Austin, TX




Before & Afters

*Each patient is unique and individual results may vary.


Surgeons at the Buckingham Center for Facial Plastic Surgery offer facelift solutions for patients in Austin & Sunset Valley, Texas. Facelift surgery gives a more youthful appearance to the face by removing excess facial skin from its lower half.

If you have begun to notice significant signs of facial aging, such as sagging skin and deep wrinkles, then a facelift could help you rejuvenate your appearance and give your confidence a major boost. As part of the aging process, the skin begins to lose its elasticity, facial fat can diminish, and wrinkles form all over the face, from the corners of the mouth to the forehead. Some people develop these signs of aging sooner than others, because of their genes or lifestyle habits.



This term is a bit of a misnomer, as the surgery does not truly focus on the entire facial area. Instead, this technique concentrates on the lower half or two-thirds of the face, following your unique goal, this is a customized facelift for each patient. If you are interested in rejuvenating your forehead or the area around your eyes, you will want to consider a brow lift or blepharoplasty (eyelid surgery) as an add-on surgery.

During a full facelift, a facial plastic surgeon will make incisions along the hairline, around the ears, and under the chin. Post facelift recovery can be extensive after a full facial lifting procedure, but the results are also more dramatic and long-lasting compared to less invasive options.


Also known as a mini facelift, this popular rhytidectomy technique is less invasive than a full facelift. During the surgery, the surgeon will make incisions along the hairline and ears, but not under the chin. The incisions and eventual scars are usually well concealed by the hair. This version of the procedure requires less downtime, but also provides less dramatic results than a full procedure. The limited incision facelift is typically performed in office under a local and oral sedation.


SMAS stands for Submuscular Aponeurotic System. The SMAS is a thin fibromuscular sheath that envelopes the muscles of the face and is involved in the bony cutaneous attachments to the skin. It is not really of importance except to the facial plastic surgeon because it relates to face lifting and other facial operations. The SMAS lies in continuity with the platysma muscle of the neck and is probably the embryonic extension of this layer into the face.

Facial rejuvenating procedures can differ based on their depth. Some lifting procedures, like the SMAS technique, go deeper than others to provide longer-lasting, more natural-looking results.

This SMAS layer is located beneath the skin. It’s a sheath of tissue that surrounds the facial muscles. While you might not hear much about the SMAS in everyday life, it plays a vital role in facial rejuvenation.

During a SMAS facelift, the surgeon elevates not only the skin but also the SMAS layer. The results are dramatic and long-lasting compared to more superficial rejuvenation procedures.


During a deep plane facial lifting procedure, the skin is elevated, but the SMAS is mostly left alone. The goal of a deep plane facelift is usually to lift the cheeks and erase smile lines. Aspects of this technique are appropriate for some patients with advanced signs of aging, but are typically combined with the SMAS approach.


A liquid facelift is not a surgical procedure at all. Liquid facelifts involve the use of dermal fillers and injectables to rejuvenate the face. There is no downtime after the procedure, but the results are usually temporary.

It is important to understand that despite its name, a liquid face-lift is not a type of lifting procedure at all. It can help to minimize the appearance of wrinkles and restore lost volume. However, it will not help to correct skin sagging. If you have significant signs of aging, a liquid procedure might not give you the dramatic results you want.


One of the most important ways to set yourself up for a successful rhytidectomy is to choose the right surgeon for your cosmetic surgery procedure. There are several reasons for a facelift and things to look for when selecting a surgeon.

First, you need to consider whether you want to work with a plastic surgeon or a facial plastic surgeon. What is the difference? Plastic surgeons are usually trained and experienced in performing surgeries for all areas of the body. Facial plastic surgeons usually complete a four-year residency after medical school that focuses exclusively on surgery of the face.

Once in practice, a plastic surgeon might decide to specialize in facial procedures, or they might focus on body procedures and perform the occasional facial plastic surgery. A facial plastic surgeon only performs facial surgeries. If you are considering facial rejuvenation surgery, it is a good idea to work with a surgeon who specializes in it.

Along with choosing someone who specializes in facelift procedures, it is also important to look for a surgeon who is board certified. Board certification means that the surgeon has demonstrated years of specialized experience and has successfully passed a difficult exam.

Finally, you should also learn more about the surgeon’s work. Ask to see photos of previous patients and consult with the surgeon before you decide to move forward.


You might be a candidate for rhytidectomy if you have signs of aging, such as loose skin near the jaw line, excess skin around the chin and neck, fatty deposits in the face, and deep creases. While there is no specific age for the surgery, candidates are usually at least in their 40s. There is no upper age limit for the surgery. If a person is in good overall health, they might be a good candidate for a rhytidectomy up into their 80s.

Ideally, candidates for facial rejuvenation surgery will be in good health, without any untreated, ongoing medical conditions. It is also essential that candidates have realistic expectations and goals for surgery. Candidates should be non-smokers or must be willing to quit smoking several weeks before their surgery for safety reasons.


The cost of a facelift can vary based on several factors, including the technique the surgeon uses, the type of anesthesia needed, and whether or not you decide to combine procedures to reach your goals.

During your consultation, you will discuss a treatment plan with the surgeon and review the cost of the procedure. There is a fee for the consultation, but that fee is then applied to the cost of your surgical procedure.

If you are concerned about being able to pay for your surgery upfront, you might be able to finance your procedure with a low-interest loan or credit card.


Recovery and care after a facelift usually takes about two weeks. During this time, you will need to stay home from work and postpone other commitments. Your surgeon will let you know when you can return to work and other activities. About three weeks after your surgery, you should mostly be back to your old self and can usually resume all of your activities, including moderate exercise.

How you care for your face and skin during your recovery can affect your initial surgical results and influence how long the results last. During your initial recovery, it is important to take it easy.


Before your surgery, prepare a comfortable area for yourself at home. It can be in your bed or on a chair or couch in your living room. Since it is important to keep your head elevated after facial surgery, have plenty of pillows nearby. An adjustable bed or recliner is ideal.

Although you should rest and take it easy after your surgery, you should not be completely immobile. Get up and go for a walk around your home from time to time. When you feel up to it, you might circle the block or walk up and down your driveway. Light movement will help get your blood flowing and speed up healing.

The surgeon is likely to give you directions for cleaning the surgical area in the first few days after your facelift. You will want to avoid taking a shower right away, as you do not want to get the incision area wet.

Day of surgery You will usually be able to go home on the day of your surgery. Have a relative or friend drive you home and stay with you overnight.
Your surgeon will most likely prescribe pain medications to improve your comfort.
Day after surgery Rest up and relax on the day after your surgery. Follow your surgeon’s instructions and continue to take medication as prescribed.
If bruising and swelling bother you, you can use a cold compress to minimize the discomfort.
Keeping the head elevated can also reduce swelling.
One week after surgery You might begin to wear makeup to conceal any lingering swelling and bruising.
If needed, sutures will be removed approximately one week after your facelift.
You might be ready to return to work after one week.
Two to three weeks after surgery By the two week mark, you should be back at work.
You can take up other activities around two to three weeks after your surgery.
You might still need to avoid exercise or physically taxing activities.
Three months after surgery By the three month mark, you should be able to see your final results.
Some swelling might still be present, but it is usually minimal.

Combination Treatments

Many patients decide to combine rhytidectomy with other facial cosmetic procedures to rejuvenate the entire face and neck area. An eyelid lift will help you look more alert and youthful, while a neck lift can tighten the platysma muscle and reduce the look of a turkey neck. A facial fat transfer uses fat from your body to replace lost facial volume; you just need to know which is best for you, a facelift or a fat transfer.

Some of the procedures that combine well with a facelift to refresh the head and neck include:

  • Eyelid surgery
  • Brow lift
  • Fat Transfer


Facelift Procedure FAQs

What kind of anesthesia is used for face lift surgery?

The type of anesthesia Dr. Buckingham uses during rhytidectomy depends on the type of surgery he is performing. A mini lift will typically be performed using oral sedation and local anesthesia. A full rhytidectomy will usually require IV sedation. For the most part, general anesthesia is not used during facial rejuvenation surgery at Buckingham Center.

How is facelift surgery performed?

Dr. Buckingham combines different surgical techniques to meet each patient’s plastic surgery expectations. Generally, the surgery is an outpatient procedure. During the procedure, the surgeon makes an incision near the hairline and ears. He will then tighten the deeper layers of the face to minimize facial sagging and remove excess skin to create a smooth, natural-looking result.

Where are the incisions for a facelift located? Will there be scars?

Incisions are made around the ears and hairline and are usually completely hidden. Some procedures also require concealed incisions under the chin. The incisions do produce scars, but because of their locations, they are typically easy to conceal.

Is facelift surgery painful?

During a facelift, you will receive anesthesia and will not feel anything. After the anesthesia wears off, you might notice some mild discomfort in the surgical area. Many patients find that extra-strength Tylenol, taken for a few days after surgery, is enough to manage any discomfort they feel. If you need them, Dr. Buckingham can also prescribe pain relievers.

How long is the recovery period for facelift surgery?

The recovery period after surgery varies. For lower facelift surgery, sutures remain in place for 6-7 days. Bruising usually clears up after a week following a limited procedure. Bruising may persist for up to 14 days after a more involved surgery. Many people can go back to their social activities within 7-10 days. How long you need to take off from work depends in large part on the type of work you do and how comfortable you are in letting people see you after surgery.

When can I exercise after facelift surgery?

You can start light exercise, such as walking, about a week after your surgery. It’s a good idea to wait at least two weeks before resuming moderate exercise. Very strenuous and vigorous workouts should be postponed for three to six weeks after surgery.

What is a pixie ear deformity?

A pixie ear deformity can occur after facial rejuvenation surgery if the surgeon removes too much skin from under the earlobe. The result is an earlobe that is pulled down. The deformity is easy to correct by detaching the earlobe from the facial skin. The correction will leave a scar, but the scar will be hidden beneath the earlobe.

Can I wear a ponytail after face lift surgery?

You can style your hair however you would like after your surgery. Dr. Buckingham positions the incisions in such a way that they are concealed by the hairline and heal well.

Can I have a facelift if I have a weak facial structure?

Your facial structure does play a role in your results from facial rejuvenation surgery. Your surgeon can adjust the techniques he uses to give you the best results possible and improve the appearance of your bone structure. He might also recommend a chin augmentation to improve your jawline or fat transfer to add more volume.

What is the average age to consider a facelift?

People start considering having limited incision facelift or a facelift in their 30’s, although I wouldn’t necessarily recommend a procedure like this at that age. It is quite variable however, based upon the patient’s bony structure, facial shape and weight. The most common age to perform a full facelift is late 50’s and early 60’s. Limited incision facelifts are common in the 40’s more so than the older or younger ages.

Facelift age limit?

There is not an absolute age limit for a facelift. I have performed limited incision facelifts on patients in their 30’s (rarely) and have also performed one on an 83 year old. Conversely I have turned patients away who are 50. The real question is what is the health of the patient? If the patient is healthy, then assuming the person has age related changes that a facelift can help it can provide great benefit. There isn’t any advantage to doing a facelift earlier or later, you should have one when your face undergoes enough changes that it bothers you enough to have a surgical procedure.

Is it possible for women to wear a ponytail after a facelift?

We pride ourselves for the fact that our patients can wear their hair in any style they want to after a facelift. Our post auricular incision is performed right along the posterior hairline. It is carefully sutured and usually heals without visibility. Incisions can also be made into the hair behind the ear however when done in that way a surgeon has to realign the hairline to prevent a step-off. Usually the neck does not lift well in that vector

What are the differences and the pros and cons of an SMAS facelift and a deep plane facelift? Are results more natural or long lasting with one over the other?

The terms you are referring to are not standardized, but I will answer the question with the traditional thoughts. The face has layers which consist of skin, fat, then SMAS, then fascia, then nerves and muscle and bone. A SMAS facelift refers to a facelift in which the skin is elevated and then the SMAS is elevated off the deeper structures and used to suspend the face. Many different degrees of SMAS elevation may be carried out from just incising the SMAS to elevating it for a great distance. The only difference between an aggressive SMAS lift and a deep plane lift is that in the deep plane lift the skin is only elevated for a short distance and left mostly attached to the SMAS and the dissection is carried out over the cheek and down one of the facial muscles to attempt to elevate the cheek and smile line. Studies have shown the smile line improvement does not last from this technique. We perform a wide variety of facelifts that are all SMAS in nature. In patients without a great degree of aging we might to a mini-lift or limited incision facelift with very little SMAS work. In patient with a greater degree of aging we will perform a more extensive SMAS lift even bordering on the traditional deep plane lift. The results from any of these can be great and they should be matched to the individual patient. They can each last the same length of time if they are utilized correctly.


Schedule Your Facelift Consultation in Austin Today

Surgeons at the Buckingham Center for Facial Plastic Surgery, near Sunset Valley, TX, specialize in performing facial plastic surgery procedures. If you are ready to learn more about facial rejuvenation surgery, schedule a consultation with one of our surgeons today. To schedule your appointment, please call 512.661.0747, or fill out our convenient online contact form.

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