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The Ultimate Guide to Facial Plastic Surgery

At my plastic surgery practice in Beverly Hills and Sacramento, I do virtually every facial procedure there is, and we are always on the cutting edge of the latest techniques and products. In fact, I regularly train other doctors in the most current methods. Here’s a guide.

What are some of the most common facial plastic surgeries?

Rhinoplasty (informally knows as a “nose job”) is among the most common facial procedure for both men and women, which makes sense, since the nose is such a prominent and central facial feature. Reshaping and resizing the nose can have a dramatic effect on the attractiveness of the face as a whole. Surgical rhinoplasty under general anesthesia has been around for a long time, but with the advent of injectable fillers, liquid rhinoplasty offers a non-invasive option that may be suitable for clients who need only subtle alterations. 

Facelifts and brow lifts are another very popular facial surgery, as the upper third of the face tends to show signs of aging sooner and more noticeably. Botulinum Toxin can also be used to diminish the appearance of lines and wrinkles in this area, and thread lifts are another non-surgical option that can be done in-office with local anesthesia. Raising the browline and smoothing out the forehead can easily take decades off a face.

Blepharoplasty (surgery on the eyelids) is an increasingly common trend in anti-aging procedures, and can also help restore any loss in peripheral vision caused by drooping or sagging eyelids. Lifting and tightening the skin around the eyes gives the whole face a more youthful, alert appearance.

For men, the most sought-after procedures tend to be hair transplants, chin implants or injections, buccal fat removal (surgically thinning out the cheeks), and/or neck liposuction to help define the jawline. Though as the stigma around cosmetic surgery continues to fade, more and more men are getting facial procedures of all kinds, as well as Botulinum Toxin and injectable fillers

For patients with a “double” chin or a sagging neck, a neck lift and/or neck liposuction are great options, restoring the neck to a lengthened and more youthful appearance. 

And of course, lip procedures continue to be in high-demand, and may include an actual lip lift, or injecting the lips with dermal fillers and/or Botulinum Toxin. This helps counteract the natural thinning of the lips that comes with aging, and corrects any downward sagging at the corners of the mouth. 

Can I have multiple facial procedures done at once?

Yes, and many people do. Facial aesthetics are all about proportion, and a truly skilled plastic surgeon will know which area to enhance and which areas to reduce in order to create the effect the client is seeking. Especially if you are having a procedure that requires general anesthesia, it often makes practical and financial sense to do any other procedures at the same time. For example, many clients undergoing rhinoplasty may opt to have chin augmentation done at the same time, which brings the entire facial profile into greater harmony. For patients getting comprehensive facial feminization with many different component procedures, it can in some cases be advisable to break it up into two surgeries, with one covering the upper face and the other covering the lower. It simply depends on the nature of the procedure. But in most cases, yes, there is no problem with doing multiple facial procedures in one surgery. 

How long does it take to heal from facial plastic surgery?

How long it will take to heal from facial plastic surgery will depend on which procedure was done and the general age and health of the patient. Nowadays, though, techniques have come such a long way that even the more invasive and extensive facial procedures will be mostly healed in 2-4 weeks. Initial swelling and bruising will probably peak at 2-4 days post-op, and can be reduced by keeping the head elevated and using cold compresses as instructed. Any non-dissolvable stitches will usually be removed 5-7 days post-op, at your first follow-up appointment. Keep in mind that initial swelling will obscure the final aesthetic results of your procedure, so there is no cause for concern if results don’t look the way you expected at first. And with rhinoplasty, your nose may take several months to settle into its new positioning, with more subtle refinements around the nasal tip sometimes taking a bit longer to become apparent. 

How much does facial plastic surgery cost?

The cost of facial plastic surgery will vary considerably, depending on what procedure you have done, where you have it done, and the experience level of your surgeon. Most cosmetic surgeries aren’t covered by insurance, so you will likely have to pay out-of pocket. Insurance may cover part of a procedure for a documented medical issue — such as a rhinoplasty for a breathing problem, or a blepharoplasty to correct peripheral vision loss — but any cosmetic alterations made at the same time will be paid for by the patient themselves. It’s worth noting that many plastic surgeons offer financing plans, so that may be an option if upfront cost is a prohibitive factor. And these days, there are so many products and techniques available that if you can’t afford a particular surgery, there is likely a less expensive alternative that can address  your cosmetic issue. At your initial consultation with your surgeon, you will get a more detailed estimate of costs, and you should always feel free to ask what all your options are so you can make an informed decision that’s right for you.

Are there non-surgical alternatives to plastic surgery?

Yes, and perhaps the best-known are injectable paralytics like Botulinum Toxin and dermal fillers like Juvederm and Restylane. Used together, they can smooth out wrinkles and add youthful volume to sagging or aging features. Injectable fillers can also be used with great success in chin augmentation and liquid rhinoplasty. A major advantage of injectables is that no sedation or healing downtime is required, and they generally cost less — though it’s worth considering that the need for repeat injections may make surgery a more cost-effective option in the long run. 

Thread lifts are another non-surgical option that has been increasing in popularity. With a thread lift, dissolvable sutures are threaded into the skin to subtly lift the surrounding features. The sutures will start to dissolve naturally after about 4 to 6 months, but the effects of a thread lift can last longer, due to the thread’s stimulation of natural collagen production. Thread lifts can be a suitable alternative to a full surgical face lift, but the effects are much subtler. Patients with only mild to moderate skin laxity are best suited to a thread lift — usually patients under 55. 

Other procedures like facial fat transfer also usually don’t require sedation or incisions. Facial fat transfer is done by harvesting fat from another area of the patient’s body and injecting it into certain parts of the face to add fullness and volume. 

While surgery will generally produce the most dramatic and long-lasting results, it may not be necessary to go under the knife to address facial problem areas. An expert practitioner well-versed in a variety of methods can offer a tailored solution using non-surgical techniques.

What are the risks of facial plastic surgery?

The most serious risks of facial plastic surgery are those associated with general anesthesia. Though rare, adverse reactions are always possible. Your surgeon will screen you for any health problems that might make general anesthesia unadvisable. Seek medical care immediately if you are having chest pain or shortness of breath following surgery. Blood clots are another risk inherent in surgery of any substantial length, and you should call your surgeon right away if you develop any sudden pain or swelling in your legs. Likewise alert your doctor if you are experiencing fever, unusually severe pain, redness, or signs of infection around your surgical site. And tearing or rupturing of stitches should also be reported to your doctor immediately.

Other risks, of course, have to do with poor healing or undesirable aesthetic results from the procedure itself. Most of these risks can be avoided simply by choosing the most qualified surgeon for the job, even if it costs a little more. It will end up costing even more down the line if you have to have the surgery fixed or redone. Common complaints following botched procedures are asymmetrical results, breathing problems from nasal repositioning, an ill-fitted or migrating implant, overly-tightened skin after a facelift, or lumps under the skin from poorly-applied fat or filler. Fortunately, many of these issues are fixable, but it’s obviously never ideal to have to.

Do I need a facial plastic surgeon near me?

Patients interested in facial plastic surgery may wish to travel to a competitive location like Beverly Hills for their procedure, just to ensure they have the very best in the business working on them. At my practice in Beverly Hills and Sacramento, it is not uncommon for us to have patients flying in from elsewhere for all kinds of different cosmetic facial surgeries.

About Dr. Jonathan Sykes

Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution. He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery, including facelifts and rhinoplasty.