What is a Vertical Restore®?

When facial aging begins to make its presence known, we no longer look as young as we feel, losing that youthful glow in the process. This can make us self-aware when it comes to photos or even close interpersonal or professional situations, robbing us not just of our youth and beauty, but even more troubling, our identities. Over the years, Dr. Karam has worked to develop the highly customizable and proprietary Vertical Restore procedure. Designed to address the specific issues that are impacting your youthful appearance, this treatment is custom-tailored to your specific needs. 

If you are looking for facial rejuvenation beyond a traditional facelift, Dr. Karam’s Vertical Restore procedure offers a groundbreaking solution.

Unlike conventional facelifts that primarily address surface-level sagging by pulling the skin horizontally, Vertical Restore focuses on a deeper, more natural restoration of the underlying facial structures. By lifting the face vertically—where aging actually occurs—this advanced approach rejuvenates not only the jawline and neck but also the midface, temples, and lateral brow in a single, comprehensive treatment.

Dr. Karam and the Vertical Restore based in San Diego can help you enjoy life-changing facial rejuvenation, simply reach out and set up your consultation with a member of our team today.

How the Vertical Restore Creates Its Results

The Vertical Restore procedure based in San Diego serves as the foundation for a highly tailored facial rejuvenation experience, capitalizing on Dr. Karam's extensive worldwide expertise to address your unique concerns.

In addition to the core procedure of Vertical Restore, during your consultation, Dr. Karam will understand your aesthetic goals and craft a comprehensive treatment plan for your facial rejuvenation that may require treatments performed in addition to Vertical Restore to achieve your desired goals.

  • Volume Loss Correction with Fat Transfer: This adjunctive technique complements the Vertical Restore by correcting sagging, hollows, fine lines, and wrinkles in a safe and natural manner.
  • Eye Treatments: To enhance the results of the Vertical Restore, these treatments focus on keeping your eyes looking bright, open, and inviting.
  • Lip Lift: As an additional procedure, the Lip Lift is performed to achieve a perfectly youthful pout, supplementing the overall rejuvenation effect.
  • Skin Resurfacing: This is the final step that works in synergy with the Vertical Restore. It ensures that your skin appears as youthful and refreshed as possible, providing the finishing touch to your transformation.

Vertical Restore and Fat Transfer

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More About the Vertical Restore Procedure

This discordance between the way you look (older) and the way you feel (younger) is the main reason people come to see double board-certified plastic surgeon Dr. Amir Karam for help. What everyone wants is to simply look as young as they feel. This requires that Dr. Karam erases the recent changes affecting your face, restoring its appearance and bringing you back to a period before aging started to make you look different. This usually relates to patients in their early 40s and mid-30s. Dr. Karam’s primary inspiration for developing this approach to facial aging is the significant emotional impact the outcomes can have on his patients. Feeling comfortable in your own skin is essential for overall happiness, and is what gives Dr. Karam’s work so much meaning.

Incredible Vertical Restore Results

This patient underwent our Vertical Retore procedure and enjoyed full facial rejuvenation, including Total Eye Rejuvenation, Upper and Lower Blepharoplasty, and Fat Transfer.

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The Facial Aging Challenge

As you age, your face slowly transforms from the rough shape of an upside-down triangle to that of a rectangle. This change occurs as the fascia in the face (also known as the “SMAS”) starts to elongate, or droop and descend. This leaves the face looking different than it did during youth, and is responsible for that visible change in the aging face.

This shift in shape is the core problem with facial aging, and addressing it is the most important and impactful way to create satisfying results. A key component in creating an ideal solution involves a keen understanding of the problem. Think of the facial fascia as cooking dough: If you hold up the dough and let it hang, it will elongate with the help of gravity.

The same thing happens to the face, over time. The fascia (or the dough, in this metaphor) is getting longer. This change occurs from the top down, and eventually impacts the entire face.

By addressing the entire face at the same time, Dr. Karam is able to create results that appear naturalistically restored.

  • The upper face starts to sag around the outer eyes, leaving them looking heavy and crowded in the corners.
  • The midface starts to descend toward the nose, leaving the cheeks looking deflated and making the nasolabial fold heavier.
  • As the cheeks sag, jowls are formed. This is often the most notable change, leaving the jawline looking square and heavy instead of oval and lean. This results from the cheeks falling and hanging over the jawline.
  • Sagging and heaviness in the neck often follow facial sagging. Your cheeks work to actively support your neck, so they tend to change in tandem. Fat also tends to accumulate under the chin, giving the neck a heavy appearance.
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A Message from Dr. Amir Karam

"Vertical Restore is a lot more than a catchy name. This is a procedure that I carefully created, perfected, and trademarked as a highly unique surgical procedure, thanks to its ability to address the entire face, and not just a portion of it.

Compared with a traditional or deep plane facelift, the Vertical Restore offers far more differences than it does similarities. The most basic points of contrast are that the lift is vertically oriented, not horizontally, which is a major reason for the natural look. Additionally, the Vertical Restore addresses your entire face and not just a portion of it, simultaneously rejuvenating the outer brow, midface, jawline, and neck. A traditional facelift only addresses the jawline by pulling it toward the ears.

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Vertical Restore releases all of the ligaments in the face and neck, thus allowing the tissue to be elevated and repositioned without pulling against those ligaments. This is the reason the effect of Vertical Restore is so massive and is also why, despite the significant changes, the results look neither tense nor "pulled back."

This is also why Vertical Restore creates results that last 10 to 15 years, which is effectively three times longer than what one might enjoy after a traditional facelift.

Vertical Restore incorporates a deep-plane approach, offering the most advanced yet reliable method for lifting the face and neck, by extending far beyond traditional deep plane lifts while also focusing on full correction of the neck.

Finally, Vertical Restore is performed under local anesthesia with IV sedation, which is much safer and has a significantly shorter postoperative recovery time. I hope you will also find that, above all, the results speak for themselves."

Vertical Restore Recovery Time

This has been a 10-year journey that has led to the culmination of techniques we now call the Vertical Restore.

Dr. Amir M. Karam

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Dr. Karam’s Commitment to Excellence

I decided very early in my medical education that I wanted to pursue Facial Plastic Surgery as my specialty. This field offers an opportunity to truly touch lives and make a difference while requiring the highest level of surgical execution and techniques.

I also love how creative it is and how it allows innovation to improve outcomes. These are all the reasons I love what I do and why I chose to become a Board Certified Facial Plastic and Reconstructive Surgeon in the first place.

It didn’t take long for me to realize that the subspecialty of Facial Rejuvenation was far from optimized when I began my training 15 years ago. People who were noticing facial aging would get a facelift, neck lift, and brow lift and wind up looking strange, different, and unnatural. Patients would lose their identities and the essence of their natural spirit. You could tell these people from across a room in a matter of seconds. This was what it meant to get a facelift. To me this was unacceptable. I made it my mission to learn and develop new ways of doing things that resulted in a more natural look and a truly restored appearance.

Comparing the Vertical Restore with a Traditional Facelift

Explore the section below to learn more about how the Vertical Restore has improved upon the traditional facelift technique. If you’re searching for a facelift or facelift surgeon and want to know how Vertical Restore compares, reach out to Dr. Karam in San Diego to schedule a consultation.

Vertical Restore vs. Facelift

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Comprehensive Balance

A big difference between Vertical Restore and a traditional facelift is how balanced and comprehensive Vertical Restore is. It addresses everything from the top of the temple down to the neck and includes the outer eyebrows, the midface, the jawline, and the neck. A facelift, on the other hand, only addresses the jawline. When the jawline is addressed on its own, the face is left looking only partially treated. The comprehensive nature of Vertical Restore is one of the keys to its high rates of worldwide patient satisfaction


No Pulling or Stretching

Traditional facelifts have a tendency to “pull” the face sideways or towards the ear, flattening the face and making it look tight and stretched. This tell-tale indication that someone has had a facelift is never ideal and points towards a facelift whose results are sub-par. The Vertical Restore avoids this issue by lifting the soft tissues of the face back to their original positions, for results that are not only more powerful and lasting but that also leave you looking more restored and youthful.

You'll look rejuvenated without giving away that you've had work done. This is something you can see for yourself if you haven’t already (my guess is that you have if you are reading this). Take your fingers and lift your cheeks toward the top of your ears. Watch your neck, jawline, and neck improve. When you do this, you’ll notice that the skin around your temple bunches up, which is how Vertical Restore goes a step beyond the traditional facelift.

With vertical lifts, the temple would form a roadblock that needs to be included in order to smooth things out and ultimately look refreshed. Next, lift your outer brow and temple straight up by placing your fingers along your temple hairline. Observe how lifting your outer brows opens the hooding around your eyes. When combined this effectively gets rid of that bunching for a smoother look.

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Addressing the Neck

The neck should always be included in these anti-aging procedures. A typical horizontal lift won’t address the neck because it pulls the face sideways. The neck’s muscle is attached to the cheeks, causing the neck to descend along with the cheeks when they begin to sag. Vertical Restore addresses this issue by vertically repositioning and anchoring the neck back up. Another key component addresses the deep fat pads under the muscles of our neck, which begin to grow with age (a process known as submental fat hypertrophy). When this occurs we lose that smooth shelf under our chins and instead develop bulges or heaviness. This looks like a double chin or in more advanced cases like a turkey waddle. Necks come in all shapes and sizes but they all have some of these above changes occurring.

Vertical Restore doesn’t just remove some fat under the skin and tighten the neck muscle (platysma). It goes under the muscle where that stubborn and ever-expanding fat pad lives and removes that, along with any other bulky structures that could make the neck look heavy and full. Going into this space is an advanced approach and to do it well and safely is even more uncommon. However, it is essential for a beautiful and youthful neck.

Once the tissue under the muscle has been addressed, the platysma muscle is addressed. Any excess that has gotten longer with age will be reduced by trimming and then suturing/folding, which creates a durable and stable neck. This will be further improved by the vertical lifting from above. Loose, excess skin will be removed both behind the ear and from above, leaving the neck significantly smoother and more youthful.

Outer Brow Rejuvenation

The outer brow is addressed simultaneously as discussed above. The approach that I have been using is not a brow lift. I don’t believe people need brow lifts because, with the exception of the other one-third of the brow, the rest of the brow doesn’t sag. So, knowing this is the case, why lift the entire brow? The answer, quite simply, is that you shouldn’t: The results can cause the patient to look surprised or entirely different, which is never the goal. 

In order to create results that see you looking restored and refreshed, Dr. Karam employs a very minimally invasive approach, repositioning the tail of the brow back to its original spot. In women, this is just above the orbital rim and in men, it is at the orbital rim. This procedure never looks extreme and always looks natural. When you’re ready to learn more about what Vertical Restore can do for you, simply reach out and set up your consultation with a member of our team.

Vertical Restore FAQ's

What is the difference between deep plane and vertical restore?

What is the average cost of a vertical restore?

What is a mini vertical facelift?

What is a vertical facelift vs traditional facelift?

How long does a vertical restore facelift last?

Where are the scars on a vertical facelift?

What is the difference between deep plane and vertical restore?

Vertical Restore, a trade marked facelift technique developed by Dr. Amir Karam in San Diego, significantly differs from traditional or deep plane facelifts. Its unique approach employs a vertical lift, rather than a horizontal pull, promoting a more natural look. Unlike a traditional facelift, which typically targets the jawline, Vertical Restore rejuvenates the entire face, addressing the outer brow, midface, jawline, and neck, providing comprehensive facial revitalization.

What is the average cost of a vertical restore?

Each Vertical Restore procedure is uniquely customized to the individual patient, considering their specific needs and aesthetic goals. As a result, the cost can vary greatly from patient to patient. For more specific pricing information or to begin your journey with Vertical Restore, please visit our Getting Started page.

What is a mini vertical facelift?

Vertical Restore is a comprehensive facelift procedure developed by Dr. Amir Karam, designed to rejuvenate the entire face, including the outer brow, midface, jawline, and neck. Due to its all-inclusive nature, there isn't a "mini" version of Vertical Restore.

However, an alternative procedure called Vertical Prevent is available. Vertical Prevent is designed to address and restore the underlying facial structure to its original, youthful position, effectively preserving the facial structure one had before the effects of aging. This can be an excellent choice for individuals looking for preventative measures against the signs of aging.

What is a vertical facelift vs traditional facelift?

A traditional facelift primarily targets signs of aging in the lower two-thirds of the face and neck, typically through a horizontal pull of the skin towards the ears. The goal is to smooth out wrinkles and reduce sagging in areas like the cheeks, jowls, and neck, often leading to a tighter, more youthful appearance.

On the other hand, a vertical facelift, like the trade marked Vertical Restore technique developed by Dr. Amir Karam, employs a different approach. This technique lifts the facial tissues vertically, counteracting the natural downward pull of gravity. It's designed to rejuvenate the entire face, including the outer brow, midface, jawline, and neck, aiming for a more holistic and natural-looking result.

How long does a vertical restore facelift last?

The Vertical Restore technique, developed by Dr. Amir Karam, offers lasting results typically extending from 10 to 15 years, essentially tripling the longevity of results compared to those from a traditional facelift. This exceptional duration is a testament to the effectiveness of the Vertical Restore procedure.

Where are the scars on a vertical facelift?

In the Vertical Restore facelift procedure, the incision designs are carefully crafted to remain concealed. There is no tension on the skin during the procedure, which promotes finer healing, rendering any potential scarring virtually imperceptible. These strategic incisions should not interfere with your hairstyle preferences, whether you prefer to wear your hair up in a ponytail or leave it down. For a detailed understanding of incision placement, please watch this video from Dr. Karam.

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