Mistakes That Could Lead to Unnatural Facelift Results

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Facelift has been one of the most commonly performed cosmetic plastic surgeries over the past several years, according to surveys conducted by the American Society of Plastic Surgeons. In 2014 alone, about 128,000 procedures were conducted by board-certified plastic surgeons, a number that is expected to further increase as more seniors postpone retirement. Because bad results from facelift are too obvious—to the point that they scream plastic surgery—the procedure has received some notoriety. However, it does not give justice to skilled surgeons whose “work of art” looks natural that no ordinary observer can tell whether a person had undergone the knife. One of the most common mistakes that lead to unnatural facelift results is too much reliant on skin pulling, without considering that facial aging is not just about the appearance of wrinkles and saggy skin. In fact, aggressive and incorrect “pull” leads to a wide range of problems such as scar migration, windswept look, and flat cheeks, thus defeating the purpose of achieving a youthful, somewhat plump face. Skin tightening alone will result in unnatural appearance and/or short-lived results, so I always include the muscular structures to create a new “scaffolding” that is strong. I have also noticed that many patients need volumizers—such as traditional fillers like Restylane and Juvederm, or fat graft in which their own fat is injected to plump up their skin—for a more rejuvenated appearance. The whole idea of volumizers is to correct the skeletonized appearance caused by loss of facial volume/fat. While add-on treatments such as volumizers and Botox often complement the results of facelift, some patients can take it too far, leading to the appearance of “pillow face” caused by excessive use of dermal fillers, or perennially surprised look due to over-injection of Botox or successive facelifts. To avoid the problems mentioned above, I often advise people to always consult or work with their facial plastic surgeon prior to these ancillary procedures. A number of botched facelift results are also caused by eyes looking weird—i.e., unusual shape or hollowness around the area. To avoid unnatural results, structural fat grafting and/or cheek lift partnered with eyelid surgery are particularly helpful. Take note that ancillary procedures can enhance or destroy facelift results; for instance, aggressive brow lift can cause high forehead and perennially surprised appearance. To avoid these problems, oftentimes I just lift the lateral brow by just a few millimeters, barely “touching” the mid brow.
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Beverly Hills Plastic Surgeon