Longview Facelift doctors

I personally would advocate against doing a direct excision of a marionette fold. Fillers, volumizers (sculptra, fat), and/or a more extended facelift would all be better options in my opinion. Although it's possible to have a scar that is imperceptible, that is not always the case. If by "glaring marionette folds" you mean long length and great depth, then an excision to treat this area would likely have to be long. The longer it is, the more noticeable it becomes.

To put in drains or not to put in drains, that is the question. Well, there is no one answer. Putting in drains are a matter of surgeon preference but in the end, their presence or absence is unlikely to change your outcome. Instead you should focus on the expertise of the particular surgeon and if they are board-certified in facial plastic surgery or plastic surgery. Also, take a look at their before and after photos. Do they have consistently good results? Do they make you feel comfortable during the consult and answer all of your questions in clear, easy-to-understand terms? I think that those factors are far more important. Take care.

Facelift surgery involves restoration and tightening of the underlying facial fascial system (often referred to as SMAS) with excision of excess skin and redraping of the skin/SMAS in an upward vector (i.e. - reverse the natural pull of gravity and aging).

Signs of fallen tissue may manifest as:

• increasing or deepening of the nasolabial folds
• marionette lines (corners of the mouth to chin region)
• jowling
• excess neck skin with less than ideal neck line, etc.

This is not to be confused with improving the actual quality of the skin itself, in terms of pigmentation (rosacea, brown spots, etc), fine wrinkles, texture, etc. It does not address the actual skin quality. This can be addressed via proper skin care and resurfacing (in the likes of laser or chemical). Furthermore, although an improvement may be seen, a complete reduction in nasolabial folds is not expected. Often times, during the initial phase of healing, fine wrinkles are significantly reduced, but often to the dissapointment of many patients, once the swelling settles, fine wrinkles resurface (as fine wrinkles are more inherent to the skin itself).

It is important to distinguish and understand the aforementioned limitations of facelift surgery. Facelift often implies necklift as well; however, it often does not include the brow/forehead lift. There are several variations of facelift surgery, all with various utilities, depending on the elements involved in the surgery. Classically, facelift mostly involved only the excision and tightening of the skin; however, many surgeons currently perform some degree of manipulation of the deeper structures (SMAS, etc). Ask your surgeon which technique is used.

There is also some minor variations for the incision patterns as well, which determines the the placement of the final scar. Some degree of lipocontouring may be performed as needed. In discussing facial rejuvenation surgery, be familiar with - i.e. ask about:

• Facelift
• Forehead lift/ Brow lift (Open, Endoscopic, Limited)
• Blepharoplasty (Eyelid surgery - Upper and Lower)
• Midface lift
• Necklift
• Facial implants (chin, cheek)
• Resurfacing (mechanical, chemical, laser - invasive/noninvasive)
• Role of fillers/botox/proper skin care

From the list above, one, multiple, or none may be applicable to your specific needs/desires. After a proper consultation, you should be clear as to why a certain recommendation was made and for what purpose. If you do not fully understand, then you are not ready and fully informed. Cosmetic surgery is an emotional topic, as we are addressing our appearance, often times reflecting our feelings for ourselves. Do not make an emotional decision, but be methodical and cautious in your approach. There have been many advancements in cosmetic surgery, but be sure to find out if it's right for you.