Preparing for Facial Plastic Surgery: What You Need to Know

A deep plane facelift is an advanced surgical technique that lifts and repositions the deeper layers of the face beneath the SMAS (superficial musculoaponeurotic system) to restore youthful contours of the midface, jawline, and neck. Unlike traditional facelifts that mainly tighten the skin, the deep plane method targets the root causes of aging for natural and longer-lasting results.

During surgery, key facial retaining ligaments are released. These include the zygomatic cutaneous ligaments (also called McGregor’s patch), cervical retaining ligaments, and masseteric ligaments. Releasing these structures allows for more effective lifting of the cheeks and jowls, improving facial support and definition without creating a pulled or tight appearance.

This technique is especially effective for addressing:

• Midface sagging

• Nasolabial folds

• Jowling

• Neck laxity

It is often considered the gold standard for facial rejuvenation in patients who want significant improvement with natural-looking results.

Preoperative preparation depends on the type of procedure and the type of anesthesia used. For surgeries performed under general anesthesia or IV sedation—such as a deep plane facelift, neck lift, or lower blepharoplasty with fat transfer—medical clearance and lab work are required to ensure a safe and smooth experience.

Preoperative requirements for surgeries under general anesthesia or IV sedation include:

• A letter of medical clearance from your primary care provider

• Lab tests, such as a CBC (complete blood count) and BMP (basic metabolic panel)

• An EKG, typically required for patients age 50 and older

• Cardiac clearance if you have a history of heart disease, arrhythmia, or other risk factors

• Stable weight for at least 4 weeks before surgery

• Discontinuation of GLP-1 medications (e.g., semaglutide, tirzepatide) for at least 1 month prior to surgery, due to concerns about delayed gastric emptying and anesthesia-related risks

All patients should also:

• Avoid smoking and all nicotine products for at least 4 weeks before and after surgery

• Hold all blood thinners, including aspirin, NSAIDs, vitamin E, fish oil, turmeric, and certain herbal supplements, for 10–14 days prior to surgery, unless otherwise directed

• Notify your surgeon about any prescription anticoagulants, which may require coordinated management with your prescribing physician

These steps help reduce the risk of bleeding, wound healing issues, and complications under anesthesia.

Procedures under local anesthesia, such as upper blepharoplasty, typically do not require labs or clearance, unless you have specific medical concerns. However, you should still avoid smoking and blood thinners, and discuss any medications or health changes with your surgeon in advance.

You may be a good candidate if you have noticeable jowling, sagging cheeks, or loose skin on your lower face and neck. Ideal patients are healthy, non-smoking individuals looking for long-term facial rejuvenation without an “overdone” appearance. A consultation is the best way to determine what approach is right for your anatomy and goals.

Surgical candidacy depends on overall health, medical history, and individual risk factors. Surgery may not be recommended for patients who:

• Require ongoing blood thinners that cannot be safely held

• Are immunocompromised or have conditions that impair healing

• Have serious or unstable medical conditions that increase surgical or anesthesia risk

These factors do not automatically exclude surgery, but they require careful evaluation. Patient safety is always the top priority, and recommendations are made on an individual basis.

Most patients take 2–3 weeks off work and social activities. Swelling and bruising peak in the first week and gradually subside. You’ll see continued improvement for several months. Final results are typically visible by 3–6 months post-op and last up to 10–15 years.

Facial rejuvenation refers to a range of surgical and non-surgical treatments designed to restore a youthful, refreshed appearance. This can include facelift surgery, blepharoplasty (eyelid surgery), neck lift, laser resurfacing, microneedling, injectables like Botox and fillers, and medical-grade skincare.

Surgical rejuvenation (like facelift or blepharoplasty) physically lifts and repositions tissue for long-lasting results. Non-surgical options (like Botox, fillers, and lasers) target surface-level aging or volume loss with temporary improvements. Many patients benefit from a combination of both.

Blepharoplasty, or eyelid surgery, is a procedure that removes or repositions excess skin and fat from the upper or lower eyelids. It can improve a tired or aged appearance, correct under-eye bags or hooded upper lids, and even improve vision in severe cases.

Upper blepharoplasty is ideal for excess upper eyelid skin, while lower blepharoplasty addresses puffiness or hollows under the eyes. A consultation will help determine the best approach—or if both are recommended—for optimal results.

Rhinoplasty, or nose reshaping surgery, improves the appearance or function of the nose. It can smooth a hump, refine the tip, correct asymmetries, or address breathing issues. Every nose is unique, so rhinoplasty is fully customized to your anatomy and goals.

Cosmetic rhinoplasty changes the shape of the nose, while septoplasty corrects a deviated septum to improve breathing. These procedures can be done together (called functional rhinoplasty) for both aesthetic and functional benefits.

Facial rejuvenation refers to treatments that restore a refreshed, balanced appearance. This may include surgical procedures such as facelift, eyelid surgery, or neck lift, as well as selected non-surgical treatments when appropriate.

Non-surgical treatments, including Botox and dermal fillers, may be offered to select patients as part of an individualized facial aesthetic plan. These treatments are available to established patients and may be considered for new patients following a consultation.

Consultations are conducted one on one with Dr. Chao and are intentionally unhurried. Each visit is highly personalized and focused on understanding your goals, facial anatomy, and long-term options. Recommendations are made thoughtfully, with time for detailed discussion and questions.