The term “facelift” is used to describe a variety of procedures that are performed to enhance the appearance of the neck, jawline, and cheeks. Many factors determine how a patient ages and how their facial features change over time.

Commonly, patients seek consultation because of the changes that occur with aging. These changes may be noticeable in patients as early as in their late 30s and people may look more tired than they feel.

Many procedures are performed at MetropolitanMD for improvement of the face and neck. Most procedures are minimally invasive and allow a quick return to normal activities. Treatment may include surgical and/or nonsurgical methods. Surgical goals vary for each patient but commonly include elevating the neck, sculpting the jawline, removing excess fat, and tightening loose muscles of the face and neck.

Dr. Rachel customizes a treatment plan for each patient depending on the extent of aging changes and the degree of improvement the patient is seeking. All procedures are performed to provide natural and long-lasting results that create a more youthful and rested appearance.

Facelift Before & After Facelift Before & After


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Weekend Facelift

For patients with double chins, drooping necks, and mild jowls, a minimally invasive procedure from which they can return to work in several days is ideal. By combining SmartLipo liposculpture with laser tightening of the skin, the lower face and neck can be addressed.

This is performed using three small incisions that are hidden from view and can be performed either under local anesthesia or with IV sedation. Patients appear refreshed thanks to this simple and minimally invasive procedure.


Some patients with early drooping of the face and jowls have only minimal descent of the neck and are excellent candidates for a minilift. A short incision hidden within the recesses of the ear allows Dr. Rachel to lift the muscles of the cheeks, removed excess fat and restore a sleeker jawline and improved angles of the neck.

Because of the well-hidden short incisions, scars heal quickly and patients may return to work quickly.

The S-Lift

The S-lift is the modern answer for minimally invasive surgery for patients who can benefit from a more comprehensive lift. The SMAS ( abbreviation for the superficial musculo-aponeurotic system) is a fibrous layer that envelops the facial muscles. This procedure allows for the elevation of the SMAS and the facial muscles. The sagging tissues of the face and neck are lifted and repositioned, then secured into a new, more youthful position.

The S-lift, done under gentle twilight sedation, involves making small incisions hidden within the recesses of the ears and beneath the chin. Through these incisions Dr. Rachel can elevate sagging facial muscles to restore the normal contours of the neck, jawline, and cheeks.

Frequently, these procedures can be combined with blepharoplasty, forehead/brow lifts, and lipoaugmentation of the face.


Patients with drooping necks are often unhappy about their appearance even when their face is relatively youthful. A necklift is a minimally invasive procedure in which small incisions are made beneath the chin and behind each ear.

Liposuction, muscle suspension, and skin tightening are performed to elevate the tissues to their proper more youthful position. Incisions often become difficult to see within months, and the procedure can be performed awake or with twilight anesthesia.


This man is not only a MASTER surgeon, he’s one of the kindest and most humble people I have ever met. […] Last week (for my 60th birthday present to myself), I had a mini-face lift. I’m only 5 days post-op and cannot believe the transformation! Dr. Rachel is thorough, professional, caring, and patient, as is his entire staff. Most importantly, his work is nothing short of perfection. Would recommend him in a heartbeat!


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  1. What is the difference between a minilift and an S-lift?

-“Facelift” is a generalized term indicating a procedure designed to improve the appearance and tighten the tissues of the face and neck. There are many procedures and procedure names that fit into this category. Some are trademarked names, and some may be common terms such as minilift and S-lift.

At MetropolitanMD, the term “minilift” is a minimally invasive procedure to improve the appearance of the lower face and neck. It is generally performed under local anesthesia and takes about one and a half to two hours to complete.

An S-lift is a similar procedure, but it is geared towards patients who are interested in and who would benefit from additional tightening of the face and neck (i.e. larger “turkey neck”). This surgery is commonly done under twilight anesthesia and takes between two and three hours to complete.

  1. Will a facelift make me look windswept or over-pulled?

-These procedures are designed to create natural and long-lasting improvement without the obvious signs associated with the stigma of a traditional facelift.

  1. How long will the results last?

Facelift results will commonly last for five to ten years depending on a number of factors, such as patient anatomy and environmental and social influences. Sun exposure, smoking history, and skin quality can have an impact on the duration of effects.

  1. Can more than one procedure be performed at the same time as a facelift procedure?

-Multiple procedures can be combined with a facelift procedure, such as upper and lower eyelid surgery, forehead lift, fat transfer, rhinoplasty, and body liposuction, to name a few. There are obvious limitations as to how many and which procedures can be performed together.

  1. How long does the surgery take?

-Depending on the extent of the surgery, a facelift procedure will take anywhere between one and three hours.

  1. Where are the incisions placed?

-The incision placement is customized based on the anatomy and the needs of the patient. Commonly incisions are hidden in and around the ear and in the crease under the chin.

  1. Will I have visible scars?

-The healed scars are often difficult to see, since they are camouflaged in the creases and folds of the ear and under the chin.

  1. Am I too old to have a facelift?

-Minimally invasive procedures can be safely performed under local or twilight anesthesia on patients in their 30s through their 80s.

  1. What are the risks?

-These procedures are generally very safe. As with any procedure, there are risks involved. Risks may include, among other things, bleeding, infection, wound-healing issues, scarring, injury to muscles and nerves, and anesthetic reactions. The recovery is usually three to ten days depending on the extent of the procedure, but periodically, it can be prolonged.

  1. Where will my procedure be performed?

-Most commonly, the procedures are performed in our office-based surgery center in Glenview. The office is fully accredited by AAAHC. Occasionally, patients may elect to have the procedure performed at a North Shore University Hospital.

  1. Is surgery performed under general anesthesia?

-The procedures are comfortably performed under either local anesthesia or twilight anesthesia. General anesthesia is not necessary.

  1. Will I have bruising?

-The extent of bruising varies among patients. Some patients have very minimal bruising and some have more extensive bruising. Avoiding certain medications before surgery and following the instructions after surgery can help minimize bruising.

  1. How long will swelling last?

-The extent of swelling also varies widely among patients. Again, some patients have minimal swelling that lasts only a few days and others may have prolonged swelling that slowly diminishes over a period of several weeks.

  1. Is there anything to do to minimize swelling or bruising?

-Medications that can “thin” the blood include products like aspirin, ibuprofen, Vitamin E, and fish oil. Avoiding these medications can help minimize swelling and bruising. Post-operatively, there are several tips that are recommended for a quicker recovery. These are reviewed during the pre-operative appointments.

  1. When can I resume exercise?

-Light exercise such as walking is usually recommended several days after the procedure. Activity can be progressively increased after one week depending on the patient and the extent of the procedure.

  1. How much pain will I be in after surgery?

-A prescription for pain medicine is given to help with discomfort after surgery. Patients’ pain tolerances vary greatly; some patients will just require some Tylenol, while others will need pain medicine to relieve the discomfort.

  1. When can I return to work or be seen in public?

-Depending on the extent of surgery and post-operative bruising, some patients will return to work as soon as three to four days after the procedure and others will be out for two weeks.

  1. When can I fly?

-It is advisable to avoid flying for at least 72 hours after the procedure.

  1. If I am a smoker, do I have to stop smoking?

-Many of these procedures have been performed on current smokers and ex-smokers who chew nicotine gum or use e-cigarettes. The vast majority of these patients have done well with no complications. However, smoking and nicotine has been shown to increase the risks of surgery, including wound-healing problems and infections.

  1. If I want to lose weight, should I wait to have a facelift?

-It is generally not necessary to lose the weight first unless significant weight loss is planned. Commonly, patients who have the procedure prior to weight loss use the improved appearance for motivation for healthier living and weight loss.

  1. Do I have to stop any medication before surgery?

-Most commonly, the medications that can “thin” the blood will be stopped prior to a procedure. This helps reduce the risk of bleeding and bruising. Other medication may be stopped as well, but this will be reviewed during your pre-operative appointment.

  1. Can I drive myself home?

-Patients will need a ride after surgery.

  1. Do you have before-and-after photos available to review?

-There are before-and-after photos available for review here and in our photo albums in the offices in Glenview and Chicago.

  1. Are you board-certified?

-Dr. Rachel is board-certified in multiple specialties. He is a diplomate of the American Board of Otolaryngology-Head and Neck Surgery, American Board of Facial Plastic and Reconstructive Surgery, American Board of Cosmetic Surgery, and the American Board of Facial Cosmetic Surgery. A full CV is available for review here.

  1. Are financing options available?

-Yes, there are several payment options available, including cash, check, credit card, and financing. The financing options are listed here.

Contact us to get your free facelift surgery consultation with Dr. John Rachel, a board-certified cosmetic surgeon.

American Board of Cosmetic Surgery FACS American Board of Facial Plastic and Reconstructive Surgery Alpha Omega Alpha Accreditation Association for Ambulatory Health Care American Board of Otolaryngology Phi Beta Kappa American Academy of Facial Plastic Surgery