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Facelift

A facelift erases the most visible signs of aging on the lower two-thirds of your face. It removes loose and sagging skin from the area, tightening the underlying muscles and support structures to provide a more youthful and rejuvenated appearance; it may improve your self-image as well. Dr. Paul G. Ruff IV perform facelift surgery in Washington, D.C. to give women and men a naturally attractive appearance, without the "pulled look" and abnormal hairline or sideburns that some people develop postoperatively.

Women and men visit Dr. Ruff for face lift surgery in Washington, D.C. from Alexandria, Reston, and surrounding communities. Request a consultation online to meet with one of our board-certified surgeons, who will help determine whether you're a good candidate for the procedure. Or call our office at (202) 785-4187 to schedule an appointment.

Before & After Facelift

Before Photo
After Photo

Before

After

For more photos of our patients, please view our photo gallery.

Are You A Good Candidate for a Facelift?

The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well defined. Most patients are in their 40s to 60s, but facelifts can be successful for people well into their 70s and 80s. If you are generally healthy, have realistic views about the results you can expect, and have any of the following conditions, you may be a good candidate for the procedure:

  • Loss of skin elasticity or muscle tone on your face or neck
  • Wrinkles or furrows on your face or neck
  • Deep creases forming between the bottom of your nose and the corner of your mouth
  • A diminished jawline
  • A sagging or heavy chin

If you have early signs of facial aging, you may be a candidate for a non-surgical approach. Dr. Ruff will discuss minimally invasive options such as ThermiSmooth™, or ThermiTight™, if they suit your needs.

Paul G. Ruff IV,
M.D. F.A.C.S.

Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.

Meet Dr. Ruff Request a consultation

Your Consultation

During your extensive consultation, your plastic surgeon will evaluate your facial and neck structure, your skin elasticity, and your underlying muscle tone to determine whether an endoscopic facelift is right for you and which technique suits you best. He will thoroughly explain each technique along with its risks, benefits, and recovery times. You will be asked to describe in detail how you want your face and neck to look after your facelift. Working together, you and the doctor will decide which technique will give you the results you desire.

Your doctor and the staff at West End Plastic Surgery will:

  • Review the various facelift options with you
  • Clearly discuss the potential risks of each procedure
  • Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost and payment information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medications you take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How Facelift Surgery Is Performed

Your facelift procedure will be performed in our state-of-the-art surgical suite or at one of the area hospitals where our plastic surgeons operate. If your facelift is extensive or is combined with other procedures, such as blepharoplasty or a forehead lift, a hospital stay of 1 to 2 nights may be required.

Your facelift will take between 2 to 6 hours to complete and can be performed using either general anesthesia or local anesthesia with sedation depending on what you and your doctor prefer. With general anesthesia, you will be completely asleep throughout the procedure. With local anesthesia, you will be lightly sedated and your face and neck area will be numbed. You will be awake but will be relaxed and will feel no discomfort. The type of anesthesia used and whether or not a hospital stay is required will be discussed with you at your initial consultation.

There are several techniques used to perform a facelift, each done in its own way and each with its own benefits:

  • In the traditional facelift, an incision is made at the hairline, excess skin is removed, the remaining skin is pulled and tightened, and stitches are used to close the incision. The traditional facelift is used when there are large amounts of sagging and drooping skin to be removed.
  • With the mini-lift, a small incision is made in front of each ear and a small area of skin is lifted. This technique is particularly suited for patients in their late 30s or early 40s because it targets the early signs of aging.
  • The "weekend facelift" uses liposuction to remove excess fat from the chin and uses lasers to constrict the fat cells and tighten the surrounding tissues of the neck area. This procedure works well for people who primarily wish to tighten the jowls to reduce the heavy look under the chin.

In a traditional facelift, Dr. Ruff use a well-concealed incision on each side of the face that starts at your hairline above the temple and ear, continues around the earlobe, and ends in the hairline behind the ear. This allows for removal of excess skin and in many instances excess fat. For men, the incision is placed slightly farther in front of the ear to accommodate the natural beard lines. If your neck is also being lifted, your doctor will make a small incision under your chin

Once the incisions are made, your doctor carefully separates the skin from the fat and muscle below. If necessary, fat is trimmed or suctioned from around the neck to improve the contour of the neck and chin. The doctor then tightens the underlying muscle and support structures, redrapes the skin, and removes any excess skin, giving the face a naturally more youthful appearance.

Once the procedure is complete, your doctor uses stitches to secure the layers of tissue and to close the incisions. Surgical clips may be used to secure the scalp. A small, thin tube called a drain may be temporarily placed under the skin behind your ear to help drain any blood that might collect there. Your head is wrapped with gauze dressings to help reduce the swelling.

What to Expect During Facelift Recovery

Activity When
Drainage Tubes Removed 1 to 2 Days After Surgery
Bandages Removed 1 to 5 Days After Surgery
Shower and Shampoo Hair 3 Days After Surgery
Stitches Removed 5 to 7 Days After Surgery
Back to Work 2 to 4 Weeks After Surgery
Driving As Soon as You Feel Comfortable
Strenuous Activity 6 Weeks After Surgery
Fading of Scars Several Months to 1 Year

Before & After Photo Gallery

We're as thrilled with our patients' results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.

Immediately After Your Surgery

In most cases, facelift surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and the surgical area will be sore, so you will need to have someone drive you home. If your facelift is performed at the hospital you can expect to stay in the hospital for 1 to 2 nights. Once you go home you may want to have someone stay with you for the first few days. There will be some bruising, swelling and numbness. You will need to keep your head elevated and remain as still as possible for a few days after surgery to help reduce the swelling. Pain medication will be prescribed to alleviate as much post-surgery pain as possible.

The First 24 to 48 Hours After Your Surgery

You may experience some numbness and temporary discomfort around the incisions. Any pain or discomfort you experience can be controlled with prescribed medication. You will also experience swelling and some bruising. You will need to keep your head elevated for the first few days after surgery to reduce the swelling of your face and neck. Your discomfort level will improve rapidly after the first 2 days.

Dr. Ruff will remove your bandages at your first postoperative visit. There may be a small amount of bleeding around your incisions. This is normal and can usually be controlled by applying light pressure to the area. If the bleeding does not respond to light pressure or becomes heavy, call West End Plastic Surgery for further instructions.

You can wash your hair 48 hours after surgery (or 24 hours after the drains are removed). However, if you dry your hair, keep the dryer on the lowest setting because your scalp may be numb and there is a risk that you might burn yourself.

The First 2 Weeks After Surgery

You will be up and around in the first few days after your surgery, but you should take it easy for the first week after surgery. Your stitches and any surgical clips used will be removed within 2 weeks of the surgery, usually in 2 steps. You can begin using makeup 2 days after your stitches are removed. Most patients are back to work within 2 weeks of surgery.

You will notice that you will become increasingly more comfortable during the first few weeks after your surgery. You may also notice:

  • Mild to moderate swelling, tenderness, and bruising in the area of the incisions. This will gradually disappear within the first 2 weeks after surgery with most of the swelling and bruising disappearing within a month. The swelling may cause it to feel funny when you make certain facial expressions.
  • Numbness in the area of your incisions; this is normal and may take several weeks to disappear completely.
  • Itching as a result of the healing of the nerves near your incisions. This feeling is more pronounced with the traditional facelift and may take up to 6 months to disappear completely.

Resuming Your Normal Routine

Everyone heals at different rates, and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work within 2 weeks of your surgery.
  • You can resume driving as soon as you feel comfortable doing so.
  • You can most likely return to your physical exercise program within 6 weeks of your facelift. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • Most of the visible signs of your surgery should fade within about 3 weeks.
  • Prolonged exposure to heat and sun should be limited for several months.

The scars caused by the incision should be protected from sunlight for at least a year after surgery.

Things to Be Aware of After Your Surgery

  • Bruising and swelling usually decrease enough so that you can comfortably go out in public about 10 to 20 days after your surgery.
  • You may experience a loss of sensation or numbness in the area of your surgery. This is entirely normal and may take several weeks to disappear.
  • Generally, the scalp heals at a slower rate than the face or neck. For this reason, any surgical clips used in your scalp will be left in longer than the stitches in your face and neck.
  • Some of your hair around the incision may fall out and may temporarily be a bit thinner than normal. Normal hair growth usually resumes within a few weeks or a month. Permanent hair loss is rare.
  • Your face and neck will feel dry. Apply a good fragrance-free moisturizer frequently.
  • Avoid saunas and steam baths the first few months after your surgery.
  • Protect your scars with sunscreen for at least 6 months after surgery. Use an SPF 15 (or greater) sunscreen every time you are outside. Apply the sunscreen before applying makeup.
  • Hair texture and manageability can change temporarily as a reaction to surgery. Wait at least 6 weeks before coloring, highlighting, or perming your hair once it returns to its normal texture.

What Are Possible Side Effects or Risks?

All surgical procedures have some degree of risk, however, major complications from facelift surgery are unusual. During your initial consultation at West End Plastic Surgery, your individual risks will be assessed and discussed. As with any surgery, you can help reduce the risks by closely following the pre- and post-surgery instructions provided to you. Your doctor and his staff will be with you every step of the way to ensure a safe and pleasing outcome.

Most likely risks include the following:

  • Infection
  • Nerve damage
  • Hair loss
  • Asymmetry
  • Blood or fluid collection
  • Skin sloughing, delayed healing at the incisions points
  • Wide or thickened scars

How Long Will the Results of Your Facelift Last?

A facelift removes excess skin and repositions fat and muscle to reduce jowls and smooth the jawline for a more youthful appearance. These results generally last between 5 to 10 years or longer in many cases. It is important to keep in mind that the effects of aging, gravity, and environmental factors will continue to affect the smoothness, sagging, and wrinkling of your face and neck. Meticulous skin care is critical to maximize the effectiveness and longevity of your surgical results.

Questions You May Have

Are there other procedures that could be done along with facelift surgery to enhance the overall appearance of my face?

A facelift is often performed in conjunction with a neck lift, brow lift, or eyelid surgery to enhance the overall youthful appearance. BOTOX® Cosmetic injections are a non-surgical alternative that may temporarily reduce the amount of lines and wrinkles in your face and neck.

Will my insurance coverage pay for my facelift?

A facelift is considered cosmetic surgery and, therefore, is not covered by insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation.

Are there alternatives to facelift surgery?

BOTOX combined with injections of fillers, such as JUVÉDERM® can be used in some cases as a non-surgical alternative to a facelift. These injections can reduce or eliminate lines and furrows by either filling them in or by blocking the nerve impulses to temporarily paralyze the muscles that cause wrinkles. Meticulous skin care may also help improve the tone, texture, and occasionally the contour of your facial skin. Laser resurfacing with the ResurFX™ or Clear + Brilliant® systems or chemical peels may also provide a less-invasive alternative to surgery.

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West End Plastic Surgery 2440 M Street Northwest #200
Washington, District of Columbia 20037 (202) 785-4187 Monday–Friday: 8 a.m.–4:30 p.m. Get Directions
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