Dr. Zelken prefers the composite deep plane facelift because it addresses some of the most stubborn signs of aging: marionette lines around the mouth, creases in the perioral (lip and chin) area, and looseness in the neck. Instead of simply pulling the skin tighter, this advanced technique lifts and repositions the deeper layers of the face, creating a smoother, more natural look. In Dr. Zelken’s experience, patients enjoy results that last longer with a lower chance of problems like skin loss or wide scars, making it a safer and more reliable option for facial rejuvenation.
Because “deep plane facelift” is a buzz word, it is often falsely marketed. For example, if you are considering a deep plane facelift, it should require at least 5-6 hours to complete. Dr. Zelken only performs one deep plane facelift per day. If you are interested in viewing this procedure, and do not mind very graphic content, you can see Dr. Zelken in action at:
The SMAS facelift (sometimes called SMASectomy or SMAS plication) is considered the “traditional” facelift technique used by most plastic surgeons. The SMAS, or superficial musculoaponeurotic system, is a thin layer of muscle and connective tissue that lies beneath the skin of the face. Manipulating the SMAS during surgery is important because it helps create longer-lasting results compared to a skin-only lift.
One advantage of the SMAS facelift is that it does not typically involve dissecting near the facial nerves, which may make it somewhat safer in that regard. However, because this technique lifts the skin away from the underlying tissues more extensively, it can disrupt the blood supply to the face. As a result, the risks of hematoma (bleeding under the skin) and skin loss may be slightly higher than with newer approaches.
For patients who have already undergone multiple facelifts, the SMAS technique can still be valuable; high-profile figures such as Kris Jenner have reportedly had success with it. That said, it is not Dr. Zelken’s first choice for most patients, as he believes the composite deep plane facelift offers more natural, comprehensive, and reliable results
Many patients are intrigued by the idea of a “Mini Facelift” or “short scar facelift” because the name suggests an easier recovery and fewer scars. While this may sound appealing, the reality is different. Dr. Zelken performs this type of facelift in fewer than 1% of patients, and only under very specific circumstances.
A mini facelift is essentially a skin-only lift, which offers limited improvements compared to modern deep plane techniques. It may be considered for patients who fully understand its limitations, are not healthy enough for surgery under anesthesia, or need a very short-term refresh, such as being camera-ready within a week.
It’s important to remember that anything marketed as “mini,” “short,” or “lunchtime” comes with tradeoffs. These procedures simply cannot deliver the same transformative, long-lasting results that Dr. Zelken aims for with his comprehensive facelifts, which are designed to maximize definition of the jawline, neck, and midface.3
In Dr. Zelken’s practice, every facelift is performed together with a neck lift. Dr. Zelken believes that the most effective way to sharpen and define the jawline is by creating balanced tension, using opposing forces to gently tighten the skin and soft tissue over the jawbone for a natural, sculpted result. This is the best combination to sharpen the jawline, smoothen vertical neck bands, and eliminate excess skin for comprehensive rejuvenation.
If you had surgery elsewhere and desire correction, refinement, or restoration of results, you may be a candidate for a revision facelift. Despite common belief, there is no maximum number of facelifts you can undertake in a lifetime. However, each facelift may be riskier than the last due to scar tissue and disruption of normal anatomic relationships, and there may be less of an effect each time the tissues are tightened. Just like first-time facelifts, there are various ways to achieve desired results in revision surgery, including conversion to a deep plane facelift. Also, Dr. Zelken aims to improve pixie-ear deformities, visible or unusual scarring, and even bulging that can occur in the cheeks after facelift.
The early intervention facelift is designed for patients who are beginning to notice the very first signs of aging, such as mild jowling, early neck laxity, or softening of youthful facial contours. Rather than waiting until these changes become more advanced, this approach addresses them at their earliest stage, helping to preserve natural beauty and extend youthful features for years to come. Because the tissues are still strong and resilient, results are often more subtle but longer lasting than facelifts performed later in life.
Many patients from across the nation, and even around the world, seek out Dr. Zelken specifically for this proactive approach. For them, it is less about dramatic correction and more about making a wise, forward-looking investment in aging gracefully, with results that appear seamless, natural, and uniquely their own.
No. While every patient’s perception of results is subjective, the deep plane facelift is specifically designed to reposition the deeper tissues in a way that restores youthful contours without creating an overtightened look. Dr. Zelken’s approach emphasizes natural outcomes, avoiding telltale signs of surgery such as windswept cheeks, a widened mouth, visible scars, or unnatural changes to the ears and earlobes.
Many patients feel presentable within about two weeks, although healing and refinement continue for months. As one of Dr. Zelken’s mentors once put it: “At two weeks you may feel comfortable going to the supermarket without feeling self-conscious, and by three weeks you’ll likely be ready for your third-favorite restaurant.”
Fillers replace lost volume temporarily, though there may be permanent and undesirable swelling that results. A facelift repositions deeper tissues for long-lasting structural improvement.
Because every face is unique, pricing is personalized. You’ll receive a detailed estimate at your consultation.
There is no strict age limit for facelift surgery. While once reserved for older patients with significant skin laxity, facelifts are now commonly performed in the 40s and 50s to address early signs of aging, often with more natural and beautifying results than when done later. Even younger patients can experience concerns like jowls or marionette lines, and in select cases, a facelift may be the best solution when nonsurgical options fall short.
Since the pandemic, Dr. Zelken has even performed facelifts on patients in their 20s and 30s, often to correct issues like overly full cheeks or jawlines that cannot be improved with fillers or energy devices. These younger patients typically seek a slimmer, more sculpted look. That said, the average facelift patient in Dr. Zelken’s practice is still in their mid-to-late 40s.
In most cases, facelift incisions are placed with precision so they blend seamlessly into natural contours. They typically begin at the sideburn, trace along the natural fold in front of the ear, curve beneath the earlobe, and continue into the hairline behind the ear. In some patients, a small additional incision may be hidden within the hair at the temple, and occasionally, a fine incision beneath the chin is used to optimize neck definition
These incisions are designed to heal discreetly, and over time they usually become difficult to detect. With careful placement, meticulous closure, and proper aftercare, most patients find that even close friends, hair stylists, or colleagues are unlikely to notice them.
For many patients, the word scar is the greatest hesitation when considering facelift surgery. Dr. Zelken, however, is committed to minimizing their visibility, through careful incision placement, refined surgical technique, and postoperative strategies like silicone sheeting, lasers, microneedling, and light therapies. Dr. Zelken is meticulous in his approach, using precise blade angles, multi-layer closures, and tension-free techniques to help ensure scars heal as discreetly as possible. While no scar can ever disappear completely, most facelift incisions fade over time to become inconspicuous. Rarely, scar revisions may be performed to minimize a visible scar.
Through meticulous technique and a commitment to scar minimization, Dr. Zelken delivers results that look natural, balanced, and undetectable. When appropriate, he also offers less invasive procedures, but for many patients, nothing achieves the same transformative, lasting impact as a facelift. This is why patients from across the country, and around the world, seek out Dr. Zelken’s expertise, entrusting him with one of the most delicate and defining procedures in aesthetic surgery.
Many of Dr. Zelken’s patients are cleared to resume light cardio and weights within 3–4 weeks. For heavier lifting or more strenuous activity, we typically recommend waiting 4–6 weeks to allow your body the best chance to heal. Following these guidelines helps minimize swelling and ensures your scars heal as smoothly as possible, so you can enjoy your results with confidence.
Facial aging is complex and involves more than just loose skin. Over time, the face experiences volume loss, thinning skin, muscle laxity, and even bony changes. Simply tightening the skin addresses only part of the problem. One of the most important yet often overlooked aspects of facial rejuvenation is restoring lost volume with fat
For this reason, Dr. Zelken performs conservative, artistic fat grafting in about 95% of his facelifts, a technique sometimes called the “lift and fill” facelift. By carefully transferring small amounts of a patient’s own fat (often from the abdomen) to areas such as the tear troughs, cheeks, chin borders, or jawline, he enhances natural contours and creates balanced, long-lasting results. Fat grafting adds little time to surgery, does not make patients look “fatter,” and is avoided only in cases where over-volumization is already a concern or when patients prefer not to have it.
Yes, but it is rarely offered. A “wide awake” facelift refers to a procedure performed in Dr. Zelken’s office using local anesthesia and oral sedation, rather than general anesthesia in a surgery center. This approach can be more convenient, cost-effective, and avoids the grogginess often associated with general anesthesia. Both mini facelifts and full facelifts can be done this way, but candidacy is highly selective. Patients with significant anxiety or difficulty tolerating dental anesthesia may not be good candidates. Above all, Dr. Zelken prioritizes safety and results. If there is any concern that an awake procedure could compromise either, he will recommend traditional anesthesia instead.
Absolutely.