Facelifts, what works best: more highlights from the Multi-Speciality Foundation for Facial Plastic Surgery 6th Annual Meeting
New York, NY, There were so many world authorities at this meeting that my head was spinning. One of the more interesting panels and set of presentations was on facelift surgery. Just when you think that most people agree on something there is a panel of recognized experts with a vast array of differing opinions on facelifts. The most senior was Dr. Bruce Connell, who taught or at least influenced many of the most accomplished facelift surgeons and teachers with his bi-plane, bi-directional extended SMAS facelift. He was supported by one of his former students and now a superior teacher in his own right, Dr. Timothy Marten. Other facelift ideas were presented by the inventor of the MACS facelift, Dr. Patrick Tonnard from Belgium, Dr. William Little with totally new ideas on vertical SMAS lifting and Dr. Gaylon McCullough with an excellent perspective from his many years performing and teaching facial plastic surgery. The outstanding statement of the meeting came from Dr. Little; when asked about his SMAS technique as a departure from the rest, he prefaced his answer by stating that he needed to watch what he said since he shared the podium with the “SMAS mafia.”
What did I take from this panel? There are many ways to perform a facelift. Most agreed that the SMAS needs to be addressed in all patients. For most, the more aggressive surgeons get with the SMAS, such as deeper plane facelifts may last longer but are technically more difficult to perform. Facelifts also need to be individualized.
As with noses, there isn’t one facelift operation that fits all. A simple short scar facelift with a few sutures in the SMAS may be easy, fast and can be done under local anesthesia and even mass marketed by national companies under catchy names, but doesn’t last for patients with more advanced facial sagging. I find myself in discussions with other plastic and facial plastic surgeons, who state, “Wow, you really do a deep plane facelift?” It takes longer and patient recovery is longer but the results are superior and the results last longer.
In summary: there are a number of ways to perform a facelift. A more comprehensive the procedure such as the deep plane facelift may take longer to perform and take longer to heal from, but the results last longer. Steven J. Pearlman, M.D.,F.A.C.S.