Biltmore Lift

Biltmore Lift Facelift

"He did everything that he told me he would do and the results were exceptional!!! I was well pleased."

"A huge thank you for fixing my face, especially my eyes... It was so wonderfully subtle"

"Dr. Harley is the most caring and compassionate doctor I've encountered."

"From every standpoint I would highly recommend Dr. David Harley."

"Dr. Harley’s one-on-one, hands on approach, and willingness to spend extended time, made me feel that we were really working together."

"If I were to have further cosmetic procedures, another surgeon would not even be a consideration."

"Dr. Harley is exactly the kind of physician everyone wants."

"(Dr. Harley) made me feel comfortable and excited about the procedure. I think I slept through most of it."

"Dr. Harley was highly recommended to me as being one of the most qualified surgeons who could perform a Mini-Lift."

"I felt like Dr. Harley was more of a friend to me than a doctor. He is so friendly, caring, and ‘down-to-earth.’ I felt completely comfortable with him."

"(Dr. Harley and his staff) will always have a special place in my heart!"

"Dr. Harley was very professional and has an enjoying and reassuring manner that puts one at ease. He made the experience positive and really takes the apprehension out."

"Besides being an excellent surgeon, he is a wonderful human being."

"Friendly and interested in his patients. He is not only my doctor, he is now my friend."

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Mary’s Story, Part One


Part One of a three part story about Biltmore Beacon Correspondent, Mary Koppenheffer’s, experience planning for, having, and healing from a face lift. Part one covers the preparation, part two the procedure and first week post-op; and part three is the healing process and the results at six weeks after the surgery.


Click Here to see a Scanned PDF File of the Actual Story



Preparing for ‘The Biltmore Lift’ took Research, Time.


It’s Sunday night. I’m staring into the mirror and pushing up the sagging areas of my face to recall how I used to look before gravity took its toll.  Am I really going to have a face lift tomorrow morning? I am. A “Biltmore Lift” by Dr. David Harley, to be exact.


When women “of a certain age” get together, the topic of plastic surgery comes up from time to time. What are the possibilities? What are the risks? Can we turn back the clock, or are we just being vain?  I admit to being intrigued by extreme makeover shows.


Over the past couple of years, I’ve occasionally caught a glimpse of myself and thought that I just didn’t look as good as I felt, or as good as I’d like. It’s not that I think I look awful. I don’t. It’s just that the skin on the sides of my face has started to sag, causing my mouth to form a perpetual frown, and it bothers me.


I take care of myself — eat well, run, strength train and do yoga. I try to stay on top of fashion trends (within reason).  But the face. There simply is a limit to what one can do with makeup, or with creams or lotions or masks promising to firm up the skin. From my research, surgery was the only way to really get the change I was looking for.


Before consulting with Dr. Harley, I had to overcome my “face lift” phobia. I remember 1978 when Betty Ford spent five days in the hospital following her surgery, and came out looking like somebody shrunk her face. And, back then, it was a big reveal when she actually admitted to having the work done. Like maybe we wouldn’t notice she looked entirely different. 


And who hasn’t caught a glimpse of a “face lifts gone bad” tabloid story while waiting in line at the grocery store?


But frankly, I might not have considered actually having a face lift had my sister not had one in the fall. The exact same procedure with Dr. Harley. I didn’t know she had even planned it. But, when I saw her a few weeks after the surgery, I couldn’t believe my eyes.


She looked great. Sagging skin was lifted, and her jaw line was contoured beautifully. 

It was still her...she didn’t look “different.” She looked rested, relaxed and younger. 


A month before “the lift,” I decided to tell some friends what I had planned. Maybe I was looking for confirmation that this was a good idea. Of course, there was the obligatory, “you don’t need that!” followed by, “I’d love to have that done.” Or, they launched into various other nips and tucks they have thought about. “I’d love to get my eyes done,” or “my nose has always bothered me.” Immediately hands went to faces, as each pointed out the areas they were less than thrilled with.


The response surprised me — I was expecting more of  “I’d never do that,” or “I’m proud of my wrinkles.” Not so much among my friends and colleagues, apparently, and they are pretty much regular working gals. 


What has kept them from moving forward was generally a lack of first-hand knowledge of what would happen.


I don’t take any surgical procedure lightly, and this is no exception.  I researched Dr. Harley, read up on the procedure, and weighed the risks vs. rewards. 


I asked Dr. Harley who was a good candidate for the Biltmore Lift. 

“Most of my patients range in age from 55 to 70 years old, but I have performed the Biltmore Lift on patients in their 30s all the way up to their 80s. I emphasize to every patient that safety is of utmost importance to me, so each patient is carefully evaluated from a medical standpoint to determine if he or she is a candidate. Those patients who benefit the most are those with obvious signs of aging such as saggy ‘bulldog’ jowls or a ‘turkey gobbler’ neck.” 


Bulldog jowls? Turkey gobbler neck? Ouch. 


Dr. Harley called the procedure minimally invasive and different from traditional face lifts in that the scarring, the downtime, the risk of a windblown appearance and the cost are all on a much smaller scale. I was happy to hear that.


He said he would use local anesthesia rather than general anesthesia, which makes the procedure easier to tolerate than most dental work. 


I am hoping that Dr. Harley can contour my jawline to give it a more youthful appearance, and it sounds like he can. 


“The procedure takes dead aim at improving the lower part of the face, the jawline and the upper neck. Usually 1 to 2 inches of saggy skin is lifted and removed from each side, and through tightening a layer of deep fibrous, muscular tissue called the SMAS, not only can the jawline be contoured, but the jowls can be lifted and the skin and fat of the neck removed.” 


Bring up the sagging jowls and tighten up the neck. Perfect.


I asked Dr. Harley where incisions would be made and whether my hairline would  change. He said in a short scar face lift, the incisions are hidden under the sideburns and in the curves and shadows of the ear, which is why a mature scar can be extremely difficult to detect. Neither the position of the hairline nor sideburns is altered. So, that handles worries about scarring.


The main risks of any surgical procedure include bleeding, infection, wound healing problems and the need for additional procedures, Dr. Harley said. In this case, the bleeding risk is between 1 and 5 percent, while the risk of infection after facial surgery is exceedingly low.  He said in short scar procedures, wound healing problems are nearly nonexistent. I’m comfortable with that.


I wanted to make sure the surgeon performing the surgery had a lot of experience. 

I found Dr. Harley had performed face and neck lift surgery on more 400 patients and more than 1,000 procedures when upper and lower eyelid and brow lift surgery is added in. A++ on experience.


I felt comfortable with Dr. Harley from the start. His Hendersonville Road office is a converted 1950s bungalow, and it doesn’t feel clinical at all. Educated at Dartmouth and Vanderbilt, he completed two residencies. 


A friend asked me how long the results would last.  I hadn’t thought to ask about that. 

“I am removing redundant skin and fat that will not return,” he said. “I am tightening muscles and other tissues that will take time and gravity to once again loosen. Therefore the changes I am making will be permanent.  Now obviously I cannot stop the clock and I cannot overcome the forces of gravity and time.  But what I can do is reposition tissue to a more youthful position so that the 65 year old who had the procedure at 55 will appear younger after 10 years than she would had she never had the procedure.” 


Naturally I wanted to know how long it would take and how much, if any, pain I would feel. 


“The procedure takes approximately two hours from start to finish.  I will administer by mouth a relaxing medication, something to settle the stomach and an antibiotic, followed by a very slow numbing process that allows me to get the patient completely numb, while still being awake. Therefore the patient does not feel any pain with the procedure itself, and most people dose off to a peaceful sleep until the procedure is over and it's time to go.” 


It was great to get confirmation from my sister that this really was the case, as I’m no hero when it comes to pain. Since I work full time, and I’m currently training for the San Francisco half marathon which is two months after the procedure, I really wanted to know how long will it take to heal. And, I admit to a nightmare about finishing the half marathon and then having my face fall back down. 


“I have had patients return to their social life and work just three days after surgery, and I have had those who take two weeks off from work.  Typically I recommend that someone who works Monday through Friday have the procedure done on a Thursday or Friday and then take the following week off, which essentially gives you 10 to 11 days until returning to work.  You will follow up with me one week after surgery for suture removal and a check up to make sure your healing is progressing normally. If you need to see me sooner, or if you have a question or problem, every patient gets my personal cell phone number so I can easily be contacted.”


Regarding running and working out, Dr. Harley told me “Patients may return to physical activity such as jogging and light weight training as early as two weeks after the procedure, but I would recommend listening to your body and not pursuing anything very strenuous for four weeks.”


All of my questions have been answered, and now I’m ready for the big day. 


Click Here to read Part 2 of Mary’s Story