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FaceliftAs the face ages, we begin to see the effects of a constant force of gravity coupled with changes in the skin and connective tissue, as well as a loss or redistribution of fat (adipose tissue). These factors lead to the well-known phenomena of jowls, deep nasolabial folds, down-turned corners of the mouth (“marionette lines”), drooping neck tissues (“turkey neck”, “turkey gobbler”, or “waddle”), and tired, hollow, or sunken-appearing eyes. The most distressing part of these changes is that frequently patients do not feel as old as they look – they have energy and passion, but people still overlook them or ask them if they’re tired or not feeling well. The unfortunate truth is that we live in an “age-ist” society, and as people grow older, they are frequently overlooked or even discriminated against. Dr. Ransom can address all of these concerns with a variety of techniques, from non-surgical treatments, to minimially-invasive procedures, to complete surgical rejuvenation.

Rhytidectomy (literally “to remove wrinkles”), also known as “facelift” or “face-lift”, is a surgical procedure designed to release and reposition the soft tissues of the face and neck, and to remove excess skin and fat. The combined effect of this procedure is a natural-appearing rejuvenation – restoring the patient’s face to a more youthful state. Dr. Ransom tailors his facelift approach to the specific anatomy of each patient, and works closely with each individual to satisfy specific goals – all the while making sure that, in the end, “you still look like you” …just a younger, more vibrant “you”! Depending on the patient’s age, degree of laxity, and other biological factors, patients may undergo a Mini-Facelift, a Neck Lift, or a full Facelift.

A Mini-Facelift is a short-incision type facelift (“S-lift”) with a more limited dissection. This type of facelift is designed for younger patients or those with less significant jowls and drooping of the neck. The surgery tightens the loose skin along the jawline and under the chin, and may also remove some excess fat from these areas. Dissection is limited, so recovery is quick – getting you back on the move with minimal down time! This procedure can be performed under local anesthesia with a mild sedative, or using conscious sedation techniques, depending on patient preference. For some patients, rejuvenation of the neck is all that is needed. In these cases, Dr. Ransom can perform a lift that is specifically tailored to the neck, without disturbing the facial structures. Please see our Neck Lift page for more detailed information.

A facelift uses a similar approach to the Mini-Facelift, but with a more extensive dissection and greater lift. This procedure is designed for patients who have more obvious and heavy jowls, drooping of the cheek area, hanging neck tissue or platysmal bands, and significant redundancy or excess skin. Dr. Ransom uses the latest in facelifting techniques to elevate the neck, jowls, and cheeks (midface) in one surgical procedure – a technique developed by world-renowned plastic surgeon Dr. Andrew Jacono (as seen on Discovery Fit & Health and the Oprah Winfrey Network), in New York City. With this procedure, Dr. Ransom doesn’t just lift the skin (which leads to incomplete correction, unnatural “wind-swept” looks, and short-lived results) – he lifts the deep tissues and muscles of the face and neck. The result is a better, longer-lasting, and more natural appearing facelift …and a more youthful, vibrant, and healthy-looking you. This procedure can be performed under conscious sedation or general anesthesia, and can be combined with other facial rejuvenation procedures (such as upper and lower eyelid lift, lip lift, or facial implants) and skin resurfacing (such as chemical peels, lasers, or dermabrasion). Please visit the photo gallery for some examples.

Rhytidectomy Before & After Photos

Who is a candidate?
Candidates for a facelift include all patients with loose or sagging skin in the lower face and/or neck region, a drooping or hollow-appearing midface, a poorly defined jawline or prominent jowls, or thick, hanging bands in the neck. The term facelift (or face-lift) can be used by doctors and in the media to imply a wide variety of procedures and approaches. Dr. Ransom tailors his surgical approach to each specific patient, working to achieve the desired goal and avoiding an “operated” look. In most cases, he performs a deep-plane facelift, which lift the deep tissues and muscle layers of the face and neck, rather than the skin alone. This makes Dr. Ransom’s patients look natural and avoids the “wind-swept” or “pulled” look.

Dr. Ransom see patients from all over Bay Area, including Mill Valley/Marin County, Napa/Sonoma, San Raphael/Petaluma and the world.

Frequently Asked Questions

Q: How long is the “down-time” after a facelift or mini-facelift?
A: Depending on the exact surgical approach needed in your case (mini-facelift vs. full facelift, more or less neck treatment required, etc.), the down time will vary. For most patients, a week off of work is sufficient. Bruising and swelling will occur immediately after the surgery, and begin to resolve around the third day. The majority of this process occurs in the first week, but some patients require up to two weeks for complete resolution. Pain is limited. Dr. Ransom works closely with you throughout the postoperative period, making sure that you are making progress toward an excellent result. Further details can be discussed with Dr. Ransom during your confidential consultation.

Q: If I am a smoker, can I still have a facelift?
A: Yes. Though Dr. Ransom would strongly advise you to quit smoking to improve your overall health, smokers can undergo facelifts. With traditional, older facelift techniques that lift only the skin, plastic surgeons worry that the delicate facial skin will not heal in smokers. However, using the deep-plane technique, Dr. Ransom is able to perform facelifts on smokers with no added risk. This is because the blood supply to the face is preserved in this approach, and better blood supply means better healing. As a side note, Dr. Ransom has a keen interest in helping patients try to quit smoking (tobacco cessation), and has even performed clinical research in this area. He would be happy to discuss this with you during your consultation, and he is able to prescribe medications to help you quit before surgery.

Q: What is the difference between a facelift and a “mini” facelift? What is a “full” facelift?
A: The terminology in facelift procedures can be very confusing. Plus, different surgeons mean different things when they say facelift, neck lift, “mini” facelift, etc. In my practice, a facelift is a comprehensive surgical procedure designed to lift and tighten the neck, jawline, and cheek areas all together. A “mini” facelift is a less extensive procedure with shorter incisions and less dissection. This procedure, as it sounds, is best used in cases where less work needs to be done. Recovery is faster, but there is some tradeoff in terms of exactly what can be accomplished. Finally, “full” facelift is a term not commonly used in modern plastic surgery. This implies longer incisions and more dissection, and includes elevation of the forehead and brow region in addition to the lower face and neck. Today, the upper face is mostly addressed with endoscopic and minimally-invasive techniques.

Q: What areas are addressed during the facelift and neck lift procedures?
A: In my practice, the facelift is performed as a deep plane extended lift for the midface, lower face, and neck. This technique allows for natural-appearing rejuvenation of the entire face and neck region, avoiding the obvious signs of other techniques. After the procedure, you will notice elevation and repositioning of the roundness of the upper cheek, improvement of the jawline, and tightening of the neck muscles and skin. All of this is performed, in the majority of cases, through incisions that are hidden in the creases around the ears.

Q: What procedures are commonly done along with a facelift?
A: Many patients seek rejuvenation of the eyelids along with the facelift and neck lift. Adding an upper eyelid and/or lower eyelid lift may dramatically improve your overall results. These procedures are designed to treat excess skin and bulging fat around the eyes, and help to give the face a brighter, more rested appearance. Another common addition is laser resurfacing. We use a fractional CO2 laser to treat fine lines, wrinkles, and pigmentation irregularity. Adding a laser treatment to the facelift enhances the results by smoothing the skin, evening the contour, and promoting new collagen growth. This gives a more youthful overall appearance of the face.

Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.