Uneven results from cheek lift procedures

Dear HelloFromTheresa This is Dr. Volshteyn and after the comments above I would like to respond. The Quicklift procedure is a modification of MACS and S lift technique very well described in the plastic surgery literature. The procedure elevates both skin and underlying SMAS layer. The additional components performed for you were suspension cheek lift also described as a part of extended MACS lift and FAME technique. You also had liposuction on the neck and jowls and plication of the platysma (neck muscles) and lateral subcutaneous brow lift. Quicklift in essence is the name, not a cookie-cutter procedure. Each patient’s surgery is technically somewhat different from another based on location of desired improvements, skin and deep muscle quality, amount of extra tissue and so forth. The duration of the results is also variable based procedure, skin quality, age, nutrition, smoking and so forth. Same is true for any facelift procedure. That is why it is very difficult if not impossible to guarantee the results of surgery in advance. There is no plastic surgeon who can honestly say that 100% of patients he or she ever operated on are 100% happy. Neither can I. We perform a lot of facial rejuvenation procedures and vast majority of patients are very happy. However, not everyone is. The reasons are numerous: technical problem, the tissue quality, suture positioning, age, expectations and so on. That is why we do make corrections, adjustments and revisions in order to keep our patients happy and to improve the overall results. This is a part of providing plastic surgery care. Sometimes the improvement is possible and sometimes it is not. It is important to keep in mind that the key to successful correction is to have open communication and discussion of specific concerns. Once the specific imperfections are identified they can be corrected. Plastic surgery is an art of repositioning living and breathing tissues. There is also very complex anatomy involved. The plan of correction has to deal with specific concerns and take in account all the factors above. However, if someone is just overall unhappy about the result it is impossible to correct. About the asymmetry. The face is not symmetric in 100% of people. Actually the asymmetry makes us unique. So we cannot expect the perfect symmetry after surgery either. The goal is to utilize the naturally existing facial features and asymmetries and lift them in the balanced fashion. This way we get a natural look that still reflects the same facial features that we started with, may be a few years younger and more refreshed. It is impossible to “just lift one side” and expect an isolated improvement. Our faces are very complex structures and any lifting of a component of the face will also result in alteration of surrounding areas. Any correctional surgery must take that in account. That is why prior to any correction a detailed discussion of outcomes and an acceptance of possible risks and side effects are needed. We will be happy to address your concerns, however, as you understand, it is very difficult if not impossible to compete with 10x magnifying mirror and a ruler. During our last visit you expressed your dissatisfaction with the result. You also indicated specific concerns related to difficulty with applying makeup and styling your hair. These concerns are difficult for me to put in surgical terms. That is why I asked you to look at your face and give me a more specific input as my perception of the result may be different from yours. In order to target my efforts in the right direction I need a specific guidance from you. That is supposed to be a topic of our next discussion in August. I understand that it is difficult sometimes to do that on the spot. That is why we asked you to make a list of what you would like to have corrected at home. This way our next discussion could be more focused and productive. If you desire a second opinion on your surgery, I encourage you to obtain it and I will be happy to provide you with copy of all your medical record including before and after photographs. Let me emphasize that I am happy to see you and provide whatever correction is needed. I respect your right to express your opinion. However, I do not find the open forum, such as this, being productive in providing real practical solution for the concerns you have expressed. I would encourage you to keep the appointment you have scheduled and make the next step in planning process for targeted revision procedure that would address your concerns and provide the improvement you desire. Sincerely, Boris Volshteyn MD