The Lanfranchi Center for Facial Plastic Surgery & Rejuvenation - Las Vegas

A: Certainly losing almost 10% of your weight can effect the overall volume of your face.  Unfortunately as we get older we lose the quality of our skin and it is more likely to droop with weight loss (versus if it happened 25 years earlier).  Thus, some individuals choose to carry a few extra pounds simply because it fills out the face and makes it appear healthier.  Once we get into our 40's and beyond, this weight loss and resultant facial drooping starts the process of considering a facelift for many.  If you decide to stay at your current weight, it would be reasonable to consider a lower facelift (even if just a "mini/jawline"lift).  Volume replacement in the cheeks/midface could be addressed with either filler or perhaps your own fat via a fat transfer procedure.  Fat transfer, of course, would be contingent on you having excess fat (to "donate") in an area that is typically harvested (ie lower abdomen or thighs).

A: As a general rule, all legitimate facelifts (deep plane or otherwise) create a fair amount of swelling, and hence discomfort.  In my experience, adding a chin implant usually adds about equal amount of discomfort that one feels on the sides of the ears and neck.  The total time of discomfort does not change, and in my experience most patient take low dose prescription pain pills for 2-3 days.  The amount of discomfort, and time it lasts, does vary on how much swelling one has, along as other factors such as how tight the headwrap is placed (and materials used).  I would mention that the surgeon's experience can also play a role in this as to how much unnecessary trauma is caused during the procedure (hence more pain), as well as his/her post-op protocols.

A: I feel it is fair to say that it is not customary to use nitro-paste as a routine treatment after a facelift.  It is true that it causes vasodilation, which in theory, delivers more blood and oxygen to healing skin.  Some surgeons do use nitro when there is potential compromise (ie necrosis) of the skin (due to excessive trauma, persistent hematoma etc.), and this is reasonable.  But as a "routine", I think it is safe to say it is not the standard.  That said, from a healing standpoint it probably will do no harm, but the side effects of lowering blood pressure and severe headaches should be a concern and consideration.  Hope this helps. -Doc L.

A: Most surgeons agree that a "mini" lift is equal to a jawline lift.  This has been known in the past as a "lunchtime lift" for some.  Certainly the recovery time for a minilift is shorter than that of a full lower face and necklift.  In our practice, we advise patients that they will look "presentable" at one week post-procedure with their hair down (ie for women with long hair).  They typically can go back to the gym at that time as well.  A lower facelift and necklift usually doubles that time frame as far as looking good and getting back to routine activity.