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Face Surgery

What Are the Signs of Facial Aging?

Unfortunately for each of us, facial aging is inevitable and is influenced by time, gravity, genetics, smoking and years of sun damage. Typical hallmarks of the aging face include Loose Skin in the face and under the chin and jaw, formation of “Jowls” under the jaw line, Sagging of the mid-face area, deep Wrinkles and Bags in the lower eyelids, lines from the bottom of the nose to the corners of the mouth (known sometimes as “Parentheses”), and “Crows Feet” (deep creases) at the outer aspects of the eyes.

With age, the facial area in fact experiences Loss of Facial Volume, and the volume and fat of the face Descends Downward, creating a Tired, sagging and sometimes angry appearance to the face. Additional lines (known as “Rhytids”) can form in the “Tear Trough” region (deep creases below the lower eyelids) and in the “Nasolabial Folds” (deep lines running between the nose and the cheek). Occasionally “Marionette Lines” form at the sides of the mouth downward to the jaw.

Facial aging that can be accelerated by smoking and chronic sun exposure can be treated by both surgical and non-surgical techniques. Commonly, a combination of therapies is employed, based on an individual’s unique anatomy, their skin condition and their particular aesthetic goals.

What Procedures Are Available to Rejuvenate the Aging Face?

Facial Rejuvenation includes a spectrum of procedures that work to reverse signs of aging and improve facial appearance, creating a rested, youthful and natural appearance to the face, eyes, neck and forehead regions.

Many facial rejuvenation surgeries are complimentary to one another and are commonly performed together to address multiple areas of the face at one time. The definitive goal of facial rejuvenation is to create a Natural, Rested and Youthful Look rather than to change your appearance or to look like you have “had work done”.

Facelift (Rhytidectomy)

A Facelift smoothes wrinkles and corrects aging in the cheeks, the mid-face, the neck region and jaw line. The outcome of a facelift is a rested, more youthful, natural result that can increase your confidence in “facing” the world with more confidence and appearing more youthful and energized.

Learn more about Facelift surgery here.

Neck Lift

A Neck Lift specifically smoothes the neck, corrects crepe-like neck skin, eliminates vertical banding in the neck, and redefines a more youthful jaw line. A neck lift is often combined with a facelift and makes up half of a “lower facelift”.

Learn more about Neck Lift surgery here.


Dr. Horton is extensively trained in ALL the available techniques for face lifts and neck lifts, from subcutaneous to deep plane, SMAS excision/plication/suspension procedures, endoscopic techniques, ones with lengthy scars to minimal scar techniques. As always, we gravitate toward procedures “that make sense” and that address the anatomic issues that are causing age-related changes to the face and neck.

The facial rejuvenation surgery preferred by our office is called the MACS lift. This procedure provides the most natural results and accurate anatomic correction of changes that take place to create aging of the lower face and neck. To learn all about this exciting state-of-the-art surgery to rejuvenate the lower face, jowls and neck click the button below.

Learn more about MACS surgery here.

Neck and Chin Liposuction

Liposuction of the chin and neck area is often performed at the same time as a neck lift, a lower facelift or other procedures to additionally de-fat the neck and chin area and to achieve the most aesthetic contour to the jaw line.

Learn more about Liposuction surgery here.

Brow Lift (Forehead Lift)

A Brow Lift corrects forehead lines and lifts the eyebrows to a more youthful position, relaxing the brow, rejuvenating the face and helping to brighten the appearance of the eyes.

Learn more about Brow Lift surgery here.

Eyelid Lift Surgery (Blepharoplasty)

A Blepharoplasty creates a rested, refreshed and rejuvenated appearance to the eyes and specifically addresses bags and extra skin of the upper and lower eyelids.

Learn more about Eyelid Rejuvenation surgery here.

Nose Surgery (Rhinoplasty)

A Rhinoplasty or “nose job” reshapes the nose, improving the appearance of the nose and changing its size, shape and effect on one’s appearance. A rhinoplasty also corrects functional problems such airflow obstruction and breathing through the nose. The goal of a rhinoplasty is to improve the balance and symmetry of the nose and to create better harmony of the nose on the face.

Learn more about Rhinoplasty surgery here.

Ear Correction Surgery

Ear correction surgery encompasses a variety of procedures that can normalize the appearance of the ears and earlobes, and includes Otoplasty to “pin back” protuberant ears, Repair of torn earlobes and Rejuvenation of aging earlobes.

Learn more about Ear Correction surgery here.

Non-Surgical (Minimally Invasive) Facial Rejuvenation

Some individuals may not want or yet need surgical facial rejuvenation, but need to address skin changes from aging or chronic sun damage. Non-surgical aesthetic treatments can include BOTOX® Cosmetic and alternatives to correct wrinkles, Injectable Fillers, Lasers and other skin rejuvenation treatments for the face, neck and chest. Some patients compliment their surgical procedures with non-surgical cosmetic treatments for the very best results. Non-surgical facial rejuvenation cannot achieve the exact outcome as surgery, but they may help postpone future surgery to some degree and can complement the results of facial Plastic Surgery.

Learn more about Non-Surgical Minimally Invasive Procedures here.

Medical-Grade Skin Care

“Medical-grade” refers to professional skin care products containing the highest possible concentration of their active ingredients, available only through a Physician’s office. We recommend only FDA-approved, clinically proven products that are supported by medical science and peer-reviewed clinical studies. Medical-grade skin care can rejuvenate the skin, help to correct aging and sun damage, prepare the face and body for other non-surgical rejuvenation, and optimize the skin when facial cosmetic procedures are being considered.

Learn about Medical-Grade Skin Care here.

Dr. Karen M. Horton, M.D. - Plastic Surgery, Physicians & Surgeons - Medical-M.D., San Francisco, CA