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What Constitutes Enough Experience in Facelifts? (photo)

I plan a facelift in January. I interviewed two docs, one occuloplastic surgeon the other a general surgeon who is board certified in plastic surgery and attended a prestigous medical school for that training. He is young and has only done 20 or so of these surgeries. Initially he wanted me to have oral anesthesia but I am not comfortable with that and would like a twilight type. Is he experienced enough? What other questions should I ask? Would you send your wife to him? Cost is lower than any.

Doctor Answers (16)

Facelift Experience does not come cheap

+3

My experience in the learning curve for a surgery is that it takes about 100 to understand the steps of the operation.  The next 100 allow you to get through the steps and think about making improvements while you are operating.  The next 100 allow you to make decisions during the operation to avoid problems.  In my practice if I have done an operation fewer than 250 times I will tell the patient that I am still on my learning curve.  You should ask to see long term (one year) before and after photos of a patient with similar facial characteristics who has had the exact same surgery that has been proposed to you. Credentials are no substitute for experience.  Experience is no substitute for poor training.  You should demand both as this is your only face and if you encounter a problem the savings become irrelevant.


Highland Park Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

What Constitutes Enough Experience in Facelift Surgery?

+3

You are asking very astute questions that more and more patients will be faced with. The bottom line is that physicians of all types are entering the field of plastic or cosmetic surgery. The risk is that patients are being exposed to surgeons who have minimal experience performing the procedure that they are recommending to their patients.

You've noted that one surgeon is cheaper than the other. While that is an important consideration it shouldn't be the primary driver of your choice of surgeon. A "cheap" facelift becomes very expensive when it needs to be revised by a more experienced plastic surgeon.

The bottom line is that nothing substitutes for experience. A competent facelift surgeon has typically performed 50 facelifts. Ideally, you want to seek out the most experienced and trustworthy facelift specialist in your area.

I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Face lift experience

+2

Your question is a great one.  I would break it down to a couple of choices- occuloplastic vs Board Certified plastic surgeon- go with the Board Certification without a doubt.  Whether or not this surgeon has done x or y number in practice, he has done the full training required to know what works, what is dangerous, and the anatomy of the entire face, not just around the eyes.  

As for experience, I would ask for some before and after photos from practice as well as training, and monitor your comfort with the answers he gives to your questions.  I know some very experienced surgeons who have done several hundred face lifts that I wouldn't let touch anyone I know.  I also know some young bucks who have had really solid training with great surgeons who know enough to be careful and meticulous rather than cavalier and quick and who do spectacular work.  It's an overall decision you want to make, rather than a decision based on one thing or another.

By the way, having done more than 20 face lifts my opinion comes from the more experienced side.

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 22 reviews

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What Constitutes Enough Experience in Facelifts?

+2

When choosing a plastic surgeon, you generally want to look for the following:

1) Board certification (Preferably by the American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery)
2) Fellowship training
3) Patient testimonials
4) Before and after photos

The surgery can be performed with either type of anesthesia. It is important to discuss your concerns with your surgeon, and he will help you choose the best method of anesthesia based on your needs. It is very important for you to ensure you have good communication with your surgeon. You will want to feel comfortable going into the procedure. If you feel the surgeon can meet your needs and is qualified, then you will be in good hands and should obtain a great result. Experience is important, as is proper training. A good surgeon will have both. Don't let a lower cost immediately deter you, as many skilled and well-qualified surgeons may price lower due to the amount of time they have been practicing. But also beware that surgeons who charge less may not be as qualified. Doing your homework will help. I hope this helps, and good luck!

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

What Constitutes Enough Experience in Facelifts? (photo)

+2

 The most important factor, IMHO, when selecting a Face Lift Surgeon or any plastic and cosmetic procedure or treatment is not only experience in performing that particular procedure (most likely hundreds not 20) but the ability to understnad and follow the proper aesthetics of facial beauty for the creation of a naturally more attractive, youthful face.  Price should never be the deciding factor in your selection.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

How to choose surgeon for facelift?

+2

Your question, of how to choose a surgeon for your facelift, brings up many good points.  There are many factors that can influence a decision.  I would say that cost should not be your primary factor in making a decision.  I would say that your comfort level with the surgeon would be very important.  In general, I would say that most facelifts are done by either plastic surgeons or facial plastic surgeons.  Oculoplastic surgeons do not normally get facelift experience during their training, unless they had a specialized fellowship in which they performed facelifts.  I would also comment on your anesthesia.  You mentioned the possibility of oral anesthesia.  I'm not sure if you mean oral anesthesia with oral medications, or oral anesthesia with a breathing tube in your mouth as part of general anesthesia.  If your preference is to have twilight type anesthesia, I think this is not an unreasonable request.  I perform the majority of my facelifts with twilight anesthesia and find it works quite well.  Your anesthesia options could be another factor for you in making your decision.   

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Facelift: It Sounds Like You Aren't Sure, So Interview a Few More Surgeons

+1

The first Criteria I would look at is Board Certification. The only two boards in consideration are the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Plastic Surgery. As far as cost goes, it isn't unusual for a less experienced Plastic Surgeon to charge less for a procedure. After all, you are paying for both skill and experience. I view a career history of 20 Facelift as the early part of the learning curve in refining Facelift technique. That having been said, the younger Surgeon may be very talented. I would not recommend oral sedation for a Facelift; Anesthesia is your friend for relief of anxiety and pain control. If you aren't sure about either Surgeon, keep looking! There is no reason to compromise on your Facelift result.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

How to Choose an Experienced Facelift Surgeon and My Recommended Procedures

+1

As a doctor who has been practicing cosmetic surgery for 20 years with an oculofacial plastic surgery background and board certification in facial cosmetic surgery, I recommend that you first be comfortable with whoever you choose. At a minimum, your doctor should have adequate training in order to perform that procedure. However, adequate training to perform a procedure and being at a level where you are a master has a range.

When I recommend people to look for a cosmetic surgeon for face lifting, I would suggest that in addition to having the training background, experience and artistry are the most important factors when it comes to getting really good results. Frankly, a younger surgeon first gets the experience, learns from it and then builds on that experience until he becomes a master.

As a specialist, I’ve done revision work on a board certified plastic surgeon’s work, a facial plastic surgeon’s work and even on a oculofacial plastic surgeon’s work. It’s not because they were not particularly good at what they did, there are just variations that surgeons approach the surgery.
I’ll tell you how people end up choosing someone like me and come to my office. First, as someone who’s had a lot of experience, I have a reputation. So people who I’ve done face lifting surgery on recommend other people. So, one of the best ways to make a decision is through a referral and knowing the quality and style.

Every surgeon has a different style in doing surgery and no two surgeons would agree on a hundred percent on how they do a facelift. I practice on the Upper East Side where some of the most famous plastic surgeons are well known for doing the most famous people in the 80’s and 90’s. I have to say that from my aesthetic sense, I really don’t like that style where the face looks very tight and very thin-looking. I prefer a more natural look and even wrote a book about this called The Fine Art of Looking Younger because a youthful face should have a nice defined jawline.

When I look at your photos, I noticed in the neck area that you have these two little bands and these are called platysmal bands. Since you have a relatively thin neck, it’s unlikely that I would do anything resembling a liposculpture because there’s really no fat to reduce. I would actually do something called a plastysmalplasty and tie those muscles together. And when I looked at the side view of your face, I noticed that the jawline needs a bit of definition and there’s a little bit of sagging. You have a relatively thin face and I can tell from many of my experiences that your skin quality is at risk at looking a little bit pulled and tight.

In addition to choosing the right surgeon, a good sign is the overall atmosphere and mood of the staff. In my practice, my staff are very enthusiastic and we’re very clear about the things we do well. That enthusiasm, honesty and integrity are felt by patients who come and see us. When a surgeon reaches a point where they do something particularly well, their own staff will stand behind the work and feel like they can really recommend him. And, like in my office, many of my staff members and their family members have also become patients.
I’m basically sharing with you a personal perspective of what it takes to be a really good facelift surgeon and I hope you take that into consideration.  I hope this was helpful, and thank you again for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 26 reviews

Enough Experience in a Facelift?

+1

     Having performed a few hundred facelifts but being young enough to remember the progression, I would say that quality of training along with additional cosmetic training sometimes separate one young plastic surgeon from another.  I would say that technique, intuition, and skill is solid by facelift number 20.  That is just my experience. 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 193 reviews

Choosing a facelift surgeon

+1

It is important to not use cost as a factor in choosing the right facial plastic surgeon.  Experienced board certified facial surgeons give the best results and tend to charge more than junior surgeons. This surgery should be performed in a certified ambulatory surgery center with a board certified physician anesthesiologist in attendance.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.