The Comprehensive Facelift

When does a mini-lift become a maxi-lift?

A common question from many patients is “do I need a full facelift?”  The term “full facelift” is very misleading and means different things to different surgeons and patients.  Basically, as stated in the previous pages, facelifts address the lower face and neck and come in small, medium and large varieties.

While patients with more aging changes need a larger type of lift, the procedure for lift is very similar to the minilift.  When most patients refer to a “full facelift” they are actually talking about a traditional facelift with simultaneous rejuvenation procedures on the upper and midface, such as eyelid surgery, brow lift or cheek implants.

For patients with more aging changes (frequently hereditarily related), the incisions and the degree of skin elevation require a more extensive procedure. We call the larger procedures “a comprehensive” facelift.  It is basically a larger version of the minilift to address the larger aging changes of the lower face and neck.

The image above shows that patients withaging changes (increased neck skin and or jowls) are candidates for the “comprehensive” facelift.  In terms of small, medium and large, this would be the large lift.  The surgery is a bit more extensive than the “minilift” (medium facelift) and the recovery is about 2 weeks.

Most patients will take two weeks away from work with the comprehensive facelift procedures. If this is not possible, some patients will have their surgery on a Thursday or Friday. This gives them a weekend, the next 5 day work week, and another weekend to recover. By doing this, they can recover 9-10 days and only miss a single work week. Most of these patients can wear sun glasses, turtle neck shirts and makeup and get out of the house after a week, but will usually recover an additional week before returning to work.  Patients who can work from home are usually able to do so at one week.

It is very common to perform other simultaneous cosmetic facial procedures with the comprehensive facelift. Eyelid and brow surgery, laser resurfacing, and facial implants are frequently performed at the same time as the facelift.

As stated earlier, there are many misleading marketing materials about supposed “new” facelifts that are done with the patient awake, don’t require bandages, no time away from work, etc. The patient must really beware of these procedures, especially if they have significant aging of the face and neck. Performing a small facelift on a patient who needs a larger one will lead to an unhappy patient with compromised results. The lift will not be as tight or last as long.  Many patients have fallen prey to procedures that sounded too good to be true.

Comprehensive Facelift Results

The above patients underwent “comprehensive” facelift.  Hereditary skin excess or stubborn fat deposits can require the larger type of facelift.  A smaller lift on this type of patient will not produce tight and lasting results.

This patient is shown 24 hours after comprehensive facelift.  This is minimal swelling and bruising.  Not all patients recover this well, but many do.

To learn more about facelift recovery visit

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and see the videos towards the bottom of the page.


Hundreds of pictures of Dr. Niamtu’s comprehensive facelift patients are shown in the gallery.  Many of the comprehensive facelift patients also had other cosmetic procedures such as eyelid tuck, brow lift, liposuction, laser skin resurfacing, etc.  Again, patients that are old enough to need a facelift usually are candidates for mid and upper face rejuvenation at the same time.  When combination procedures are performed, the total is greater than the sum of the parts. In other words, the degree of rejuvenation is much greater with larger lifts and simultaneous combination procedures.