The Short Scar, 2-Layered Facelift

Facelifts have become such a notorious procedure in plastic surgery. If you put 20 plastic surgeons in a room to discuss a facelift patient, you'll get 21 different approaches, because the first person will have changed his mind by the end of the discussion! And yet, everyone in the room will be able to show you excellent results with their technique.  This makes the discussion so confusing for consumers that simply want to look better. I'm going to simplify this discussion for you.

Most plastic surgeons perform a two-layered facelift. While I teach the "deep plane technique" to the plastic surgery residents at Cornell and Columbia Medical Schools, I feel strongly that the technique is overrated, embarassingly expensive, and higher risk. In fact, a recent paper published in the prestigious journal "Plastic and Reconstructive Surgery" concluded that the deep plane facelift was inferior to the type of facelift that I perform. It did not last as long and had a higher chance of injuring delicate facial nerves which can cause paralysis. I perform the "SMAS lift", a 2 layered technique that balances excellent results with a fairly low complication rate. I combine that with an aggressive "corset platysmaplasty", removing fat in the neck and bringing the neck bands together to give a youthful neck contour.

Specifically, I do not remove the submandibular salivary glands that may cause noticeable lumps in the neck. I don't remove them because there have been terrible complications associated with their removal. Those include severe bleeding, nerve injuries, dry mouths, altered taste sensation, and even deaths. I believe that cosmetic surgery should use procedures that are effective and relatively low risk.

I prefer to use intravenous sedation for my facelifts, because there is a lower chance of nausea. And nausea is associated with a higher bleeding (hematoma) rate. I will perform this procedure under general anesthesia if you prefer, however.

A typical facelift takes about 4 hours. I make an incision under the sideburn and connect it to an incision that goes in front and inside the ear and travels a short distance behind the ear. This is called the "ponytail friendly" incision, eliminating the most noticeable scars behind the ear in the hairline. Almost everyone can have this type of facelift.

You'll recover with my luxury recovery package, with a nurse in a neighboring hotel, and hide out in the hotel or your own home for a week or two.

Men don't do as well as women with facelifts for many reasons. They don't wear makeup and they usually can't cover incisions with hair. And facelifting brings hair into the ear, which is particularly annoying to men. So, I prefer to do a neck lift and include liposuction of jowl fat. Instead of lifting neck skin into the cheeks and removing it there, I directly and vertically emove skin in the middle of the neck, extending from the chin down the neck. Not for everyone because this technique leaves a midline scar, It is a great solution for manuy men. When I get up the nerve to have a facelift, this is the technique I will have.

Facelifting - whether it is cheek lift, a neck lift, or both - can be performed as early as your 40s or as late as your 80s.  The younger you are when you have the procedure, the longer it will be expected to last.