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Let Dr. Karam’s remarkable facial rejuvenation techniques help reduce the signs of aging.

If you look older and more tired than you feel, consider a facelift in San Diego with our board certified facial plastic surgeon Amir Karam, MD. Dr. Karam is considered among the best facelift surgeons in San Diego, La Jolla and beyond, consistently drawing new clients not only locally, but internationally as well.

Dr. Karam delivers between 200 and 250 facelifts per year, placing him among the most experience facelift surgeons in the country. With his experienced, comprehensive approach, patients can rest assured they will never have a strained or unnatural appearance.

A normal and expected part of the aging continuum is the laxity that occurs in the soft tissues of the upper face, mid-face, lower face and neck. The tissues descend in an oblique direction as the deep facial fascia, SMAS (superficial muscular aponeurotic system), begins to thin and slide downward with each passing year. This is what we all begin to fear in our 40s and beyond -- the sad, sagging skin of middle age.

As a result of that signature sagging of the soft tissues of the face and neck, the face is transformed from a youthful oval shape, with a smooth, firm jawline and neck, to an aged shape that is square along the jawline and loose-appearing in the neck.

These changes in facial structure can instantly give away the individual’s age; they no longer retain that healthy, fresh and attractive look of their youth, as it is now replaced by a haggard, tired face.

Although many alternatives and options are available, none exist that can effectively and completely correct the lower face and neck sagging as effectually as a properly performed facelift and neck lift. This is simply the gold standard in facial rejuvenation and the positive effects can last for decades beyond the procedure.

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Advantages of the short incision vertical facelift with extended neck lift

  • Vertical lifting results in naturally restorative results
  • Consistency and reliability
  • Simultaneous lifting of the mid-face, lower face and neck
  • Low complication rate
  • Long-lasting results (5-10+ years)
  • Removal of the chin (submental) fat pad
  • Performed under local anesthesia with IV sedation; no need for general anesthesia
  • Two-week downtime
  • Ideal balance between excellent and natural results, low risk and brief recovery

Complementary combinations

The SI vertical facelift in San Diego with extended neck lift is designed to lift the lower jawline laxity, remove excess fat under the chin (submental fat pad) and tighten and redrape the loose neck muscles (platysma). The procedures that are most commonly combined with the SI vertical facelift and extended neck lift are the lateral brow lift, skin pinch and fat transfer.

The lateral brow lift is an extension of the SI vertical facelift. As the soft tissue of the lower face is lifted vertically, the descending lateral brow and temple will become bunched if the outer brow and temple are not simultaneously raised. In order to create a balanced and seamless lift, the lateral brow lift is combined in nearly all cases.

The lower eyelid skin pinch is commonly performed simultaneously with the SI vertical facelift, for the same reasons as the lateral brow lift. When the mid-face and upper cheeks are lifted, the excess skin under the eyes becomes bunched as a result of the vertical lifting vector.

This can make the lower eyelid skin look even worse than before the facelift. The lower eyelid skin pinch is performed to remove the excessive skin and create a soft, youthful transition between the lower eyelid and upper cheek.

Replacing the lost volume with fat transfer is an essential part of looking youthful and refreshed. Adding volume to the cheeks, under the eyes and around the mouth works synergistically to achieve a natural rejuvenation of the face. The fat transfer creates smooth, three-dimensional contours that compliment and enhance the lift. Without volume augmentation, the face can sometimes appear flat and maintain that aged tiredness.

Secondary facelifts

With people living healthier and significantly longer lives, many want to continue to look their best and have a face that matches the way they feel inside. More and more people are returning for second or even third facelifts to maintain the youthful shape of their faces.

There is no specific age restriction to limit these procedures, but the patient must pass the standard health criteria. These facelift procedures are performed in a similar fashion to the previously mentioned facelifts.

For individuals who have had a facelift that had a more horizontal vector or did not combine lifting of the neck or upper face, the short incision vertical facelift with extended neck lift, combined with other complimentary treatments, can not only rejuvenate the appearance, but also make the face appear more natural than with the initial lift.

Sometimes a second facelift is performed to correct inadequate lifting from a previous procedure, even when it was recently performed, or if the initial lift left an unnatural look. These are termed “revision facelifts.” Our practice in San Diego has significant experience performing these procedures with very high success rates.

Technique

The advantage of the short incision vertical facelift and neck lift is that the incision is significantly shorter than with a standard facelift and neck lift. For the extended neck lift, an incision is made in the submental crease (which is under the chin).

Next, the submental fat pad is directly removed. This is essential for creating a smooth contour in the neck. This fat pad cannot be removed with liposuction because it’s between and beneath the neck muscles. The direct removal means a sculpted and youthful contour can be established and that the fullness will never come back.

For the short incision facelift in La Jolla, the incision begins along the temple hairline, then extends down and hides either within the natural creases of the ear or goes behind the tragal cartilage, ending behind the earlobe.

Next, the skin is lifted off the fascia, and the SMAS and platysma muscle is lifted in an upward direction toward the temple, which tightens the neck, jawline and mid-face. The muscles and SMAS are fully tightened and secured with sutures. Next, the excess skin is removed and meticulously sutured. No drains are used during this procedure.

In cases where a lateral brow lift is performed, the incision is extended toward the top of the temporal hairline and the skin is lifted off the superficial temporal fascia. Next, this loose fascia is lifted and tightened. Just like the facelift, the excess skin is then removed. This gives a subtle lift of the corner of the brow, improves the hooding on the corner of the eyes, and allows for a smooth transition toward the upper face.

Anesthesia

Procedures are performed in our accredited and certified (JCAHO and Medicare) surgical center, Carmel Valley Surgical Center, located within the suite in San Diego, CA. The center offers the highest level of safety and state regulations for outpatient surgery.

Highly-trained and experienced surgical techs, medical assistants, nurses and a board-certified anesthesiologist all work together to create the safest and most comfortable experience possible.

Carmel Valley Surgical Center in San Diego hosts two state-of-the-art surgical suites and a recovery center. The rooms are equipped with only the best equipment and instruments, and the center also has a separate entrance and exit from the main office, which allows our patients to undergo procedures in privacy. Your comfort is always our priority during these surgical procedures.

Perhaps one of the biggest advantages from a safety standpoint is that these facelift procedures can be performed under local anesthesia with IV sedation. With this technique, patients are comfortable, moderately sedated and without any pain.

Most patients in San Diego choose this method to avoid any of the risks associated with general anesthesia. For those patients who do prefer general anesthesia, our facility is fully-equipped for general anesthesia.

Post-procedure care

Following facelift surgery, a head wrap gauze dressing is applied and patients return to the comfort of their home or hotel room. Patients come back for an in-office check where the dressings are removed and the face is examined.

Antibiotic ointment is used on the incisions for one week. A lighter dressing is used for a minimum of four days and recommended to be used at nights for one week. At one week, sutures are removed in the office.

At this point, swelling is starting to resolve rapidly. Follow-up appointments are made at one month, three months, six months and one year to monitor healing and make sure all questions are answered.

Recovery

Recovery is primarily related to swelling. Bruising is not commonly seen in our patients, although it is a possibility. The typical recovery takes between 10 and 14 days. We recommend planning two weeks off of work or social engagements to allow sufficient time to heal. Although healing is not completely finished by two weeks, most patients are sufficiently healed and can return to work and other occasions.

Incisions, numbness and minor swelling continue to improve steadily for up to one year following the procedure. Exercise is resumed between three to four weeks following facelift surgery, depending on the nature of the activity and the degree of swelling involved.

FAQ

Depending on the individual’s anatomy, lifestyle, degree of age-related changes, and the amount of downtime and cost the individual is able to handle, several options are available to re-contour the face.

These consist of the mini face lift (cheek lift), facelift, full face and neck lift. Each technique has a different aesthetic outcome, risk profile, and recovery time.

It is important to note that every facial plastic surgeon performs these procedures differently. The best way to assess whether a particular surgeon’s facelift approach is consistent with your personal goals and taste is to exam the surgeons before and after photographs, visit or talk with past patients from San Diego, compare incisions styles, and recovery rates.

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Facelift

The facelift addresses the upper cheeks, midface, jowls, jawline, corners of the mouth and neck. The difference between this procedure and the micro lift (mini facelift) is that the upper cheeks and midface are addressed. Essentially, the same incisions are used in both procedures.

Individuals in San Diego with moderate amount of skin and muscle laxity are good candidates for this procedure. The neck is treated with liposuction and the muscle is tightened and repositioned. The midface and upper cheeks are treated by repositioning the malar (cheek) fat pad back towards a more youthful position.

Mini facelift (cheek lift)

The mini facelift addresses the jowls, jawline, lower cheeks, and neck. This procedure has become extremely popular at Dr. Karam’s practice in San Diego, California. The reasons are, it is very effective at treating the jawline and neck, it has a short recovery period, low risk, lower cost, lasting, and can easily be done under local anesthesia.

There are a lot of different types of mini facelifts being performed. Some procedures involve simply removing a small amount of skin. However, to create lasting and meaningful results, the deep muscles (SMAS) of the face and neck need to be addressed. In this case, through very small incisions, the muscle layer of the face and neck are repositioned to a more youthful position. Contact us for a mini facelift in San Diego today.

Full facelift and neck lift

The target areas of this procedure are the upper cheeks, midface, jowls, jawline, corners of the mouth, and neck. This facelift procedure is often used for patients with moderate-severe age related changes in the face and neck. Individuals who would benefit from this procedure are those who have heavy necks or those with a significant amount of laxity and redundant skin.

Neck Lift

In specific cases in which the rest of the face is in good shape but the neck begins to sag, an isolated neck lift can be done. With the neck lift, small incisions are placed under the chin and behind the ear, the extra fat is removed, the deep muscles are tightened, and the extra skin is removed.

Neck liposuction

This is a versatile treatment that can help improve neck contour in a wide range of patients. This is a quick fix for individuals who have isolated problems with too much fat underneath the chin and neck.

The best candidates are those with good skin elasticity and mild-moderate fat deposits. With the use of a liposuction, the fat underneath the skin is reduced, allowing the skin to redrape over the smoother more youthful neck contour.

Anesthesia

These facelift procedures can be done with local or IV sedation or general anesthesia. The choice is made based on the patient’s preference, health status, and the number of additional procedures that are being done at the same time.

Expected outcome

There is simply no substitute for well-done facelift. The effects can be dramatically rejuvenating and natural. The mid-face is lifted, enhancing the shape and fullness of the cheeks. The smooth youthful shape of the jawline is restored.

Recovery

Generally, the more surgery that is done, the longer the recovery. The micro-lift has a recovery of about 5-10 days, while the full facelift and neck lift can take a little over 2 weeks. On average, our patients look good enough to get back to their social and professional lives in about 1-2 weeks.

Dr. Karam, who is board certified by the American Board of Facial Plastic and Reconstructive Surgery and American Board of Otolaryngology, offers services in San Diego County including San Diego, Del Mar, Carlsbad, Carmel Valley, Encinitas, Rancho Bernardo and La Jolla in Southern California.

If you are ready to schedule an appointment with Dr. Karam, contact us today.

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