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.
The best candidate for a facelift is a woman or man whose face and neck demonstrate skin laxity (sagginess), especially of the lower face/jowl area, and neck. Most patients who seek the NYC plastic surgeon’s expertise are in their forties to sixties, but facelifts can be performed successfully on people in their seventies or eighties as well, as long as they are in good health. In very selected cases, Dr. Rapaport will perform a facelift on women below the age of forty, if they have experienced significant facial aging, particularly as a result of sun exposure.
With regard to terminology, Dr. Rapaport feels that there has been a veritable explosion of names for types of facelifts, and he regards these names to be more marketing and sales maneuvers than meaningful descriptions. Dr. Rapaport considers the terms facelift, lower facelift, and neck lift all refer to 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 is opening the face in order to rejuvenate it, he should, of course, perform every maneuver which is safe and reasonable to achieve optimal results. Some patients like to think of their facelifts as mini facelifts simply because they do not want to admit to themselves that they have had a facelift.
A short scar facelift is a specific type of facelift, which refers to the facelift scar not extending far behind the ear and into the hairline or scalp. As noted above, however, the exact same type of operation is performed internally, and therefore a short scar facelift is truly not a mini facelift.
Lifestyle Lift is a specific term used by a company for marketing, which does deserve some attention. Although the name Lifestyle Lift seems to denote a specific surgical technique, according to Dr. Rapaport, what it really denotes is a facelift performed under local anesthesia, which is marketed by a specific company.
Dr. Rapaport feels strongly that, while he prefers IV sedation to general anesthesia, some form of monitored sedation in the presence of an anesthesiologist is extremely important for the performance of a safe and optimal facelift procedure. When a facelift is performed solely under local anesthesia, the surgeon is under significant time pressure to work fast so that the patient does not become uncomfortable. Indeed, having a surgeon rush through the facelift procedure is not in the patient's best interest.
Furthermore, it stands to reason that the plastic surgeon performing a facelift is the key factor which determines the quality of the result. To the best of Dr. Rapaport’s knowledge, when a facelift is performed by the Lifestyle Lift people, the surgeon’s remuneration is quite secondary to the profits of the company at large. This may motivate them to cut costs wherever possible in order to achieve maximum profitability.
Midface lifts generally refer to facelifts that are performed via the lower eyelid and lift the soft tissues in an upward direction. 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.
Because facelifting involves removal of excess skin, they do require scars. These scars, however, can be very well hidden around the patient’s ears, and in women can be covered very well 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. In fact, 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 that selecting the scar location to be pre-tragal (in front of the tragus) or retro-tragal (behind the tragus), is a decision made on an individual basis. In many patients, there is a fine wrinkle immediately in front of the tragus, making the pre-tragal scar very appealing.
Perhaps more importantly 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 retro-tragally (behind the tragus), one is draping skin from the cheek onto what is really a part of the ear, and this 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 at least 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 highly desirable, both for comfort and well as for monitoring of blood pressure and to help allay any anxiety on the part of the patient and their family.
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 and/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 incidence of this complication in Dr. Rapaport’s hands is significantly lower, likely a result of multiple factors, including 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 lead to an increased risk of hematoma following facelift. It is therefore not surprising that 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.
Your facelift surgery will be performed by Board Certified Plastic Surgeon, David P. Rapaport at his fully accredited Manhattan, New York out-patient facility. In very selected cases, the surgery may be performed at Manhattan Eye, Ear, and Throat Hospital or at Lenox Hill hospital.
Yes, in fact many of the Board Certified Plastic Surgeon’s facelift patients choose to have their facelifts performed in conjunction with other facial cosmetic surgery procedures, such as blepharoplasty (eyelid surgery), earlobe repair, or chin enhancement.
The length of the facelift surgery will depend on the individual. Typically, a facelift can be completed in less than three hours. However, the amount of work you will require will directly affect the amount of time the operation will take.
Yes, bandages may be applied to the head and neck with the purpose of providing mild compression to the area and preventing excessive motion. Your nurse will typically remove the bandages the day after surgery.
After a facelift, many patients are surprised by the lack of pain they experience after surgery. For several weeks, expect some swelling around the eyes; however, as the swelling goes away, you’ll begin to see the surgery’s progress. Bending or lifting can extend swelling and is not suggested for three weeks after surgery. Running, cycling, and aerobic exercise in general may resume after three weeks. Driving is permissible when the swelling goes down and does not get in the way of your vision. Flying is generally permitted approximately 10 days after surgery.
Yes and no. Obviously, facelifts do not stop the aging process, so that as time goes by, the facelifted face will show signs of aging, such as jowls and loosening skin. On the other hand, the person who has facelift surgery will always appear more youthful than they would if they hadn’t had the facelift surgery, even years later. The Board Certified Plastic Surgeon, David P. Rapaport, MD' s favorite analogy is to imagine two identical twins needing a facelift. Only one decides to have facelift surgery, and they both return every year to been seen by the plastic surgeon. The patient who had facelift surgery will always appear younger than her "identical" twin, even when she feels she is ready for another one, 7-10 years after the first facelift.
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