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
SOME SPECIFICS OF OUR APPROACH TO FACELIFT
- 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
- 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,
All facelifts are created equal?
Cosmetic Surgery: Promises and Pitfalls™
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.
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
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
Goals of surgeon and patient.
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)
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,
- 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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