Facelift

Technique — the deep plane facelift

Dr. Arredondo performs a deep plane facelift. Modern facelifts work beneath the skin, on the SMAS — the superficial musculoaponeurotic system, a continuous sheet of tissue that connects the muscles of facial expression to the deeper framework of the face. When that layer sags, so does everything attached to it. The deep plane technique goes a step further than a traditional SMAS facelift: it releases the specific supporting ligaments that tether this layer to the underlying bone, which allows the cheek, jowl, and neck to be repositioned together as a single unit. The result is a more complete, longer-lasting correction — and, importantly, one that preserves natural facial movement and expression because the skin itself is redraped rather than pulled. Dr. Arredondo’s approach emphasizes structural repair of this deeper layer, which is the single biggest factor in whether a facelift looks natural or looks done.

Neck component

Most facelifts include work on the neck, because the neck rarely ages independently of the face. The key structure here is the platysma — a thin muscle that runs from the collarbone up onto the lower face. As it loosens, its front edges separate and become visible as vertical bands (the “turkey neck” appearance). Platysmaplasty tightens and re-approximates these bands, usually through a short incision hidden under the chin, combined with the facelift itself. The result is a cleaner cervicomental angle — the line between the jaw and the neck.

Incisions

Facelift incisions are placed carefully along the hairline in front of the ear, traced around the contour of the earlobe, and then curved back into the hairline behind the ear. With attention to incision design — including how tissue is tensioned and how the hairline is respected — scars typically become nearly invisible within several months. A short, well-hidden incision under the chin is standard when neck work is included.

Anesthesia & duration

Facelift surgery is performed under general anesthesia in an accredited surgical facility. The procedure typically takes five to six hours, depending on whether the neck and eyelids are addressed at the same time. Most patients go home the same day with a soft head wrap and stay local to the office for the first week of recovery.

• A facelift doesn’t stop aging. It turns the clock back meaningfully, but time continues. Most patients can expect seven to twelve years of real improvement before considering a significant re-evaluation.
• Smoking and nicotine are a dealbreaker. Nicotine constricts the small blood vessels that keep the skin edges alive after surgery. Patients who use any nicotine product must stop for a minimum of four to six weeks before and after surgery — the risk of skin loss near incisions is otherwise dramatically higher.
• Facial nerves are close to the work. The face and neck carry many important nerves for movement and sensation. In experienced hands, nerve injury is rare, but temporary weakness in facial expression or altered sensation can occur and almost always recovers over weeks to months.
• A facelift does not address everything. It will not improve skin quality (pigmentation, fine texture — better treated by resurfacing), volume loss in the mid-face (better served by fat transfer or filler), or the eyelids (which require blepharoplasty).
• Results are partly up to you. Outcomes depend on underlying anatomy, skin quality, and how consistently a patient protects the skin from sun damage long-term. The patients who age well after a facelift are the ones who treat the skin as an ongoing investment.