Overview
A facelift, technically known as rhytidectomy, is the gold standard for correcting visible signs of aging in the face and neck. At The Ferguson Clinic in Honolulu, Dr. John C. Ferguson, MD, FACS, performs facelift surgery using advanced deep-plane and SMAS techniques refined over more than 25 years of practice. As a quintuple board-certified cosmetic and facial plastic surgeon, Dr. Ferguson brings a level of anatomical expertise to facelift surgery that is exceptionally rare. His primary training as a head and neck surgeon means he operates with an intricate understanding of the nerves, muscles, and tissue layers that other surgeons must work carefully around because he trained on them first.
Dr. Ferguson’s RapidLift is his approach to facelift surgery that prioritizes both the quality of the result and the efficiency of recovery. Rather than relying on skin-only techniques that produce short-lived results, the RapidLift addresses the deeper structural layers of the face, the SMAS (superficial musculoaponeurotic system) and, where indicated, the deep plane extending to the corner of the mouth, to lift and reposition tissues where gravity and time have caused them to descend. The result is a more natural, longer-lasting rejuvenation that avoids the “pulled” or “windswept” look that patients rightly fear.
For patients in Honolulu and across Hawaii who are considering facelift surgery, Dr. Ferguson’s combination of fellowship-trained facial plastic surgery credentials, head and neck surgical training, and decades of cosmetic surgery experience makes him one of the most qualified facelift surgeons available anywhere in the Pacific.
Am I a Good Candidate?
You may be a good candidate for a facelift if you are experiencing sagging or drooping in the mid-face, deepening folds between the nose and mouth (nasolabial folds), jowling along the jawline, or loose skin and excess fat in the neck. The best candidates are generally in good overall health, do not smoke (or are willing to stop well before and after surgery), and have realistic expectations about what surgery can achieve.
Facelift surgery is most effective for patients who have moderate to significant facial laxity ; the kind of aging changes that cannot be adequately addressed with injectable treatments or non-surgical skin tightening alone. During your consultation, Dr. Ferguson will evaluate your facial anatomy, skin quality, bone structure, and areas of concern to determine whether a facelift, a complementary procedure such as neck lift or eyelid surgery, or a non-surgical approach is the right path for your goals.
Patients in their late 40s through 70s most commonly pursue facelift surgery, though candidacy depends on anatomy and goals rather than a specific age.
The Procedure — What to Expect
Dr. Ferguson performs facelift surgery at his AAAHC-accredited facility in Honolulu, typically under general anesthesia or intravenous sedation depending on the extent of the procedure.
The RapidLift technique begins with carefully planned incisions that follow the natural contours of the ear and hairline, designed to heal inconspicuously. Through these incisions, Dr. Ferguson accesses the SMAS layer, the structural foundation beneath the skin. Rather than simply pulling skin tighter (which produces unnatural results and does not last), he lifts and repositions the SMAS to restore the deeper facial structures to a more youthful position.
For patients with more advanced aging, Dr. Ferguson may employ a deep-plane technique, which releases and elevates the facial tissues as a single, composite unit. This approach produces the most dramatic and long-lasting improvement, particularly in the mid-face and nasolabial region, because it repositions tissue rather than merely tightening it.
Excess skin is then redraped over the newly lifted structures and trimmed precisely. If neck laxity is present, Dr. Ferguson may combine the facelift with a neck lift (platysmaplasty) to address banding, loose skin, and submental fat beneath the chin.
The procedure typically takes two to four hours, depending on the techniques employed and whether complementary procedures , such as eyelid surgery (blepharoplasty) or fat transfer, are performed simultaneously.
Recovery and Results
The first week after facelift surgery involves the most visible swelling and bruising. Dr. Ferguson applies a light compression dressing that is typically removed within 24 to 48 hours. Most patients feel comfortable enough to move around their home on the day of surgery, though rest is strongly encouraged for the first several days.
Week 1: Moderate swelling and bruising are normal. Sutures are typically removed between days five and seven. Most patients describe discomfort as mild, managed easily with prescribed medication. Head elevation is recommended when resting.
Weeks 2–3: The majority of visible bruising resolves. Many patients feel comfortable returning to non-strenuous work and social activities by the end of week two, particularly with the help of mineral makeup to cover any residual discoloration.
Weeks 4–6: Residual swelling continues to subside. Patients may resume light exercise around week three or four, with full activity permitted by six weeks post-surgery, per Dr. Ferguson’s guidance.
Months 3–6: The final results continue to refine as deep tissue healing progresses. By three to six months, patients see the full outcome of their facelift — a naturally refreshed appearance that typically takes ten or more years off the face.
Follow-up: Dr. Ferguson believes in frequent follow-up. You will always see him the day after surgery, 1 week later, and 2 weeks later. After that it depends on how you are healing. But you will always see him frequently during the first year after surgery and then yearly afterwards.
Facelift results are long-lasting, particularly with deep-plane and SMAS techniques. While the aging process continues naturally, most patients enjoy their improved appearance for ten to fifteen years or more.
Frequently Asked Questions
How long does a facelift last?
A well-performed facelift using deep-plane or SMAS techniques can provide results that last ten to fifteen years or longer. Because Dr. Ferguson addresses the structural layers of the face rather than just tightening skin, the results of a RapidLift age gracefully over time. You will always look younger than you would have without surgery.
Will I look “pulled” or unnatural after a facelift?
Not with Dr. Ferguson’s approach. The RapidLift technique specifically avoids the skin-only tension that creates an overdone appearance. By repositioning the deeper tissue layers, the result is a natural-looking rejuvenation not a stretched or “windswept” face.
What is the difference between a mini facelift and a full facelift?
A mini facelift addresses limited areas of laxity, typically along the jawline, using shorter incisions and a less extensive dissection. A full facelift addresses the entire mid-face, lower face, and jawline, and is often combined with a neck lift. During your consultation at The Ferguson Clinic in Honolulu, Dr. Ferguson will recommend the approach that matches your anatomy and goals.
Can a facelift be combined with other procedures?
Yes. Many patients choose to combine facelift surgery with neck lift, eyelid surgery (blepharoplasty), fat transfer for volume restoration, or skin resurfacing for texture and tone improvement. Combining procedures can reduce overall recovery time and produce a more comprehensive rejuvenation.
What kind of anesthesia is used for a facelift in Honolulu?
Dr. Ferguson typically performs facelift surgery under general anesthesia or intravenous sedation at his AAAHC-accredited facility in Honolulu. The choice depends on the extent of the procedure and patient preference, and is discussed in detail during your consultation.
How much does a facelift cost in Hawaii?
The cost of facelift surgery varies based on the specific technique, the extent of the procedure, whether complementary procedures are included, and anesthesia and facility fees. Dr. Ferguson’s office provides detailed cost information during your consultation so you can make an informed decision.
At what age should I get a facelift?
There is no single “right” age. Dr. Ferguson evaluates each patient’s facial anatomy, skin quality, and goals individually. Most facelift patients are in their late 40s to 90s, but the best time is when the aging changes you see bother you enough to want a lasting solution.
Why Choose Dr. Ferguson for Facelift Surgery
Facelift surgery is one of the most technically demanding cosmetic procedures. The face contains a dense network of nerves, blood vessels, and delicate structures that require precise surgical navigation. Dr. Ferguson’s primary board certification in Otolaryngology — Head & Neck Surgery means he trained specifically on the anatomy of the face and neck before adding four additional board certifications in cosmetic and facial plastic surgery. This is not a general plastic surgeon who learned facial anatomy incidentally; this is a head and neck surgeon who then dedicated his career to making faces look their best.
As President-Elect of the American Board of Facial Cosmetic Surgery, Dr. Ferguson is actively involved in setting the standards that define excellence in facial cosmetic surgery nationally. His AAAHC-accredited surgical facility in Honolulu provides the highest level of safety and quality assurance for ambulatory surgical procedures. And with more than 25 years of experience, his judgment about technique selection, whether SMAS, deep-plane, or a tailored combination, is informed by thousands of cases and decades of refined skill.
Schedule a consultation with Dr. Ferguson at The Ferguson Clinic in Honolulu. Call (808) 521-1999 or book online.