Where are the facial incisions for a facelift? Incisions for Vertical Restore™ Facelift
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Incision Lines for Vertical Restore™ Facelift by Double Board-certified Facial Plastic Surgeon, Dr. Amir Karam, San Diego, CA.
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Dr. Karam invented the Vertical Restore, an advanced technique for the common face and neck lift. In this video, he explains where the incisions go, why they are placed with precision around the hairline, and what to expect from this innovative procedure. Some before and after photos are included. For more before and after photos, please visit our website:
Transcript:
– A lot of people ask, where are the incisions for the Vertical Restore™. I think it's a great question, obviously everyone wants to know if it's gonna affect their hairline, or if it's gonna affect the way they wear their hair. And the answer is, it really shouldn't affect anything with respect to how you like to wear your hair. You know, women like to wear their hair in a ponytail, no problem, we're conscious of this when we create an incision design that hides it as well as the fact that there's no tension on the skin. And the actual incision line heals so fine that with a little bit of healing time the rest of the incision is, basically, imperceptible. Because the Vertical Restore and the Vertical Prevent address the lateral brow, the midface, the jawline, and the neck, we're gonna start our incision up in the top of the hairline, right in here. And I give it about a centimeter to two centimeters of space, depending on how much movement I believe the lateral brow segment's gonna do, so that this patch of hair will still be in front of the incision. So we make the incision up here and it's usually a moving line, it's a zig-zag type of an incision because the eyes have a hard time finding that type of movement as opposed to a straight line. Then when we come down to the level of the temporal tuft, we want the incision to be at the hairline. And the reason we want it to be just at the hairline, just behind it a little bit, is because we don't want this temporal hair tuft to shift. One of the tell-tale signs of facelifts is that this hair ends up going from here to here and that's because when the skin gets removed, all that hair gets removed. So we want there to be a nice, natural temporal tuft, and as a result, we need to convert this incision to a hairline incision. And the way it's done is it bevels the hair follicle so you get some hair that actually grows through the scar and hides it even further. And then once we get down to this area, the ear, we're gonna use the natural shadows and contours of the ear to further hide it. So we go into that little groove right there, and then we come behind the ear there, and then as we come down to the bottom of the tragus, we'll make a cut across here so that this unit and this unit become completely isolated. And whenever you have movement in the line, lines are hard to follow, visually. So then once we've done that part there, we're gonna come, basically, here, and go behind the ear, and from there, we're gonna put the incision in the natural ear socket. So it's way deep in here. I'm sorry, I'm going to turn your head a little bit. So it's deep in here, right in the natural crease so you can't see it, and then we're gonna bring it up to a certain level, and then from there, we're gonna convert it to behind the hairline incision right here. And what this is gonna do, is going to allow the incision to hide within this hairline here, but also allow us to be able to remove skin going in this direction, because the Vertical Restore vector is upward and the neck skin is gonna be removed in this horizontal fashion right here. And the length of this incision is dependent on how much laxity there is in the skin. Some people who are younger and they don't need a whole lot, the incision might end right here. Older patients, it might go down a little bit further. Basically, the incision under the neck will be right in the natural crease underneath the chin, hiding really well so when the head is down, you can't see the incision. Okay, so that's the extent of our Vertical Restore, Vertical Prevent incisions. The quality of incisions heal really well, they hide the natural contours, can't see them. This gives you an idea of the natural direction and vectors of lift that we perform as part of our procedure. Everything going upward.
Incision Lines for Vertical Restore™ Facelift by Double Board-certified Facial Plastic Surgeon, Dr. Amir Karam, San Diego, CA. Visit us online at or call 858-259-3223.
Dr. Karam, Did you invent this kind of incision? Or are there other surgeons that do the same? I ask because it’s awesome how you are able to make the incision so discreet.
Have these incisions been tried on darker skin tones (like 4, 5, or 6) as far as greater scarring risks?
I would really like to know this as well because I’m an African person and would like to see it on a black person. We tend to scar pretty badly.
Hi Dr. Karam,
When tiding up the muscle bands in the neck and say you add a small chin implant, how long will the numbness will last around the area right below the chin?
Also, is the incision healing time behind the ears longer than the incision in front since the skin is thicker behind the ears?
Thank you so much for explaining the vertical restore method. This is so very informative.
I’m becoming such a super fan! I’m a fan of the results , and of the generosity of the education being provided here!!!
I’m from Minnesota and in the Upper Midwest there is still so much stigma around plastic surgery. Folks in most of the cultures in my part of the country look down on vanity and it bums me out because I get so excited at the possibilities that are being developed.
I have to find the courage and individuality within myself to begin planning my own vertical restore. It’s such a hard decision only because rallying the support of my family and friends will be so hard.
We are all very health conscious and frugal with our finances so I’ll need to convince people close to me that this will be amazing for me.
I am currently collecting the videos provided here to share with my loved ones and try to get them as excited as I am.
Currently they are basically opposed to it since I am 41 years old and they believe it’s too young. I believe this is the perfect age !!
Nice demonstration. For males, how to avoid getting the beard line closer to the ear? I see many pictures of facelift where the incision is imperceptible but the beard is too close to the ear in an obvious way.
@dramirkaram
Gosh does anyone even notice that kind of detail?
What is the typical fee for this procedure?
Hi Doctor. How does this affect us who have thinning hair 😣. I’m going to see you in exactly two months for my vertical prevent 🙌
You take a chance with thinning hair. He will tell you thinning hair is hormonal or hereditary. When you sign the thousands of pages of your surgical agreement – it will state, not his fault if your hair continues to fall out and the scars are visible. With any plastic surgery – it is elective surgery and you elect for any and all mistakes to happen. That is why lots of thought needs to go into booking such a surgery. I worked in a plastic surgery office.
What about microblading or micropigmentation of the scalp?
If he can help with thinning hair please let me know!
Awesome information. Thankyou!
Very informative
Can you do a vertical lift using local numbing instead of full sleepy time??
He said in another video that it is IV sedation and local anesthetic
Why don’t the Drs ever answer what the cost is when asked?
I want my skin is neet fair colour but coz of pigmentation my skin is ruff and dull i am residence KSA but how is possible
@K Wilson I can’t see that happening. The well known (high profile) surgeons like this you would probably keep over from the sticker shock at the high price point lol. Dr. Kao (ponytail lift guy) starts at over $100k from what has been reported online by those who have had consults.
Because if all doctors start mentioning prices, it will lower the price based on competition. They’ll then have to act like Amazon sellers or gas stations (which they are not). Plus, everyone’s treatment price might vary. In addition, you can talk yourself out of something great for you by tuning out once you hear the price. There’s saving and financing. You know you need at least 10k to pay in full or, for some doctors, to be a down payment on your financing.
You can do it if you set your mind to it. Get a consult and Make it happen.
They want you to come in for a consultation.
What is the cost? The before and after photos are absolutely beautiful.
@Zoe Park I saw a comment on another video of his that that particular procedure would have cost around $80k. The person who commented had apparently emailed the practice and they gave her range prices for different procedures. It was more than one procedure though, including this one.
@Pickle Pickle if that’s the case, thank goodness… but I’ve heard that this specific doctors pricing is around $40,000.
@Zoe Park naw, depends on the surgeon, procedure that wish to be done and city but usually it’s between $12,000 & $20,000 or a bit more.
I heard it’s around $40,000.
I wonder as well, too bad you wouldn’t have any answer
Super helpful
How much does vertical restore cost for a 57 year old female?
@Chinyere Okoro Ojiaku Good luck!
@Silvia Lola thanks for your response, I live in Texas, USA
I don’t know where you live, so I can’t really tell you how much this procedure costs. I just had this done a month ago in Amsterdam, and I paid €11.000. The best thing EVER!
Good luck🍀😊❤️
@nadia reaves Dr. J.J.N.M. van der Meulen. Velthuis Kliniek
I totally recommend him!
Good luck😊🍀
Would you please tell ne the dr name in Amsterdam?
🚨Dr. K could you please explain the difference between The Vertical Restore vs. Ponytail Lift:
Thank you soo much for explaining.. I will schedule a consultation..
Is this procedure the same as the one called Deep Plane facelift? What’s the difference? Is any clinic in Europe applying this technique? THANKS!!!
After 3 pregnancies and gaining+losing 70lbs with each… my jaw, neck, and cheeks are very relaxed at only 31 years old.
I hope to one day visit him for a lift because he seems like the only person I could trust 😆
Dr. Karam is an artist!! Ive been a patient for several years. His work is excellent, super nice guy and his staff is wonderful as well. I highly recommend him to anyone thinking about plastic Surgery.
He is definetly the plastic surgeon I want to see.