This is an intriguing question that I have been thinking about for years and I have some answers to share. There are many facial muscles. Some are single, others are paired, existing one on each side of the face. Some have important functions that we absolutely need, others are dispensable. Some are important for facial expression, others are not critical. There has always been a lot of talk by lay people about the importance of facial exercise in maintaining youth. There are website and YouTube videos showing people how to exercise the facial musculature, but relatively little interest has been paid by the professionals. As a plastic surgeon practicing for 28 years in Morristown New Jersey and during my long surgical training as well as plastic surgery training, I have always been interested in facial muscles. Years ago I worked with a friend plastic surgeon from France who was doing injection of fat to the facial muscles to increase their volume and therefore increase facial volume. He had developed special cannulae with the right curvature to inject each muscle with fat and we had to master the position of each one of the facial muscles. I believe that facial exercise could help the rejuvenation of the face by two mechanisms. One is by increasing the tone to some specific muscles for example the frontalis muscle which is responsible for the position of the eyebrow. The other is by increasing the size and volume of the muscles which could be valuable in the cheeks. I believe that, as it is true for any other aspect of plastic surgery a consultation to evaluate your personal needs is very important, because facial exercise can have a negative effect on rejuvenation, for example the nasolabial folds could be exaggerated by increases tone of cheek muscles or the crows feet could get worse with increased tone of the lateral orbicularis. In summery I believe there is a role for facial exercise, but seeing an expert is very important to obtain the proper results. Just because it is not surgery, it doesn’t mean that any lay person could give you advice about how to exercise facial muscles and how to obtain optimal results.
Common Questions Patients Search About Facelift Surgery
How long does it take to look normal again after a facelift?
Most Northern New Jersey facelift patients look presentable in public around the 10–14 day mark, particularly with a little concealer for residual bruising. The polished, fully-rested result comes in over 3 months as subtle swelling resolves and incision lines fade. Patients who have surgery under local anesthesia with light sedation (Dr. Rafizadeh's standard approach) tend to look fresher faster than those who had general anesthesia.
How long do facelift results last?
A well-executed deep plane or SMAS facelift typically lasts 10–15 years before patients consider a refresh. The face continues to age — the facelift turns the clock back roughly 10 years, but does not stop time. Patients who maintain skin health (sun protection, medical-grade skincare, occasional non-surgical maintenance) tend to extend the visible lifespan of the result substantially.
Should a 70-year-old get a facelift?
Yes, when health allows. Many of Dr. Rafizadeh's North Jersey facelift patients are in their late 60s, 70s, and 80s — the operation is well tolerated at this age when performed under local anesthesia with light sedation, which avoids the cognitive and physiologic burden of general anesthesia. The right question isn't “am I too old” but “am I healthy enough,” and the answer is usually yes.
Is a deep plane facelift better than a SMAS facelift?
Not universally — the right operation depends on the patient. A deep plane facelift releases ligaments that anchor the cheek and midface, producing more dramatic midface elevation; it's well suited to patients with significant midface descent and deeper nasolabial folds. A SMAS facelift is excellent for jowls and the lower face when the midface still has good support. Dr. Rafizadeh chooses the technique based on the patient's anatomy, not a fixed preference.
What is recovery like from a deep plane facelift?
The first week is the most involved: bandages for 24–48 hours, then gradual de-swelling. Bruising peaks days 3–5 and fades by days 10–14. Most patients are back to non-public activities within a week and to social activities by week three. Numbness around the ears and jawline is normal for several weeks and resolves on its own. Dr. Rafizadeh's deep plane patients in Morristown typically describe the recovery as “more tedious than painful.”
What causes a Joker smile or windswept look after a facelift?
The “Joker smile” comes from over-aggressive horizontal pulling of the skin, and the “windswept” look comes from pulling skin and deep tissue in the same direction. Both are technique problems, not facelift problems. Dr. Rafizadeh lifts the deep layers vertically (which mimics how the face descends with age) and the skin in a more horizontal direction; that separation is what produces a natural result. Patients who look pulled or operated were almost always lifted in a single vector with too much tension.
How will I look 3 weeks after a facelift?
At three weeks most North Jersey patients look refreshed and natural in public. Subtle residual swelling along the jawline and beneath the chin softens through weeks 4–8. Incisions are pink and continuing to fade. Patients can wear makeup, attend events, and go back to most workouts (other than heavy lifting and contact sports) by this point. The face will still look incrementally better at 3 months than at 3 weeks.
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