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A well-executed facelift corrects skin laxity that results in a loose neck, sagging jowls, and the loss of youthful cheekbones. It leaves the face looking soft, refreshed, and natural.  Evaluation of the aspects of facial aging involves an individualized strategy to correct the individual’s face by applying reliable and reproducible maneuvers. Changes in the underlying bone structure, the central fat compartments of the face, accumulated fat and the loss of muscle tone in the neck as well as the aging processes of the skin and underlying subcutaneous tissues are all considered. Assessment of the original underlying facial structures and knowledge of genetics and racial factors are also considered. Environmental damage can accelerate the aging process.

A well-done facelift is still the gold standard for the correction of advanced facial aging.

The facelift is one of the most misunderstood procedures in plastic surgery because when we see a poorly executed facelift, it draws our attention because it is too extreme and overdone; there is disharmony. It looks unnatural or, as I like to say, “supernatural” (not found in any human in this world). Likewise, this can be said of an under-corrected and under-executed, “mini” facelift that hasn’t utilized the necessary maneuvers to make key transformative changes that will in a natural, “refreshed” look. Lesser amounts of dissection under the skin, combined with excess pulling and the use of threads or other gimmicks, may look good for a few months or so, but they ignore the more important areas that require correction. Knowing where and how much undermining to do, how much fat to place and where to place it, and where to reposition the facial structures is an art.

The goal is to restore the facial shape to restore a refreshed and youthful look while still having people looking like themselves. The face elongates and deflates as the tissue structures weaken and atrophy, so lifting the tissues naturally over critical structures, such as the lower jaw and cheekbones, while tightening and contouring the neck provides a natural, unoperated, and beautiful result. Selective fat grafting to those areas that have lost facial fat restores volume and defines contours. Added micro-fat grafting improves skin quality, provides suppleness, and reduces the “hollowed out” and fatigued look.

Long-Lasting Results

The results of your facelift surgery can last upwards of 10 years in most cases, as long as a healthy lifestyle is maintained and your skin is cared for properly. A well-done facelift cannot be performed in two to three hours. A nicely performed neck lift will last exceedingly long if the procedure is executed correctly. Facelifts done on younger patients tend to look more polished and last longer than in older patients, as the tissues have more holding power. The ideal time to have a facelift is when the tissues no longer support a youthful and refreshed look, leaving the face looking tired, with jowls, a loose, sagging neckline, flattened cheekbones, and droopy eyelids. These cause the face to lose its triangular youthfulness, becoming oval shaped without the striking contours in the cheeks and jawline.

Facelift Procedure

The incisions: The incisions for your facelift are placed to maintain a normal hairline and to be invisible while hidden within the hairline. They will extend from the lower sideburn, down around the back of your ears, and up into your scalp. Smaller or limited incisions that do not extend into the back of the hairline can be used when there is not as much neck skin.

Anesthesia: Dr. Stephens performs his facelifts utilizing light, general anesthetic techniques and local anesthetic placed in and under the skin. This is as safe, if not safer, than deep sedation techniques, where there is a risk of losing control of the patient’s breathing and oxygenation. It allows for efficient and controlled procedure maneuvers in an unrushed environment.

Types of facelifts:

The Traditional facelift: Our most common procedure is used for full-face rejuvenation. Fat is selectively removed and placed; the neck muscles are tightened, and deep tissues in the mid-face are lifted and repositioned before the skin is redraped.

Limited incision facelift: Patients who require less correction, or who do not wish to undergo more extensive surgery, may choose this option. They are usually younger and require less correction. Incisions are shorter and less dramatic correction may suffice.

Combination Procedures:

There can be other procedures done on the eyelids and eyebrows at the same time as a facelift:

Blepharoplasty: Also known as an eyelid lift, this procedure lifts and rejuvenates the eyelids for a more youthful appearance.

Brow Lift: Selective lifting and correction of the lateral brow or a full brow lift may be indicated. Corrections to weaken the frown muscles may be performed as well.

Selective fat grafting: Used for enhancement of the cheekbones and jawline, around the eyelids or temples or in the neck. Micro-fat can be placed in and around the eyelids, fat injections to the skin lines and nano-fat placement can be used to improve the quality of the skin, or a corrective laser may be used at the same time or in another procedure. This is done conservatively to provide correction but not over-enhancement.

Woman of middle age


There is usually not much pain after a facelift. You can expect variable amounts of swelling and bruising for a few weeks after your surgery. Small drains are placed that are usually removed after three to five days. We do not use large dressings or garments on the face, which is left exposed. The incisions are cleaned with cotton swabs to remove any dried up blood.

We highly recommend Manual Lymphatic Drainage (MLD) for our patients, which reduces swelling, bruising, and discomfort. This is done by our aesthetician. We also recommend skincare products to maintain and improve the quality of your skin after your facelift.

Scar Care:

Facelift incisions are hidden and made as small as possible. They typically heal well. We recommend a simple silicone scar gel to help the scars fade. Initial redness can be covered with makeup, and all scars will fade with time.


The cost of your facelift surgery will vary depending on the extent of correction needed and procedures performed. It includes the surgeon’s and facility fee and anesthesia costs. You will be provided a price quote at your consultation appointment.

Frequently Asked Questions

Am I a good candidate for facelift surgery?

Candidates for facelift surgery can be as young as their 40s but are usually in their 50s or older. A facelift done on younger patients often gives outstanding results, but this does not mean that excellent results cannot be obtained in most patients. Patients wanting a facelift are dissatisfied with signs of facial aging, heavy jowls, and sagging cheeks, as well as a poorly defined neck and jawline. There is a loss of the facial structures, giving a fatigued look. Many patients say, “I feel great, and I am happy, but my friends and co-workers say I look angry or tired.” Patients should also be in good general health and have realistic expectations of their results.

Frequently Asked Questions

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Consecutively voted in the top 5 “Best Favorite Plastic Surgeon” in Evening Magazine’s Best of Western Washington and “Best Cosmetic Surgeon” in 425 Magazine.

Dr. David Stephens, Plastic Surgery | Medical Aesthetics

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Within easy access from all points in the Northwest, Bellevue makes the ideal location for all your cosmetic needs. Free parking included.

10687 NE 2nd Street
Bellevue, WA 98004

Phone: (425) 455-0444

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