Worry About the Sausage-Maker, Not About How the Sausage is Made

For the sake of simplicity, patients should focus much less on technical jargon, and much more on what they can see with their own eyes.  A catchy name for a procedure creates a marketing buzz or tries to draw a distinction between one surgeon who offers it, and the next who perhaps doesn't.  A reliable procedure performed with technical skill and artistry by an experienced surgeon, and simply called a "Facelift", trumps any "facelift of the week" technical jargon term, any day of the week.

As a patient, you will never see "under the hood" to know what technique was used below the skin surface during your operation.  What counts is what your own two eyes can tell you before surgery, when you look at before-and-after results from different surgeons, or see their patients "in the flesh".  Patients with natural-looking results and good improvement of signs of facial aging, are a much better endorsement of a surgeon's skill and artistry than any hair-splitting technical jargon term to describe which suturing technique will be used deep to the skin, that you will never see anyway.

As surgeons, it is our responsibility to keep up with advances in the field as far as new techniques, materials and methods are concerned.  It is far better for the patient to trust the sausage-maker, rather than to obsess about how the sausage is made.

Many of the deeper facelift techniques elevate or tighten the deep layer, or SMAS.  Depending on which layers exactly are involved, and where exactly the surgeon changes planes, the Composite Facelift, the Deep Plane facelift , Standard SMAS, facelift, SMAS-ectomy facelift, SMAS plication facelift, Extended SMAS Facelift, PSP facelifts, 360 Facelift, are all techniques which can be used.

Certainly every experienced facelift surgeon should be capable of performing each and every one of the above techniques if necessary.  But the above techniques are just a start to comprehensive rejuvenation.

Modern facelifts don't just pull.  They pull in different directions.  They redistribute volume in the face, not just "really really tight" as was the goal in the past.  They keep earlobe architecture natural appearing, not pulled or canted.  They presefrve the hairlines.  They keep the direction of pull on the face minimally detectable.  They use scar minimizing and concealing techniques.

Expert facelifts often involve one of these techniques above plus many, many ancillary procedures such as volume restoration (fat injection, LiveFill or implants), periorbital surgery (fat preservational vs fat removal), midfacial/cheeklift surgery (many types of cheeklifts), browlift surgery (many types of browlifts), lip/periorbital volume restoration, resurfacing of the facial skin with lasers, etc.

The goals and the specific plan of the surgeon should be crystal clear to the patient before the surgery proceeds.  When they wake up in the recovery room, the procedure will be done.  The result they get for the rest of your life will depend on the artistry, style, experience, customization to the patient's specific needs, not on whether the patient chooses a doctor based on wanting to have a "PSP or a SMAS lift" .   

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