| pre and post op picture of patient who underwent face lift under local anesthesia and concious sedation. | |
This is truly the best way to perform a face-lift. The patients recover faster. There is less nausea and vomiting from heavy sedation or general anesthesia, therefore less bruising and swelling. There is only one requirement you have to know how to pick the right patient for this procedure and know how to give an efficient effective local anesthesia. The sedation is secondary and plays a supportive role. The key to the procedure is the knowledge of the anatomy and the sensory nerve distribution of the face. This knowledge allows me to anesthetize the face with fewer injections and make the patient more comfortable.
As far as picking the right patient 70 t0 80 % of my patients chose this procedure rather than getting general anesthesia or heavy sedation by an anesthesiologist. This has become a specialty for me and about 20% of my patients are ecstatic when they learn that I offer this option. I like the fact that the patient is awake and can cooperate with me. For example they can hold their head to one side and stay still. They can open their eye, lookup and open their mouth when I do the lower lid and remove the excess skin. This allows me to remove the exact amount of skin without over resection. Once the operation has started and the patient realizes that they don’t feel anything and they are comfortable, they totally relax. We typically use intravenous sedation and a pain medicine to prevent anxiety and take the edge out of the slight pain of injections. We often have interesting conversation with the patient. This make the time pass faster. Good relaxing music is also part of the experience. Sometime patients tell us that they had a good time. Saving on the anesthesia fees is another side benefit.
Of course if the patient likes to be totally unconscious during the injection of the local anesthetic, we would have an anesthesiologist present. We would also use an anesthesiologist if the patient has any medical condition like high blood pressure that needs control during anesthesia. This is also a better option for patients who are supper anxious and have a hard time relaxing. Call us if you have any other question about this blog. We would be happy to talk to you and explain anything that is not clear.
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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