Michigan Facelift | Ann Arbor Plastic Surgery


Facelift in Ann Arbor Plastic Surgery

Facial aging is a process that affects us all. As time goes on, wrinkles start to deepen, there is increased hollowing around the eyes and cheeks, and the soft tissues and skin start to sag, leading to jowls and hanging skin in the neck. While non-invasive treatments can help minimize the effects of aging over time, at some point you may reach the point where a facelift is the best option to achieve your desired appearance.

Our board-certified plastic surgeons at Ann Arbor Plastic Surgery specializes in facelift surgery. They will discuss your concerns with you, assess your anatomy, and develop a customized plan to help you achieve the appearance you’re looking for. The goal is a natural rejuvenation that will remind you of how your face used to look. At Ann Arbor Plastic Surgery, we believe in super-specialization, so each surgeon performs only a selection of procedures to ensure they are performing each surgery with the highest level of expertise. 

Continue reading or contact us online to learn more about Michigan facelift surgery at Ann Arbor Plastic Surgery.


Facelift: Insider Tips from the Surgeons at Ann Arbor Plastic Surgery

Reduce downtime after your procedure by asking your surgeon about tumescent anesthesia for facelift surgery. Infusing the tissues with a local anesthetic reduces bruising, bleeding, and swelling. Our patients enjoy minimal downtime and some of the best results in Michigan due to our use of tumescent anesthesia during facelift surgery, in addition to meticulous dissection technique.

Male facelift surgery is especially complex due to the hair-bearing skin on the lower face. Choose a surgeon that is experienced performing this procedure on both men and women. The techniques used are the same for both genders, but there is a little variation in how the incisions are planned and the surgery is performed to ensure a natural-looking result.

If you’re not ready for a full facelift, ask your surgeon about a mini lift. A less robust, mini-facelift treats drooping cheeks and nasolabial folds. Depending on what areas bother you, this procedure may be a better fit for your budget and schedule.

Avoid the “wind tunnel” look, a telltale sign of facelift surgery, by pairing skin tightening with SMAS tightening. SMAS facelifts tighten the tissues below the skin for a refreshed and very natural appearance. See our natural-looking results in our before and after gallery.

Discuss adding fat grafting to your facelift procedure to enhance your result and fill your nasolabial folds and cheeks utilizing your own tissue.

Avoid smoking, and if you do smoke, you must quit at least one month before surgery and throughout the recovery period. Tobacco and nicotine products constrict blood vessels, reducing blood supply, slowing healing, and increasing the chances of surgical complications.

What is a Facelift?

A facelift is a comprehensive facial rejuvenation surgery that aims to reduce the hallmarks of aging.  While the word facelift can be a scary thought for some, conjuring images of celebrities with overdone facelifts of the past, the reality is that you probably know someone who has had a facelift and don’t even know it! 

The goal of modern facial rejuvenation is to produce a very natural appearance and to make you look like a younger version of yourself—to set back the clock. How is this done? It involves making an incision along the hairline and around the ear, elevating the skin, and tightening or repositioning a layer underneath the skin called the SMAS, which stands for the Superficial Muscular Aponeurotic System. 

Anatomy of Skin & SMAS Muscle Layer

How does all this help rejuvenate your appearance?

  • Adds volume to the cheekbones
  • Softens the nasolabial folds
  • Lifts and removes the jowls
  • Redefines the jawline
  • Tightens the muscles and skin of the neck
  • Softens wrinkles on the face
  • Removes excess skin

Schedule A Consultation

Our Michigan plastic surgery specialists understand that the difference is in the details when it comes to achieving your desired results. Visit Dr. Malhotra and Dr. Ballard at Ann Arbor Plastic Surgery, schedule your consultation today.


The Benefits of a Michigan Facelift/Neck lift

Ideal candidates for surgery are in overall good health and have realistic expectations about the outcomes for this procedure. A consultation with our doctor can help you decide if rhytidectomy surgery in Ann Arbor is a good fit for you.

To ensure each patient receives maximum benefit from their procedure, we offer many different variations on the traditional facelift including SMAS facelift, neck lift, and mini facelift.

You may benefit from this procedure if you have:

  • Saggy, loose skin on the lower face or neck
  • Descent of the fat along the jaw and chin creating jowls
  • Wrinkling around the nose and mouth, on the cheeks, or along the jawline
  • Droopy, deflated cheek appearance
Before and After
Before and After

How Does the Face Change with Age?

The face changes in three primary ways with aging. The first is that the skin changes with age. Starting in your 30’s, your skin starts to lose collagen and elastin, making the skin appear thinner and more stretched out and causing the appearance of fine wrinkles on the skin. Additionally, muscle activity throughout your life can lead to deeper lines in the skin. You can also start to develop hyperpigmentation on the skin, leading to an uneven appearance. Sun exposure and smoking can worsen these changes, so make sure to wear SPF every single day, and talk to your doctor about stopping smoking if you want to minimize the effects of aging! Skin changes are treated with medical-grade skincare for maintenance, as well as lasers and chemical peels for more advanced changes.

The second way the face ages is through volume loss. This starts at the bone level, where the bone begins to recede in the cheekbones and eye socket, leading to the deepening of the under-eye area. The fat pads of the face, which contribute to a youthful appearance, also decrease in size. This creates a hollower look to the face, further deepening the undereye, cheek, and nasolabial folds. This is the aspect of aging that can be treated with fillers, or for a more permanent solution, fat grafting can be performed to provide a more complete volume rejuvenation.

The third way the face ages is through ptosis, which essentially means the drooping or sagging skin and soft tissues of the face and neck. This leads to changes such as jowling, a squarer shape to the face, deep nasolabial folds, dropping of the eyebrow (leading to a heavy upper eyelid), and hollowing of the upper cheek. It can also lead to sagging of skin in the neck, leading to a fullness or hanging skin, which patients often refer to as a “turkey neck.” This is where a facelift is especially important when it comes to reversing signs of aging. It is the only way to actually lift the soft tissues in a predictable and long-lasting way.

What Happens During a Facelift?

We perform facial plastic surgery procedures requiring IV sedation or general anesthesia at an outpatient surgery center affiliated with a local area hospital. We find that these surgery centers are one of the safest options for our patients. They are equipped with the latest equipment and are continually improving, a claim that few in-office surgery centers can make. More minor or limited procedures may be done in the office with oral sedation and local anesthesia only.

Throughout the surgical process, we’ll be by your side. We’ll answer questions, provide detail about what to expect next, and help you feel safe and comfortable.

  • We often use a tumescent technique for facelift surgery, infusing the tissues with a local anesthetic. This technique reduces bleeding and swelling and can significantly shorten recovery.
  • Incisions are placed in the hairline and around the ear, beginning at the front of the ear and looping around to behind the ear.
  • We don’t just tighten the skin. The supportive tissues deep within the face are meticulously tightened. Fat is sculpted and repositioned to create rejuvenated, younger-looking facial contours.
  • Skin is laid into position without tension. This ensures a soft and natural look, avoiding the windblown appearance that is common after a poorly executed facelift.
  • If neck tightening is needed, additional incisions are made under the chin through which liposuction and muscle tightening or release are performed.
  • Incisions are closed using advanced techniques to ensure a smooth, imperceptible scar after healing.

Patients spend a short amount of time in recovery before returning home to rest and heal.

Who is a Good Candidate for Michigan Facelift Surgery?

Have you ever looked in the mirror and lifted up your cheeks and wished that’s how your face always looked? If so, you might be ready to discuss a facelift. So, who is really a candidate? Anyone who feels their face has changed with age might be a candidate for a facelift. Some of the telltale signs of aging include dropping of the cheek, deeper nasolabial folds, jowls, loss of jawline definition, and hanging skin on the neck. At your facelift consultation, our doctor will listen to your concerns, assess your face and neck, and determine the recommended plan to help you achieve the look you desire!

Other important factors can determine whether you’re a good candidate. There is no set age limit at which you may have a facelift procedure. Most of our facelift patients are in their 40s to 60s, but patients both younger and older can be candidates depending on their concerns and overall health. It is essential to ensure you are in good general health to be a good candidate for cosmetic surgery and to minimize the risk of complications. You must quit smoking at least three months prior to your procedures to be a candidate for surgery. If you have any health issues, our doctor will discuss these in detail at your consultation and will determine if you are a candidate for a surgical procedure.

What are the Different Types of Facelift Surgery?

A traditional facelift procedure involves treating the face, including the cheeks, jowls, jawline, and nasolabial folds, as well as the neck, to achieve a comprehensive facial rejuvenation.

Some patients, however, may have only specific concerns, and alternative procedures may be a better fit for them.

A mini-facelift is similar to a facelift in that it involves tightening the SMAS and removing excess skin. The main differences are that it involves a shorter scar and does not involve tightening of the neck. It is good for patients with early jowls who do not have concerns about loose skin or sagging in the neck.

A necklift involves tightening of the platysma muscle in the neck and removal of extra skin. It involves a shorter scar than a traditional facelift. It is good for patients that have fullness or laxity in the neck area and may also help to soften jowls. It does not, however, treat the cheeks and its effect on the jowl is limited compared to a traditional facelift. It is a great option for patients who are primarily bothered by the appearance of their neck.


Let our before and after gallery show you the expertise of Michigan’s plastic surgery specialists, Dr. Pramit Malhotra and Dr. Tiffany Ballard. Place your trust in the skilled hands of our board-certified surgeons who understand that the difference is in the details.

Which Technique is Best for Me?

There are many facelift techniques that exist including deep plane, SMAS plication, SMASectomy, high SMAS, MACS lift, among numerous others. Effectively, all are trying to achieve the same thing: repositioning/tightening the SMAS layer and removal of excess skin.  All techniques have been shown to be effective at rejuvenating the face. The best technique may vary depending on your anatomy, a surgeon’s experience with different techniques, and if you’ve had prior surgeries in the past.  Our doctor most commonly performs deep plane and SMAS plication facelifts, but the best technique for you will be determined at your consultation based on your personalized surgical plan.

What is the Recovery After Facelift?

Generally, recovery is approximately 1-2 weeks. Pain after a facelift is generally mild and is easily controlled with pain medication in the days after surgery. It is not uncommon for patients to require only Tylenol and an anti-inflammatory. On the day of surgery, you will be discharged home with a head and face wrap. You will be seen in the office the following day for a follow-up. Swelling is expected as well as mild bruising. The head wrap will be removed, and you will be placed in a removable elastic compression garment that you will wear for one week. At your one week follow-up, all visible sutures will be removed. At this point, you will likely have minimal pain, and you will feel recovered in terms of completing day-to-day tasks. However, it is normal to still have residual swelling and possibly mild bruising. Therefore, it is recommended that you allow a minimum of 2 weeks before any major social gatherings, though the swelling will continue to decrease, and your new look will continue to improve for a year after your surgery.

In order to maximize results, it is recommended that you follow these important instructions:


  • Get up and walk at least every 2 hours while awake
  • Keep your head elevated at least 30 degrees for the first week
  • Apply cold compresses to the face for the first 24 hours to help to minimize swelling.
  • Keep your compression garment on at all times, other than for washing for the first week.
  • Begin showering 48 hours after surgery and wash with a gentle cleanser.
  • Apply ointment to your incisions daily as instructed.
  • Take your medications as prescribed


  • Exercise for 3 weeks after surgery
  • Lift anything heavier than 10 lbs
  • Smoke or drink alcohol after surgery
  • Apply ice directly to the face or neck after surgery
  • Take NSAIDs, such as Aspirin or ibuprofen, or other blood thinners, until cleared by your surgeon.

Will I Look Unnatural After My Facelift?

The goal of facelift surgery is to reverse the signs of aging while providing the most natural result possible. Many steps are taken to ensure natural look. Incisions are designed to be easily concealed. The face is lifted in a vertical direction to directly counteract the effects of gravity (and avoid the “Joker” look that every patient fears). Additionally, the surgery is completely customized to address your individual concerns and anatomy. We want your friends and family to marvel at how young and refreshed you look, while leaving no obvious signs a facelift was performed.

What Will Scars Be After Facelift Surgery?

The facelift, the incisions begin at the sideburn area to the ear, down inside the tragus (part of the ear), and continue around the earlobe and along the hairline behind the year. All these incisions are designed to lie in natural skin creases or junctions so that they are as hidden as possible. While this is the general pattern, the length of your incision will vary depending on the amount of loose skin that needs to be removed. Please see the video below showing how the incisions are designed.

Can I Combine a Facelift with Other Procedures?

It is very frequent to combine a facelift with other facial plastic surgery procedures to provide an even more comprehensive rejuvenation of the face. The most common procedure performed is fat grafting, which is performed in most facelifts. This helps with some of the volume loss that occurs with aging, and fat also contains stem cells that can help regen skin and soft tissue at a cellular level, further enhancing the surgery results. Other surgeries that are frequently combined include brow lift, upper and/or lower blepharoplasty (eyelid lift/eyelid surgery), lip lift, and/or chemical peels. It is our goal to keep surgeries under 5 hours in length to ensure the utmost safety for our patients, so your plan will be reviewed at your consultation to determine which surgical procedures can be safely combined at one time.

How Long Does a Facelift Last?

Aging is a process that never stops. While facelifts are an effective way to reverse signs of aging, it is a process that will continue to affect change over time. Therefore, there are many factors that can affect how long a facelift lasts, including age, sun exposure, health status, and genetics, among others. Since a facelift is turning back the clock, you will likely always appear younger than your age. However, generally, we say that facelifts last at least 7-10 years, though it is not uncommon for patients to be happy with their results for much longer.

Facelift FAQs

Costs vary significantly depending on the complexity of your desired lift, but with many options available, we can generally find a good fit for your aesthetic goals and budget. Typically, a rhytidectomy costs between $6,500 to $11,500, including all fees.

Our advanced surgical techniques combined with our use of tumescent anesthesia allows for a much shorter facelift recovery period. In general, the expected cosmetic downtime from social settings is 1 week. Our patients that can work from home usually only need 2-3 days off from work. Rest a lot, and be sure to use sun protection as the skin is very sensitive.

Surgical and non-surgical treatments at Ann Arbor Plastic Surgery can enhance your results. Some of our favorite non-surgical pairings include Botox® and dermal fillers. Surgical enhancements include eyelid surgery (blepharoplasty) or facial fat grafting.

Scarring is usually minimal after a rhytidectomy if the procedure is performed by a skilled plastic surgeon like Dr. Lapaine. Incisions are carefully placed and expertly closed to ensure good healing and minimal visibility. We use a multi-layer suturing technique and place incisions in natural folds and creases. Any scars that do occur will be most noticeable in the first few months after your surgery. After incisions mature and fade, they are usually hard to spot.

There is no set age for considering facial plastic surgery. We operate on patients in their 40s and others in their 70s. Come in for a consultation to explore your candidacy for this procedure. If aging isn’t sufficient for a full facelift, we offer a less invasive mini-lift, a rejuvenation procedure that uses smaller incisions to lift and tighten away the early signs of aging. Patients that want to avoid or delay surgery altogether may want to consider an injectable treatment. Dermal fillers and Botox® restore a youthful appearance with minimal downtime and no incisions.

Most patients will need 7-10 days of “cosmetic downtime” following a traditional facelift or necklift before they are ready to resume public activities.

Good skincare and taking care of yourself are cornerstones of optimizing and preserving your results. This involves a medical grade skincare regimen with maintenance treatments. Maintaining a stable weight is also important to long-lasting results. 

A mini facelift best addresses mild to moderate signs of facial aging, such as early jowling. The incisions used for a mini facelift are shorter and the procedure itself is less invasive. A mini facelift is not designed to address significant neck skin laxity. Patients with more extensive or pronounced signs of aging are likely better candidates for a traditional facelift, which serves to rejuvenate the cheek and jawline areas. While the incisions are longer, they are placed in discrete locations to be well-hidden from view.

A patient care coordinator from Ann Arbor Plastic Surgery will contact you prior to your appointment to review our consultation process. Typically, we ask patients to send photos of their areas of concern so that we can ensure you are a good surgical candidate and that we can help you meet your goals. Be sure to write down any questions you may have to discuss with your surgeon during your consultation.

You should pick up all of your prescriptions ahead of time and plan to avoid any strenuous physical activities and important social functions while you are healing. Ensure you follow all of the preoperative instructions and avoid any nicotine prior to surgery.

A facelift procedure involves all of the typical risks associated with any surgery, including bleeding, scarring, and infection. Specifically, it also involves working over areas of the face that are in close proximity to the nerves that control facial movement and ear sensation. You should always seek out the care of a Board Certified Plastic Surgeon to minimize your risks and ensure your surgical procedure is done as safely as possible.

Anyone considering a facelift must refrain from nicotine use of any kind for at least 4 weeks before and after surgery. This is to minimize the risks of this elective surgery and ensure a successful outcome. Smoking and nicotine use significantly increases the risks for major complications, including skin necrosis and infection.

Patients will have 7-10 days of “cosmetic downtime” during which they usually will refrain from public activities and social engagements. Patient should refrain from strenuous physical activities for at least 3 weeks to allow their incisions to heal and the swelling to resolve fully.

Patients can typically resume working out 3-4 weeks following surgery.

Patients with low impact or desk jobs may return to work 7-10 days after their procedure. For patients whose jobs require more strenuous activities, they can typically return around 2-3 weeks after surgery.

A facelift is the gold standard for excess skin and can address laxity, sagging, jowling, and rejuvenate the midface and neck more powerfully than any non-surgical option. However, there are many non-surgical options that can improve and rejuvenate one’s appearance, including fillers, Botox, Ulthera (skin tighteing), and skin care and resurfacing.

A liquid facelift involves the use of hyaluronic acid fillers to restore volume to the face. These fillers are usually injected along the cheeks and nasolabial folds to rejuvenate the face and correct volume loss and deep wrinkles. A traditional facelift involves excising the lax skin of the face and tightening the underlying layers of the face to provide a powerful method of rejuvenation.

A facelift typically lasts approximately 10 years.

SMAS is short for superficial musculo-aponeurotic system, which is the thin sheet of muscle and connective tissue deep to the subcutaneous fat in the mid and lower face. A SMAS facelift is a specific facelift technique that targets both sagging skin and the underlying SMAS layer of the face. It is performed to address sagging skin, excess fat, jowls, and loss of volume in the cheeks.

Unfortunately, there is no true alternative that can achieve all the changes of a facelift.  However, there are many other treatments that go a long way to slowing the signs of aging, potentially delaying or avoiding a facelift altogether!  The simplest step is a good skin care regimen.  It is never too early to start.  The perfect skin care routine varies from one person to another as every person’s skin is different.  The best recommendation is to come in for your complimentary skin consultation with our medical aesthetician!  However, regardless of your routine by far the most important part is sun protection, as UV will accelerate the aging of your skin.  Make sure you apply SPF of at least 30 every single day (yes, even in the winter), and reapply every 2 hours if you are going to be exposed to the sun. 

Professional treatments, including Hydrafacial, chemical peels, laser, microneedling, or Ultherapy can all help to reverse signs of aging without any surgery. Finally, injectables can be a powerful tool when used correctly. Neuromodulators (such as Botox, Dysport, or Daxxify) help to weaken the muscles of the face, which can lead to reduction in wrinkles on the face. If done well, you should still have natural movement, but the wrinkles will be minimized and prevented. Fillers can also be very helpful in replacing volume loss with aging and providing improved balance to the face. However, one must be careful not to overdo it with dermal fillers, or you risk complications and a puffy appearance. Therefore, it is important you go to a well-trained, experienced injector to achieve the best possible results. If you’re not sure where to start, come see one of our excellent injectors for an assessment of what may be beneficial for you!

Call Ann Arbor Plastic Surgery to learn more about Michigan facelift surgery in Ann Arbor or to schedule your consultation.