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The Daily Dish The Real Housewives of Orange County

Thinking of Getting a Lower Facelift Like Tamra Judge? Here's What You Need to Consider...

Tamra's plastic surgeon, Dr. Milind Ambe, gave us all the details on the Real Housewife-loved procedure. 

By Marni Eth
What Did Tamra Judge Have Done to Her Face?

It’s no secret that Tamra Judge takes very good care of herself, but even with keeping a healthy diet and exercising regularly, she also had some plastic surgery to turn back the natural process of aging. The Real Housewives of Orange County mom has always been an open book about her cosmetic procedures, and shared intimate details of her lower facelift recovery after she first went under the knife two years ago and debuted her post-surgery face on Watch What Happens Live with Andy Cohen

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When considering plastic surgery, finding the right doctor is key. Tamra chose Dr. Milind Ambe, Board Certified Plastic Surgeon in Newport Beach, California. Dr. Ambe had performed Tamra's mother’s facelift, neck lift, and eye lift eleven years ago, and the Real Housewife was so impressed with the results that she knew she could trust him with her own face. Most recently, he tightened up Vicki Gunvalson's face too. chatted with Dr. Ambe, who has been in practice in Newport Beach for over 20 years, to learn more about the procedure. Read on to learn everything you need to know before considering a lower facelift.

What is a lower face facelift and how is it different from a regular facelift?

Dr Milind Ambe: A lower facelift technically is a facelift that addresses the middle portion of the face, the jawline and jowls, the area around the mouth, and the neck. All of these areas of the face are tightened in a lower facelift, without necessarily addressing the forehead, brows or upper and lower eyelids.

A lower facelift is essentially tightening/removing of excess skin of the face and neck/jawline and jowls, in addition to tightening the underlying muscles (SMAS) in order to [obtain] a longer lasting result. It is not just a skin tightening procedure, as muscles are tightened, as well. In terms of it being different than a “regular facelift,” it is more semantics than anything else, but most patients think of a regular facelift as including surgery of the eyelids at the same time. 

How much does it cost? 

Costs for a lower face and neck lift can vary significantly based on the skill level and reputation of the plastic surgeon performing the surgery. Plastic Surgeons with top reputations in the country charge anywhere between $20,000 and $35,000 (or more) for a lower face and neck lift (without eyes).

What are the risks involved?

The risks are minimal in the hands of a Board Certified Plastic Surgeon who specializes in facelifts. Infection and nerve damage are extremely rare in the hands of a capable surgeon. The key for any patient is to find a surgeon in the country who can consistently (without any compromise) get them a natural and balanced result each and every time.

How long is the recovery time after this type of surgery? 

In my hands, and with my level of experience, patients that I perform a lower facelift and neck lift on (without the eyes) will typically be socially presentable by 7-10 days. If I am performing eyelids (upper and lower), in addition to a lower facelift and neck lift, then one can expect to look very normal within 10 days to 2 weeks. This is readily seen in reviewing the video clip of Tamra Judge’s 15 day post op result (watch the video above) when she is being interviewed live by Andy Cohen on his show WWHL. One can see that she looks extremely natural and normal 2 weeks after having her lower facelift and neck lift, as well as having her upper and lower eyelids addressed at the same time.

Who is a good candidate for this type of surgery?

The best candidates for this surgery are those where I, myself, in an examine room, can easily assess (via tensioning the face in various directions) that the patient has moderate to significant laxity (looseness of skin) of the lower and face and neck, that can be readily addressed surgically. 

What age are the patients who see the best results?

This question is somewhat difficult to answer, as I see in my own practice, very effective and dramatic results in all age groups. What makes a patient a good candidate for a lower facelift and neck lift is more related to aging changes (how advanced they are in their aging spectrum) and not so much, on the actual age of the patient.  In my practice, the most common age range for first time lower facelift patients is somewhere around 52-55.

If a patient gets this procedure when they are on the younger side, will they have to get it done again as they age or is it a permanent solution?

Patients who get a lower facelift and neck lift (and possibly upper and lower eyelids) when they are relatively young certainly can have the procedure repeated more than once in their lives. The objective of these procedures are to “turn the clock back," but they are not expected to stop the clock. In my practice, I see patients returning for secondary facelift and neck lift procedures somewhere between 10-15 years after having their first procedure performed.

Tamra mentioned she also got an eye tuck with it. Is it common to pair those two surgeries together?

Yes, it is true that I performed upper and lower eyelid procedures (referred to as an upper and lower eyelid blepharoplasty) on Tamra at the same time that I performed her lower facelift and neck lift. In my patient demographic, the most common operation I perform 3 days a week is a combined lower facelift and neck lift with the upper and lower eyelids. This enables me to get the most balanced result that I am able to achieve aesthetically all at one time. 

Anything to add on the subject?

The best advice that I can offer to patients who are interested in this procedure (lower facelift and neck lift with or without eyelids performed at the same time) is to not make any compromises or restrictions in their selection of a surgeon. Patients should be very analytical in their approach, as it is their face that is being addressed surgically, and it cannot be covered up — they only have one chance. Additionally, they should absolutely be able to examine and assess numerous before and after facelift and eyelid results of surgeons they visit and analyze these photos very critically. There should never be any change in shape of the eyes of the patient or never any changes in shape of the mouth. If a plastic surgeon is not willing to show a prospective patient numerous (more than 50 results) before and after facelift results, and they say that “their patients are too private,” that means the surgeon does not perform enough facelift surgical procedures, or they do not have enough great, natural results to show patients.

Finally, I have patients that come to see me from all over the country and various parts of the world for this procedure and it is for a very good reason: it is their face. There should never be any geographical restrictions that a patient should place on themselves that wants a facelift/neck lift and or eyelid procedure performed in exactly the right way.  A 10-day visit out of one’s own state is well worth it to insure that they obtain a natural facelift result that is without compromise. That is the single best advice I could give any patient thinking about this procedure. It is the absolute best plastic surgery procedure on the planet — but only if performed in exactly the right tension-balanced manner.

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