Standing in the January snow in front of Manhattan Eye and Ear Hospital, I had no idea what was ahead of me. As the senior plastic surgery resident from the University of Missouri, my chief simply told me to go to New York and spend the month working with Dr. Tom Reese and the NYU Plastic Surgery Residents. Fortunately, I was in a position to be introduced to surgeons who were or would become icons in the world of Plastic Surgery.
At this international center for cosmetic surgery, facelifts were one of the most popular procedures. At that time, many facelifts were done by undermining and tightening just the facial skin. But because skin can easily stretch over a short period of time, many patients returned for revisions or additional procedures. Today, many surgeons continue do a skin-only facelift, but the effects are not as lasting or profound.
At Manhattan Eye and Ear, in an effort to improve the results of the facelift, some surgeons revisited and developed a technique that tightens deeper structures of the face to provide a more lasting result.
The power of this technique was realized when we learned how to adequately mobilize these deeper structures to their optimum position, and over the years these techniques have been perfected for a lasting natural looking result for very happy patients.
Along with addressing deeper structures, many surgeons now use shorter incisions and have also learned how to address the neck through a small incision under the chin, lessening scarring as well. The importance of volume replacement as part of a facelift has been clearly demonstrated. Because of my preference for these advanced Facelift techniques, I was led to my mentor Dr. Fritz Barton, and adopted many of his advanced techniques. He even did my facelift and I experienced his perioperative care and facial surgery involving correcting lower structures firsthand.
Not all plastic surgeons do – or can – perform a facelift that involves the sculpting and repair of deeper structures of the face and neck. However, it is the best procedure to leave you with a natural and a longer lasting, refreshed look without the ‘stretched’ look every patient wants to avoid. With a skin-only facelift, the price may be lower, surgery times shorter, and you may not be fully put to sleep, but you cannot get the best result.
When you are consulting with a plastic surgeon, make sure they clearly explain which type of facelift you are getting and what you can expect. Get several opinions, educate yourself, and choose the best procedure that will give you the best results.
I have seen facelifts evolve over my 30 years in practice, and my techniques have evolved as well. They have gone from simple skin tightening procedures, to procedures that involve multiple layers, structures and restoration of facial volume. I have learned what works best in my hands, from the creative surgeons who, over the years, have shown me the way. •