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Wading Through Confusing Doctors' Opinions on Facelift

I am ready to make a decision on which surgeon to choose in Sacramento for Facelift. I'm not an extreme case. I'm 52. I've been examined by 5 drs to make the best choice.

I've narrowed it down. One says that if the muscle is plicated (folded) that it can leave a bump that could show through later. The other Dr. says this could benefit by adding some fullness to side of my face.

Also, one said the incision is only necessary in the sideburn (horizontal), while the other says that is must also extend over the ear. I'm very confused. Thank you.

Asked 29 months ago by fabb50 in sacramento

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Which Facelift Procedure?

You should not be put in the position of having to decide which facelift technique is best for you. All you're interested in is the results. First, you must be comfortable with the surgeon. You want to know what will be done, what will change, what is your post-operative course, what are potential complications and what it will cost. See before and after pictures of patients similar to you. Hopefully this will eliminate the confusion.

Doctor's Website

Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

Facelift options

There are several ways of performing facelift operation, all of which can give excellent results. Review some photos from the surgeons that you are leaning towards choosing. Seeing acutal results should give you confidence in that particular surgeon's technique. The options that have been offered to you are all accepted methods of performing facelift surgery.

Maurice M. Khosh, MD

New York Facial Plastic Surgeon

Sorting out facelift options

Having seen 5 doctors you have hopefully discovered that there is no one facelift operation - but this can become very confusing. My best advice is to look at lots of photos from each of the doctors and decide who's look best and most like what you want. Then be sure you "click" with that doctor and his/her staff and then go ahead with surgery. Don't fret over small details like incisions and plication vs SMAS flaps. This is an artform and no 2 surgeons are the same and... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

See facelift before and after photos

With respect to the facelift incisions, the incisions are not placed in a vertical fashion in front of the ear. The incision is usually placed behind the tragus and half the hairline in the sideburn area. The excess skin that is removed is bald skin, not hair-bearing skin so as not to raise the hairline. This holds true for the postauricular area as well. The muscles are usually folded over in the neck when the neck muscles are tightened, and this does not show through. On the side of... more

Doctor's Website

William Portuese, MD

Seattle Facial Plastic Surgeon

Establish A Level of Trust With ONE Plastic Surgeon

I think it is very important to establish a level of trust with the surgeon you choose. It is important to do your homework and seek out well trained experienced board certified plastic surgeons who does facelifts on a weekly basis. Do this and you will probably get a good result with whomever you choose. While facelift nuances you mentioned are important to understand, they are not critical for you to receive an excellent result. There are many more nuances and decisions that a... more

Doctor's Website

David L. Mobley, MD

Sarasota Plastic Surgeon

ASAPS ASPS

Word of mouth

As other surgeons have noted on this topic, there are different approaches that can yield excellent results. The key is finding a surgeon who uses an acceptable technique, while obtaining stellar results. Most accomplished Facelift surgeons agree that the best results are obtained with some form of SMAS mobilization technique (elevation, repositioning, and suturing of the SMAS). My observations are as follows: 1) Listen to what people say about a surgeon's staff, his manner, his results... more

Doctor's Website

Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Ask to see facelift before/after photos

You are confused, but this can be alleviated by seeing multiple before and after photos of each surgeon's patients. It is most important to see patients with your type of facial morphology and deformity and approximate age range in my opinion. Don't rely just on computer imaging for this procedure. I would advise narrowing the decision down to no more than 2 or 3 surgeons, and then make a choice. Talking to former patients can be helpful, if they are willing and open to discussion. more

Doctor's Website

Harrison C. Putman III, MD

Peoria Facial Plastic Surgeon

Talk to former Patients

Fabb50, As always you have received excellent advice from the Doctors here. I would add one more thing: Ask the Surgeons to speak with former Patients of theirs who have undergone the procedure they are proposing to you and also have (had) similar anatomy to yours. They should be at least 6 months to one year or more from having had their procedure. While this does not serve as any guarantee of what you can expect it will give you an idea of the Surgeon's experience, results and what... more

Kamran Jafri, MD

New York Facial Plastic Surgeon

Confusing facelift

You are confused by the myth that there is a "RIGHT" in Plastic Surgery. Many studies have shown that skilled Plastic Surgeons can get excellent results from substantially different techniques. Read the book "Blink" by Malcom Gladwell, do your homework on your possible surgeons and go with your instincts. Stop worrying about where he makes his cut.

Donald Kress, MD

Frederick Plastic Surgeon

ASAPS ASPS

Doctors' opinions on facelift can be confusing

First and foremost, I would recommend the services of Dr. Jonathan Sykes at UC Davis. He is a very talented facial plastic surgeon and an expert in facelift. The varying techniques for facelifting all involve some manipulation of the "muscle layer", which is under the skin but actually on top of the facial muscles. One can plicate (fold on itself) or imbricate (remove a section and reconnect) the SMAS (muscle) layer to lift the jowls and tighten the neck. If either technique is... more

Min S. Ahn, MD

Westborough Facial Plastic Surgeon

No Easy Answer

Greetings, Unfortunately there is no easy answer to your question. As pointed out by Dr. Chaboki, a facelift is not just one procedure but a range of procedures. Each surgeon will have a slightly different way of performing the procedure. The results that they discuss in consultation will be a combination of their experience and the procedure they perform. In the end you can get excellent results with several options. Choose a surgeon with whom you feel comfortable. Sometimes more important... more

Doctor's Website

D.J. Verret, MD

Dallas Facial Plastic Surgeon

Various face lift techniques with facial plastic surgeons

A cosmetic face lift is not one operation, but many potential operations. There isn't a best face lift for all patients. Variations exist for the amount of skin, tissue, and muscle reshaped and modified based on the patient's individual needs and surgeon's expertise. Choose a plastic surgeon whom you are the most comfortable with and whom can help manage any issues that may arise during the healing period, regardless of the specific surgical variation. You've already seen plenty of plastic... more

Doctor's Website

Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon

Don't have surgery until you're no longer confused

The outcome of any facelift is the product of one and only one variable--the surgeon. If the surgeon has not succeeded in completely discussing with you the surgical approach, the anticipated outcome, the risks, the convalescence, and so forth so that you are not 100% certain of your choice--don't have surgery. Facelift results are predictably good in the hands of a good and experienced surgeon. You should have little concern with resulting scars and be delighted with your choice. Make... more

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Different facelift opinions

So you now know that this is part art and part medicine, there being no consensus. I believe that the incision hidden in the scalp hair above your ear can displace the sideburn/temple hair and potentially give an unnatural result. As to the bumps from folding the SMAS layer, that can be seen at the time of surgery before the skin is closed and can be remedied by placing small sutures to smooth it out.

Doctor's Website

Julio Garcia, MD

Las Vegas Plastic Surgeon

ASAPS ASPS

How many consultations should you have?

If you have seen 5 good, reputable physicians for a consultation for a facelift, that is MORE than enough. All you get by doing this is getting 5 different opinions and most of us realize tha there are different minor modifications in technique which all may give excellent results. Choose a surgeon with whom you feel comfortable and follow his recommendations. I think you will be glad that you did.

Doctor's Website

Lawrence Kass, MD

Saint Petersburg Oculoplastic Surgeon

Choosing A Facelift Surgeon

The most important factor in a facelift is the surgeon. It can be very difficult to see a facelift surgeon and determine which surgeon is the "real deal". Here are some criteria to look at: Type of Facelift- Surgeons who perform less anatomically correct facelifts (limited facelifts, skin only, etc) will likely lead to less robust results with poor scarring. Board Certification- Surgeon should be Board Certified Facial Plastic or Plastic Surgeon... more

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Surgeon is much more important than a particular technique

Dear Fabb50 What you are searching for chemistry with your surgeon and the confidence in the work they perform. Their facelift theory is almost unimportant. What you need to focus on is what does their work look like. Reputation is important but at the end of the day, it does not really matter what other people think of your surgeon. It is much more important what you think of the surgeon. I strongly recommend that you carefully look at the before and after pictures. This will always be... more