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Are you considering a facelift surgery and looking for a trusted facelift surgeon in the Bay Area? Dr. Evan Ransom, a renowned San Francisco facelift surgeon, has expertise with a full spectrum of solutions to make you look younger. As 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, San Francisco facelift surgeon, can address all of these concerns with a variety of techniques, from non-surgical treatments, to minimally-invasive procedures, to complete surgical rejuvenation. This skilled facelift plastic surgeon sees patients in his offices in the Bay Area.

A facelift surgery uses a similar approach to the Mini-Facelift, but with more extensive dissection and greater lift. Facelift Surgery 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, skilled San Francisco facelift surgeon, uses the latest in facelifting techniques to elevate the neck, jowls, and cheeks (midface) in one surgical procedure. With this procedure, Facelift Surgeon 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.

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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 facelift surgery is a natural-appearing rejuvenation – restoring the patient’s face to a more youthful state. Dr. Ransom, experienced San Francisco facelift surgeon, 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 surgery. San Francisco Facelift Surgeon Dr. Ransom will evaluate your face and discuss the best option for you during your facelift consultation at his office in the Bay Area.

Types of Facelift

Mini Facelift

A mini-facelift is a short-incision type facelift (“S-lift”), and is a surgical procedure designed to release and reposition the soft tissues of the face and neck. This type of limited facelift is appropriate for early aging changes and has a faster recovery than a more complete or full facelift. Mini-Facelift surgery tightens the loose skin along the jawline and under the chin, and may also remove some excess fat from these areas. It can be paired easily with liposuction of the neck and under-chin areas as needed. Candidates for a mini-facelift include all patients with early signs of facial aging, including loose skin in the lower face and jawline region and early jowls.

Incisions are hidden in the hairline around the temple or sideburn area and behind the ear, as well as in the groove where the ear meets the cheek. Stitches are in place for about a week, and for most patients, a week off of work is sufficient. For some patients, rejuvenation of the neck is all that is needed. In these cases, San Francisco Facelift Surgeon 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.

Endoscopic Midface Lift

The earliest changes occur in the area around the eyes (periorbital region) and the midface (the part of the face between the eyes and the mouth). The youthful convexity (fullness, or round appearance) of the midface decreases as the malar fat pad descends. This has two major effects: first, and most obvious in younger patients, is the appearance of tired, hollow, or sunken eyes; second, and often a little later, is the development of visible nasolabial folds – even at rest. Dr. Ransom can address these specific concerns with a variety of techniques, and is proud to be one of a select few surgeons in the Bay Area offering a minimally-invasive endoscopic facelift (also known as the extended centrolateral, transtemporal midface lift). With a minimally-invasive midface lift, all of the incisions are placed behind the hairline – so that they leave no visible scars! Dr. Ransom uses these hidden access points to lift the soft tissues of the midface, returning them to a more youthful position and giving a natural-appearing rejuvenation.

Candidates for a midface lift (endoscopic facelift) include all patients with a drooping or hollow-appearing midface, and the early signs of jowls and loose or sagging skin in the lower face. Dr. Ransom uses the midface lift (endoscopic facelift) for select candidates with primary aesthetic concerns in the middle and upper thirds of the face. This approach is minimally-invasive, using small incisions placed behind the hairline. As such, it is not appropriate for patients with significant skin excess or heavy neck tissues. These patients are better served with a mini-facelift or facelift. The midface lift uses a predominantly vertical vector, which helps Dr. Ransom’s patients look natural, avoiding the “wind-swept” or “pulled” look.

Revision Facelift

For patients who have undergone a facelift elsewhere and who have incomplete or unsatisfactory results, Dr. Ransom offers revision surgery. Dr. Ransom is a specialist in revision plastic surgery and revision facelift surgery. A common problem of skin-only facelifts, and most facelifts with a horizontal vector, is the appearance of tightness of the skin and what is often called the “wind-swept” deformity. A related problem may occur in the neck when the skin is tightened but the neck muscles are not treated. This can lead to the appearance of two tight bands in the anterior neck (the medial edges of the platysma muscles), which is called a “cobra neck” deformity. Other common issues after traditional, limited facelifts include incomplete treatment or early recurrence of the jowls and persistence of the drooping cheek area (midface ptosis).

A revision facelift, as performed by Dr. Ransom, uses a similar approach to the primary facelift. With this approach, Dr. Ransom doesn’t just lift the skin (which creates the unnatural “wind-swept” look and fails to lift the cheeks) – he lifts the deep tissues and muscles of the face and neck. Revision facelifts address the specific problems or deformities caused by the previous surgery and are designed to improve the previous result – all while keeping you looking natural. Revision facelift is most often performed under sedation or general anesthesia, and can be combined with other facial rejuvenation procedures (such as upper and lower eyelid lift, lip lift, or implants) and skin resurfacing (such as lasers).

Secondary Facelift

For patients who have already undergone a facelift elsewhere and who have experienced a recurrence of sagging or drooping jowls and neck, Dr. Ransom offers a secondary facelift. Despite an overall improvement in the facial contours, having a facelift cannot stop the passage of time. As such, some patients will require a second – and typically more limited – facelift, sometimes referred to as a “tuck up”. These patients typically were satisfied with the results of their first facelift, but have continued to age and experienced some recurrence of drooping skin, neck bands, or jowls. Depending on your age and the type of facelift that you had, this recurrence is often a few years or even a decade later.

A variety of approaches can be used in secondary rhytidectomy, and Dr. Ransom specifically targets the areas that need rejuvenation or refinement. This helps to limit the total amount of surgery and promotes a faster recovery. A secondary facelift may be performed under conscious sedation. After the procedure, the face will appear puffy or swollen. A soft cotton dressing is used to wrap the face and neck for about 24 hours, after which a light bandage may be applied. Some bruising will occur, but pain is limited. Patients are generally able to return to work in about a week, though direct or prolonged sun exposure should be avoided during the healing process.

Who Is A Candidate?

Candidates for facelift surgery 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 facelift surgeons and in the media to imply a wide variety of procedures and approaches. San Francisco Facelift Surgeon Dr. Ransom tailors his surgical approach to each specific patient, working to achieve the desired goal and avoiding an “operated” look. In most cases, this skilled facelift surgeon performs a deep-plane facelift, which lifts 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.

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Dr. Ransom, a renowned San Francisco facelift surgeon, sees patients from all over Bay Area, including Mill Valley/Marin County, Napa/Sonoma, San Rafael/Petaluma, Hillsborough, San Mateo, Menlo Park, Orinda, Palo Alto, Piedmont, Walnut Creek, and the world.

Frequently Asked Questions

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.

How do I get rid of my double chins?

Extra fat and skin under the chin can be a challenging problem. Treatment options depend on the amount of tissue as well as the patients specific anatomy, skin elasticity, and age. There are nonsurgical options which use heat or laser energy to reduce fat, injections to reduce fat, and surgical procedures (including liposuction and neck lift).

How do I prepare for a facelift?

Preparing for a facelift includes good skin care, avoiding excess sun (UV) exposure, and maintaining good habits like a healthy diet and regular exercise. Some medications and supplements should be avoided in the weeks before the procedure, including any that can thin the blood.

How do you take care of your face after a facelift?

Taking care of your face after facelift involves gentle skin care, avoidance of sun (UV), avoidance of strenuous activities, and keeping the head elevated.

How long after a facelift can I exercise?

For the first 2-3 weeks after facelift, patients should limit physical activity to walking. After this, low-impact cardio can be started. Weight lifting and strenuous activities typically are avoided for 4-6 weeks.

How long does facelift last?

Facelift changes are permanent, however the aging process continues. The duration of a facelifts effect is dependent on patient factors including age, diet, exercise, sun exposure, skin type, etc. in addition to the details of the procedure performed.

How long does fat transfer face last?

Fat transfer to the face is permanent, but not all of the fat that is placed will survive. For most patients, about 1/2 to 2/3 of the transferred amount will survive over time. Some patients with specific health problems (e.g., diabetes, vascular disease) or exposures (e.g., tobacco use, radiation) will have a lower fat survival rate.

How do you reduce swelling after a facelift?

Swelling in the face after facelift surgery is a normal part of the recovery. Reducing this may include certain medications as well as reducing strenuous activities, avoiding high-salt foods, and maintaining an upright position even during sleep.

How do I reduce swelling in my face?

Swelling in the face after facelift surgery is a normal part of the recovery. Reducing this may include certain medications as well as reducing strenuous activities, avoiding high-salt foods, and maintaining an upright position even during sleep.

How do I tighten my jawline?

The jawline can be tightened via surgical and nonsurgical procedures. In the nonsurgical options, energy is delivered to the skin and fat in the lower face/upper neck to improve the contour. With surgery, excess skin is lifted and removed around the ears to improve the contour in the jawline.

How long does it take for bruising on the face to go away?

Bruising occurs mostly in the area around the ears and in the lower neck. Facial bruising may occur around the eyes. For most patients, this will resolve in about 10 days.

How long is recovery from a facelift?

The initial recovery from the operation is about 14 days. However, the full process of recovery and tissue remodeling, regaining sensation, etc. is about 6 months or so.

Does a facelift make you look younger?

The goal of a facelift surgery is to make the face and neck look younger by removing excess skin, tightening the muscle and connective tissues, and elevating the cheek fat.

How can I tighten loose skin on my face?

There are many nonsurgical options for minor laxity, however, the gold standard is a facelift.

How long do ears hurt after facelift?

Ear pain is uncommon after facelift. In fact, many patients will have temporary numbness in the area of the ears and lateral cheeks. If there is pain, this should be evaluated.

What is a facelift called?

While its often referred to as a facelift, its actual medical name is a rhytidectomy.

Can a facelift correct sagging in the neck area?

It depends. Yes, a facelift can also address some neck/jowl sagging but it is often combined with a necklift for a more comprehensive rejuvenation.

Is a facelift effective for both men and women?

YES! Facelifts are suitable for both men and women, with techniques tailored to each genders anatomy for natural-looking results.

How long should I wait after a facelift before returning to exercise?

Patients typically need 4 to 6 weeks before resuming vigorous physical activity.

Can a facelift improve deep wrinkles?

A facelift primarily addresses sagging skin, but complementary treatments like neurotoxins, fillers, or lasers can help address deep wrinkles.

Are facelift results permanent?

While a facelift provides long-lasting results, aging continues, and some patients may opt for touch-ups or non-surgical treatments over time.

Are there non-surgical options for face and neck tightening?

Yes, there are many non-surgical devices for face and neck tightening. These energy-based skin tightening treatments aim to firm skin by heating deeper layers, but they have limitations. They cant tighten the platysma muscle in the neck, which requires surgical correction through a face and neck lift. For patients with poor skin elasticity, non-surgical devices may be used after surgery to enhance skin texture and results. In select younger patients with neck-only concerns, we may combine non-surgical facial treatments with limited neck surgery to avoid full incisions.

How is an SMAS facelift different from a deep plane facelift?

A SMAS facelift lifts and tightens the layer of muscle and connective tissue just below the skin to improve sagging in the lower face and neck, whereas a deep plane facelift goes beneath the SMAS layer to reposition deeper facial muscles and tissues for more natural and longer-lasting results.

How long will I be swollen after a facelift?

Bruising and swelling after a facelift or neck lift usually subside within 2–3 weeks, so its best to avoid major events or photo opportunities during that time. Most patients experience gradual healing over 4–6 months, with continued improvement in the texture and color of incisions around the ears and under the chin.

How do I use a jade roller?

About two days after your sutures are removed, use the provided jade roller three times a day for one minute, starting at the midline of your face with moderate pressure and rolling outward to promote lymphatic drainage and reduce puffiness; keeping the roller cold enhances its soothing effect.

Do I need a chin implant after a facelift or necklift?

In facial and neck surgery, a small or recessed chin can limit jawline improvement. For patients with a short distance between their chin and the voice box, chin augmentation—usually with an implant—can enhance the angle between the jaw and neck, improving contour and overall facial harmony.

Can you correct Ozempic face?

The rise in GLP-1 medications like Ozempic and Wegovy for weight loss has led to a common side effect known as Ozempic Face—loose skin and volume loss in the face after rapid weight loss. Surgical correction, often with a face and neck lift, can restore facial contour, though it may be more complex depending on age and weight loss extent.

How do I use drain bulbs?

Face and neck lift patients will have two drain bulbs after surgery, which may need to stay in longer depending on fluid collection; detailed instructions will be provided for safe home care and keeping the drains compressed to maintain suction. Button-up clothing is recommended to avoid pulling on the drains or delicate areas during recovery.

What is face & neck lift massage?

Face and neck lift patients should massage along the jawline three times daily for 3–5 minutes, using gentle pressure with the thumb and index finger to press along the incision and jaw bone, avoiding bruising or pain. If significant swelling or discomfort occurs, stop the massage and contact your care team.

How can lasers & microneedling improve surgical results?

We use devices like fractional CO2 lasers, radiofrequency microneedling, and IPL to improve surgical results by tightening skin, enhancing texture, addressing pigmentation, and managing scarring—especially after procedures like eyelid or facelift surgery—to help ensure more seamless healing and nearly invisible incisions.

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Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.

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