Facelift & Neck Lift
Artistry as a surgical principle
The best facelift is one that is never identified as such. The goal is not to erase the passage of time but to restore what time has quietly altered, the jawline, the neck, the natural lift of the face, while preserving what makes a person distinctly themselves.
Every case is planned individually. Anatomy is studied carefully. The approach is tailored to each patient's structure, skin quality, and goals, not applied as a standard template.
Both cosmetic and functional concerns are addressed. When indicated, adjunct procedures such as lower blepharoplasty, fat grafting, or laser resurfacing are incorporated into a single operation to produce a complete, cohesive result.
"This surgery is not transformation. It is restoration."
Facelift surgery is among the most technically demanding procedures in facial plastic surgery. The difference between a result that looks operated and one that looks natural lies entirely in surgical judgment, anatomical respect, and meticulous execution.
Trained to operate at the highest level
A background spanning both cosmetic refinement and complex reconstructive surgery informs every procedure performed here. Facelift at its most nuanced demands both artistic judgment and deep structural mastery.
American Board of Otolaryngology – Head & Neck Surgery
American Board of Facial Plastic & Reconstructive Surgery
Facial Plastic & Reconstructive Surgery
University of Toronto
Advanced training in facelift, neck lift, blepharoplasty, and facial rejuvenation.
Deep-plane and composite techniques address the underlying facial anatomy, not just the skin, for natural, lasting results with reduced tension on closure.
Is a facelift right for you?
Candidacy is nuanced and determined together in consultation. These are the considerations weighed most carefully.
Facial aging concerns
Jowling, loss of jawline definition, descent of the midface, or deepening of the nasolabial folds. Good candidates have specific, articulable goals and realistic expectations.
Neck concerns
Neck laxity, banding of the platysma, or excess submental fullness. Neck lift is frequently performed alongside facelift, as the two are anatomically continuous and best addressed together.
Skin quality & health
Good skin elasticity and overall health support better outcomes. Smoking history, prior surgeries, and skin conditions are reviewed carefully in consultation.
Readiness & timing
Emotional readiness and settled, non-pressured motivation matter as much as physical candidacy. There is no optimal age, the right time is when the concern is present and the patient is prepared.
A conversation, not a sales pitch
Consultations here are unhurried. The approach is to listen first, ask questions, and offer an honest clinical perspective second. Facial anatomy is reviewed in detail, goals are discussed, and a clear picture is given of what is surgically achievable and what is realistically expected.
Imaging is used to communicate goals and serve as a reference for surgical planning. When adjunct procedures, blepharoplasty, fat grafting, laser, would meaningfully contribute to the result, they are discussed openly and incorporated into the plan if the patient agrees.
If a procedure would not meaningfully serve a patient's goals, or if expectations exceed what surgery can reliably deliver, that will be stated directly. That honesty is a feature of this practice.
Complexity is where your surgeon's skills show
Facelift and neck lift are procedures of significant anatomical depth. Deep plane techniques, which reposition the underlying facial structures rather than simply tightening skin, produce the most natural and lasting results. But this approach operates in close proximity to the facial nerve and its branches, structures responsible for the movement and expression of the entire face. Operating safely and effectively at this level requires a surgeon who is not only trained in deep plane surgery, but who is genuinely experienced working near critical nerves in more demanding dissections.
The neck presents its own complexity. Restructuring deep neck anatomy, including the platysmal muscle and underlying glandular structures, to produce a clean, defined cervical contour requires precise judgment about how far to go and how to manage what is encountered along the way.
"The face is the most precious real estate. Every decision made within it deserves that level of respect."
Today's patients arrive having undergone years of injectables, volumizing fillers, radiofrequency treatments, laser resurfacing, and thermal skin procedures. Each of these alters tissue in ways that may not be visible on the surface but become apparent intraoperatively. Planes of dissection may be altered, tissue may behave differently, and the surgeon must make real-time correlations and judgments to proceed safely and to bring the surgery to a complete, effective result.
This is why experience in facelift surgery is not simply about volume of cases. It is about the range and complexity of what has been encountered, navigated, and resolved. That depth is what allows a surgeon to adapt when the anatomy presents something unexpected, and to protect what matters most while still achieving the result the patient came for.
Before your surgery
Once a surgical plan is agreed upon, the pathway to the procedure is organized and well-supported.
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Medical optimization
Facelift is a low-to-moderate stress procedure; routine pre-operative testing is not always required and depends on individual health status. Any specific requirements will be reviewed and coordinated in advance. All nicotine, smoking, and vaping must stop at least four weeks before surgery and remain stopped for four weeks after. Nicotine significantly impairs wound healing and increases the risk of skin necrosis, this is non-negotiable.
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Medications & supplements
Aspirin, ibuprofen, fish oil, vitamin E, and turmeric must be paused one week before surgery. All prescriptions should be filled before surgery day. Prepare soft foods, electrolyte drinks, and extra pillows for head elevation.
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Ancillary considerations
In the weeks before surgery, take care of the routine monthly appointments and life tasks you would normally attend to, haircuts, color, dental cleanings, and similar. If coloring or cutting hair, do so at least one week before surgery; the next opportunity will be six to eight weeks after. This is also a good time to coordinate any other personal or professional obligations so that your recovery period is free of obligations and low in stress.
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Arranging support
A trusted adult is needed to drive home and stay the first night. Ideally, having someone present for the first 48 to 72 hours is valuable, during this window the compression wrap, drains, and early wound care require some assistance. After that, most patients are quite independent and manage well on their own. For those who would prefer professional support during early recovery, private nursing care is available and can be arranged through the practice.
Deep plane facelift
Most facelift techniques operate at the level of the skin or the superficial fascial layer just beneath it. Deep plane surgery goes further, releasing and repositioning the deeper structural layer of the face, the SMAS and the ligaments that tether it, before any skin is addressed. This distinction matters enormously for the result.
Because the lift is performed on the deeper tissue, the skin itself bears no tension at closure. It is simply redraped over a repositioned foundation. Skin closed under tension heals with distortion — it pulls, puckers, and creates the telltale signs of surgery. Skin closed without tension heals cleanly, the scars mature well, and the face moves naturally.
The result is a lift that glides with the face rather than against it. Expressions remain fluid. The contour is restored, not manufactured. This is what allows a deep plane facelift to look like the patient, only more rested, more defined, more themselves.
Operating at this depth places the dissection in close proximity to the branches of the facial nerve, the structures that govern facial movement and expression. This is precisely why the technique demands a surgeon with genuine experience in deep structural work, not simply familiarity with the approach.
Deep neck lift
The neck is its own anatomical problem, and it is addressed as such. Pulling skin alone produces a temporary, unnatural result. A lasting, defined neck contour requires operating on the deep structures directly.
Through a small incision placed beneath the chin, the deep neck is accessed and addressed directly: the platysmal muscles are repositioned or tightened at the midline, deep fat compartments are reduced, and when present, submandibular gland ptosis or hypertrophy is managed. These are permanent structural changes, not surface adjustments. The excess skin is then excised without tension, and it heals with the qualities of unstressed tissue.
For most patients this surgery is restorative, returning a neckline that age, weight change, or gravity has altered. But for patients with congenitally obtuse neck angles, a blunt cervicomental contour present since early adulthood, deep neck contouring can be genuinely transformative. Lifting alone cannot correct an anatomy that was never sharp to begin with. Deep structural work can. In select cases, a chin implant is also considered, as lengthening the chin projects the submental angle forward and creates definition that no amount of soft tissue work alone can achieve.
What to expect when you arrive
Facelift and neck lift are performed under general anesthesia in an accredited surgical facility. Nothing to eat after midnight; small sips of water only for approved medications. Wear a front-button shirt and avoid makeup, lotions, and jewelry.
Arrival & preparation
Arrival approximately one hour before surgery for check-in, nursing assessment, IV placement, and anesthesia consultation.
The procedure
The surgical approach is tailored to each patient's anatomy and goals. The deeper facial structures, not just the skin, are repositioned, producing a natural result with reduced tension on closure. When indicated, blepharoplasty, fat grafting, or laser resurfacing are performed in the same session.
Who is in the room
Throughout the entire procedure, the surgical team consists of a board-certified anesthesiologist dedicated solely to monitoring and managing your anesthesia and safety, a circulating nurse present at all times, and a scrub technician assisting directly with instruments. Before surgery begins, the anesthesiologist and nursing staff will each introduce themselves and speak with you personally, so you know exactly who is caring for you during your surgery.
Closure & dressing
A compression wrap is applied at the close of surgery and worn continuously for the first week. Small drains may be placed depending on the case; these are typically removed within 48 hours at the first post-operative visit.
Discharge
Most patients spend one to two hours in recovery before discharge the same day. That evening, Dr. Hashemi will personally reach out to check in, a reflection of the hands-on, engaged care that defines this practice.
Engaged care, directly from the surgeon
Recovery is not a period of uncertainty. Patients here have direct access to Dr. Hashemi throughout the healing process, not through a general inbox.
Evening of surgery
Dr. Hashemi personally reaches out the evening after surgery to check in, review how you are feeling, and address any questions before the first night.
Throughout recovery
All surgery patients have direct after-hours access to Dr. Hashemi, for any question, urgent or otherwise.
Follow-up visits
The first post-operative visit, suture removal, and all milestone follow-ups are conducted personally by Dr. Hashemi, ensuring continuity from first consultation through final result.
Healing in three phases
Facelift recovery is explained to every patient in terms of three general phases. Understanding this framework sets realistic expectations and removes much of the anxiety from the process.
Surgery through one week
The most active phase of recovery. Swelling and bruising peak in the first days. The compression wrap is worn continuously. Drains are removed within 48 hours. Rest, head elevation, and wound care are the priorities. The first post-operative visit occurs during this phase.
Weeks two through four
Bruising and swelling visibly resolve. The wrap transitions from continuous wear to home and nighttime use. Light activity resumes gradually. Sutures and staples are removed. Most patients are socially presentable by the end of this phase.
Months two through twelve
The third phase is one of gradual refinement. Residual swelling continues to resolve, scars mature, and the final contour of the result becomes apparent. Most patients feel fully themselves again within two to three months.
The first days at home
The following reflects the exact instructions given to every patient: specific, practical, and designed to optimize recovery from day one.
Activity & sleep
Spend awake time out of bed, walking is encouraged. Avoid heavy lifting, strenuous activity, and weight greater than 10 lbs. Sleep with the head elevated on two to three pillows or a wedge for the first two weeks. Limit neck movement; use a neck or travel pillow to maintain position.
Cold therapy
Cool packs applied for the first 72 hours: 15 minutes on, 15 minutes off, while awake. No direct ice on skin. This is more effective than continuous cold for reducing early swelling and bruising.
Compression wrap & drains
Keep the wrap on at all times until the first visit unless instructed otherwise. If drains are placed, strip the tubes and record output twice daily. Drains are typically removed within 48 hours at the first post-operative visit.
Diet
Soft, easy-to-chew foods. Avoid salt for the first week, as it promotes swelling. Good options include protein shakes, broth, mashed avocado, banana, eggs, shredded chicken or fish, blueberries, and pineapple.
Caring for your incisions
Meticulous wound care in the weeks following surgery directly supports scar quality and healing. The following protocol is followed by every patient.
Showering
The body may be washed from the start, but avoid getting the head wet until cleared, typically by day three once drains are out. When showering, do not soak or scrub incisions. Use a gentle shampoo such as baby shampoo.
Ointment & wrap protocol
Weeks one–two: After showering, pat dry and apply a thin film of Bactroban (mupirocin) ointment to all incisions, then rewrap with Coban. Keep Coban on at all times.
Weeks two–four: Transition to silicone scar gel applied twice daily. Continue wearing the wrap at home and nightly.
Weeks four–eight: Silicone scar gel at night only. Wrap worn nightly.
First three months: Protect all incisions from direct sunlight.
Fat grafting donor site
When fat grafting is performed, the abdominal donor site will have small stitches. The area may be bruised, firm, or tender for one to two weeks, this is normal. Apply antibiotic ointment twice daily. Gentle massage may begin after two weeks once tenderness subsides.
Adjunct procedures
When laser resurfacing or blepharoplasty is performed concurrently, specific wound care instructions for those areas will be reviewed in detail before discharge. Each area has its own healing timeline and protocol.
What you will be prescribed
All prescriptions should be filled before surgery day. The regimen below is designed for effective pain control, swelling reduction, and a smooth first week.
- Tylenol: 650mg every 4 hours (max 4,000 mg/day). First-line pain control throughout recovery.
- Celebrex: morning and evening for 5 days, then as needed. Do not combine with ibuprofen or aspirin.
- Oxycodone: for severe pain only. Start with half a tablet every 4 hours; increase to one tablet if needed. Causes constipation, stay hydrated and use Miralax or Colace.
- Zofran: as needed for nausea in the first 24 hours.
- Oral antibiotic: begin the evening you return home from surgery.
- Bactroban ointment: applied to all incisions twice daily for the first two weeks, then transitioned to silicone scar gel.
Office: 650-313-2338
All surgery patients have direct after-hours access to Dr. Hashemi.
- One-sided tense swelling or rapid enlargement
- Persistent or heavy bleeding
- Fever above 101.5°F
- Foul-smelling drainage from incisions
- Sudden facial weakness
- Severe pain not controlled by medication
- Shortness of breath or chest pain, call 911
Returning to normal life
Week one: Walking encouraged. No lifting greater than 10 lbs. No strenuous activity. Head elevated at all times during sleep.
Weeks two–three: Activity increases gently. Light cardio permitted at week three, keep heart rate near 100–110 bpm. Begin to liberalize neck movement but avoid sudden or forceful motion. Heavier lifting may resume gradually.
Week four: Resume normal activities. Extreme sports or high-impact activity should be cleared with the surgeon before starting.
No ibuprofen, Motrin, Advil, or aspirin throughout recovery unless specifically cleared.
The result reveals itself gradually
The final result of a facelift is not visible at one month. Residual swelling, early scar maturation, and tissue settling all continue well into the first year. Patients should expect a gradual process of improvement, not an immediate outcome.
Wrap and drains removed. Swelling and bruising present. First close look at the result.
Bruising resolved. Most swelling down. Socially presentable for the majority of patients.
Contour actively refining. Scars maturing. Most patients feel fully themselves again.
Essentially at final result. Scars fully matured. Jawline and neck definition stable.
Expected long-term changes include mild residual firmness along the jaw and neck, altered sensation in the cheeks and ears, and visible scars that continue to fade for up to eighteen months. These are normal sequelae of facelift surgery and are reviewed in detail during consultation.
Your face. Your identity. Your result.
Facelift done well is invisible. It is the version of you that people notice looks somehow more rested, more defined, more like yourself, without being able to say precisely why. That is the outcome aimed for with every patient.
For those considering facelift or neck lift in Palo Alto or the Silicon Valley area and looking for a thoughtful, honest conversation about what it can achieve, a consultation is the right first step.
Schedule a Consultation