The face is the primary aesthetic part of our body. When engaged in conversation or day to day interactions, we
always look at the other person’s face. It is the one characteristic of our body which distinguishes us from one
another. A youthful face represents a more youthful person.
The "layer approach" to the face is the most comprehensive. The most superficial layer of your face is your skin.
To correct the effects of sun damage, Dr. Sayah first recommends excellent skin care including good skin care
products, IPL Photofacials, or chemical peels.
The next layers of your face are addressed by a facelift procedure. Also known as rhytidectomy, a facelift
smoothes the loose skin on your face and neck, tightens the underlying tissues, and removes excess fat. Dr. Sayah
performs most of his facelifts using new endoscopic techniques. With these techniques, a small endoscope measuring 5
millimeters in diameter is inserted through a small incision in the scalp. The entire surgery is performed under the
facial skin resulting in no visible scars on the face. There is a quicker recovery with minimal bruising and swelling.
The deeper soft tissues of your face account for your cheeks and dark depressions under the eyes. Dr. Sayah may
recommend fat injection to augment cheeks or correct depressions in the face in conjunction with your facelift procedure.
If necessary, your cheeks may also be augmented with cheek implants to improve their contour while giving you a more
Cheek fat removal techniques are combined with spot facial or neck suctioning, or buccal fat excision, in which excess
cheek fat is removed through a tiny incision inside the mouth, resulting in a more sculptured appearance to the cheeks.
While the cheek augmentation makes the cheek bones themselves wider or more forward appearing, the buccal fat excision
removes fat from “chubby cheeks” below the bones. Fatty tissue removed from the face or other parts of the body can often
be liquefied and used to fill out thinning lips or small depressions of the face at this time.
We strongly recommend that you take advantage of the entire range of services available in our office. To make it
simpler to do so, you will receive a complimentary medical facial to prepare your facial skin for surgery. Standard
packages which you may choose to benefit from include medical facials prior to and after your procedure to improve the
quality of your skin while reducing the minimal swelling you may experience. The packages also include a series of laser
facials to improve fine wrinkles, correct pigmented age spots and broken capillaries, and generally enhance the results of
your facelift. Please ask our staff about the complete facial rejuvenation packages to address all aspects of the aging
Rhytidectomy can either be done alone, in conjunction with a neck recontouring procedure (cervicoplasty), forehead
lift, or with other procedures you might desire. At your consultation, Dr. Sayah will help you decide which option is
best for you.
Dr. Sayah performs most surgeries at an affiliated surgery center. You may choose to have your procedure done at any
of the local hospitals including Cedars Sinai, Century City, or Saint John’s. The surgery is best done with a light
general anesthesia, with long acting local anesthetics added to minimize postoperative pain. After you are asleep, the
surgery begins with the injection of a long-acting local anesthetic to keep you comfortable long after the procedure is
over. If excess fat is present, your neck and face are sculpted by liposuction (liposculpture).
Incisions are made in front of your ear and continued behind your ear. The skin is next elevated from your face to
reveal the deeper SMAS layer. This layer of your face includes all of the muscles of facial expression and is pulled
upwards towards your scalp in order to correct the sagging effects of gravity on your face. The skin is then re-draped
over your face and similarly pulled in an upward direction. In this manner, Dr. Sayah performs his facelifts in
multiple layers to assure long-lasting results. The incisions are lastly closed in a meticulous manner using multiple
layers, paying special attention to place the scar in front of the ear in a location that will appear like a natural
crease in the skin. The incisions behind the ears will be covered by the ear and therefore not visible.
In the endoscopic technique, your face is anesthetized as before. Small hidden incisions are made in the scalp and
using a special camera (endoscope) along with special endoscopic instruments, the procedure is performed while
visualized on a monitor. The skin is elevated away from the SMAS layer and the SMAS is suspended superiorly. The skin
is then re-draped over the face and suspended in place with special sutures. A multiple layer approach to facial
rejuvenation is again used to give you long-lasting results. The surgical scars are within the scalp and therefore
invisible. The minimally invasive approach utilized in this technique leads to a more rapid recovery and shorter
In both approaches, your face will be covered by special bandages after surgery which is used to lightly compress
your skin in order to decrease any swelling.
After your procedure you will be resting comfortably in the recovery room. Please make arrangements for
transportation home prior to your surgery. If you would like to stay at a post-surgical recovery center, please
inform us ahead of time.
On the day of surgery, you will be perfectly comfortable and pain free due to the long-acting local anesthetic
used by Dr. Sayah. You may drink clear liquids, but avoid solid food as it may induce nausea. Take your medications
as prescribed. It is important that you maintain your head elevated while lying in bed in order to minimize swelling.
This is best done by placing 3-4 pillows under your back to sit up in bed. You must avoid flexing your neck for
prolonged periods as this may jeopardize the skin on your neck. More than one pillow under your head is to be avoided,
unless elevating your back simultaneously. Do not turn your head from side to side as this may disturb your neck
recontouring procedure. Our office staff will be contacting you daily over the first week to address all of your
The first day after surgery is typically the most difficult. You should begin to walk around the house with
assistance, and resume a regular diet. Continue to avoid large bites and foods which require strenuous chewing such
as apples or steak. Let your face “set in place” by resting your facial muscles and avoid extreme facial expressions
including prolonged conversations and laughter. Cold packs applied to your face will help reduce any bruising and
swelling which may result. You may take a sponge bath with assistance, but keep your head clean and dry for 48 hours
During the first week after surgery, you should walk around increasingly more. Do not lie in bed for prolonged
periods as it may interfere with your nightly sleep while increasing your risk for complications. On the second day
after surgery, your bandages will be removed and you may enjoy a shower. Switch from cold packs to warm on the third
day after surgery in order to reduce any swelling or bruising. Your sutures will be removed at approximately 5 days
after surgery. Over the next 6 to 8 weeks, you will experience 80% recovery from your surgery.