By the time most people wish to have a face lift, they also need something surgical performed around their eyes. Treating both at the same time allows for a harmonious result rather than a incongruous one in which certain things that tend to occur along with others have been erased while others remain. My face lift technique is a “short scar” technique. I almost always perform liposuction in the neck in order to allow the skin in the neck to redistribute properly in conjunction with the face lift. This gives some degree of neck correction, but not enough for those individuals who have severe tissue sagging in the neck. Such individuals are best treated with a face lift in combination with a formal neck lift.
To be fair to the injectables, I think that the best results in facial rejuvenation are achieved with the judicious and combined use of muscular denervating agents such as Botox, facial fillers such as Juvederm and surgery. Typically, I think that patients experience in them in that order. Most people start by having Botox treatments, since its use can prevent the formation of wrinkles, erase mild to moderate wrinkles over time and help maintain a relatively wrinkle free visage throughout one’ life. Then, they begin to use facial fillers, which decrease the prominence of facial creases that can be aging. But, time graduates most to the point where only surgery can address sagging skin and the facial tissues beneath the skin that sag along with it. These takes the form of jowls, lower eyelid “bags,” droopy cheeks and unattractive skin folds in the upper eyelids. While some practitioners feel that injection of filler into the cheeks will “lift” the face, I prefer to do this surgically, in the hopes that my intervention is less likely to change the general configuration of a person’s face than aggressive injections of filler often seem to do. My goal is to make my patients look like a younger version of themselves, not a younger but also different version of themselves. After surgery, I think that most patients should absolutely continue to use Botox and facial fillers. These are adjunctive treatments that enhance the results of surgery and in fact also enhance each other’s results.
My goal is a natural result. I would rather leave something alone than risk a result that looks “operated.” An operated looking result is one that often cannot be corrected and therefore is best avoided. A well performed face lift, however, produces a result that fillers and Botox alone cannot achieve.