then typically return 7 to 8 days after surgery for the removal of the stitches in front of the ears and under the chin. A 3rd post-operative appointment is made 19-14 days after facelift surgery to remove the stitches behind the ears. Additional appointments are then made in one month, three, six, and 12 months to monitor your progress and ensure that you are healing as expected. 

How Long Until I See Results?

Most patients see visible lifting and tightening along their neck and jawline the day after surgery once the dressing is removed, despite the early swelling. While many patients look normal enough to return to most routine activities in 7-10 days, the majority of swelling can still take at least six months to resolve and see the final outcome. While the facelift resets and turns back the clock, you can enjoy your results for many years and continue to age at your own pace. However, if a facelift takes ten years off of your face, over the next 15 years, you will still continue to age, but you will still look about ten years than had you not had the facelift.

The best way to achieve optimal results is to follow Dr. Mandal’s pre-and post-operative instructions carefully and attend all of your follow-up appointments for 12 months after surgery. 

Can I Combine a Facelift with Other Procedures?

While each patient’s anatomy and genetics are unique in that we all age differently, what is certain is that aging is not limited to one facial feature or one area of the face.  For this reason, many of our West Palm Beach and Palm Beach Gardens facelift patients opt to have other additional facial rejuvenation procedures to restore the imbalances throughout our faces caused by the natural aging process. Popular facial surgery rejuvenation options include a neck lift, brow lift, eyelid surgery, fat grafting, and Fractional CO2 laser resurfacing to achieve an overall rested, relaxed, and youthful appearance.

If you have specific aesthetic goals, please discuss them with Dr. Mandal during your initial consultation. She will be more than happy to provide you with her expert opinion.

What Are the Risks Associated with a Facelift?

While very rare, as with most cosmetic surgical procedures that Dr. Mandal performs, there are general risks common to many surgical procedures, as well as procedure-specific risks. General risks include, but are limited to, bleeding, infection, poor wound healing, and anesthesia risks. The procedure-specific risks of a facelift include: 

• Under-correction
• Facial nerve weakness
• Over-correction
• Asymmetry
• Skin or soft tissue irregularities  
• Persistent numbness
• Need for revision surgery

A Natural Facelift Look

Dr. Mandal’s preferred facelift approach for Palm Beach patients involves repositioning the underlying SMAS layer tissues and excision of lax muscle. She then artfully redrapes and trims excess skin. This method is key to natural, youthful, and defined facial contours and reduces the chances of a “pulled,” “stretched,” or “windblown” appearance.

The incisions are skillfully concealed within your natural creases and contours in front of and behind the ears as well as under the chin. Some incisions are also hidden within the scalp to minimize hair loss and bald spots.

Facelift Differences Between Men & Women

Dr. Mandal believes in maintaining a masculine and feminine appearance for men and women following facelift surgery. She uses special techniques to achieve these outcomes. She is often sought after for revision procedures to restore a more balanced appearance in both men and women. 

Revision Facelifts

Approximately half of the facelifts that Dr. Mandal performs are on men and women who previously had face surgery by another doctor. A revision facelift requires a much higher surgical skill level since the underlying tissues and nerves have commonly been shifted from their normal position. Dr. Mandal has considerable experience in revising facelifts. 

Complementary Rejuvenation Procedures

By the time most patients undergo facelift surgery, they typically experience aging in other aspects of the face. Addressing these concerns, which are not corrected with facelift surgery, can give a more balanced facial appearance. Additional facelift procedures may include:

• A brow lift and /or eyelid surgery: A non-surgical browlift with Infini™ RF / Genius™ RF can also give a lift to the upper face
• BOTOX® can improve crow’s feet, frown lines between the brows, and forehead wrinkles to soften the upper face
• Restylane® Silk or Belotero® as well Genius™ RF / Infini™ RF can smooth out lip wrinkles
• Bellafill® – the 5-year filler, Restylane® Refyne or Juvéderm® Ultra Plus can fill deep nasolabial smile lines, marionette or puppet lines and lift droopy mouth corners. This treatment can also restore lost volume in the cheeks, temples, or under the eyes.
• Genius™ RF / Infini™ RF can help poor skin elasticity. Having a facelift in the presence of poor skin elasticity increases the likelihood of an overpulled or windblown look. Pre-treatment with Genius™ RF / Infini™ RF before a facelift can help build tissue elastin and collagen to avoid an overstretched result from facelift surgery.
• Fractional CO2 laser surfacing to soften and improve face and neck wrinkles

Fat Transfer consists of fat taken from the inner thigh, flanks, or abdomen, processed, and injected into facial areas with volume loss and deeper lines.