Avoiding a done look with facelift or plastic surgery

Avoiding a done look with a facelift will not occur by accident.  It will only occur if techniques that avoid a pulled look are used.  The signs of a top facelift should literally be minimally detectable or undetectable.

The most modern facelifts do not rely on very tight pulling of tissues as was the practice in the 80's.  Rather, volume distribution and replacement are more important, and skin tightening is done more smartly, avoiding a high pull on the side of the face.  For volume replacement, we prefer LiveFill(R) grafts over fat injection.

Ear reconstruction after the facelift is also key.  Ears should look flawless, not pulled.  One giveaway area is the bump in front of the ear, the tragus.  It should look natural and relaxed.

The hairline should be preserved, not pulled up at the sideburn.  For most women, a high vertical pull on the skin will permanently alter the hairline.  That is totally avoidable.

Ancillary procedures have a huge impact also on the overall look.  The more signs of aging that are minimized, the better the overall result.  Many of these ancillary procedures are NOT cookie cutter, and are individualized to each patient.

The facelift is the time not only to turn back the clock, but to improve the beauty of the face as well.  If the upper lip is too long, the earlobes too large, if there is an imbalance or unusual asymmetry, if there is sun damage or sun spots on the skin, these can all be treated and minimized.

You see bad results, you don't see good results other than people look good.  Celebrities do often see top doctors, but often make bad choices along the way.  The high profile victims of the disgraced silicone injection doctor are prime examples.

Dear Anonymous

On Rodeo Drive, in the middle of the street is a sculpture of a female torso with no head and no arms. I guess a hacked up body is the model of female beauty in the center of the plastic surgery universe.

One thing is for sure, if our most famous stars can't get great surgery, what hope do mere mortals have? I think your concerns are appropriate. I am not really sure I argee with my colleague here who argues that most facelifts come out great or that the bad facelifts are the results of old fashion techniques. Some of the most horrid results I have seen are by some of the most famous facelift surgeons in the world using the latest deep plane methods. On the other hand some of the most natural results are in individuals who have had their facelifts done by extremely conservative surgeons who still perform skin only facelifts.

The bottom line is that a facelift is the most powerful cosmetic procedure we have but it is still an art form that must be tailored to the individual. It does not matter if the surgeon used the latest variation on the deep plane facelift if they can't exercise artistic judgement. At the same time, mass marketed facelifts at the other end of the spectrum can also lack artistry and tailoring necessary for a natural but effective result. 

Remember what the screenwritter Nora Ephron said that just because a surgeon is famous does not mean that they are talented at sewing up human beings. Studying before and after pictures is helpful. These will be the surgeon's best work. Don't just fall in love with a doctor because they were featured in your favorite magazine. This often just reflects the quality of the public relations firm.

If I wanted to hire an architect I would want to see finished examples of his work! Why not take the time to do your homework and see long term results of a surgeon you are considering? These "weird looks" are not a result of complications. You don't notice the great facelifts, because they don't look done.

The best way to avoid freakish results is to carefully select an experienced surgeon  and look at that surgeon's results. Carefully describe what you want to achieve.  More is frequently not better; you want to appear "natural", not surgical. Celebrities are not immune from making bad decisions. A pulled, tight  look is not a possible complication when the surgery is properly done.

Hello,

The best advice I can give you is to do your research when choosing a physician. And once you make the choice, be sure to communicate with them what you would like to achieve, and make sure they are capable of handling it safely and professionally. You may look at the doctor's style via before and after photos. Thank you, and best of luck to you.

Dr. Nassif