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Getting a Facelift? What You Should Know

Facelifts, or rhytidectomies, are popular cosmetic procedures that remove wrinkles, sagging and a general tired look from the face. Performed by a skillful cosmetic surgeon, While a facelift won’t make you look like your own daughter, if performed by a skilled surgeon, you’ll look years younger.

Steps to Getting a Perfect Facelift

Consult local cosmetic surgeons who have performed numerous facelift procedures. Make sure your surgeon speicalizes in cosmetic surgery for the face. A good plastic surgeon will explain the procedure, preparation, recovery, and potential complications. He will also discuss payment options with you and determine if you’re a good candidate for surgery. If you are, he’ll take your photograph and schedule surgery.

There’s some preparation on your part that you will need to make to have the best facelift experience.

Do you smoke? Time to quit. If you take blood thinning medications or supplements that could interfere with the healing process, you will need to stop taking them, but only under your doctor’s supervision. Discuss all medications and supplements with you plastic surgeon and family doctor before going in for any surgical procedure.

During surgery, your surgeon will comb back your hair and hold it back with a rubber band. Depending on what you and your plastic surgeon decide, you will go under a sedative and local anesthesia (applied to the areas where the incisions will be made) or under general anesthesia (most plastic surgeons prefer this method).

Your surgeons will make small incisions around your temples, ears and lower part of your scalp in an irregular fashion to reduce scarring. He will then create a skin flap and remove or move around fat and tissue under the skin. Your facial muscles will be raised and the skin will be fitted over your newly sculpted face. He will then remove the excess skin and close the incisions using glue or sutures.

Performed by a skilled surgeon, scarring will be minimal and well hidden; they may even appear to be natural lines around the face.

After your facelift procedure, your surgeon will remind you of how to perform self-care during recovery, including pain management, caring for surgical incisions, and when you can return to your normal routine. You will also schedule follow-up appointments to check on progress, manage any post-surgical complications that may arise, and take more photographs for comparison.

Though it might be a while before you see the amazing results of your facelift, like the great majority of patients, you will enjoy your more youthful face and smile when people assume you’re your daughter’s older sister.


Copyright 2012. As licensed to Pearlman Aesthetic Surgery. All rights reserved

Facelift in New York; getting even

Don’t get mad.. get even!

Revenge Surgery 

What’s better than getting even when it’s time to move on with your life? In an April article i the NY Post, a number of women were interviewed who were

NY Post, for full text please click on link in the blog

going through life changes. Included in this article is Sue, a patient of mine who, at the time, was scheduled for a face/neck lift. Sue is now over a month post op and feeling great.

Sue is a wonderful lady with the most amazing and sensitive disposition, but her marriage of 12 years was coming to an end. She was also transitioning in another big life change: a new career as a schoolteacher. Like so many young minded women, her face didn’t match her young body and mind. A facelift is just what she needed for an, excuse the pun, “pick me up.”

I expect to be posting her before and afters in a few months when all healing is over, but already she is thrilled and has been told by many friends that she looks like her old self, not someone pulled or “done.”

If you feel like you look dated, you might do with a little tweak or two to get a fresh outlook on life. Revenge is sweet, especially when you look younger than your old spouse!

Facelift or Facial Fillers in NYC

To lift or fill the face?

I recently saw a patient who came in because I did a facelift on one of her childhood friends and she liked what she saw: a more youthful look without looking “pulled.” She had a facelift about 7 years ago and feels that it helped a little but the skin of her lower face is “wrinkley” with some excess skin under the neck and cheek folds. She sought out a few opinions of other doctors and the suggestions ranged from fillers to implants to a revision facelift. My first inclination was to suggest another facelift. This would help the jowls and extra skin under her neck. What concerned me is that when listening to this lady, she was more distressed about the way the skin hung around her mouth and narrowing of her cheeks. As a surgeon, facelifts are more interesting and fun for me to perform, plus this patient was basically asking if a revision facelift would be the best solution without specifically stating it. However, I felt that a facelift wouldn’t be the best initial solution for her concerns. I suggested that we first try Sculptra to restore volume to her face and fill out the deflated cheeks and areas around her mouth. A facelift can be performed later to lift the drooping facial skin and muscles.

This is really about deciding priorities. I categorize facial aging into 5 categories: skin changes, dynamic muscle action, loss of volume, gravity and loss of elasticity. Everyone experiences all 5 as they age. It’s more a matter of what should be addressed and in what order. For this patient, I feel it is volume first (high volume fillers with longevity – Sculptra) then combat gravity and loss of elasticity next (facelift). 

 The face ages in 5 ways: skin, muscle action, volume loss, gravity and loss of elasticity. When the question is to fill or lift the face, both the doctor and patient need to determine the best treatment plan per the patients priorities. Steven J. Pearlman, MD, FACS

Facelifts in NYC

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.

New York Facelift, the best techniques

I recently returned from the annual Fall meeting of the AAFPRS (American Academy of Facial Plastic and Reconstructive Surgery) in San Diego, California. I look forward to that meeting every year as the Academy’s premiere meeting. It is a forum for experts to discuss procedures on panels, new innovations being presented by researchers, new products from medical vendors, and last but not least – the chance to catch up with good friends from all around the country. I missed only one of these fall meetings since my fellowship (1988), and that was two years ago when my twins were due. My next few blogs will be devoted to advances in plastic surgery that premiered at the meeting.

The meeting started off with a superb panel on facelifts. Panelists were chosen to discuss the various popular techniques practiced around the country. These ranged from mini-facelifts to (open) suture suspension lifts, MACS lifts, deep-plane facelifts, bi-planer extended SMAS lifts and the latest: laser lifts featuring the new laser SmartLiftTM.

The goal of facelifts are to re-suspend drooping facial tissues by tightening the underlying muscle layer called the SMAS, then gently laying down the skin, without tension, to obtain natural long lasting results. Each of the above techniques has advantages and disadvantages. My main take home lesson was that there is no one facelift for every patient. Mini-lifts have a place for patients who need minor improvement of the jowls, jawline and mild skin excess under their chin. For patients with heavy faces, the deep-plane facelift is still king.

I was enthralled by the laser lift.  I recently purchased the SmartLipo Laser to use for neck contouring and to enhance liposuction results. I have been using it since August for neck liposuction, skin and jowl tightening and getting fabulous results. This laser can also be used to raise the skin for a facelift. By using the laser there is less bleeding and the skin flat is elevated more smoothly and rapidly… which all leads to less downtime and recovery, which gets the patient back to work quicker.

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