Dallas: 214.363.2575 Allen: 214.509.0270  
OUR APPROACH TO FACELIFTS      


Our objective is to satisfy the goals of our patients. In achieving these goals, we strive to maintain a natural, normal post-operative or post-treatment appearance after the facelift surgery.

SOME SPECIFICS OF OUR APPROACH TO FACELIFT SURGERY

  • Personal consultation with the surgeon, not an assistant.
  • Local anesthesia and twilight sleep by a nurse anesthetist. (CRNA) –We find general anesthesia unnecessary for facial surgery.
  • Accredited office surgical suite; accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF)
  • No hospitalization necessary, however, we do provide overnight care.
  • Limited and carefully placed incisions minimize final scars and avoid damage to the hair and scalp and changes in the location of the hairline.
  • Deep tissues are managed by various techniques depending individual changes to be corrected
    • fat reduction and/or suspension, fat grafting
    • muscles of the neck are tightened to reduce banding;
    • other deep tissues are addressed as indicated.
  • Limited use of technology. Our experience shows the best results are based on individualized planning, as well as, careful surgical technique and not on the use of high-tech equipment.
  • Fat grafting is often used to add volume to the face when appropriate.
  • Use of skin care, chemical peels, etc., to optimize the end result.

No pressure dressings, and usually no dressing at all. Limited use of drains which are unnecessary due to use of the progressive tension sutures (PTS) ». We find patients actually do better without tight pressure dressings - which others commonly use - as they have less swelling, discomfort, etc.

Facelifts: All facelifts are created equal?

Cosmetic Surgery: Promises and Pitfalls™

PROMISES

A facelift surgical procedure, in combination with certain other procedures, can provide a more youthful appearance of an aging face. Advertisements promise beauty, youth and happiness. However, there are many factors to be considered.



PITFALLS

No Two Facelifts are the Same
Modern marketing often reduces operations, such as a facelift, to the status of a commodity in which all facelifts, likened to other services, are represented to be exactly the same. A facelift is far from a standard procedure and, in fact, there are many techniques and variations. Differences in facelifts can be quite significant: this fact emphasizes the importance of selecting the right Board-certified surgeon - which should include referrals from physicians, recommendations from friends, but most important credentials and hospital affiliations.

  • Extent of the facelift surgery - how much is done. A simple tightening of the skin and then re-suturing the skin around the ear can produce “facelift” scars and very temporary tightening of the skin of the face. However, the benefits are negligible. More extensive procedures have a similar placement of incisions, but are more extensive and more effective. Each plastic surgeon must determine the extent of surgery to be preformed, based upon his/her experience and judgment. Many factors must be considered including:
    • Effectiveness of procedure face
    • Extent of the deformity to be corrected
    • Goals of surgery
    • Risk of complications
    • Length of convalescence
  • Depth of the surgery -- the actual layer “lifted”. Historically, facelifts started as a simple tightening of the skin. Today, there are procedures done at different depths; some provide a lift at the level of the facial bones.
  • Use of patient’s fat, implants and filler materials. This may be indicated if the surgeon determines that there is a deficiency of bone or soft tissues. However, this added volume may change the appearance of the face; this may be good or bad depending on the goals of the patient. An example is the current fad of lip enlargement that often produces an unattractive duck bill appearance.

Cosmetic surgery can improve one's appearance - but it can also change it! AN UNNATURAL RESULT IS NOT AN IMPROVEMENT!


  • Alterations in the volume of facial fat: Selective removal of fat can have a positive effect, especially in the neck. It is important that this is not overdone, as a skeletonized (no fat) appearance is both unnatural and unattractive. However, since facial fat decreases as an individual ages, often fat grafting is necessary to create a more youthful appearance. Replacement of this lost fat can restore facial contours and actually reduce winkling of the skin. An alternative is the use of commercially available filler injections which might be periodically needed.
  • Use of technology. Use of lasers, endoscopes, fixation devices, and liposuction, is determined by the surgeon. Technology may have actual benefits or may be used for its marketing value. High tech has the implication of being better! However, in cosmetic surgery technology can be over utilized, more expensive and potentially more risky than conventional (open) methods.

Goals of surgeon and patient.
What does the patient expect from the surgery and what is the plastic surgeon trying to accomplish? Does the patient and surgeon prefer a natural postoperative appearance or an extreme makeover (see below for an example)

What was she thinking?
What was her goal?
What is the surgeon's concept of beauty?

  • Risk of complications. Cosmetic surgery is real surgery and complications can occur. Facelifts vary in terms of relative risk of the procedure. No surgery is free of potential risk.  
  • Length and severity of convalescence. This varies greatly with each procedure.

Patient Considerations About Facelift Procedures - Worth Understanding:

  • Patient’s goals: goals should be realistic -- the final result depends on quality of skin, bony structure, etc.
  • Patient’s motivation: the best reason for this surgery is to make one feel better about him/herself.
  • Patient should be in good general health, and should maintain a healthy lifestyle.
  • Patient should thoroughly understand the pitfalls of this or any elective surgery -- and should weigh the perceived advantages of the surgery against risk, expense, time out of normal activities.
  • Despite marketing to the contrary (e.g., Extreme Makeover) PATIENTS SHOULD UNDERSTAND THAT AN IMPROVED APPEARANCE DOESN’T GUARANTEE HAPPINESS.
  • The most important decision is the selection of a qualified plastic surgeon.

This is the reality of cosmetic surgery and, in particular, the facelift , WHICH IS  the reason it is important for a consumer to do his/her research. However, specific information can only be obtained from a personal consultation with a plastic surgeon.

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