Dr. Karen Horton has either authored or reviewed and approved this content.
Page Updated:
As we age, the effects of time, gravity, and environmental factors can lead to visible changes in the face. Common concerns include sagging skin, deep wrinkles, jowls, and a loss of youthful definition in the jawline and neck. These changes can make individuals look older or more tired than they feel, often affecting their confidence. Pursuing a facelift is a highly personal decision, motivated by the desire to address these concerns and restore a refreshed, vibrant appearance. At her San Francisco practice, Dr. Karen Horton works closely with patients to understand their goals and create a customized plan to rejuvenate their appearance while preserving their natural beauty.
A facelift, or rhytidectomy, is a surgical procedure designed to reduce visible signs of aging by addressing sagging skin, deep wrinkles, and diminished facial contours. Over time, natural aging processes, gravity, and environmental factors such as sun exposure can lead to the development of jowls, loose neck skin, and a loss of youthful definition in the face.
By carefully lifting and tightening the underlying facial structures, removing excess skin, and re-draping the remaining skin, a facelift can restore a smoother, firmer appearance to the face and neck. This cosmetic surgery procedure is ideal for individuals seeking to look refreshed and rejuvenated, often reflecting the vitality and energy they still feel within.
Facelifts are highly customizable to each individual’s unique needs and aesthetic goals. Techniques can range from targeting specific areas of concern to achieving comprehensive rejuvenation. While a facelift cannot stop the aging process, it can provide long-lasting, natural-looking results that subtly enhance your appearance, helping you look like a more youthful version of yourself—never overly “done” or artificial.
Facelift surgery offers a transformative approach to addressing the visible signs of aging, providing numerous aesthetic and emotional benefits. By lifting and repositioning sagging skin and underlying tissues, a facelift can help you achieve a more youthful, refreshed appearance. Specific benefits include:
In addition to physical improvements, many individuals experience a boost in self-confidence and a renewed sense of vitality after a facelift. For those seeking comprehensive facial rejuvenation, a facelift can also be combined with procedures like neck lift, brow lift, or eyelid surgery to achieve even more dramatic and harmonious results.
Ideal candidates for facelift surgery are generally healthy individuals who are at or near their ideal body weight, including those who have achieved a stable weight after significant weight loss. They should have realistic expectations for the procedure and a clear understanding of its benefits and limitations.
Certain factors may disqualify someone from being a good candidate for facelift surgery. These include active smoking, untreated medical conditions, or emotional readiness issues. It’s crucial for prospective patients to be physically prepared, emotionally stable, and supported by family or friends throughout the process.2
A facelift can be a highly rewarding procedure when performed for the right reasons by a Board-Certified Plastic Surgeon. Proper education about the surgery and its recovery is essential to ensure a successful experience.
There are several different facelift surgery techniques – some are subcutaneous, many involve manipulation of the SMAS (submusculoaponeurotic system of the face), and others go “deep plane” – which can put the vital facial nerve for movement of the facial muscles at risk. All facelift techniques involve creation of permanent scars, repositioning the deep tissues of the face, lifting the skin and removing excess neck fat at the same time.
There are also trendy techniques that use “threads” or energy-based devices to try to lift or tighten the skin in a minimally invasive fashion. These methods have been around for decades, and there’s a reason why most Board Certified Plastic Surgeons do not offer them—they don’t work! If it sounds too good to be true…it usually is.
Most patients present to our office with the complaint of jowls and loss of definition of their jawlines, together with accumulation of fat in their neck and under their chin. Many also describe a “turkey neck” appearance due to downward and forward migration of loose neck skin.
Because of this, Dr. Horton focuses on the lower face and neck as the procedure of choice for her patients. Most patients do not require an extensive all-day full facelift that treats all areas of the face, including the brow (forehead), eyelids, midface and cheeks at the same time as their lower face. The MACS lift only addresses the lower face and neck, leaving the forehead and eyes alone. If desired, patients can “add on” additional complimentary procedures such as a blepharoplasty at the same time as facial surgery to also address their eyelids.
Also called a short scar or MACS (minimal access cranial suspension) facelift, the MACS lift is the most common procedure performed in our practice. A technique that focuses on the lower face and neck, this surgery makes an incision in front of the ear and short zig-zag just below the sideburn.
Focused on the superficial musculo-aponeurotic system (SMAS), the MACS lift technique repositions deeper tissues to restore volume and structure to the cheeks, jawline, and neck. It offers significant improvements in midface and lower face rejuvenation. This approach addresses sagging in the lower face, jowls, and neck by combining facelift and neck lift techniques. It refines the jawline and tightens loose skin beneath the chin but does not treat the upper face or brow.
Taking approximately three hours under general anesthesia, the MACS lift lifts the soft tissues of the face, eliminating jowls, and resuspends the lower face and neck skin upward, in a natural direction. It often includes liposuction of the submental region (under the chin, in the neck area) as well for the most aesthetically pleasing results. Learn more about the MACS lift short scar facelift here.
The journey to a successful facelift begins with your consultation. During this appointment, your Board-Certified Plastic Surgeon will take the time to understand your concerns and goals. Your surgeon will review your medical and surgical history, evaluate the areas you wish to address, and determine if you are a good candidate for the procedure. This is also the time to ask any questions and discuss what a facelift can and cannot achieve.
Once your surgery is scheduled, you will receive detailed pre-operative instructions tailored to your needs.
Preparing for Plastic Surgery
A facelift is an outpatient procedure that is typically performed in a fully equipped operating room under general anesthesia to ensure comfort and safety. Our Quad A-certified San Francisco Plastic Surgery center facility was created for procedures such as this!
During MACS lift surgery, the skin of the face and neck is gently lifted to access the underlying structures. Using precise techniques, the deep layers of the face and neck known as the superficial musculo-aponeurotic system (SMAS) are repositioned and tightened to restore a youthful contour.
A minimal amount of excess skin is trimmed, and the remaining skin is redraped naturally upwards, avoiding any unnatural tension. Dissolving sutures are used. Drains are inserted for twenty four hours, and are removed the day after surgery at the first postoperative visit.
After the procedure, soft dressings are applied to protect the area, and a compressive chin strap. Postoperative pain is typically minimal, and prescribed medications can help manage any discomfort.
Facelift scars are permanent but are skillfully hidden within natural folds and the hairline. As healing progresses, swelling and bruising subside, and results become increasingly visible over the following weeks. Final results, including fully matured scars, may take several months to a year to develop.
To maintain your rejuvenated appearance and protect your results, it’s important to follow your post-operative instructions, including minimizing sun exposure. Over time, your facelift can provide a natural, refreshed, and more youthful look, boosting your confidence and reflecting the vibrant person you are inside.
Swelling and bruising are normal parts of the healing process after any type of facial surgery. It’s common for the skin to appear uneven or for mild asymmetry to occur due to swelling, but this typically resolves as the healing progresses. Within about two to four weeks, noticeable signs of surgery, such as puffiness or discoloration, should significantly diminish.
To help reduce swelling, it’s recommended to sleep with your head elevated using a few extra pillows for several days. We do not recommend heat or ice to the area because of the risk of thermal injury to numb skin, and normal circulation is necessary for uneventful healing. Exercise or any activity that elevates heart rate or blood pressure should be avoided for a full month after surgery.
Protecting your skin from the sun is critical during recovery. Use a broad-spectrum sunscreen with at least SPF 30 daily to prevent hyperpigmentation or sunburn, and avoid direct sun exposure. Makeup can be applied over sunscreen about after the first week, and can become part of your regular routine to conceal any residual redness or discoloration. Our office offers medical-grade skincare products specifically designed to protect and enhance your skin during recovery.
For patients with short hair, growing it slightly longer before surgery can help conceal incisions as they heal. Avoid chemical hair treatments, such as coloring, for at least a month after surgery. Scheduling a salon visit before your facelift can be a relaxing way to prepare.
Following your first postoperative visit the day after surgery, you will see Dr. Horton next one to weeks later for a check of healing, followed by scar therapy education at approximately 6 weeks. Follow up photos are taken at three months and again at one year after surgery.
Postoperative Instructions Special Instructions for Facial Surgery
A facelift provides long-lasting results, offering a rejuvenated and refreshed appearance that endures for years. While the procedure cannot stop the natural aging process, it ensures you will continue to look younger than you would have without surgery. Importantly, modern facelift techniques are designed to deliver natural results, avoiding the tight or “overdone” look that can appear unnatural.
Maintaining healthy skin habits, such as using effective skincare products, protecting your skin from the sun, and considering non-surgical treatments, can help extend the longevity of your facelift results. Over time, as facial aging continues, some patients may notice signs of aging reappear. In such cases, a secondary facelift may be an option to refresh the results. This procedure requires the expertise and careful judgment of a skilled Plastic Surgeon to achieve optimal outcomes. Regular follow-up appointments with your surgeon can ensure your results are monitored and maintained for years to come.
A facelift by itself facilitates improvements to the jaw line, the cheeks and the “nasolabial area” (from the nose to the corners of the mouth), but does not specifically address the neck, forehead (“brow”) or eyes. A full facial examination at your consultation will elucidate which surgical option(s) will tackle the specific features of aging present and best achieve your goals.
A facelift is often complimented and further enhanced by a variety of Complimentary Facial Plastic Surgery Procedures, including a:
Non-Surgical Procedures are commonly added to a facelift to enhance its success. Pre-treatment of the face with minimally invasive procedures or skin care regimens can promote the best aesthetic outcome of facelift surgery, and help prolong its results.
Non-surgical procedures that may accompany a facelift include:
As with any surgical procedure, facelift surgery carries some risks. While serious complications are uncommon, potential risks include bleeding (hematoma), infection, nerve injury resulting in temporary or permanent weakness, fluid accumulation (seroma), skin discoloration, or changes in sensation such as numbness. Additional risks may involve poor wound healing, unfavorable scarring, hair loss near incision sites, or skin irregularities.
More serious but rare complications include deep vein thrombosis, cardiac or pulmonary issues, or anesthesia-related risks. Minor issues, such as asymmetry, persistent swelling, or the need for revisional surgery, may also occur in some cases.3
To minimize these risks, it is essential to choose a Board-Certified Plastic Surgeon like Dr. Karen Horton, who has the expertise to reduce complications and ensure a safe, successful outcome. Dr. Horton will discuss all potential risks in detail during your consultation and provide comprehensive post-surgical care instructions to support your recovery.
Yes, facelift surgery involves incisions, so scars are a natural part of the healing process. However, Dr. Karen Horton takes great care to place incisions in discreet locations, such as along the hairline and natural crease behind or in front of the ear, to make them as inconspicuous as possible. With proper care, scars typically fade over time and become less noticeable. Dr. Horton will provide guidance on scar management, including sun protection and recommended skincare, to promote optimal healing and minimize their appearance.
The cost of a facelift in San Francisco varies, and is determined by factors such as the surgeon’s experience, the techniques employed, and the patient’s unique treatment plan. Following your consultation with Dr. Horton, you will receive a detailed cost breakdown for your fully customized facelift procedure.
As a Board-Certified Plastic Surgeon, Dr. Karen Horton understands how an individual’s appearance can impact self-image and self-esteem. During a facelift consultation, Dr. Horton takes the time to get to know each patient personally and conducts a thorough medical history review.
Dr. Horton carefully evaluates the patient’s facial bone structure, skin composition, thickness, texture, elasticity, and the extent of wrinkles or folds. This comprehensive assessment is used to create a customized surgical plan tailored to address the unique features of aging and meet each patient’s specific aesthetic goals. The surgical technique selected will prioritize achieving the best possible results while minimizing potential risks.
Dr. Horton also explores the patient’s reasons for considering a facelift, ensuring they are an appropriate candidate for surgery. All options and procedural details are discussed thoroughly to help patients make informed decisions about their care.
If you’re considering a facelift to address signs of aging and achieve a more youthful, refreshed appearance, scheduling a consultation with Board-Certified Plastic Surgeon Dr. Karen Horton is the first step. During your appointment at her San Francisco practice, Dr. Horton will take the time to understand your goals, assess your unique features, and discuss the best options for achieving natural-looking results. To learn more and take the next step toward your facial rejuvenation journey, contact our office today to schedule your consultation.
1 Mayo Clinic. Face-lift. Available: https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059. Accessed December 3, 2024.
2 American Society of Plastic Surgeons. Who is a good candidate for a facelift? Available: https://www.plasticsurgery.org/cosmetic-procedures/facelift/candidates. Accessed December 3, 2024.
3 American Society of Plastic Surgery. What are the risks of facelift surgery? Available: https://www.plasticsurgery.org/cosmetic-procedures/facelift/safety. Accessed December 3, 2024.
Dr. Karen Horton has either authored or reviewed and approved this content.
Give us a call or fill out form below to schedule online.
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the Pacific Heights District in the Pacific Professional Building.
Monday-Friday: 9am - 5pm
Saturday-Sunday: Closed
Monday:
9 AM to 5 PM
Tuesday:
9 AM to 5 PM
Wednesday:
9 AM to 5 PM
Thursday:
9 AM to 5 PM
Friday:
9 AM to 5 PM
Saturday:
Closed
Sunday:
Closed
Dr. Karen M. Horton
2100 Webster St UNIT 520
San Francisco, CA 94115
Phone: 415.923.3067
We are located in the
Pacific Heights District
in the Pacific Professional Building.
SHOP SKIN CARE*Please note: Our office is no longer a Participating Provider for insurance. We can provide a financial quote for what anticipated surgical fees will be after your consultation.
