The results depend on the patients aging and the surgeon.

Toby G. Mayer, MD answers: Book:The Facelift Letdown- Why are surgeons not doing Composite Face Lift?

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.


Toby G. Mayer, MD
15 days ago

 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 not do this and can cause a much longer recovery.

The bottom line is choose an experienced facelift surgeon and let him give you the pros and CONS of different ways of fixing the aging you have.

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A: Composite facelift vs other techniques

Brent Moelleken, MD
15 days ago

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 an unsatisfactory fashion.  Women cannot grow a sideburn to compensate for its loss.  Loss of temporal hair and sideburn results in a prematurely aged appearance.

Modern facelifts incorporate numerous ancillary procedures as well, not just to tighten, but to replace volume.

The paradigm of just tightening a face and not restoring lost volume is, in my opinion, dated.

The composite lift is easy to perform for an experienced plastic surgeon.  It may not, however, be the best choice for the reasons above.

Experienced plastic surgeons will be able to show the prospective patient many short and long term results.  Every patient is, however different.  Their results are also different.  Identical twins who have very different exposures to the sun, for example, will have entirely different long term results.  And that is just one variable.

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