Vertical Restore Deep-Plane Facelift

Dr. Karam's proprietary Vertical Restore is a deep-plane facelift that repositions the SMAS and underlying facial fat pads using a vertical lifting vector rather than a horizontal pull. It simultaneously addresses sagging cheeks, drooping brows, jowling, neck laxity, and lip elongation in a single operation performed under local anaesthesia with IV sedation. Recovery is approximately two weeks; travelling patients are advised to plan a 10–14 day post-operative stay in San Diego. Results are designed to remain stable for 10–15 years.

The Vertical Restore is the cornerstone procedure at Amir Karam MD's San Diego facial plastic surgery practice in Carmel Valley. Unlike traditional facelift techniques that rely on lateral skin tension and often produce a pulled or windswept appearance over time, Vertical Restore uses deep-plane dissection to release and reposition the anatomical structures — the SMAS layer, malar fat pad, and nasolabial fat compartments — in the direction they descended: vertically. This approach restores the triangular shape of youthful facial volume rather than simply redistributing stretched skin. The procedure treats four distinct zones simultaneously: the outer brow and temple, the midface and cheek, the jawline and jowls, and the neck. Addressing all four areas in a single session avoids the staged approach that often leaves some zones looking younger than others. Anaesthesia is local with IV sedation rather than general anaesthesia, which Dr. Karam cites as safer with a smoother recovery. Dr. Karam has performed over 7,000 facial rejuvenation procedures and holds dual board certification from the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology–Head and Neck Surgery. He trained at UC Irvine and has authored more than 20 peer-reviewed publications and 25 textbook chapters. He has been named Best San Diego Facial Plastic Surgeon by Ranch & Coast every year since 2010 and holds Castle Connolly Top Doctor status since 2008. Patients travelling to San Diego from other US cities or internationally for Vertical Restore are advised to remain in the area for 10–14 days post-operatively for follow-up visits. Pricing starts at $95,000 for women and $120,000 for men, reflecting the complexity of male facial anatomy. A combined package including facial fat transfer and facility fees is available from $142,500 (women) and $167,500 (men).