 |
| Dr Vaibhav Shah |
I can’t tell you how many times that I (and every cosmetic
surgeon) hear that question. I think that the word “facelift” has more
meanings to people than any other word in cosmetic surgery. People ask
about a “full facelift”, “half facelift”, “neck lift” and so on. This can
be very confusing to patients and some may forego treatment because of
preconceived notions that are not true.
A “facelift” by definition is a procedure called
rhytidectomy. A rhytid is a wrinkle and “ectomy” means to surgically
remove, so technically it refers to a surgical procedure with incisions removes
skin to tighten wrinkles. A traditional facelift includes hidden
incisions in front of and behind the ear. The skin is then separated from
the underlying tissues and the deep layers are tightened. Then the skin
is pulled in a natural direction and the excess is removed.
Traditionally, the platysma (muscles in the central neck) are also tightened.
A traditional facelift does very little (or nothing) for the
central oval of the face (brow, central forehead, eyes, nose and mouth).
It also does very little, if anything for tissues above the nostrils. So,
a “facelift” is more for the jowls and neck, in fact, all about the jowls and
neck. Now you know what a facelift really is!
The “wrinkle” in this description (yes, pun intended) is that
not all surgeons do the same surgery the same way. Some surgeons omit the
platysma procedure. Personally I think that is short changing the
patient, although very young patients may not need a platysmaplasty.
Also, some surgeons “invent” shortcut facelift procedures where they omit the
incision behind the ear. I am always leery about someone who takes a
procedure that is 100 years old and puts his or her name on it, or even worse,
a corporate name. Again, facelift surgery has been around for a century
and all the tricks have been attempted and abandoned because a short cut in surgery
almost always translates to a short cut in result and longevity. Some
surgeons try to avoid several inches of incision behind the ear and end up
doing a procedure that will begin to relapse in several years. These
types of shortcuts always claim easy surgery with fast recovery.
Remember, in cosmetic surgery, you always get what you pay for….not in terms of
money, but in terms of recovery. The cosmetic consumer should always be
cautious about any surgery that deviates significantly from the standard of
care in technique. Just because something is new, does not make it
better. Obviously, we do make advancements in materials and techniques,
but if and when that happens, it becomes widely adapted and the norm. Any
patient that is looking at a “new” or “miracle” procedure should ask the
surgeon to see 20 pictures of patients that had this procedure by same surgeon
and the pictures should be 1-2 years after the procedure. If a surgeon
can’t show you that (for any procedure) you better think closely about getting
surgery that is different from the way most surgeons do it. Cosmetic
surgery patients often get the short end of the stick from hype delivered by
companies, media and surgeons. If it sounds too good to be true, it
is! If someone invents a new and radical improved facelift procedure, it
won’t be in TV ads, it will be front page news.
So, back to the“facelift” definition. Much of the
confusion about the definition of the word comes from a patient’s
experience. A patient may have “rhytidectomy” but also have a brow lift,
eyelid surgery, cheek implants, chin implant, laser skin resurfacing,
etc. So when this patient tells someone they had a “facelift” the
listener may assume that a facelift includes all that additional surgery.
They would be wrong! Rremember, a facelift primarily addresses the jowls
and neck. The patient merely had other procedures along with their
facelift. When you get your engine tuned up, it may include a wheel
alignment at the same time, but technically, an wheel alignment is not part of
a tune up.
The best way to keep this all simple is to divide the face into
4 segments:
- Upper face
- Midface
- Lower face and neck
- Face and neck skin
Each of these regions concerns separate cosmetic procedures to
address the aging in that area and the facelift concerns the third item on the
list. Also facelifts come in three sizes; small, medium and large.
It is basically the same procedure in different versions. Patients in
their early 40’s may need a small lift, while patients with more aging need
bigger versions of the same operation.
www.vaibhavshahblog.blogspot.com.
No comments:
Post a Comment