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.

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.

Botox relaxes muscles that cause wrinkles (like frown lines or crow’s feet), while dermal fillers restore lost volume or enhance facial features (like cheeks or lips). Both are injectable treatments but serve different purposes.

Botox typically lasts 3–4 months, while fillers last anywhere from 6–18 months depending on the product and area treated. Regular maintenance can help you preserve results long term.

If you’re looking for subtle contouring or early volume loss correction, fillers may be sufficient. If you have significant sagging, jowling, or deep folds, a facelift may offer a more effective and permanent solution. Often, both are used together to maximize results.

Sculptra is an injectable biostimulatory treatment made from poly-L-lactic acid. Unlike traditional fillers like Juvederm or Restylane that add immediate volume, Sculptra works gradually by stimulating your body’s natural collagen production over time. It’s ideal for restoring global facial volume loss and improving skin texture and firmness.

Sculptra is often used to enhance:

Hollow temples or cheeks

Jawline contour

Skin quality and elasticity

Results develop slowly over several weeks and can last over two years. It is often done in a series of treatments spaced several weeks apart. Sculptra is an excellent option for patients seeking natural-looking, long-term improvement without the overfilled appearance that can sometimes occur with HA fillers.

Sculptra is not recommended if you’re seriously considering a facelift within the next 1 to 2 years. While Sculptra is an excellent non-surgical option to stimulate collagen and improve facial volume gradually, it creates tissue changes that can make future facelift surgery more technically challenging.

Sculptra (poly-L-lactic acid) works by inducing controlled inflammation and stimulating your body to produce new collagen over several months. This collagen is not easily reversible and can create fibrous tissue planes that may interfere with dissection and repositioning during a facelift, particularly deep plane techniques.

If you're thinking about surgical facial rejuvenation in the near future, it’s best to discuss your goals with your surgeon first. A facelift may be more appropriate and provide longer-lasting, more natural results in the right patient. You can always consider Sculptra or other collagen stimulators later as a complement to surgery once healing is complete.