Question from Toronto, ON: I am thinking about a Face lift but I am confused after reading so much about Facelifts. Please give me your opinion. Thank you very much.
Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:
You appear to have a fuller and tighter face than the usual individual requesting a face lift. You also appear to have a fuller side and a flatter side which is found in almost all patients. Both a “Face Lift” and a “mini Face Lift” primarily redrape the skin in a upward and outward direction, followed by removing skin excess and then sewing the edges together. Based on your photos, I do not believe this will significantly help you. Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below. Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material. Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift. Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed. The most popular of thefillers,RestylaneandPerlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting “cousin”Juvederm Ultra Plusare similar skin fillers, used to soften and fill the nasolabial (“parentheses”) and marionette folds, the brow (“number 11”) lines and fill and lift the cheeks and lateral brow or chin.Volumais the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!. Scuptrais the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent. BotoxandDysporttoo have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles! Dr. Obagi’s new, second generationZO Skin Healthprograms may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. IPLand fractionatedlaserssuch asCO2 and erbium and now RF(radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation. If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin. Returning to your concerns, it appears that lipo-contouring the lower cheek / jowl / neck, fillers, Sculptra and proper skin healthcare with retinoids may be best options for you. Face and neck enhancements or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills. I hope this has been helpful! All the best!