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Book:The Facelift Letdown- Why Are Surgeons Not Doing Composite Face Lift?

asked 2 years ago by Catalina in OK in Bartlesville, OK
Latest answer by Kamran Jafri, MD
Question viewed 1,889 times
Tags: technique

I have read several posts indicating that clients are getting to wrapped up in the type of procedure. But it appears to me from this book there should be only 1 procedure. How can one identify the work of a plastic surgeon without knowing how he/she does a facelift? Looking at before/after pics does not tell me what the patient looks like, 3-5 years or longer, later.

15 answers to Book:The Facelift Letdown- Why Are Surgeons Not Doing Composite Face Lift?

The results depend on the patients aging and the surgeon.

The most important issue is the surgeon. I have been doing facelifts for more than 30 years and use different combinations of techniques for different patients. Experienced facelift surgeons should be able to show you patients who are long term. We developed the irregular, trichophytic forehead lift 30 years ago to prevent the shifts in a womens hairline and actually lower the hairline at the same time. Thus, we never remove any of a womens hair, only bald skin. Composite lifting does... more

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Composite facelift vs other techniques

We abandoned the composite facelift more than 5 years ago, in favor of the 360 Facelift concept. The reason is simple: the way the technique is described, a great alteration in the hairline occurs. The composite lift is not done in a multiplanar fashion. It is not possible to independently manipulate the deep tissues and the skin. Rather, they are attached to each other. Thus in order to elevate the deep tissues, the skin must rise as well. This, in my opinion, raises the sideburn in... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Is there one type of face lift which is better than the rest?

To answer your question about composite face lift, one has to first understand the difference between the various types of face lifts. Mini face lift. The least invasive of the lifts. It involves a shorter incision. In addition, most of the lift comes from removing excess skin rather than lifting the deeper SMAS layer. Results are less dramatic. These are ideal for younger patients who need minimal results. Results can look unnatural and pulled if too much tension is placed on... more

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon

The Facelift Letdown

I appreciate the question, which relates to Dr. Sam Hamra's recently released book. Dr. Hamra is distinctive pioneer in Facelift surgery. Although not all high quality Facelift surgeons use Hamra's exact technique, many rely on elements of the composite approach in treating their patients. However, I feel that one of the major points of his recent book is as follows: many patients are choosing highly marketed, quicker, cheaper procedures (ie Thread lifts, Lifestyle Lift, Quicklift, etc)... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Top 5 reasons to get or not get a Composite Facelift

Hi Catalina, Here are my thoughts on the interesting question that you have posed. I will present them in a Top 5 format of reasons to get (or not get) a Composite Facelift: 1. Longer lasting results - certainly one of the premises of doing a Composite Facelift (CF) is that the deeper repositioning of the tissues results in longer lasting results. This is true in a general sense but be aware that the deeper dissection comes with higher risks and that not all patients need a CF - they may... more

Kamran Jafri, MD
New York Facial Plastic Surgeon

Composite Facelift

A good facelift surgeon will use many different techniques and combinations of techniques individualized for the needs of each patient. Results are more important than technique. An experienced surgeon can show long term results. I recently saw two patients with 25 year rhinoplasty results and several others with 15 year results from facial rejuvenation. To answer your original question, some patients complain about the extended recovery after the composite lift.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Which facelift technique is right for you

The facelift technique that each surgeon employs is generally based on a risk versus reward scale. The composite facelift is a wonderful procedure when well executed. The problem with the technique is that there are many potential pitfalls in the procedure that can occur even in the most experienced surgeons hands. Most of the comparitive studies that have been done on facelift techniques have demonstrated no increased longevity of results using this technique versus other less invasive... more

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon

Which facelift type is best?

I would agree with the previous answers -- no one surgical techinique is superior, or even appropriate, in every patient and circumstance. The single biggest key to getting consistent, natural, beautiful resuls is not which procedure I choose to use -- it is truly examining and identifiying what changes each specific patient's face requires to achieve a natural, refreshed look. Once the patient's specific circumstances -- bone structure, skin type and tone, fat distribution, medial health,... more

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon

www.nayakplasticsurgery.com

Facelift

Not having read the book, I have to disagree that there is only one way to do a facelift. That's like saying, if you have only on hammer everything is a nail. You must have more than one tool in your toolbox to fix things. Composite facelift are right for one kind of patient and a minilift is right for another. For example, a busy executive that has minimal excess of the jowl and neck area but doesn't have time to recovery for 3 to 4 weeks will do great with a minifacelift. As long as the... more

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Again it is the surgeon not the surgery that makes the difference

Dear Catalina Everyone is looking for the exact formula. The reality is that a great surgeon can do almost anything with any technique. Having said that there has been a realization that higher risk facelift have not produced more profoundly improved results. Deep plane and composite facelifts increase the risk of facial nerve damage. How high is the risk compared to a SMAS flap facelift? One or two percent compared to essentially a zero incidence. Is the risk justifiable? Time has... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Type of Facelift

The Composite Facelift to which you refer is just one of a number of SMAS facelifts. It was developed by Dr. Sam Hamra and is one of the best SMAS lifts there is. It is also one of the hardest for most surgeons to get safe, reliable results. It also has a prolonged recovery in my experience. We have adopted the MACS lift which we have modified. This techniqiue does not elevate below the SMAS and has a much more vertical lift. By doing this, we have been able to get superior results with... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

It's the facelift surgeon that matters, not the specific facelift technique.

Hi! This is very confusing and scary for patients, bur there is no magic in a particular facelift technique. You can get a terrible result from a poorly executed composite facelift. It is the skill and artistry of the individual surgeon that determine the result. Try to talk to patients who are happy and who don't look pulled.

George J. Beraka, MD
Manhattan Plastic Surgeon

Faces are all different, therefore there isn't one facelift for all patients

Surgeons tend to have a "favorite" facelift technique that they feel works best for them. However, not all patients are created equal. Some have more drooping than others, some have wider faces and the skin varies as well. So, you should seek out a facelift specialist to determine which is best for your. Of course, surgeons will put their best results in a website or book. It is a matter of deciding who you feels understands your needs and can deliver a quality, natural result. more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Before and After Facelift Results

Your question is a good one and this book was recently highlighted in a New York Times article last month. I think the bottom line is that there are different types of facelifts and many highly skilled and qualified surgeons that can get fantastic results with these procedures, both early on and for years to come. While I think all of us as plastic surgeons can have very strong opinions about what is the "best" procedure for a specific problem, I think most of us can agree there... more

Shahram Salemy, MD
Seattle Plastic Surgeon

Long term facelift results

Any surgeon should be able to show you results at several months out and also a few years out from a facelift. How you age with the result will depend partly on the technique and also on your own tissues and skin elasticity.