Why Should I Choose Dr. Minoli for My Facial Surgery?
Dr. John Minoli offers you years of trusted experience and a range of procedures for beautifying and restoring your face and neck. He holds multiple board certifications in aesthetic surgery and has particular expertise in facial rejuvenation. Dr. Minoli has treated thousands of patients in Las Vegas and throughout the United States.
Dr. Minoli continues adapting his practice through extensive surgical education and experience. A personal consultation with Dr. Minoli may help you further appreciate these highly individualized issues and leave you with only one question:
Is aesthetic facial and neck surgery right for you?
Am I a Candidate for Face and Neck Lift Surgery?
Any one or a combination of the following may indicate that you are a good candidate for a facelift and neck lift:
- Deep nasolabial folds — creviced lines running from the corner of the nose to the corner of the mouth
- Deep wrinkles in the cheeks
- Excess fat within the neck
- Long vertical cords in the frontal neck, running from the chin down past the Adam’s apple
- Loosened skin of the face and neck
- Loss of a well-defined jawline
- Sagging of the cheekbones
A facelift can improve all of these problems. However, it cannot correct conditions like sagging eyebrows, excess skin and fat of the eyelids, or wrinkles around the mouth. Dr. Minoli can treat these areas with additional cosmetic procedures and will provide further information as needed.
Facelift and Neck Lift Incisions
Most rhytidectomy incisions are camouflaged within the natural contours of the external ear, in front of and behind the earlobe, and within the hair above and behind the ear. There may also be a small incision in a natural, horizontal crease under the chin to address certain aging features with the frontal neck.
Through these discreet incisions, Dr. Minoli separates facial skin from the deeper tissues, the extent of which depends on the selected technique. After the skin has been pulled up and back, any excess is neatly trimmed. Often, the underlying soft tissues of the face and neck, such as SMAS fascia and platysma muscle, also need to be repositioned — creating a supporting lift underneath the skin of the actual face-neck lift.
Almost all facelifts include correction of the neck. The small incision behind the chin may be used to remove excess neck fat or smooth the cord-like muscular structures along the center of the neck.
Restoring Facial Fullness With Autologous (Self) Fat Transfer to the Face
Fat grafting is commonly included in face/neck lifting procedures to restore facial and jawline fullness. Autologous fat injections involve the transfer of self-fat from one part of the body to another. This transfer helps to recontour the face in various ways by:
- Defining important facial subunit-areas, such as cheeks, lips, and chin
- Diminishing frown lines, crow’s feet, and nasolabial folds (smile lines)
- Filling out depressed scars
While some fat particles permanently survive the transfer, others do not. Repeated treatments may be warranted for ideal results. Although the autologous fat-transfer injection technique is a minor surgical procedure, it provides an excellent source of permanent soft-tissue filler material.
Additional benefits include:
- Fat injections are natural and non-allergenic.
- Fat injections cause little downtime.
- Fat injections can be performed as an outpatient procedure.
- Fat injections cause minimal discomfort, which can be controlled with oral medication.
- Fat injections are from the patient’s body, so no pre-testing is required. (A person’s own fat cannot be rejected; however, another person cannot donate fat to a given person.)
- Fat injections last several months, and a good portion of fat injections last permanently.
- Fat injections are cost-effective if combined with other procedures.
Your Customized Facial Rejuvenation Procedure
A face-neck lift is not a one-size-fits-all procedure. Each patient requires a customized treatment plan, including one or more of the techniques listed above.
Should I Combine Any Other Surgeries With My Facelift?
Facial aesthetics considers all of the separate subunits of the face: the brow, eyelids, cheeks, nose, mouth, and jawline. Depending on the desired results, your face and neck lift may be combined with additional surgical procedures, such as eyelid surgery, brow lift surgery, facial implant surgery, and even rhinoplasty for an aging nose.
Eyelid lifting (blepharoplasty) remains one of the most common facial rejuvenation procedures. Aging eyelids can add a tired or sad-looking quality to the face: blepharoplasty surgery improves droopy upper lids and baggy lower lids by removing displaced fat, trimming wrinkled skin, and firming up the general laxity of the eyelid skin and its surrounding tissues. Blepharoplasty incisions are typically placed within natural creases of the eyelids themselves. Dr. Minoli performs aesthetic eyelid surgery to correct aging issues and to improve upon inherited traits that may manifest as early as a person’s 20s.
Dr. Minoli may also suggest a forehead lifting (brow lifting) technique. Dr. Minoli is experienced with several different types of forehead lifting (brow lifting) techniques which may utilize incisions behind or within the frontal hairline — or even within mid-forehead creases in certain older individuals. Properly selected forehead lifting (brow lifting) surgery can tremendously enhance the overall rejuvenation when hooded-heaviness appears in the upper one-third of the face.
While surgical options are excellent tools, non-surgical choices exist too. Non-surgical injectable neuromodulators, such as BOTOX® or DYSPORT®, can treat the face and neck and may replace the need for upper facial rejuvenation surgeries.
How Long Is Facelift and Neck Lift Recovery?
Recovery from a face-neck varies among people. The average recovery time after facelift surgery is about two weeks. Appropriate prescription medications are provided for preoperative and postoperative at-home use (e.g., antibiotics, muscle relaxants, and painkillers).You will return to Dr. Minoli’s office regularly to have our team assess your postoperative progress.
During the early stages of healing, you will notice puffiness and discoloration which may be more pronounced in some portions of your face than others. Do not be alarmed by unevenness or temporary asymmetry caused by this variance in swelling and bruising; it is perfectly normal.
Facelift Recovery Week By Week
First few days: The most significant swelling occurs 24 to 72 hours after surgery. During this time, you will need personal assistance for meal preparations and bathroom visits. This is one of the reasons that overnight nursing care is so helpful following surgery.
You will be instructed to sleep on your back with a pillow under your knees. Keeping your head elevated while you sleep will help minimize bruising and swelling.
Remember, you must not take aspirin or certain anti-inflammatory medications during this postoperative phase, and you should not smoke or be exposed to heavy secondhand smoke for a while.
Our team will encourage you to get out of bed for short walks — even within the first few hours after surgery. This ambulation will promote healthy circulation of blood. Oddly though, you will simultaneously be asked to restrict your activities and ease into the first few postoperative days of relaxation and quiet healing. Straining, bending, and lifting are to be avoided since these activities cause increased swelling and possible bleeding.
Sometimes, a temporary drain tube may be placed along the side of the neck, under the bandages. Such a drain can help prevent the accumulation of postsurgical fluids under the skin of the face and neck. This type of surgical drain is typically removed the first day after surgery, but a full shower or bath is not permissible until the drain’s exit. Facial washings must be done gently during this early period. Specific instructions are reviewed with each patient.
Your dressings will be removed in the days following surgery so that Dr. Minoli can examine the treated areas. He will suggest that you start showering three days after your facelift.
You will experience numbness and tenderness in the facial area, which may be present indefinitely.
First week: You will gain more independence as the first postoperative week progresses. External sutures are usually removed within 5 to 10 days.
Week 2: By the second week, driving privileges likely will resume. Bruising and swelling will have subsided significantly, and you will be able to wear makeup as a foundation over any lingering discoloration. Depending on the extent of your face-neck lift surgery, you may be able to return to non-strenuous work; however, all vigorous exercises and exhausting sexual activity should be avoided for at least 2 weeks.
Weeks 3 to 5: After a few weeks you can resume most of normal activities, including modest exercise. You may continue to experience mild periodic discomfort and swelling — but, severe pain should be reported! In general, the timing of your recovery depends largely on the extent of your surgery and your healing capacity.
You will be instructed to avoid exposure to direct sunlight during the early postoperative phase, and you will be guided toward sunblock-conscientiousness for good skin protection.
Week 6: It takes about 6 weeks to allow social scrutiny. Incisions will initially be red or pink; they may remain this way for many months following surgery before fading. They may even appear to worsen before they fade. There may also be numbness in some areas, which can take months to normalize.
When Will I See My Facelift and Neck Lift Results, and Are They Permanent?
Your facelift and neck lift results may be dramatic or subtle, depending on how you looked before surgery; and depending on the specific goals that you establish with Dr. Minoli. Of course, nobody skips recovery. Since the healing process is gradual, you should not expect to appreciate your “new look” for several weeks.
Modest changes continue to occur gradually, and patients often experience residual lumps and bumps for the several months before ultimate dissipation. When healing finalizes, face-neck lifting (rhytidectomy) surgery will give your face an enhanced and refreshed appearance. It may take some time to adjust to your new facial image, but you will likely feel a boost in self-confidence as you progress in your healing.
It is important to remember that various healing factors may prolong the final result. Fluid retention and prolonged swelling are typical in the months following surgery. The healing process is gradual, so you should expect to wait a while before fully enjoying the outcome. Nevertheless, the results of your surgery should be long lasting. Aging, gravity, and weight fluctuations take their toll. Secondary procedures are available if your face, brow, and eyelids change after surgery.
Scars will fade nicely over time, but they are, of course, permanent. Most incisional scars are concealed by natural facial creases and softened by time. Occasionally, a touch-up revision may be desired to further improve a contour or a scar.
You will return to Dr. Minoli’s office for follow-up care at prescribed intervals, and your progress will be evaluated in this serial manner. Please remember that your relationship with Dr. Minoli and our team does not end when you leave the operating room.
Facelift, Neck Lift, and Fat Transfer FAQ
What will my face and neck lift consultation with Dr. Minoli be like?
Your consultation will include a discussion about your overall goals: What do you wish to achieve through face and neck lifting (rhytidectomy) surgery?
You should come to the consultation prepared to discuss your medical history — including any conditions you may have, such as diabetes, high blood pressure, or heart disease. Dr. Minoli will want to know about your current medications, prior surgeries, and previous medical treatments.
If you plan to become pregnant or change weight, you should discuss this with Dr. Minoli. Complete information is important for proper decision-making.
Dr. Minoli will also examine your face, brow, eyelids, and adjacent structures. Pre-existing scars will be evaluated. (Scars from previous facial, neck, and eyelid surgery may limit the outcome.)
Not everyone will achieve the same results. Dr. Minoli will consider your unique features. During the consultation, you will be asked to point out areas you would like improved. This helps Dr. Minoli understand the reality of your expectations.
How should I prepare for my face and neck lifting surgery?
We want to make your surgical experience as easy and comfortable as possible. Preparation is so helpful. Dr. Minoli and his staff will advise you and provide preoperative instructions.
- If you are a smoker, stop smoking completely 6 months before surgery.
- Avoid aspirin, anti-inflammatory drugs, and supplements such as fish oil, flaxseed oil, garlic supplements, green tea, and vitamin E. These agents can increase bleeding.
- If you have short hair, consider letting it grow enough to cover your incisions while you are healing.
- Maintain a healthy weight. Should you want to lose 15 pounds, or even more, please plan this beforehand: Quick, fad diet-type weight loss can delay healing and impact results.
What will the day of my facelift and neck lift surgery be like?
Depending on the extent of your facelift and the type of anesthesia required, your surgery will be performed in our office, in a free-standing accredited ambulatory surgical facility, or in a hospital setting. Most likely, face-neck lifting surgery will occur in a free-standing accredited ambulatory surgical facility.
Medications are administered for your comfort during and after the surgical procedure. Dr. Minoli, in concert with a board-certified anesthesiologist, will determine the type of anesthesia, such as: local anesthetic injections, intravenous sedation, or general anesthesia. For your safety, various monitors may be used to check your blood pressure, pulse, and circulating blood-oxygen levels during your surgery.
When your surgery is complete, you will be taken to a recovery area, where you will continue to be monitored closely. Surgical dressings and bandages are placed around your face and neck, and small tubes may be inserted beneath your skin to drain away fluid that might otherwise accumulate.
After proper recovery room monitoring, you will be discharged in the company of another adult after receiving inappropriate postoperative instructions, or you will be guided to an overnight postoperative care setting at a nearby hotel with full nursing supervision.
Dr. Minoli and his staff will help guide you in these preparations.
How is fat transfer performed?
The fat transfer-injection technique can be described as follows:
- The donor site (for example, the abdominal wall, buttocks, or thighs) and the treatment site are injected with local anesthetic.
- Local anesthetic fluids may also be injected into the donor site to facilitate fat collection.
- Fat is extracted through a specialized needle (cannula) then processed to remove excess fluids.
- It is then re-injected in multiple thin strands within a desired recipient area. Overfilling may be necessary to counter the natural effects of partial fat resorption during the weeks that follow treatment.
Will insurance help cover the cost of my face-neck lift surgery?
Face-neck lifting surgery is a cosmetic procedure that is not generally covered by insurance companies. However, under certain circumstances, insurance coverage may be available. For example, if a patient has heaviness of the upper eyelids, which directly blocks peripheral vision, an eyelid lift (blepharoplasty) or brow lift may be needed. Such procedures may be covered — at least partially — by insurance. Many factors determine your eligibility for coverage, including the specific terms of your insurance policy. A letter of predetermination may be required by your insurance company prior to surgery.
What risks are associated with facelift and neck lift (rhytidectomy) surgery?
Significant complications from face-neck lifting surgery are uncommon. This accounts for thousands of procedures worldwide as part of this consideration. As benefits are considered, so too are specific risks. These include:
- Contour irregularities
- Fluid collection that may require a secondary procedure to remove
- Need for further surgery
- Oral incompetence
- Painful or unattractive scarring
- Prolonged discoloration
- Reactions to anesthesia
- Speech impediment
- Tissue loss
- Unsatisfactory overall results
Supported by a
Dedicated and Skilled Team
Even with Dr. Minoli’s accomplishments and training, he couldn’t do this without his dedicated team, led by his wife, Anita. Together, they have built a family practice based on compassionate and personalized plastic surgery care.