Facelift Overview

We’re in a constant battle with gravity, and nowhere is this more evident than on our faces. As the years roll by, the once plump and firm tissues that gave us a youthful, heart-shaped appearance lose volume and succumb to gravity’s pull. Our faces become more square, flat and hollow. On our worst days, we may feel like we barely recognize the reflection staring back at us.

But here’s the good news: you don’t have to accept these changes as an inevitable part of aging. A facelift, skillfully performed by board-certified plastic surgeon Dr. Matthew J. Nykiel, can turn back the clock, restoring that refreshed, rested, ready-to-take-on-anything appearance you remember.

Dr. Nykiel artfully addresses the root causes of facial aging at Butts By Design in Newport Beach. Book a consultation with Dr. Nykiel to discuss your options for facial rejuvenation.

What Is a Facelift?

A facelift (rhytidectomy) is a surgical procedure that addresses the visible signs of aging in the mid-to-lower face and the upper neck. There are many different techniques a surgeon can use to accomplish these goals. Dr. Nykiel will select the best technique for you based on your anatomy and goals.

During a facelift, Dr. Nykiel makes incisions within the hairline and natural contours of the face and ears. These access points allow him to reposition and tighten the deeper tissues of the face, creating a strong foundation for your rejuvenated appearance. He then redrapes the skin over the new contours and trims any excess away.

One of the most important things to understand about facelift surgery is its objective. Depending on the technique used, a facelift addresses the lower third or lower two-thirds of the face (from the cheekbones to the jawline) and the upper neck. It does not target the forehead or eye area. 

If you have concerns about these areas, Dr. Nykiel may recommend a brow lift or blepharoplasty. They can be done instead of a facelift, or in addition to a facelift for comprehensive rejuvenation.

Why Choose a Facelift?

You deserve to feel confident in your skin at every age. A facelift can erase years from your appearance by lifting sagging cheeks, tightening jowls, smoothing nasolabial folds and restoring a more youthful neck contour. Many patients report increased self-esteem and confidence in both personal and professional settings after the procedure.

Gone are the days of tight, pulled-back faces. Modern facelift techniques, especially in the hands of an expert, produce natural-looking results. Dr. Nykiel’s approach ensures you won’t “worked on” or unnatural — you’ll simply look like the best version of yourself. 

A facelift can be easily combined with other facial rejuvenation procedures for more comprehensive results. Many patients choose to add eyelid surgery, a brow lift or fat grafting to their facelift for total facial renewal.

Am I a Candidate for a Facelift in Newport Beach?

You may be an excellent candidate for facelift surgery if you meet the following criteria:

  • You notice significant signs of facial aging that can’t be adequately addressed with nonsurgical treatments
  • You are in good general health and have no medical conditions that could impair healing
  • You do not smoke
  • You understand the the goal of cosmetic surgery is improvement, not perfection
  • You are willing and able to follow postoperative instructions and attend follow-up appointments to ensure the best possible outcome

From Dr. Nykiel 

Many patients ask me, “Am I too old for a facelift?” The truth is, age is less important than you might think. Your overall health matters more than the number of candles on your birthday cake. 


The majority of my facelift patients fall in the 55-65 age range because this is when facial aging really starts to take its toll. However, I regularly perform facelifts on patients at 70 and beyond. 

Here are two key things I look at when I evaluate an older patient’s candidacy for surgery:

Heart Health: Can your heart tolerate the stress of surgery?

Medical History: Do you have any history of conditions like diabetes, heart attacks, strokes, blood clots or bleeding disorders that could impact your ability to undergo surgery safely?

In my practice, we require medical clearance for all patients over 50. This extra step ensures we’re making the safest possible decisions for your care.

What Are the Treatment Steps for a Facelift?

Your facelift journey begins with an in-depth consultation. During this meeting, Dr. Nykiel will assess your facial structure, skin quality and signs of aging while you explain your goals, concerns and expectations. He will thoroughly explain the facelift process and the best technique options available to you.

On the day of your surgery, you’ll be comfortably settled in our state-of-the-art surgical suite and administered anesthesia. Dr. Nykiel will make the planned incisions. The exact pattern depends on your facial structure, the extent of correction needed and the technique agreed upon during your consultation. In all cases, the incisions are designed to be as inconspicuous as possible once healed.

Through the incisions, Dr. Nykiel will reshape the underlying tissues to create more youthful facial contours. He will also remove excess skin and, if necessary, may remove or redistribute fat.

Most facelift procedures take two to four hours to complete.

What Types of Facelift Does Dr. Nykiel Offer?

Facelift techniques have evolved in leaps and bounds since the early days of the procedure. While we once saw faces that looked permanently trapped in a powerful gust of wind, today’s facelifts do more than pull the skin tight. A modern facelift is a sophisticated reshaping of the entire facial structure.

Traditional (Full) Facelift

A full facelift addresses signs of aging in the mid-face, lower face and upper neck. This comprehensive approach is ideal for patients with significant sagging in the cheeks, pronounced jowls and noticeable neck laxity. 

Mid-Facelift

A mid-facelift is perfect for those primarily concerned with sagging cheeks and deepening nasolabial folds. This technique creates a more youthful contour in the middle portion of the face.

Mini Facelift

Also known as a “weekend facelift,” this less invasive option is suitable for those with early signs of aging. It targets the lower face and upper neck, smoothing out early jowls and mild skin laxity.

SMAS Facelift

This technique focuses on manipulating the SMAS (superficial muscular aponeurotic system), a sheet of tissue beneath the skin that connects the facial muscles. Lifting and tightening this layer creates more natural and longer-lasting results compared to skin-only facelift techniques. 

Deep Plane Facelift

For patients with a substantial degree of facial sagging, a deep plane facelift can provide dramatic rejuvenation. This is an advanced technique that involves lifting the skin, fat and muscle as a single unit. Though it requires more technical skill to perform, it can yield impressive, natural-looking and long-lasting results.

Neck Lift

A neck left is often performed in conjunction with a facelift. This combination approach is ideal for those troubled by a “turkey neck,” excess fat under the chin or prominent neck bands. 

What Anesthesia Is Used During a Facelift?

Dr. Nykiel performs most facelift surgeries using general anesthesia. You will be in a controlled state of unconsciousness, free from pain or awareness during the surgery. A board-certified anesthesiologist will administer the anesthesia and monitor your vital signs continuously throughout the procedure.

While general anesthesia is safe in the hands of experienced professionals, it’s normal to have questions or concerns. Dr. Nykiel and our anesthesia team will gladly address any worries you might have about this aspect of your procedure. 

What Goes Into the Facelift Recovery Process?

After your facelift, you’ll be closely monitored in our recovery area as you wake up from the anesthesia. Most patients describe feeling groggy but not in pain when they first wake. Our staff will ensure you’re comfortable and stable before you’re released to go home under the care of someone you trust. You’ll have bandages around your face to minimize swelling and bruising.

Prioritize rest in the first few days. You will experience some discomfort, swelling, bruising and tightness in your face and neck. These are normal and can be managed with the medications Dr. Nykiel prescribes. Keep your head elevated, even while sleeping, to help reduce swelling.

Swelling and bruising typically peak around day three or four and then begin to subside. You will likely feel comfortable moving around the house and performing light activities by the end of the first week. However, you should still avoid bending, lifting and all strenuous activities.

Weeks two and three are milestones. Many patients are ready to return to work or social activities around the 10 to 14 day mark. You may have some residual swelling and bruising, but they can be concealed with makeup.

How Is Pain Managed During Facelift Recovery?

Dr. Nykiel has developed a comprehensive pain management protocol to ensure your facelift recovery is as comfortable as possible. His multi-modal approach addresses discomfort from various angles:

  • Pre-Emptive Analgesia: We start pain management before your procedure begins. This proactive approach has been shown to significantly reduce discomfort after surgery.
  • Long-Acting Local Anesthetics: During your facelift, Dr. Nykiel uses long-acting local anesthetics to numb the surgical area. This helps minimize pain in the immediate postoperative period.
  • Prescribed Medications: You’ll be given a curated regimen of pain medications to take at home. This may include:
    • Gabapentin (Neurontin)
    • Diazepam (Valium)
    • Celecoxib (Celebrex)
    • Hydrocodone (Norco)
    • Acetaminophen (Tylenol)

Most patients describe their discomfort after a facelift as more of a feeling of tightness or pressure rather than sharp pain. The first 48 to 72 hours are typically the most uncomfortable, and pain levels generally decrease significantly after this period.

It’s normal to experience some degree of numbness or altered sensation in the treated areas. This is due to the disruption of sensory nerves during surgery and usually resolves over time.

Where Are Facelift Scars Located?

While no surgery is completely scarless, the goal is for your scars to be so well-hidden that only you know they’re there. Dr. Nykiel takes into account your typical hairstyle when planning incisions so the scars are hidden even if you wear your hair up or short.

Typical facelift scar locations include:

  • In the hairline at the temples
  • In front of and behind the ear
  • In the lower scalp behind the ear

For male patients, Dr. Nykiel takes special care in scar placement. Men’s shorter hairstyles and beard growth patterns require a slightly different approach to ensure scars are inconspicuous.

What Are the Risks of Facelift Surgery?

Dr. Nykiel and his team work diligently to minimize the risks of every procedure, but you must be fully informed before making your decision. Here are some potential risks associated with facelift surgery:

  • Anesthesia reactions
  • Infection
  • Bleeding or hematoma
  • Nerve injury (temporary or permanent)
  • Hair loss near incision sites
  • Skin necrosis
  • Asymmetry
  • Dissatisfaction with results
  • Visible scarring

Facial fat transfer is a fantastic complement to a facelift. Let’s talk about why.

A facelift addresses sagging skin beautifully. It can also help reshape some of the face’s underlying contours. However, it doesn’t address another key aspect of facial aging: volume loss.

Facial fat transfer is a great way to restore the “padding” beneath the skin that disappears as we age. Fat is soft and pliable, just like our natural tissues, and most of us have excess somewhere we’d be happy to get rid of.

We can use your own fat to restore volume in multiple areas of the face, including:

  • Under-eye area to reduce hollow appearances
  • Cheeks for a more youthful contour
  • Nasolabial folds to soften deep lines
  • Lips for subtle enhancement
  • Chin to improve profile and definition

During your consultation, we’ll discuss whether adding facial fat transfer to your facelift could help you achieve your goals.

When Will I See the Final Results of My Facelift?

Most of the visible signs of surgery will fade by weeks four to six. This is usually when Dr. Nykiel clears patients to resume exercise and other vigorous activities. 

Your results will continue to refine over the coming months as any lingering swelling resolves. By six months post-op, you will be enjoying the full results of your facelift.

Scar maturation is a longer process. They will gradually fade and flatten. By six to 12 months post-surgery, most patients’ scars have matured to thin, pale lines that are barely noticeable.

Is a Facelift Permanent?

Although no procedure can stop the aging process entirely, a facelift can set the clock back significantly. Many patients find that their results last 10 years or more with proper care and maintenance. 

Contact Our Board-Certified Facelift Surgeon in Newport Beach

At Butts By Design, we believe the best facelift is one that leaves people wondering why you look so refreshed and vibrant, not asking what work you’ve had done. Dr. Nykiel’s expertise in facial anatomy and his artistic eye allow him to create results that enhance your natural beauty and restore your confidence.

Call 949-416-0038 or schedule your consultation online to get started. We offer in-person appointments at our Newport Beach and Upland locations, as well as virtual consultations for your convenience.