We're not sure about you, but for us, the term 'ponytail facelift' conjures images of someone rocking a super slick, super high, super tight pony that basically pulls their entire face up and back. And, well, that's not entirely incorrect. Ponytail facelift isn't a medical term—it's a marketing one—but it's a technique that's rapidly gaining popularity.
We asked board-certified plastic surgeons Carolyn Chang, MD, Steven Levine, MD, and Robert Guida, MD, to explain what exactly a ponytail facelift is (spoiler alert: it is a surgical procedure), plus everything else you need to know about this trendy treatment.
Meet the Expert
What Is a Ponytail Facelift?
"A ponytail facelift is a generalized description of a minimally-invasive lift performed through small incisions in order to mimic the look of the face when the hair is pulled in a tight, high ponytail," explains Chang. The name actually has a two-fold meaning. Because the incisions are placed entirely within the hairline—and not around the ears as they are in a traditional facelift—you can easily wear a ponytail after surgery without worrying about the appearance of visible scars, adds Levine. However, as mentioned, both doctors are quick to note that this is a marketing term, and not a standard textbook procedure.
Benefits of a Ponytail Facelift
The primary benefit is a lifting of the midface, temples, and jowls, notes Chang. "Because the lift concentrates on the midface and doesn't allow for much skin excision, it's best for those with earlier signs of facial aging," she adds. In short, a ponytail lift can make your face, especially the mid-face, look lifted, but it's not going to address things that a traditional facelift can—think loose skin or the neck.
In related news, Guida says he often likes to complement the procedure with a fractional C02 laser in order to address the texture of the skin and further up the youth-boosting ante. "The laser provides a new texture to the skin, and greatly enhances the results of the ponytail facelift," he says.
How to Prepare for a Ponytail Facelift
The standard prep protocol that applies for most plastic surgery also applies here. More specifically, that means no smoking for at least one month prior, being at a healthy weight, having realistic expectations, and not eating anything after midnight the night before the surgery, says Guida. You'll want to stop taking any blood-thinning medications beforehand (though of course discuss this with your doctor). Also important: making sure your facial skin is in good condition, and carving out some time afterward to recover and let yourself heal, advises Chang.
What to Expect During a Ponytail Facelift
Again, because this isn't a textbook medical procedure (have we made that point clear yet?) there will be some variability in how it's performed, notes Chang. But, in general, "small hidden incisions are made in the hairline area and the deeper structures are lifted and suspended into a more favorable position. This may be performed with the assistance of an endoscope and suspension sutures," she explains. And yes, this is a surgery that is performed under general anesthesia.
Ponytail Facelift vs. Traditional Facelift
The main point of differentiation is where the incisions are made. A traditional facelift will have longer scars around the ear and into the scalp, says Chang. (Although Levine is quick to note that the more modern versions of traditional facelifts typically come with very minimal scarring around the ears as it is. "I tell all my patients that they should be able to wear their hair up after surgery," he says.)
Still, the placement of the incisions is what gives doctors the ability to remove loose skin, lift the lower face, and even address the neck during a traditional facelift, whereas that can't be done during a ponytail facelift. On the flip side, because a ponytail facelift is minimally-invasive and the scope of procedure is less than that of a traditional one, the recovery is a bit quicker, says Chang.
Potential Side Effects
"As is the case with any facelift, the most common complication—occurring in about five to seven percent of patients—is a hematoma or a small collection of blood under the skin," says Guida. Other possible side effects include a risk of bleeding, infection, nerve injuries, numbness, unfavorable scarring, and delayed wound healing, adds Chang. It should go without saying, but ensuring that you're working with a licensed, reputable, board-certified plastic surgeon in order to mitigate the likelihood of all of these is paramount.
The price tag can vary greatly, based on everything from where you live to your particular surgeon. For context, Guida says the average cost of a ponytail facelift in Manhattan is $20,000 to $30,000.
"Most people return to work and their social lives after about a week, since you'll experience some bruising and swelling for five to seven days post-surgery," says Guida. (That being said, you'll want to avoid any kind of strenuous activity for a few weeks after.) Also, the surgery itself isn't particularly painful, so minimal pain meds are required, adds Levine.
The Final Takeaway
Just because you've been hearing a lot about ponytail facelifts doesn't necessarily mean this procedure is right for you. "I general, I think it's a bad idea to go into a surgeon's office with a certain procedure in mind," cautions Levine. "The best thing to do is to tell the surgeon what bothers you and work with them to determine what is the best treatment for your issues. Don't be fooled by clever marketing."
Chang agrees, noting that one specific procedure may not provide the optimal result for any given individual. The point being, if a ponytail facelift interests you, by all means, discuss it with your plastic surgeon. But just because it sounds intriguing, doesn't mean it's going to be the right type of facelift—or cosmetic procedure in general—for you.