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APPROACH TO FACELIFTS |
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Our objective is to satisfy the goals of our
patients. In achieving these goals, we strive to
maintain a natural, nomal post-operative or
post-treatment appearance.
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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
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A
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.
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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
a surgeon—which should include referrals from physicians, recommendations from
friends, but most important credentials, hospital affiliations
- Extent of the surgery - how much
is done. A
simple removal and resuturing of the skin around the
ear, can produce “facelift” scars and even 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 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
- 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.
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Cosmetic
surgery can improve one's appearance - but it can
also change it! AN UNNATURAL RESULT IS
NOT AN IMPROVEMENT!
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- 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, a skeletonized
(no fat) 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. Until recently, in our practice we have been
very disappointed with the unpredictability and lack
of longevity fat grafting. However, using a new liposuction
device, Body Jet to harvest the fat for grafting has
improved our results with fat transfer or grafting.
The Body Jet uses an intermittent jet of fluid to dislodge
fat cells from the surrounding fibrous tissues in very
gentle manner—thereby protecting the fat cells. In
fact, recent studies have shown that 90% of fat cell
harvested with Body Jet are viable (living) cells.
This compares to 30% of cells that are living after
conventional methods of harvest. Seventy
percent (70%) of fat grafts obtained with Body
Jet has been documented in imaging studies. This method,
with its impressive results, make fat transfer a safe
and effective addition to our other techniques of facial
rejuvenation. This technique is very cost effective
when the expense of repeated injections of commercially
available fillers.
- 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 surgeon
trying to accomplish? Does the patient and surgeon prefer
a natural postoperative appearance or an extreme
makeover (see below for an example)
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What
was she thinking?
What was her goal?
What is the surgeon's concept of beauty?
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- 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 - 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 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 one.
Facial
Rejuvenation Page »
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