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Facial cosmetic surgery is a very personal and monumental decision. Universally, all patients want the best outcomes. In today’s corporatized America, with heavily influential marketing spin, pharmaceutical companies, medical device companies, and even practitioners promote a less is more mentality to push products and services that often over promise and under deliver on the results. In no way can skin creams, injectables, or lasers deliver the types of results once can achieve with surgery. In a similar manner, minimally invasive sounding surgeries are in no way a substitute for time tested peer reviewed procedures that provide quality long lasting results.
Unfortunately not every person will achieve acceptable results with Botox or injectable fillers such as Juvederm, Restylane, and Radiesse. These products have their place in facial aesthetic practices, in properly selected patients, but in general should be viewed as temporary treatments with less impressive results when compared to surgery. Their primary advantage is that they have minimal social while providing a benefit. Botox is being used more and more as a preventative cosmetic medicine that delays wrinkle formation. Fillers camouflage initial signs of aging, but ultimately putting too much filler in a face, the liquid facelift, can alter ones appearance creating an artificial overinflated appearance. Using filler to augment facial structures can be useful to patients wanting to get a general idea of the appearance prior to permanent surgical procedures such as lip and cheek enhancements procedures. Creams reverse the signs of photo aging and contribute to collagen formation and production but are limited in their effectiveness. Lasers are an excellent option to delay the signs of aging and treat sun induced skin photoaging, but in no way can they tighten skin like facial cosmetic surgeries such as a facelift.
Surgical procedures are the best option for impressive endurable results. Rhinoplasty can dramatically affect ones facial appearance in a way that almost no other cosmetic surgery can. The nose can cause undue and unnecessary attention drawing attention away from other attractive facial features. Aging face surgery has many layers of effectiveness based on the surgical techniques used and how they are applied. In general, minimally invasive techniques can produce an artificial appearance and or short-term results. When considering aging face surgery most sophisticated patients are looking for surgeries that will last as long as possible with the most dramatic natural appearing results. There are no shortcuts to achieving optimal results and when applied, shortcut techniques frequently under deliver on the surgical results end.
Becoming an informed patient who understands the benefits of finding the right intervention or surgery for the right patient will ultimately save one time and money over the long haul. Getting things done right the first time is of paramount importance to achieving optimal outcomes with a high degree of patient satisfaction, while avoiding problems and bad outcomes.
Posted by: Benjamin C. Stong MD
Facial plastic and reconstructive surgeons are highly skilled and trained specialists in plastic surgery in the head, face, and neck. Their skill set is diverse and comprehensive in both reconstructive and cosmetic surgery. The American Academy of Facial Plastic and Reconstructive Surgery founded the Face to Face program in order to allow these specialists to give back to their communities both locally and internationally. There are three ways in which the face to face program and the surgeons give back to communities: the domestic violence initiative, the international assistance reconstructive effort, and the faces of honor program to help wounded soldiers from Iraq and Afghanistan. The surgeon’s partner with their hospitals and surgery centers who donate their time, staff, facilities, and equipment to help those in need who would otherwise never be able to afford these surgeries.
The domestic violence initiative partners facial plastic surgeons with their local domestic violence advocacy programs to provide pro bono surgery to victims of domestic violence. After a comprehensive screening process by the face to face program, victims of domestic violence are sent to facial plastic surgeons for reconstructive surgery at no cost to the patient. In addition to donating their surgical skills, many facial plastic surgeons are involved in fundraising for the local domestic violence coalitions and shelters that provide such essential and necessary services for the victims including protection of the victims and their children.
The international reconstructive effort is aimed at helping children in underdeveloped countryies who are in need of reconstructive surgery and either don’t have access to medical care or can’t afford the surgeries. The vast majority of these surgeries are congenital craniofacial anomalies such as cleft lips and palates and microtia (malformed ears), as well as deformities from traumas and burns. The surgeons incur the cost of funding the trips bringing all of the equipment and personnel to set up fully functioning clinic, operating rooms, and recovery areas for the children and their families. Often these trips are a week long and go all over the world wherever there is a need.
The newest initiative of the Face to Face program is the Faces of Honor program. This program was designed to help soldiers who have facial deformities as a result of being wounded in combat. Similarly to the domestic violence victims, these soldiers receive pro bono surgeries from facial plastic surgeons who donate their time and skills to correct the veteran’s deformity.
Facial plastic surgeons are dedicated to their craft and enjoy giving back to their local communities as well as around the world to those in need. Facial plastic surgeons also perform many cosmetic surgeries including: facelift surgery, rhinoplasty, blepharoplasty, midface lifts, brow lifts, hair restoration surgery, otoplasty, scar revision, and laser skin surgery. Facial plastic surgeons provide a comprehensive skill set for reconstructive surgery in the head and neck. The face to face program allows them opportunities to give back to society through a collaborative organized effort.
Posted by: Benjamin C. Stong MD
The fourth and fifth decades of life are a time when people often begin to become more aware of age and committed to facial plastic surgery procedures. Accumulated sun damage and prior skin care rejuvenation regimens affect when patients begin to consider blepharoplasty, brow lifts, and facelifts during these decades. Often, patients will also add staged or simultaneous skin resurfacing rejuvenation procedures to maximize and augment surgical results. There is often a misconception that surgery and procedures need to be delayed as long as possible to avoid additional surgeries in the future. The truth is there is no good or bad time to under go surgical and skin rejuvenation procedures; it is only appropriate when a patient becomes bothered enough by the issue to consider surgery and is an intensely personal decision. The most important consideration to avoid bad outcomes and unnecessary surgeries is to find a practitioner who uses techniques that will provide superior, long lasting results.
Eyelid lift surgery or blepharoplasty offers a long lasting procedure and when performed correctly is often not necessary to have repeated in the future. Similarly, Brow Lifts usually only need to be performed once if the surgery addresses the laxity issues in the forehead, upper eyelid, and brow complex and adequately releases and re-suspends these tissues. Minor touch up procedures may be included in future treatments to maintain and maximize results from blepharoplasty and brow lifts. Revision surgery becomes important when considering revising suboptimal results from poor, inadequate techniques and is more difficult due to scar tissue from the previous surgery and is more expensive. Having a procedure performed correctly the first time is of paramount importance.
Facelifts are procedures that can be performed multiple times over a patient’s lifetime. To avoid unnecessary and costly revision surgeries, finding a surgeon who effectively releases and re-suspends the SMAS layer, the primary support layer, of the face is important. Many surgeons believe they get equally effective results with less aggressive work on the SMAS layer, but there is no short cut to providing superior long lasting results. When performed properly, a facelift can provide patient satisfaction for ten years, or more. A facelift addresses an aging jaw and neck line, resetting the clock, but it does not stop the clock from restarting. Some patients who want to be aggressive about hiding their age may choose to undergo two or three facelifts during their life. Another popular misconception is that undergoing multiple facelifts will result in a pulled or windswept look. The truth is that when the skin and deeper SMAS layer are pulled in the correct direction, a facelift can be performed as many times as desired to maintain a more youthful jaw and neck line. An additional misconception is that a comprehensive and thorough jaw, cheek, and neck lift can’t be performed through an abbreviated mini facelift incision. This notion is also false; a thorough facelift can be performed through the short scar, abbreviated, mini, s-lift facelift incisions safely with superior outcomes. Consultation with a knowledgeable facial plastic surgeon will allow for a comprehensive facial rejuvenation plan over the years when a patient is interested and healthy enough for surgical procedures.
Skin resurfacing rejuvenation procedures are important to consider when augmenting and maximizing surgical results. In addition to noninvasive lasers such as IPL LimeLight and YAG Laser genesis procedures, ablative resurfacing procedures become necessary to maintain youthful looking skin. Finding a practitioner who offers the state of the art laser rejuvenation procedures is necessary for excellent outcomes with the shortest healing times. Currently, combining confluent and fractionated laser modalities offers the best treatment for both superficial and deep discolorations and wrinkles as well as stimulating collagen formation. It also avoids complications and prolonged healing times from more traditional chemical peels and lasers. Laser resurfacing rejuvenation procedures can be performed as often as necessary to restore and maintain youthful, vibrant looking skin.
Botox, facial fillers, medical skin care products and other preventative and maintenance therapies should be continued in the forties and fifties to maximize the longevity of surgeries and skin rejuvenation procedures. Consultation with a knowledgeable facial plastic surgeon, who applies a global perspective when discussing patient goals and their future considerations, will put the patient at ease and establish trust that the practitioner is making thoughtful recommendations based on his expertise and training.
Posted by: Benjamin C. Stong MD