Schedule a Consult Today!
521 Park Avenue, New York, NY 10065
Tel 212-223-8300
Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

Schedule a Consult Today!


« Back to Blog

Category: Facelift

Thread Lift vs. Facelift: Which Is for You?

Portrait of beautiful healthy happy smiling mature woman with curly hair When it comes down to correcting facial aging, you have many options ranging from non-invasive to minimally invasive to an actual surgical procedure. While all of these techniques aim to restore youthfulness and rejuvenate the face, the results they offer are not equal, and therefore the procedures should not be considered interchangeable. This is especially important between thread lift surgery and facelift surgery.

Both the thread lift procedure and facelift surgery improve sagging skin on the jowls, cheeks, and neck. However, while these may treat similar signs of aging, they are not substitutes for each other, and the difference between these go far beyond the fact that one is minimally invasive and the other is surgery. While both of these procedures can leave you feeling younger and revitalized, each is distinctively designed for specific candidates. The hard part is determining which may be right for your level of facial aging.

What Is a Thread Lift?

The Silhouette InstaLift™, also called a thread lift, improves the appearance of facial sagging and visible signs of aging with the use of dissolvable surgical threads. These threads work to “lift” the underlying tissues of facial structures that have been impacted by gravity and the loss of collagen. Once these threads are inserted and anchored, collagen production is stimulated, which allows for lasting results. The Silhouette InstaLift™ is non-surgical, minimally invasive, and provides natural-looking rejuvenation of your cheeks, jawline, and neck. We like to tell patients that you will get about 25 percent of the result of a surgical facelift with a thread lift.

How Does Facelift Surgery Differ?

Unlike the Silhouette InstaLift™ that uses the insertion of threads to mildly lift and tighten the underlying muscles, facelift surgery removes excess skin on the lower to midface while significantly tightening the muscles. Facelifts restore a more youthful appearance and can noticeably improve sagging jowls, vertical banding on the neck, and loss of volume in the midface. There are several levels of facelift surgery available depending on your needs. These range from the “mini-lift” that focuses on early signs of aging in the jowls and lower face to the “deep plane lift” that provides extensive rejuvenation of the jawline, jowls, midface, cheeks, and neck.

Which Procedure Are You a Candidate for?

Both of these procedures are suited for those in good physical health with realistic expectations. Candidates who have noticeable and significant aging indicators such as extensive sagging, deep creases, jowls, and drooping skin under the chin are likely best suited for facelift surgery. While the Silhouette InstaLift™ will subtly reverse the early signs of aging, it cannot reach the same level of correction of traditional facelift surgery. The Silhouette InstaLift™ is typically ideal for younger patients experiencing the onset of facial aging and skin laxity. These patients are those who wish to delay the need for surgery and want to combat the signs before they worsen. This procedure is also best for patients who have already undergone facelift surgery but require a “touch-up” due to further skin laxity.

Dr. Pearlman is a facial plastic surgeon who has been in practice for almost 30 years. When it comes to the face, for both surgical and non-surgical facial rejuvenation, you should trust your face to a facial plastic surgeon. Contact our office at 212-223-8300 to schedule a consultation to see what facial rejuvenation treatment would be best for you.

Improve Facelift Results With Facial Implants

Defined, angular facial features not only distinguish facial beauty but also point to youth and vitality. Age-induced skin laxity produces sagging cheeks and jowls, and the cheeks, jawbone, and neckline often lose their youthful definition. Patients who would like to reap the greatest benefits from their facelift should consider combining their facelift with facial implants or fat injections to enhance their facial structure. Alternatively, a deep plane facelift may accomplish both, without implants.

Cheek Surgery GraphicFacial Structure and Aging

New scientific research has shown that facial structure can be adversely affected by the aging process. The bones of the body, formerly perceived as relatively static once we reach adulthood, are now known to be constantly changing. This is why individuals tend to lose stature and become shorter as they age. In several studies of men and women ranging in age from 20 to 65+, researchers discovered that the older individuals had comparatively shorter jaws, receded chins, sinking cheekbones, and lower rims of the eye sockets. This research suggests that aging leads to a loss of bone support and structure in the face, specifically in the jaws, cheeks, and eye-socket bones. This reduction in structural support demonstrates that skin and soft tissue laxity are not the only cause of sagging cheeks, jowls, and drooping brows.

Facelift Surgery and Facial Implants

Beautiful long curly blond hairstyle female portraitWhile facelift surgery has advanced far beyond the “cut and pull” techniques of the 20th century, it still focuses on the soft tissue rather than the bones. Experienced facial surgeons can skillfully tighten and lift the muscles, tissues, and skin of the face to rejuvenate the appearance. Surgeons may also use fat injections or dermal fillers to reverse facial volume loss. With these techniques, a facial surgeon can noticeably rejuvenate the face with natural-looking results. But to adequately address age-related bone loss and achieve the most dramatic results, it may be advisable to incorporate facial implants with facelift surgery.

Facial implants are used to augment the facial skeleton in the following ways:

  • Chin implants are used to enhance a receded chin and improve the balance and definition of the profile and neckline.
  • Cheek implants, cheek fillers (such as JUVÉDERM VOLUMA® XC), or fat transfer are used to create a more angular face shape and counteract sagging cheeks.
  • Sub-malar implants or fat transfer are used to restore youthful fullness to the midface by elevating the area below the cheekbones and above the nasolabial folds.
  • Jaw angle implants or facial fillers are used to enhance a small jaw and restore jaw definition loss from sagging jowls.

Since research shows that bone loss occurs as we age, bone implants can be just as important for facial rejuvenation as skin and muscle tightening. Facial implants are long lasting and can enhance the results of facelift surgery. When placed on the facial bones, implants serve as part of your facial skeleton and can support the soft tissues in their newly tightened and lifted positions. Strengthening the facial structure with implants can counteract the loss of bone definition due to aging and restore a youthful, natural-looking appearance.

How to Know if You’re Ready for a Facelift

Facelift Dr. Pearlman Before and After photosIf your face is showing significant signs of aging, you could benefit from facelift surgery. But are you ready to undergo this procedure? Here are some ways to know whether you’re ready to change your life with facial rejuvenation surgery.

Physical Signs That You’re Ready for a Facelift

A facelift corrects sagging tissues in the lower face and neck. If you have jowls, significant lower face wrinkles, and poor jawline definition, you could be ready for a facelift. A good test is to set your hands along the sides of your jaw and pull gently toward your ears. If the results seem desirable, you could be a good candidate for this surgery. Other physical signs that you’re ready for a facelift include sagging neck tissues and muscle banding on the neck.

In addition, you should be in good physical and mental health. A facelift is a major surgery, and if you have notable health issues, you are not ready for major surgery. Once your health is under control and your doctor has given approval, you could be ready for facelift surgery.

Emotional Signs That You’re Ready for a Facelift

You may also be ready for a facelift if you have certain emotional indicators. Candidates with noticeable signs of aging should desire a change because they are bothered by their wrinkles and sagging skin. If you look in the mirror and feel discouraged because your appearance does not reflect the youthful and confident person you feel you are, then you may be ready for a facelift. If you are ever dissatisfied that your aged appearance makes you look tired, angry, or sad when you do not feel so, it could be a good time to undergo this procedure. Most importantly, you should be self-motivated. If you are receiving outside pressure to get a facelift, it may be better to hold off until you want it for yourself. On the other hand, if you know you want the procedure, you should feel free to pursue your desires.

The Right Time for a Facelift

Timing is one of the most critical aspects of preparing for a facelift. Most facelift patients are between the ages of 40 and 60. Patients who get a facelift before age 50 may see the best results because they tend to have more youthful skin elasticity. Additionally, because the tissues of your face will be more sensitive to the sun during recovery, it may be best to get a facelift in the fall or winter. Winter is also opportune because sun exposure is more minimal and hats and scarves are more appropriate accessories. These factors will help protect your skin and reduce scarring.

Lastly, you will not be ready for a facelift until you can schedule your time and life around the recovery. Patients must be prepared to take at least 10 to 14 days off of work for their surgery and recovery. Dr. Pearlman also recommends scheduling your facelift at least two to three months or more before an important function, such as your daughter’s wedding. This surgery can change your life, so it is best to make sure that you are ready for it and that you will be able to enjoy the results.

Other factors such as finances can also determine whether you are ready for a facelift. If you feel that now may be a good time to consider this procedure, schedule your consultation with Dr. Steven J. Pearlman. Dr. Pearlman is dual board certified in facial plastic surgery and can help you determine whether you are a good facelift candidate and whether you are prepared for this surgery. To book your appointment with Dr. Pearlman, call 212-223-8300 or contact us online today.

Facial Rejuvenation Surgeries

Facelift Before and After PhotosThere are a variety of types of facial rejuvenation treatments and procedures. While non-surgical methods can be incredibly effective, in many cases, surgical methods prove to be the better approach and may produce better results. If your face has begun to show signs of aging such as sagging skin, fine lines, wrinkles, and folds, the following facial rejuvenation surgeries can help you achieve a more refreshed and youthful appearance.

Facelift Surgery

Facelift surgery can improve many signs of facial aging in the mid face, lower face, and even the neck. Various techniques including the mini-facelift, mid-face lift, deep plane facelift, neck liposuction, and Ultherapy® can correct the following issues:

  • Jowls
  • Sagging facial tissue
  • Turkey neck
  • Descending cheeks
  • Nasolabial folds
  • Wrinkles and lines in the mid and lower face

Dr. Pearlman can help you determine which facelift approach you need and whether you should combine your facelift with other procedures for more complete facial rejuvenation.

Silhouette InstaLift™

The Silhouette InstaLift™ is a minimally invasive surgical procedure that can lift the deeper layers of the facial skin to rejuvenate your appearance. The surgeon uses sutures with bidirectional cones to elevate and reposition the skin on your face. Over time, your body naturally absorbs the sutures and stimulates more collagen to improve skin quality.

Brow Lift Surgery

Brow lift surgery can lift and tighten the tissues of the upper face. This surgical approach corrects horizontal forehead lines, drooping brows, and brow furrows, and it may also improve upper eyelid hooding in some cases. Certain techniques can also elevate sagging cheeks. Patients who need a brow lift may feel that they look continually angry, sad, or tired. After the procedure, your forehead and brow area will appear lifted and smooth, erasing the negative expression that previously marred your appearance.


Another facial rejuvenation surgery is blepharoplasty, more commonly called eyelid surgery. This procedure can correct sagging eyelids and displaced fat in the areas around the eyes. Patients can receive upper blepharoplasty, lower blepharoplasty, or both to fully rejuvenate the tissues around the eyes. The surgeon will adjust the muscle tissue, eliminate excess skin and upper eyelid hooding that may impair vision, soften fine lines, redistribute fat tissue, and reduce puffiness and bags around the eyes.

Each of these surgical procedures can be performed alone or may be combined with other procedures for complete facial rejuvenation. During your confidential, personal consultation, Dr. Pearlman can recommend which procedures will best help you achieve your aesthetic goals and desires.
Dr. Pearlman offers facial rejuvenation surgeries and many other plastic surgery procedures to enhance the appearance and rejuvenate the face and body. If you would like to learn more, please call (212) 223-8300 or fill out our online contact form to request your consultation today.

The 6 Types of Facelifts

Before and After FaceliftIf your face is noticeably aging, it may be time to consider getting a facelift. As individuals age in different ways and at different rates, Dr. Pearlman offers six types of facelift procedures, including surgical and non-surgical options. Depending on your needs for facial rejuvenation, one of the below facelift procedures could help you achieve a more youthful and rested appearance.

1. The Mini-Facelift

The mini-facelift targets aging in the lower face, including minimal skin sagging, early jowls, and excess skin. This procedure is not designed to address heavy jowls or severe signs of facial aging, but it can create a more uplifted, smoother facial contour. The best candidates for this procedure are younger patients with the aforementioned characteristics of aging who desire a more youthful and well-defined lower face and neck.

2. The Mid-Facelift

The mid-facelift targets cheek sagging to rejuvenate the midface region. This procedure elevates the tissues of the cheeks to eliminate sagging and reduce deep creases. Best for patients who do not have jowls or excess skin sagging in the neck, the mid-facelift can enhance facial definition, create more attractive cheek contours, eliminate nasolabial folds, and even improve the lower eyelids. It can also be incorporated with other facial procedures if needed.

3. The Deep Plane Facelift

The deep plane facelift targets severe cheek and neck aging. This procedure lifts the muscle tissue and skin to correct heavy cheeks, neck sagging, and skin laxity. Long recognized for its ability to produce the most natural-looking and longest-lasting facelift results, the deep plane facelift can yield a refined and rejuvenated appearance. Research has shown that patients look at least five years younger after a deep plane facelift and still look better five and a half years after their surgery than they did before. This gives the best and longest-lasting result in facelift surgery.

4. The Silhouette InstaLift

The Silhouette InstaLift uses dissolvable sutures and cones to anchor the cheeks and re-suspend sagging facial structures such as jowls, cheeks, nasolabial folds, and excess neck skin. The Silhouette InstaLift procedure mitigates many signs of aging with very little downtime, ultimately encouraging the body’s natural process of producing collagen around the threads. The procedure is typically used around the cheeks, brows, jawline, and neck in order to restore structure and youthful orientation to the face. Patients often wish to correct sagging facial tissue, such as jowls along the jawline, mild drooping skin under the chin (“turkey neck”), descending cheeks, and deep creases from the outer nostrils to the corners of the mouth (nasolabial folds). The best candidates for this procedure are younger patients who aren’t quite ready for a full surgical facelift.

5. Neck Liposuction

Neck liposuction targets excess fat in the neck and even the jowls.This procedure is often combined with facelift surgery to eliminate surplus fat that accumulates beneath the chin. This procedure may be appropriate for individuals who would like to eliminate a double chin and flatten prominent jowls. The best candidates have minimal laxity of the neck skin.

6. Ultherapy®

Ultherapy® is a non-surgical treatment that can lift and tone sagging, loose skin along the jawline and under the chin, and it can even raise your brows. Using ultrasound energy, Ultherapy® stimulates the foundational tissues and support layers of the skin to help tighten early jowls and early skin laxity. This procedure is best for younger patients, those who would like to preempt the need for surgery, patients who may not be ready for surgery, or patients who wish to prolong the effects of a previous facelift procedure.

Steven J. Pearlman, M.D., F.A.C.S. is dual board certified in facial plastic surgery and would be pleased to help you achieve your aesthetic goals with facial rejuvenation. To schedule your confidential, in-depth personal consultation with Dr. Pearlman, please call 212-223-8300 or fill out our online contact form today.

Lifting Your Appearance With The PearLift

During this past month we held a media event announcing the release of a brand new non-surgical procedure that starts with Ultherapy  which tightening the underlying facial structures including the SMAS and Platysma. After that we continue with the Dot™ fractionated CO2 laser. That way the skin is rejuvenated inside and out. 

We were fortunate enough to have Carol Ruth Weber attend our event this past month and go through the motions of the Pearl Lift. Like any patient she had concerns, which we were able to address. 

You can read her account of our event by clicking here

Back To Top