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In all my years of practice, no other procedure brings more trepidation and fear than the facelift. When we age, at around the mid-century mark (the 50’s) the tissues of the face start to sag. This is due to three things: The skin and supporting soft tissue of the face has lost it’s elasticity and support. The volume of facial fat decreases ( not everyone ) The facial bones and the jaw begin to recede. What are the issues people have with facelifts? The pain, the bruising, the scar. That it must take a long time to heal. That it won’t look natural, and they will look like they’ve had a “facelift”. The proper facelift today addresses the causes of the aging face: Re-draping and tightening the supporting structures (SMAS) and skin. Re-store lost facial fat volume with fat transfer Restoring the receding bone volume with facial implants Re-surfacing the skin with a chemical peel or laser. A skilled facial cosmetic surgeon can perform a good facelift by: Proper dissection in the right plane to minimize bruising, swelling and potential complication of nerve injury. Hide the incision so that people can’t notice a scar. Retracting and redraping the tissues so that the face looks even and smooth without “stretch marks”.   The jawline should look clean and straight. The cheeks will be rosy, full and round.   The forehead and brow should be elevated when relaxed. Fat transplantation and or facial implants are used to restore volume. A facelift will take anywhere from three to six hours depending on how much is done. The patient should look presentable by one to two weeks, but complete recovery will gradually take a few months.  A good facelift will keep looking better and better as the years go by.