Why is Facelift PLUS better than Facelift?

Features of the face age together so should be restored together

Anti-aging surgery and cosmetic treatments have improved based on new understanding of aging anatomy, technological innovations, and market demand for better outcomes. Software that instantly reverses aging features establishes benchmarks that surgeons must create in the operating room. Both surgeons and patients prefer less surgery or no surgery when goals can be achieved with less, or if goals can be achieved non-surgically with medical treatments. Less surgery is less cost, less chance of complications, and less recovery, all good. In the domain of aesthetic surgery however, less surgery implies less results. Less surgery must be reconciled with the demand for more and better results. Disappointment from a lesser result may drive desire for additional separate procedures later adding cost and recovery. Less results may create un-natural aesthetic mismatch if one area of the face appears younger and other area(s) appear older. In the words of the great Dallas, TX plastic surgeon Sam Hamra, “areas of the face age together so it is reasonable to restore all aging features together.” Despite the appeal of less surgery, appropriate procedure(s) matched to patient circumstances always beats compromising the paramount goals of a beautiful natural and long-lasting result. Better results and the correct procedure(s) offer most value. For aesthetic surgery, value is not what you pay for the procedure because payment is similar whether the result is better or worse. Value is proportional to the quality and longevity of the outcome. If more surgery is indicated for the best result, then more surgery if well planned and performed is the path of wisdom. Judgment and mutual communication between patient and surgeon are important to know when less is more and when less is less. Masterful surgeons subscribe to the philosophy expressed by Antoine de St. Exupery, “Perfection is achieved not when there is nothing more to add, but when there is nothing left to take away.” Thus, do only what must be done for the required result, but no more or less. Facelift alone rarely produces satisfactory improvement by contemporary standards for treatment of the aging face.

Traditional face lift repositions sagging skin of the cheeks and the jaw line in an upward and backward direction to reverse the decades long downward and forward descent of these tissues.  The operation is performed from the sides of the face around the ears, so this is the area that is most corrected.  However, most aging occurs in the central face:  from the forehead and brows above to the eyelids, the cheeks, the lips, the jowls, sagging of the neck, textural skin changes, and soft tissue atrophy.  Face lift alone does not restore the most aging areas of the face.  Improving these features implores treating physicians to directly address and modify the central face and aging skin for a balanced, natural, and aesthetically youthful appearance.

PLUS procedures sometimes added to facelift for better results include:

1. Carbon dioxide laser or peel to even pigmentation spots of aging and smooth rough skin texture around eyes, lips, and elsewhere.

2. Forehead and/or brow lift for wrinkles, sagging, and/or to match the lifted face.

3. “Permanent Botox®” removal of squint muscles behind the inner brows.

4. Lift and open sagging (“ptotic”) upper eyelids to change a fatigued appearance to a more awake alert presentation.

5. Cheek lift, fat repositioning, lower eyelid support (“canthopexy”) and removal of loose lower eyelid skin. This elevates the cheek to youthfully reflect light, smooths the lower eyelid, and aesthetically shapes the eyelids (“palpebral aperture”). Elevating lower eyelids and cheeks balances the face-lifted sides for aesthetic harmony.

6. Aging lips treatment by upper lip lift and/or corner of lip lift. Facial skin descent vertically elongates the upper lip which conceals upper teeth and exposes lower teeth, an aged appearance. Cheek descent pulls down corners of the mouth creating a frown, even when not sad.  These aging features are not corrected by face lift.  Adding them to the procedure improves consistency.

7. Facial implants along the chin or lower eyelid lift and support skin and soft tissue, may improve proportion, and gently projects aesthetic features.

8. Fat transfer to add volume and softness to areas of the face that have degenerated with aging, or have a drawn appearance that tissue elevation alone does not correct.

9. Neck Lift beneath the chin to remove fat, smooth neck bands, and tighten loose neck skin.

10. Earlobe adjustment or lift.

Dr. Steve Laverson observes that “patients don’t come for surgery; they come for a result. After the procedure they forget details, discomfort, or inconveniences during recovery, but they see the result daily for their remaining life and depend on it.” Dr. Laverson reviews younger photographs of patients before face lift to differentiate aging features which have developed over the years from identity features which must be preserved so friends and family recognize patients after the procedure. Face lift PLUS should result in the appearance of your younger self, not someone else. Dr. Laverson develops a care plan and simulates the result of each component of treatment in the mirror before every operation, so patients understand what to expect.

Other important PLUS improvements of face lift happen during follow-up care after healing. Aging resumes after rejuvenation procedures although one never in the future appears as aged as one would appear without the operation. Awareness and control of sun exposure, avoiding tobacco smoke, healthy body weight and lifestyle, prescription tretinoin, occasional medical aesthetic treatments, and other supplemental care maintains, preserves, and even improves the result over time, adding return on investment in the form of confidence and life success.

For a lasting youthful, energetic, and attractive appearance, facelift is one part of a more comprehensive anti-aging program.