Facelift & Neck Lift

Beneath the skin and the fat layer lies a continuous sheet of muscle and fibrous tissue called the SMAS — the superficial musculoaponeurotic system. It's what lets your face move expressively, and it continues down into the neck as the platysma muscle. This layer, not the skin above it, is what gives a facelift its structure and its staying power.

Anchoring the SMAS to the underlying facial skeleton are several retaining ligaments — dense fibrous bands along the cheekbone, around the jaw, and in the neck that hold soft tissue in its youthful position. These ligaments gradually stretch with age, which is precisely what allows the SMAS, the fat above it, and the skin above that to descend and form jowls, midface heaviness, and neck laxity in the first place.

Why the plane of dissection matters

Repositioning skin alone, without addressing the SMAS beneath it, tends to look pulled rather than lifted, and relapses faster because the underlying support was never actually changed — only stretched skin was re-stretched.

Working in the deeper plane beneath the SMAS — at the same level as these retaining ligaments — allows Dr. Kim to selectively release the ligaments that have loosened and reposition the entire composite layer of muscle, fascia, and fat as one unit, then redrape the skin over it without tension. That's the structural reason a well-executed facelift can look rested rather than tight, and hold its result for years rather than months.

A facelift repositions the underlying facial tissue — not just the skin. The supportive layer beneath the skin is lifted and secured in a more youthful position, then the skin is redraped over it without tension. That distinction is why the result reads as rested rather than pulled: the change happens at the structural layer, and the skin is simply along for the ride.

Combined with a neck lift where needed, this addresses jowls, nasolabial folds, midface descent, and neck laxity together, restoring a more defined jawline and smoother neck contour without changing the underlying character of the face.

Benefits patients most often ask about

• Softens furrows and creases around the eyes and mouth
• Long-lasting results
• Minimal scarring that's easily concealed
• Replenishes lost volume through the midface and beneath the eyes
• Lifts sagging cheeks and softens a double chin
• Restores a more defined jawline and neck contour

Central New York has several practices that perform facelifts as one of many procedures they offer. Dr. Kim performs them as his primary focus, exclusively of the face and neck, with results represented in an extensive, filterable before-and-after archive of over 100 documented cases.

Most patients also combine a facelift with one or more adjunct procedures in the same surgery — blepharoplasty, midface volume restoration, facial implants, laser resurfacing around the eyes and mouth, or deep-crease treatment — which is more cost-efficient and means a single recovery period covers everything.

A facelift is worth considering for anyone noticing visible jowling, midface descent, or loose, lax neck skin who wants to restore a more rested appearance rather than a different one. Age alone doesn't determine candidacy — overall health and realistic expectations matter more.

• Visible jowling or midface descent
• Loose or lax neck skin, with or without vertical banding
• Generally good health
• Non-smoker, or willing to quit before and after surgery
• Realistic expectations — a refreshed appearance, not a different face

What to expect at consultation

We start by listening — your concerns and goals come first. A careful examination follows to identify the unique features that will determine which procedure, or combination of procedures, best achieves your goals while minimizing risk.

Before scheduling, our office coordinates with your primary care provider for preoperative medical clearance. Depending on age, medical history, and the procedures planned, some patients need one or more tests beforehand to ensure the surgery can proceed safely.