Tip:
Highlight text to annotate it
X
How often are composite facelifts done versus traditional. Is deep plane another type?
The doctor on realself who promoted it made it sound much better than the traditional
facelift, so I'm curious what method you guys use. It's the first time I've heard of it
and I've been on realself a lot! So sorry to keep bugging you doctors...this is just
such a big deal and the more I read the more questions I have.
Thank you for your question!
You've asked a question about how often can composite facelift is done versus a traditional
one and then you asked deep plane facelift. And you wanted to get opinion and you submitted
a single photo.
This is an interesting discussion. If you were to go to any cosmetic surgery meeting
where face lifting is discussed, you would see how passionate doctors are about the types
of procedures they do. Very often, they're will be few who would advocate one particular
type of procedure among all other.
Well, being a facial cosmetic surgeon and being in practice for 20 years, I can tell
you I have seen a lot of things that come and go in terms of benefits over versus over
risks and long term benefits. And the art of doing face lifting starts with communication
and understanding what is your ultimate goal. In my practice for most people who come for
face lifting surgery, they first have to understand what a facelift ultimately gets done. A lot
of times, people believe that face lifting is everything from the top of the head all
the way to the down of the neck. In actuality, face lifting address sagging tissues of the
cheeks and the jawline and the neck. With that being said, our goal is to elevate the
cheek, improve the quality and sharpness of the jawline and improve the angularity of
the neck.
The reason why I think that a lot of doctors feel passionate about their particular method
is that they have developed their own particular style in doing a procedure the way they do
it. So the name of the procedure is not as important as the doctor's way of doing it.
Unfortunately when marketing was so aggressive, it is easy to become confused with terminology
and methods and claims of one doctor's great superiority over the other. In the New York
City area, there are doctors who claim to only do deep plane facelifts and therefore
they are better than the many cosmetic doctors in Manhattan. Clearly that is not true.
Understanding the basic outcome is and yes you can learn about these particular procedures.
If you do some researches, you will learn that Dr. Sam Hamra, one of who developed the
concept of composite facelift. He wrote a textbook about it and wrote many articles
and certainly, technically, most surgeons can do these procedures.
The question we have to deal with in the modern world is, how much can we do does not mean
what we ultimately should do. And there is a direct correlation between level of invasiveness
and longevity of the healing process and swelling. It is well known that the composite procedure
as described as Dr. Hamra is where you can get certainly nice results. But many people
have significant swelling afterwards.
In my practice, I've had patients who are in the full range of extremely wealthy and
people who work really hard and save their money to come and have their procedures. But
the one common denominator for all is the need for quick recovery. Quick recovery means
getting back to normal life somewhere in a 1-2 week range. So that has to be factored
in as well.
The strategy of the overall procedure has also to be flexible. As you learn about this,
you'll learn about the anatomic part of the face called the SMAS or superficial muscular
aponeurotic system. Now this is an area of tissue which is the layer that translates
the movement of the facial muscles to the skin above it. And when people say, "Do you
tighten the muscle?" The question really is, "Do you tighten the SMAS?" and the extension
of the face called the platysmal muscle and that is the muscle that originates from the
clavicles and up. And as we get older, we get these bands called the platysmal bands.
So, when you perform a facelift surgery, the surgeon is more flexible than what is advertised.
In that, when you go in, you have to evaluate the tissue and you have to say if the tissue
is properly meant for a SMAS flap or a deep plane approach or there are so many variations.
The key is whether or not you're doing the necessary procedures to maximize the benefit
such that you are able to get the results that you are looking for.
So when I perform face lifting surgery, I plan to do some type of SMAS elevation procedure.
You need to do that in order to restore the foundation of the face so that the skin doesn't
stretch. One of our mentors taught us that the skin on the face is like taffy. And if
you just pull the skin alone, it can stretch and regress. There's always a certain amount
of regression no matter what but if you lift the SMAS, you're able to maximize the foundation.
It's kind of like the studs of a house against which you put the walls. You need to have
that foundation in place.
So understanding that there's a balance between level of surgery, time of recovery and ultimate
desired outcome. And in the modern world, a lot of these same doctors who advocated
very aggressive surgery during the 80s and 90s with the typical plastic surgery patients
was different, was a wealthier person who was able to stay away from their normal life
and be away for a month to more natural quick recovery procedures, that's key. So in our
practice, it's very critical for us to deliver consistent long-term natural results and get
people back to work very fast.
So I think at this point, it's best for you to do some consultations and meet with some
surgeons and get to learn from the surgeon and the staff in the office what the typical
recovery is like, what the level of patient satisfaction is like. I think it's not so
much about the technical abilities but it's more about the communication, the artistry
and the understanding between the patient and doctor about the ultimate desired result
is and what will be satisfactory and then developing a strategy. A lot of times, face
lifting can be combined with laser and other things to enhance the face. In the end, you
want to look better and be happy that you made the decision you made. So I wish you
the best of luck, I hope that was helpful and thank you for your question.