Facelift and Neck Lift – What You Need to Know

One of the most common concerns of the aging face is the appearance of sagging, wrinkled skin around the neck and jowls. The effects of aging, sun exposure, or even weight loss in the face can cause drooping skin along the jawline and under the chin. You might also start to see those deepening fold lines between the nose and the corner of the mouth. There comes the point when simpler treatments, such as injectable fillers and surface lasers, are no longer enough to make a significant difference in hiding the excess skin laxity. In these cases, the only real option is a facelift and neck lift.

Facelift Basics

Facelifts and neck lifts are surgical procedures where the skin and underlying tissue layers are “lifted” upward, and the excess sagging skin is removed and tightened, regaining a more youthful appearance. Facelifts are commonly performed under anesthesia, typically through IV sedation (much like during a colonoscopy.) Under anesthesia, incisions are hidden around the ear, and from that approach, the tissue below the skin is “lifted up” with buried sutures and anchored higher in the front and back of the ear. A significant amount of excess skin is removed, matching the incision around the ear. The underlying tissue lifted is called the SMAS fascia, which is basically the structure that supports the face and is unlike stretchable skin. It has high tensile strength. This high-strength fascia is what gives facelifts and neck lifts longevity for years of improvement.

Prime candidates for a facelift/neck lift are patients who are forming excess skin under the jawline (jowls) or wrinkly, hanging skin under the chin or neck. It is often better to address the problem at an earlier age when it is first noticed rather than wait until the skin is hanging. Depending on the situation, facelifts are performed in men and women beginning in their 40s or 50s, but it can be done as late as in their 80s if their overall health is generally good.

What Type of Results Can I Expect?

I remind patients that after their facelift, they will continue to have birthdays, and the skin will continue to age naturally. The benefits of a facelift/neck lift will last a few years up to ten years. Most patients are happy with one facelift, but a second or third facelift is certainly possible if needed.

Before we go any further, it is essential to know that at Advanced Dermatology & Skin Surgery, we strive to provide beautiful, natural-looking results…never “over-done.” Our aim is not to make you look like a teenager again but to provide you with a refreshed, younger-looking you!

What is the Difference Between a Facelift vs. a Neck Lift?

Technically, a facelift addresses the face above the jawline, and a neck lift treats the skin of the neck below the jawline. Because the face and neck are intimately connected and contiguous, a facelift and neck lift should always be considered in combination. The surgical procedure can and should address both the face and the neck. Whenever I recommend a facelift, that always includes a neck lift. Another procedure that can also be done at the same time is a blepharoplasty or eyelid surgery.

The best way to decide if a facelift is appropriate for you is to come in for a cosmetic consultation. During the consultation, you will first chat with a Board-Certified Dermatologist to determine what your concerns are and what options are best to address them. During your discussion, the Provider will examine your face and skin not only to see if you are a good candidate for a facelift, but they might suggest other effective treatments that would specifically fit your personal needs. Knowing your medical history and what medications you are taking is also important. Your Provider can show you in a mirror what results you can realistically expect.

Recovery From a Facelift/Neck Lift

A facelift procedure is a significant surgery and does have downtime to allow for recovery and healing. After a facelift, you can expect a recovery of a few weeks before fully engaging in everyday activities. Most visible recovery happens in the first two to three weeks but healing under the surface continues for 9 to 12 months.

During the first week after surgery, you will need to restrict any physical activity and plan to rest and relax. Usually, the face is swollen and may have some bruising. Any pain is mild to moderate and can be controlled with appropriate medication. Typically, you will see the doctor one day after surgery for a post-op check and dressing change. Showering and shampooing are allowed beginning a day or two after surgery and are incorporated as part of wound care. A second post-op visit is made one week after surgery when all stitches are removed, and questions can be answered. Your activity level gradually increases as your healing progresses over the next several weeks. Another follow-up appointment is made one month after surgery to check your progress.

What are the Risks Involved

As with any surgical procedure, there are various risks involved. Your Provider will review them with you before your surgery. Risks include bleeding, infection, fluid accumulation, reactions to the anesthesia, and scarring. Fortunately, these occur rarely and typically can be managed easily. Nerve damage with resulting numbness or facial muscle weakness is also extremely rare but more serious.

Reach out to Advanced Dermatology & Skin Surgery with any questions you have about facelifts and neck lifts. Our highly trained and experienced Providers are available for a consultation and will be happy to review all your options to develop the best plan for you. Book an appointment today at any of our three locations in the Greater Spokane and Inland Northwest area.


Joel Sears, M.D., FAAD – Dr. Sears is a Fellowship-Trained Mohs Surgeon and Board-Certified Dermatologist who devotes his practice to treating skin cancer and facial plastic surgery. Dr. Sears is the founder of Advanced Dermatology & Skin Surgery, which he started in 1991. He is currently affiliated with the University of Washington School of Medicine WWAMI medical residency program as a Clinical Assistant Professor. Read more about Dr. Sears here.