When you evaluate the results of facial rejuvenation, there are technical (the surgeon) and physiologic (the patient) issues that need to be optimal to get the best, longest lasting results. Surgeons who perform facelifting surgery frequently are more likely to get reproducible results. There are many ways to perform a facelift, but typically a surgeon will master and utilize a handful of these ways making is easier to produce the same results in patients.
Factors that have to do with the patient, may make it difficult to get a good, long lasting result. I typically speak to my patients about the following: age, sun exposure history, sun screen usage, smoking history, body weight, water intake history, airborn pollutants, facial asymmetry, exercise routines, and family genetics of aging. I think we are all born with the capacity to age well, but when you throw in the multitude of ways in which we abuse our skin it makes it difficult to provide great results to some patients.
I tell my patients that the face ages in four layers: the skin, the underlying muscles, the facial fat content, and facial bone position. Facelifting surgery really only tightens skin and muscle. It does nothing to alter the age characteristics of the skin itself, or revolumize the facial fat or bone. I think that when all four areas are rejuvenated, the overall effects are more natural and pleasing to the eye (yours and those of people around you.) This means that working on your skin first may make any future follow-up facelifts more successful in your eyes.
