Facelift in NYC

Board-certified plastic surgeon David P. Rapaport, MD, is one of Manhattan, New York’s most sought-after facelift surgeons. His nuanced, skillful approach creates unrivaled results that appear spontaneously beautiful and natural.

Facelifts have become increasingly popular in recent years to rejuvenate and enhance one’s appearance. With Dr. Rapaport’s advanced surgical techniques, a facelift can help reduce the signs of aging, such as sagging skin and jowls. The results of a facelift can be truly transformative, restoring a patient’s confidence and enhancing their overall appearance.

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A Pioneer In Plastic Surgery

Why Choose Dr. Rapaport for Facelift in NYC?

Dr. David Rapaport’s high degree of skill and deep knowledge of facial anatomy make him one of the top facelift surgeons in NYC. A facial-rejuvenation specialist with over 30 years’ experience, Dr. Rapaport understands the best and safest ways to restore patients’ youthful looks.

Dr. Rapaport is a double-board-certified plastic surgeon and has been honored as a Castle Connolly Top Doctor since 2016. Along with serving as a member of the American Society of Plastic and Reconstructive Surgeons, he has delivered presentations at medical conferences and authored several medical journal articles.

Dr. Rapaport’s years of training helped him become the best facelift surgeon in New York City. He studied medicine at Boston University and Tel Aviv University, and he completed residencies at Harvard’s Beth Israel Hospital and New York University Medical Center.

Meet Dr. Rapaport

Learn More About Facelift

The best candidate for a facelift is a woman or man whose face and neck demonstrate skin laxity (sagging), especially of the lower face and neck. Most facelift patients are in their 40s-60s, but facelifts can be performed successfully on people in their 70s-80s as well if they are in good health. In select cases, Dr. Rapaport will perform a facelift on women under 40 if they have experienced significant facial aging, particularly due to sun exposure.

You may encounter various names for different types of facelifts, such as “mini facelifts” or “lower facelifts.” Dr. Rapaport regards these names to be more marketing and sales maneuvers than meaningful descriptions. He considers the terms facelift, lower facelift, and neck lift to be the same operation.

The term “mini facelift” can be very misleading. According to Dr. Rapaport, there really should be no such thing as a true mini facelift. Once the surgeon opens the face to rejuvenate it, he should perform every safe and reasonable maneuver to achieve optimal results. 

A short scar facelift is a distinct type of facelift in which the scar does not extend far behind the ear and into the hairline or scalp. Nonetheless, the operation remains the same internally, meaning it is still not a “mini” facelift.

The phrase “Lifestyle Lift” is specifically used by a company for marketing purposes and typically refers to a facelift performed under local anesthesia. While Dr. Rapaport prefers IV sedation over general anesthesia, he emphasizes that some form of monitored sedation is vital for a safe and optimal facelift procedure. When a facelift is performed solely under local anesthesia, the surgeon is under pressure to work quickly so the patient does not become uncomfortable. Having a surgeon rush through the facelift procedure is not in the patient’s best interest.

Midface lifts generally refer to facelifts performed via the lower eyelid to lift the soft tissues upward. These types of lifts are more commonly performed in the south than in the northeast because they generally involve significantly more facial swelling and a prolonged recovery period. There also can be more issues with asymmetry using this technique. For these reasons, Dr. Rapaport does not perform facelifts via the lower eyelid approach.

A facelift addresses the core problems that result from significant facial aging. While injectables can provide dramatic solutions for volume loss of the midface (areas around the cheeks and eyes), injectable fillers have a fairly limited role in addressing the jowls and neck. When the neck demonstrates significant crepe-like skin and vertical bands or folds of skin (we call these platysmal bands or neck bands), there is very little that fillers or Botox® can do. 

Patients with these problems are ideal candidates for a facelift. Liposuction and reducing and contouring neck fat are intrinsic parts of the facelift procedure to create a natural and rejuvenated appearance. Many patients have other facial rejuvenation procedures, such as an eyelid lift or brow lift, performed simultaneously. 

Anesthesia

Unlike many plastic surgeons who perform their facelifts under general anesthesia with the patient completely unconscious, Dr. Rapaport strongly prefers “twilight” anesthesia, also known as IV sedation. With this form of anesthesia, the patient is breathing independently and responds to verbal commands (such as a request to take a deep breath) but typically has no memory of the procedure. Dr. Rapaport considers twilight anesthesia safer than general anesthesia, with a smoother, faster recovery. Anesthesia is administered by Dr. Rapaport’s board-certified anesthesiologist, Dr. John Grillo (or one of his associates).

Incisions

Because facelifting involves removing excess skin, they do require scars. Facelift scars can be well hidden around the patient’s ears and easily covered with a variety of hairstyles.

People sometimes talk about the facelift scar being either “in front of” or “behind” the ear. This is another example where terminology can be very misleading. All common facelift techniques involve a scar in front of the ear. The “in front of” or “behind” terminology refers to whether the scar is in front of or behind the tragus. Dr. Rapaport believes selecting the scar location to be in front of or behind the tragus is an individual choice. Many patients have a fine wrinkle immediately in front of the tragus, making the pre-tragal scar very appealing.

Perhaps more important is the fact that the tragus is truly a part of the ear; it contains cartilage like the ear and has a color and texture that match the ear much more than the cheek. When a scar is placed behind the tragus, the surgeon drapes skin from the cheek onto part of the ear, which can result in an unnatural appearance.

Dr. Rapaport sends his facelift patients home accompanied by a nurse hand-picked by our practice, who remains with the patient overnight. The morning after surgery, the nurse removes all bandages and any drains (if used) and forwards detailed photographs for the doctor to review. The presence of a nurse following facelift surgery is beneficial for the patient’s comfort as well as monitoring blood pressure and overall recovery.

After a facelift, many patients are surprised by the minimal pain they experience. Most patients return to work within two weeks. There will be swelling around the eyes for several weeks, but as this subsides, you’ll begin to see the progress of the surgery. You should avoid bending or lifting for three weeks after surgery as it can prolong swelling. Running, cycling, and other aerobic exercises can be resumed after three weeks. Driving is allowed once the swelling has gone down and does not impair your vision. Flying is generally permitted after ten days.

Risks & Complications

As with all surgery, there exists the possibility of complications. The most common complication following facelift surgery is hematoma. Hematoma refers to a collection of blood under the skin of the face or neck, which, depending on its size, may require intervention, such as drainage or re-operation. The literature reports the incidence of hematoma to be about 3% in female facelifts, higher in males because of the more vascular nature of men’s bearded skin.

The risk of this complication in Dr. Rapaport’s hands is significantly lower thanks to his careful technique and our insistence on nurse monitoring for the night after surgery. This keeps blood pressure under control. It is well established that increases in blood pressure heighten the risk of hematoma following a facelift. Therefore, having a trained nurse present for the highest risk period after surgery (90% of bleeding complications occur within 12 hours of surgery) will reduce the risk of this complication.

Facelifts do not stop aging, so as time goes by, the facelifted face will show signs of aging, such as jowls and loosening skin. For this reason, facelift results typically last 7-10 years. Many patients choose to have another facelift at this point.

Though facelift results may not be permanent, the person who has facelift surgery will always appear more youthful than they would if they hadn’t had the surgery, even years later. Dr. Rapaport’s favorite analogy is to imagine two identical twins needing a facelift, but only one has the surgery. The patient who had facelift surgery will always appear younger than her “identical” twin, even when she feels she is ready for another procedure.

Signs of a great facelift. Discreet Scarring, natural look, attention to detail, maintained facial movement, directionality of tissue repositioning

Take the Next Step

Every patient’s transformation journey at Rapaport Plastic Surgery begins with a detailed consultation with Dr. Rapaport. To learn more about facelifts and determine if it’s the right choice for you, fill out the form below or call us at (212) 249-9955 to schedule an appointment. Our team is dedicated to providing the best plastic surgery NYC has to offer.

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Facelift Frequently Asked Questions

A facelift, also called a rhytidectomy, is basically the ultimate operation for providing facial rejuvenation. It addresses almost every aspect of the aging face which primarily consists of volume loss due to fat atrophy, and sagging of tissues, both skin and deeper tissues. A facelift removes fat where appropriate, repositions fat to areas where it was lost, lifts and tightens the deeper tissues which have become lax over time, and removes excess skin after the deeper tissues have been appropriately restored. The only issues a facelift typically does not address are those related to skin pigment and coloration.

Skin and muscles naturally lose strength over time, making them less able to support fatty tissue. As a result, the fat, skin, and muscles sag.

A full facelift targets the mid and lower face, along with the neck. This includes the jawline, the cheeks, and the area under the chin. Because of this, a facelift typically does a great job at eliminating or greatly reducing jowls, loose skin under the neck, and neck bands. The area of the midface also becomes rejuvenated by repositioning fat and other tissues into their more anatomic and youthful position. Interestingly, nasolabial folds, though they often improve, cannot be eliminated by a facelift. When the brow is lifted, that is called a brow lift, which can be added to a facelift, but is not intrinsic to a facelift. Also, blepharoplasty, which is eyelid surgery, can be performed at the same time of a facelift and commonly is.

Facelift surgery by NYC plastic surgeon David P Rapaport takes, on average, anywhere from three to five hours to perform. The exact length of the procedure depends on the anatomic considerations of each case, including whether or not the platysmal muscle is directly approached by platysmaplasty.The surgical session may take longer when the facelift is being paired with other facial procedures and treatments.

In the hands of Dr. Rapaport, one of the best facelift surgeons in NYC, your facelift will not make you look unnatural or “pulled.” Because Dr. Rapaport is a facelift specialist, he has the skill required to create natural-looking facelift results for his patients.

In the past, traditional facelifts would sometimes create a “frozen” or “worked-on” appearance. Now, since the techniques utilized focus on lifting both the underlying tissues and the skin, results look much more natural.

Smokers can undergo facelifts, provided they refrain completely from all tobacco smoking for at least six weeks prior to the procedure and two weeks after. Dr Rapaport is uncompromising on this policy. This is because tobacco smoking greatly affects the circulation within the skin by blocking connections that naturally exist between very small blood vessels. This effect on skin circulation, in addition to the deprivation of oxygen which smoking causes, greatly increases the risk of skin crisis following a facelift. Skin necrosis means skin death, resulting in poor scars and a poor result.

Yes, with very few exceptions, Dr. Rapaport’s facelifts are performed at his fully accredited outpatient facility on the corner of 72nd St. and Fifth Avenue. It is indeed rare that Dr. Rapaport will insist that a facelift be performed in a hospital. This would be reserved for patients who have unique health issues that require in-hospital monitoring either during or after the procedure. In all other cases, the surgeries are performed in the office. A private duty nurse escorts the patient from the office to the Manhattan location, where they will be staying under the supervision of that nurse for one night. The nurse removes bandages in the morning as well as drains when appropriate and communicates with photos with Dr. Rappaport before leaving the patient’s bedside.

Yes, you can! It is, in fact, quite common for people to get a second facelift 8 to 10 years after their first. Dr. Rapaport likes to explain to his patients that they can look at a facelift similar to a major external home repair, such as replacing their roof and gutters: The home will continue to age, but will always be better off for having received the attention.

In cases where patients are unhappy with their facelift results from another surgeon, they frequently can benefit by undergoing a secondary facelift.

Dr. Rapaport will be honest and very detailed in terms of reviewing which specific issues are likely to be improved, and which, if any, cannot be improved.

Dr. Rapaport and his staff will provide you with detailed instructions to help you prepare for your procedure.

Your instructions will include a detailed list of supplements and food additives or ingredients to avoid and for how long, as well as a specific timeline for activities to avoid, like dying your hair and other similar activities. The office will make sure to provide you with a detailed timeline in terms of work and social downtime depend depending on your circumstances and your surgical plans.

No, a facelift alone does not treat the upper or lower eyelids. However, as noted above, upper and or lower eyelid blepharoplasty can be added to the facelift procedure.

No, facelifts are elective, cosmetic procedures, and are not covered by insurance.

Surprisingly, as it may seem, facelifts are typically not at all painful! For this reason, narcotic medications are typically not prescribed following a facelift.

The procedure itself is comfortable because the patient is under some form of anesthesia. Post-operatively, the most common feeling and complaint is some degree of discomfort because of bandages and drain tubes, but true pain is actually not part of the postoperative recovery.

In fact, if a patient is complaining of pain after a facelift, we see that as a sign to investigate further as to whether there is a different problem going on, such as a hematoma or a drain that is being pulled on and needs to be repositioned. So in short, although bruising is an issue to contend with following facelifts, pain is typically not.

The best way to answer that question is to say that there’s really no such thing as a true non-surgical facelift. Which one is trying to achieve lifting and tightening results without a facelift? The results will not be as sharp and strong as a facelift.

Procedures such as the trifecta, which Dr. Rapaport performs commonly in the submental area, should improve the patient’s contour and rejuve their appearance, but should not be looked at as a mini facelift because there is no real skin removal, and the results are therefore more limited.

It is worth mentioning that many people talk about a liquid facelift, using injectable fillers and Botox. While these procedures are commonly performed for rejuvenation, they do not produce the major structural change and long-term improvements that a facelift produces.

Dr. Rapaport emphasizes meticulous patient education and setting proper expectations in every patient he sees for facial rejuvenation, so they will best understand what to expect from the procedures they may choose.