Facelift and Neck Lift in Michigan
Allure Medical Spa Serving Livonia, Shelby Township, Clarkston, and the Detroit Area

What is a Facelift?

A facelift is a cosmetic surgical procedure designed to restore a youthful appearance to the lower face and neck. Other terms for facelift include “rhytidectomy”, “neck lift”, “platysmaplasty”, or “mini-facelift”. It corrects sagging jowls, a droopy jaw line, neck bands, and the “turkey waddle” under the chin.

Facelift History

The original facelift procedures in the early 1900′s simply tightened the skin of the face. Skin-only lifts lead to an overly tight appearance, and the skin would quickly stretch so the results did not last very long. This type of lift was common until the 1970′s when Dr. Skoog (from Sweden) and Drs. Peyronie and Mitz (from France) discovered that the deeper muscular tissues of the face could be lifted, resulting in a more natural and longer-lasting result.

The Modern Facelift

Today, nearly all facelifts involve tightening of the deep facial layers (also called the SMAS) and then redraping of the overlying skin. There are several facelift varieties, including mini-facelifts (or short-scar facelifts, rapid lifts, or so-called “lunchtime lifts”) which use smaller incisions than full facelifts. The more extensive deep-plane and SMAS-flap facelifts elevate the deep facial muscles, allowing for improved longevity.

In the area under the chin where people tend to develop loose skin, fat, and/or muscle, a face lift will help to rejuvenate these aging signs. Loose neck skin is lifted along with the lower face and jowls during facelifting. Excess fat deposits are sculpted during a facelift with liposuction or direct fat removal to create a more pleasing contour. A sagging neck muscle (platysma muscle) that causes neck banding is improved with a corset platysmaplasty. This part of the facelift procedure tightens the neck muscle centrally with cinching stitches placed under the skin. This maneuver can elevate a sagging neck resulting in a sharper, younger neckline.

New Advances

There are some new techniques that can enhance the look of a face lift.

Adding volume: It is now understood that we lose fat in our faces as we age. This leads to more sagging, drooping, and an overall older appearance. Fat lost with age can be replaced during a facelift with fat transfer or injectable fillers (e.g. Restylane, Perlane, Juvederm, Sculptra). In cases with fat deficiency, replaced volume results in a more pleasing, natural look.

Lasers: Lasers are often used to make the surface of the skin look younger and smoother with more even tone. Several types of skin resurfacing lasers can accomplish this at the same time as a facelift, such as the fractional CO2 laser (e.g. ActiveFX) or the erbium laser (e.g. Fraxel). Some lasers can also be used under the skin (e.g. CoolLipo) to help sculpt fat and stimulate collagen growth at the same time as a facelift. Cosmetic surgeons sometimes refer to this as a laser facelift.

Is a Facelift for Me?

You might be a Michigan facelift candidate if you want to achieve a younger appearance in the lower face. Depending on your unique needs, our talented Michigan facial plastic surgery providers can combine face lift with other facial procedures, such as laser skin resurfacing for wrinkles, upper and/or lower eyelid lift for aging eyelids, and brow lift for droopy brows. Facelift helps correct signs of premature aging and sagging in the neck and jowls. Most people undergoing the procedure say they want to look as young as they feel. There is no specific age that is right for a facelift. Anyone from the age of 30 to 90 could be a potential candidate for a facelift. Determining factors include health status and pre-procedural expectations.

SAGGING Jowls and poor jawline definition

A facelift will tighten the skin along the jawline and help improve sagging jowls. This is achieved by elevating the muscle (SMAS) and removing excess skin.


Improvement of sagging jowls and jawline definition before (on left) and after (on right) facelift performed by Dr. Kotlus in Michigan.


Improvement of jawline definition before (on left) and after (on right) facelift performed by Dr. Kotlus.

Neck bands and the turkey waddle

What about the bands under the chin or the loose hanging skin that looks like a turkey waddle? A facelift corrects these issues by tightening the muscle under the neck with a technique termed platysmaplasty (tightening of the platysma muscle that causes the bands) while the loose skin is lifted.


Neck bands before (on left) and after (on right) facelift performed by Dr. Kotlus

Jawline and neck improvement

A facelift is designed to improve both the jawline and the neck at the same time. If you have both of these concerns, facelift surgery can be the ideal solution.

Necklift Before and After Photos - #1
Correction of loose neck skin and sagging jawline, before (on left) and after facelift (on right) performed by Dr. Kotlus

Necklift Before and After Photos - #2
Correction of loose neck skin and sagging jawline, before (on left) and after facelift (on right) performed by Dr. Kotlus

Necklift Before and After Photos - #3
Correction of loose neck skin and sagging jawline, before (on left) and after facelift (on right) performed by Dr. Kotlus

Does a facelift hurt?

Minimal discomfort and minimal downtime are hallmarks of the modern facelift performed at Allure Medical Spa in Michigan. An anesthetic solution (tumescent) consisting of dilute lidocaine and epinephrine, as also used in liposuction allows for a safer and more comfortable procedure with minimal bruising. Monitored sedation is also administered for comfort. Stitches are removed in one week, and most patients are comfortable enough to do light household chores the day after surgery.

What about scarring?

The incisions are expertly hidden around the ear, into the hairline, and sometimes in the crease under the chin, so they are often well hidden. The incision is usually placed in a crease around the ear and behind the tragus, the small bump in front of the ear opening. This placement is more desirable than an incision in front of the ear, which can be an obvious facelift “giveaway”.

Facelift Before and After Photos - #1
Neck bands before (on left) and after (on right) facelift performed by Dr. Kotlus

Will I look too tight?

The best cosmetic procedures are those that look natural, without the “operated-on” look. The most current facelift methods create a natural, rejuvenated appearance without the “windswept” signs. Other telltale facelift signs to conscientiously avoid are the “pulled-down” ears, irregular hairlines, too-high sideburns, and obvious scars.

Natural Facelift and Eyelift Before and After Photo
Natural facelift (performed with upper eyelid lift) before (above) and after (below). Her jowls and neck are smoother and more youthful-appearing and her lower face was reshaped from a square to rounded look. She does not look overly pulled or tight. Surgery performed by Dr. Kotlus

How long will it last?

A facelift generally “sets back the clock” five to ten years. It can take five to ten years to return to the “before surgery” appearance, although a facelift can last longer than 10 years in some cases, especially in people who maintain their results with good skin care, lifestyle choices, and non-surgical enhancements (e.g. laser skin resurfacing, inject-able fillers).

What if I already had a facelift?

Facelifts can be repeated. This may be required if you are displeased with the result of a previous facelift (for example, if you had a mini-facelift and the neck wasn’t addressed) or if you have aged or lost significant weight since your procedure and would like additional rejuvenation.

Before and After Revision Facelift
Before and after revision facelift to correct loose skin under chin and jowls. First surgery performed elsewhere; revision performed by Dr. Kotlus

Am I a candidate for a mini-facelift?

The term “mini” facelift usually refers to a less invasive version of a facelift, often with smaller incisions, or incision limited to a smaller area around the ear. A mini facelift is generally reserved for younger patients or those who only require correction of jowls and the jawline. It tends not to be ideal for those with significant neck banding or heavy necks. In your consultation, your doctor will discuss the various facelift options with you.

Before and After Mini Facelift Photo
Before (left) and after (right) of mini facelift (incision only around the front of the ear) performed for a small jowl and improvement of jaw line and lower face in a patient without a heavy neck. Performed by Dr. Kotlus