At FacesFirst in Denver and Lone Tree, we know how delicate facial tissues are, and how important their appearance is to our patients. Your face is the first thing people see. It’s the first impression you make. And it’s what people remember. A facelift procedure is a way to address patients’ concerns about aging.

And it goes beyond appearances. Your face represents you and your personality, and it should exude the same level of self-confidence on the outside that you feel on the inside.

We are experts in creating natural-looking facial beauty and a youthful appearance that allows patients to trust in their treatment and, more importantly, their results. Our experienced board-certified plastic surgeons, Dr. Nicolette Picerno and Dr. Christopher Cote, practice precision care that creates a more radiant version of you.

There are specific facelift techniques available to our facial plastic surgeons and each patient will be suited to a different type depending on the specific issues they wish to address. After a consultation, we will recommend the type of plastic surgery that will best meet your needs. Some facelift surgery options include a mini facelift, lower facelift, neck lift, or mid-face cheek lift. Some Denver facelift patients may also benefit from a combination of these.

*actual patient of FacesFirst Cosmetic Surgery

What Does a Lower Facelift Surgery in Denver, CO Do?

A Denver facelift procedure, or rhytidectomy as it is medically called, treats the neck, cheek, jowl, lateral temporal and/or eyebrow area. It gives the ultimate improvement in facial plastic surgery because it addresses all the areas of concern and will reposition tissues into a more normal, natural position. It helps to turn back the clock against the aging process by approximately 10 years for most people.

As we age, a youthful almond-shaped face sags into more of an oval configuration. As the aging process continues, an oval face becomes more rounded, eventually leading to a square shape. The square-shaped face ages the least gracefully because even minimal lax skin and excess fat is noticed immediately. This is why women appear to age more rapidly than men, who have more square-shaped faces to begin with, and why they seek facelift procedures to get a more youthful appearance.


from our patients

I got a rhinoplasty done by Dr. Cote and I’m so happy with my results! He definitely paid attention to what I wanted and was also so kind throughout the entire process. The whole FacesFirst team was so nice and made it very stress free! I can’t recommend him & his team enough!

-Martha Zellmann

After reading about Dr. Picerno, from a man’s point of view, I can only add my absolute agreement to the multitude of five star reviews she and her staff have received. Professional, competent, friendly and caring only begin to scratch the surface when describing she and her staff. Suffice it to say, the procedure performed produced an amazing result and I couldn’t be more pleased. I would recommend her services to anyone who wishes to have facial surgery of any type. Thank you Dr. P for your caring way.

– Terry Allard

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The Facelift Surgical Procedure

A facelift is primarily focused on correcting the signs of aging in the lower face, including the cheeks and jowls, but it can be customized to also tighten muscles and loose skin around the eyes and forehead that cause deep wrinkles for an overall more youthful appearance.

Facelift incisions are hidden within the skin creases around the ear, going behind the tragus (the small flap of skin immediately in front of the opening to the ear canal). This means there is no incision in front of the ear, which is an unsightly and telltale sign of facial surgery. The incision goes behind the ear and up into the hairline, without hair needing to be shaved. Incisions are closed with dissolvable sutures in multiple layers. Small clips are used to allow facelift patients to shower following surgery.

This facial plastic surgery can take between three and six hours and requires patients to take 10-14 days off work to heal. Any major family event or reunion should be scheduled at least one month after this procedure. Dr. Picerno and Dr. Cote may also recommend laser resurfacing, facial fat transfer, or dermal fillers to further improve your results.

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Mid-Face (Cheek) Lift

As we age, a pad of fibrous and adipose tissue over the cheekbone, called the malar fat pad, can drop to a lower position in the cheek. This results in several side effects, such as a flattened cheek area, excess facial skin along the jawline, and a deepening of the nasolabial fold (the fold that runs from the corner of the nose to the corner of the mouth).

Known as a mid-face lift or cheek lift, this limited-incision facial rejuvenation surgery can be highly effective in restoring the natural curves and fullness to the lower eyelids and cheeks by moving the soft tissues and underlying muscle to a more youthful position. Endoscopes are used to enable smaller incisions to be used for this facelift technique making this a minimally invasive option for facial rejuvenation.

Advantages of a mid-face cheek lift include:

  • Minimal swelling and bruising
  • No need for general anesthesia
  • Surgical time is less than an hour
  • Most patients are able to resume their normal activity within three to seven days

This procedure works best for a patient who has good skin elasticity but is displaying early signs of aging and needs to have tissues repositioned. A patient who has excess skin, as well as sagging of the malar pad, can have the mid-face cheek lift procedure performed in conjunction with a full facelift or a mini facelift to provide maximum aesthetic enhancement.

A cheek lift offers the same natural and long-term results as a facelift does in appropriate patients. The incisions are hidden in the hairline and under the lip, and because the incisions are not visible, this procedure is good for both men and women who have active lifestyles and desire very minimal downtime.



Before and After

Facelift and neck lift surgeries tighten loose skin and eliminate wrinkles for a more youthful appearance. Patients can choose to have a facelift or neck lift, but these procedures are often combined for complete rejuvenation.



The Weekend (Mini) Facelift Surgery

The Weekend Facelift (also called the mini facelift or the S-lift) is designed to have minimal downtime and a lower cost than a traditional facelift. This facial plastic surgery procedure can treat early skin laxity around the corners of the mouth and jowl area that is too advanced to be treated simply by a mid-facelift (cheek lift) procedure alone. It differs from a full facelift in that it does not treat laxity (sagging skin) in the neck or the lateral temporal area.

A mini facelift is performed through small incisions around the ears. Loose and sagging skin through the cheeks and lower face are lifted for a more youthful appearance and reduced wrinkles. Your facelift surgeon may also tighten the facial muscles at the SMAS for a more complete rejuvenation of the lower face.

With a Weekend Facelift Denver, patients are able to resume their normal activity within several days after surgery. Performed under local anesthesia, a mini lift takes only about four days from pre-op to recovery. Plus, we use a tumescent solution that results in less bruising and faster recovery.

For a candidate with early aging changes and an active lifestyle, this procedure can be extremely beneficial. It can also be combined with a mid-facelift or forehead lift for additional benefits, such as reducing forehead lines and wrinkles.

Benefits of the Weekend Facelift include:

  • Minimal discomfort
  • Accelerated recovery time – just four days from pre-op to recovery
  • The ability to maintain your active lifestyle
  • Years of lasting facial improvement
  • Reduced cost

Deep Plane Facelift

The deep plane lift is the most sophisticated facelift technique, used to treat severe signs of aging in the mid-face and lower face.  It is the “gold standard“ lift used to create the most dramatic but natural results. The deep facial tissues, muscles, and fat pads will be resculpted and lifted to improve the look of significant wrinkling, jowling, and sagging skin. Loose or excess skin will be carefully removed to achieve a smooth natural appearance without a “windswept” look. Because the procedure targets the deep layers of facial tissue, patients should expect swelling and recovery of about 7-14 days.

Advantages of the deep plane facelift include:

● the longest-lasting results compared to most other techniques
● Natural-looking rejuvenation
● Improvement of advanced signs of aging

This procedure is best for patients who have moderate to severe signs of aging and skin that has lost some of its elasticity. It’s important to have realistic expectations about the results you can achieve, depending on the severity of wrinkles and sagging skin.

Neck Lift

Sagging jowls, fat under the chin, or visible bands in the neck (sometimes called “turkey neck”) present obvious signs of aging. The neck tends to show signs of aging before the face due to excess sun exposure and lack of protection through SPF or proper skincare over time. Reduce the signs of aging and create a naturally youthful look through a neck lift.

While the neck lift is not a replacement for a facelift, in many cases, 80% of the improvement that a facelift would provide to the lower facial area can be achieved with a neck lift. Plus, a neck lift allows patients to avoid any visible external incisions and has a reduced healing time. This technique is especially beneficial in patients who want to avoid the around-the-ear incision that is necessary in other surgical cosmetic procedures, yet are concerned over laxity of tissue in the neck area.

The neck lift procedure uses an incision under the chin and sometimes in the nape of the neck through which excess skin is removed and the underlying muscle tone is tightened. A neck lift requires twilight or general anesthesia.

Your Facelift Consultation

Denver patients and those in the surrounding area can schedule a facial plastic surgery consultation with board-certified plastic surgeon Dr. Cote to learn more about facial procedures and whether they are a good candidate for this surgery. Dr. Cote will examine the aging signs that most concern you and review all your options for improving your overall facial anatomy and achieving more youthful natural contours. As a board-certified plastic surgeon who specializes in facial cosmetic surgery, Dr. Cote utilizes the latest techniques in facelift surgery to offer the best possible results.

We understand that choosing to have a facelift is a deeply personal and important decision, which is why we are available to answer any questions and guide you toward the treatment that makes the most sense for your circumstances. Schedule an initial consultation to discuss how our facelift cosmetic procedures can smooth wrinkles, reduce excess or sagging skin, and dramatically enhance your appearance.

To schedule your consultation with Dr. Picerno and Dr. Cote in Denver or Lone Tree, Colorado, call FacesFirst at (720) 414-3332 or request your appointment through our online form.

Frequently Asked Questions

Does a facelift make you look younger?

A facelift in Denver can certainly make you look younger. This procedure will lift loose or saggy tissue that has fallen do to the effects of gravity. What is important is it careful analysis by and experienced surgeon and a well executed face lift that may also include other complementary procedures. Facelift can certainly make you look younger. This procedure will lift loose or saggy tissue that has fallen do to the effects of gravity. What is important is it careful analysis by and experienced surgeon and a well executed facelift that may also include other complementary procedures

How can I tighten loose skin on my face?

The tightening of loose skin on your face may be done by use of many treatment modalities. Well a facelift may lift droopy skin and other tissues, tightening lines and wrinkles can also further be improved with laser, radio frequency treatments, sub dermal plasma. It's best for an experienced surgeon to assess this and give you information on the most effective treatments. Our board certified surgeons at Faces First are qualified to best address this.

How do I get rid of my double chins?

A double chin usually refers to excessive tissue in the upper neck underneath the jaw. This can be due to excessive fat, loose skin or muscular tissues, or the anatomical shape of your jaw line and neck structures. A procedure that addresses the individual issues you have in your neck will give you the best improvement in a double chin. Board-certified plastic surgeons such as Dr. Cote may recommend plastic surgery such as a Denver facelift or neck lift to reduce sagging and excess tissue in your face and neck.

How do I reduce swelling in my face?

After face lift surgery many people have swelling. There are a number of routine techniques that are used to reduce swelling. First, keeping your head in an upright position during the day and during sleeping may improve swelling due to the gravitational flow of your lymphatic tissues. Second, cooling the neck and face after surgery as a positive impact on reducing the swelling as well. There are a number of different techniques to do this from basic ice packs to more complex cooling systems that are very convenient. Third, easy movement and activity within the guidelines of your surgeon might help reduce swelling and improve healing as well. Later on in the healing process people have found that warm compresses and lymphatic massage are helpful to reduce swelling as well. Ask your surgeon specific details on what might help you.

How do I tighten my jawline?

Jawline tightening treatments might depend on what is causing the jaw to be poorly defined. Treatments might include chin or jaw implants, a lifting treatment such as a facelift or seamless plasma lift, liposuction, Kybella, or fillers to camouflage the contours or define certain areas along the jawline. When it comes to deciding the best treatment it is important to have a consultation with an experienced provider who can offer all of these options and help choose what is best for you and your time in budget. At FacesFirst we can offer all of these options.

How do you reduce swelling after a facelift?

After face lift surgery many people have swelling. There are a number of routine techniques that are used to reduce swelling. First, keeping your head in an upright position during the day and while sleeping may improve swelling due to the gravitational flow of your lymphatic tissues. Second, cooling the neck and face after surgery has a positive impact on reducing the swelling as well. There are a number of different techniques to do this from basic ice packs to more complex cooling systems that are very convenient. Third, easy movement and activity within the guidelines of your plastic surgeon might help reduce swelling and improve healing as well. Later on in the healing process, people have found that warm compresses and lymphatic massage are helpful to reduce swelling as well. Ask your plastic surgeon for specific details on what might help you.

How long does facelift last?

I get asked this question a lot and the answer is really, forever. You will never regain the skin excess that was removed in this first procedure. You will look 10-15 years younger after this surgery and at every age down the road, you will still look 10-15 years younger even when you are 80.

How long does it take for bruising on the face to go away?

Bruising after a facelift can last one to six weeks depending on the type of procedure that is performed and your inherent risk for bruising such as age.

How long is recovery from a facelift?

This depends upon the type of facelift chosen and ranges from 1-2 weeks. The non-surgical facelifts may take only 1-3 days to recover.

Is a facelift permanent?

There are many different techniques in which a facelift may be performed and there are some techniques that are considered having longer lasting results than others. At FacesFirst, A deep plain surgical lift is the gold standard that creates the most natural and long lasting results. Any procedure will have long lasting results but the effects of the ongoing aging process will continue and you may see some of the saggy tissues to return in appearance in a period of time from months to years after surgery.

What is a facelift called?

The technical term for a face lift is rhytidectomy. When translated this essentially means wrinkle removal. When it comes to this plastic surgery procedure, the upper, middle, or lower third of a patients face can be treated in numerous ways. A board-certified plastic surgeon at Faces First can give you the best options for a lift during your consultation in our Denver plastic surgery office.

What is a mid face lift?

A mid face lift is a term for a procedure that improves the appearance of saggy tissues in the middle part of the face that typically includes the lower eyelid and cheekbone area. Many different procedures have been developed to address the concerns in this area. So there is no single recognized procedure that is considered the best. Examples of procedures may include endoscopic lifts, deep plane lifts, and volume eyes Asian procedures such as lower blepharoplasty and fat grafting. They careful examination of what's causing the unsatisfactory appearance in this area is a good way to determine what works best for you.

What is a neck lift called?

Rhytidectomy is the medical term for necklift or lower facelift. Some surgeons brand their necklift with a number of different terms to give it a unique name, but they all have a goal of a natural, rejuvenated look.

What is a non surgical facelift?

Non-surgical facelift is a very general term that generally means a procedure that is done to tighten or lift the face without lengthy scars or open surgery. When it comes to lifting the face, the gold standard still is a well-executed deep plane facelift. However, some patients are not ready for that yet or may not even need a procedure that is this extensive and may benefit from a complement of minimally invasive or non-surgical facelift options. The best treatment when going minimally invasive is likely a combination therapy treatment that can be identified with a consultation from a board-certified plastic surgeon at FacesFirst. At FacesFirst, we have many therapies that can be non-surgical that fit your time and budget.

What is a thread lift?

A thread lift is a procedure that uses disposable threads to lift the tissues in the face. They usually produce very subtle results, far less than surgery and so you need to adjust your expectations on wht they can do.

What is the difference between a deep plane and SMAS facelift?

The SMAS is the short term for what is called the sub-muscular aponeurotic system. It's the tissues that are deep underneath the skin that need to be lifted for an effective facelift. There are many ways a facelift can be described but in general, a SMAS facelift lifts the tissue layer in a more superficial fashion whereas a deep plane lift goes underneath this SMAS and releases the deep ligaments and allows the most complete and natural lift. This should be done by an experienced surgeon. At Faces First in Denver and Lone Tree, we have surgeons who have done these types of facelifts for many years, and after examining, you can explain what will work best for your goals and objectives.

What is a facelift?

The term facelift means different things to different people. In general, the term facelift means some type of surgical procedure that elevates the jowls and the lower neck and reduces signs of aging in the lower face.

How much does a facelift cost?

The cost of a facelift in Denver varies upon which type for which you are a candidate. A mini facelift in the office can cost as little as $4800 ranging up to a lower facelift and neck lift at $9600-$12000.

How is a facelift done?

No two Denver facelifts are exactly the same, but the basic techniques are similar. The variations occur in how much skin and muscle are elevated, whether the forehead is also corrected and whether there is a lot of excess skin in the neck. In general, an incision is made around the ear and the skin is elevated. The muscle underneath is separated from the underlying tissues and elevated superiorly (not posteriorly) The skin is then gently draped over the newly positioned muscle and then the excess is trimmed. The closure and placement of the incisions are as important and take just as long as the actual lifting of the tissues.

What is a mini facelift?

In my hands a mini facelift is a smaller procedure with less skin and muscle elevation and can be done in the office. I feel the recovery is less at 5-7 days vs 10-14 days with a lower facelift and neck lift. The incision is in front of the ear only and this procedure is primarily for the jowl area and not the submental or neck area. The primary age range for this procedure in the early 40's-55 and will take about five years off of your appearance.

What is a lower facelift?

A lower facelift includes the jowls and neck and provides complete rejuvenation of the lower face and neck. The incision usually runs from the temporal region, in front of the ear, and then behind the ear to a varying extent. There is usually a submental incision as well that corrects those bands in the neck that cause the excess skin to “hang”. The primary age range for this surgery is the late 40's and over. The lower facelift usually takes at least 10 years off your appearance.

How long will a mini facelift last?

The mini facelift procedure has less longevity due to the fact that the neck is not treated with this procedure. Therefore, the aging changes will develop in the neck and require another procedure at some point in the future.

What is a “liquid” facelift?

A liquid facelift is a full facial rejuvenation with a variety of injectable fillers or fat injections to achieve a more youthful appearance. This usually requires anywhere from 4-8 syringes and lasts two years or more.

Can you combine a facelift with a neck lift?

Yes of course, and the most natural results are obtained when these are done together. Rarely, a neck lift is done alone, mostly in men who want to rid themselves of the turkey gobbler neck appearance but also do not want the incision in front of the ear. A “facelift” alone is usually termed a mini facelift.

What skincare products can I put on my face after a facelift?

After a facelift we recommend cleansing with gentle facial cleansers and moisturizing with hypoallergenic moisturizers. There are many skin care products out there so it's best to discuss what you otherwise use daily with your doctor and they can give you guidance on what you can or cannot use during recovery.

How long until I can wash my face?

The day after your facelift surgery when your dressings are removed is the first time we want to clean your wounds and you can begin daily washing of your face.

When can I take a shower after a facelift?

Showers can be taken approximately 48 hours after your facelift surgery. However, you must be especially careful with the wounds that are close to your hair and avoid any aggressive hair combing during the first week so as to not aggravate or even open the wound.

How often do I wear the jaw bra?

The jaw bra, The removable Velcro dressing after your facelift, should be worn 24 hours a day for the first week after surgery except for when you are cleansing or showering. After the one week appointment you likely will only use this for half the day in the second week and not like we needed much beyond that.

How often should I be using the cooling system?

Cooling your face after a facelift surgery can be helpful for reducing swelling and discomfort for the first 3 to 5 days. We do provide our patients the option of a convenient cool water circulating system they can wear in their dressings that makes it easy to keep things cool and reduce swelling.


Mayo Clinic –
WebMD –


Nicolette Picerno, M.D.

Dr. Nicolette Picerno is a double-board-certified facial cosmetic surgeon certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. She received her medical degree from Hahnemann University, School of Medicine in Philadelphia, and completed her fellowship for the American Academy of Facial Plastic and Reconstructive Surgery at the Beeson Aesthetic Surgery Institute in Carmel, IN. She also completed the Cenegenics Physician Training and Certification in Age Management Medicine program in 2012 and became a certified BioTE provider in 2014. When not in the office, Dr. Picerno enjoys spending time with her family, hiking, skiing, playing tennis, and running her doggie daycare with her husband.

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