So many celebrities have had facelifts or eye jobs done. The result is that they look like different (odd) persons post-procedure. For example: Rose McGowan, Melanie Griffith, Gwenyth Paltrow--the list goes on. How does one avoid looking weird after a procedure like that? I'm assuming those folks went to reputable physicians. What went wrong?
How to Avoid Freakish Results from Facelifts
Doctor Answers 23
Finding the Best Plastic Surgeon for a Facelift
When choosing a plastic surgeon it is imperative to select a surgeon who is certified by the American Board of Plastic Surgery. Often, plastic surgeons who perform a great deal of aesthetic or cosmetic surgery will also be members of ASAPS. A plastic surgeon who is a member of ASAPS is an indication that a surgeon has significant interest in aesthetic plastic surgery. When evaluating a surgeons training, look for completion of a plastic surgery fellowship. A fellowship is an elite qualification that only a small percentage of surgeons performing cosmetic plastic surgery can claim. , a surgeon who has had an additional fellowship of training has completed focused and intense specialized training in a particular area of interest
Be careful about investigating board certification. Some doctors today are promoting themselves as being double board certified, triple board certified and even quadruple board certified.
Thousands of physicians with no residency training in plastic surgery and without certification from the American Board of Plastic Surgery (the only Board recognized by the American Board of Medical Specialties that certifies plastic surgeons) promote themselves as `cosmetic surgeons' and `plastic surgeons'. Some are primary care physicians, some are emergency room doctors; some have never completed a residency training program in any specialty and are not eligible to take any specialty board exam. Many take `weekend courses' on liposuction, or breast augmentation, or facelifts, then return to their practice and begin promoting that procedure and performing it on patients.
The minimum amount of training in plastic surgery that will allow a physician to be eligible for certification by the American Board of Plastic Surgery is five years, and many board-certified plastic surgeons, myself included, have several additional years of training in general surgery and plastic surgery. There are a number of reasons for such a significant training requirement. Chief among them are the following: one does not acquire sophistication in diagnosis and treatment planning, superior surgical skill, and the capacity to minimize the possibility of complications and unfavorable outcomes by taking weekend courses. It requires years of training experience under the direction of talented mentors. It requires devotion to the art and practice of plastic surgery.
Be careful in evaluating physicians whose `Board Certification' is by a `Board' which is not recognized by the American Board of Medical Specialties (ABMS), and who belong to an `Academy' that does not require residency training in plastic surgery. Some will claim that they are `double-' or even `triple-board certified', when only one (and occasionally none) of those `boards' are recognized by the ABMS. Visit the ABMS website to see which specialties have ABMS recognition.
It takes just a few mouse clicks to verify a surgeon's credentials online. Make sure that the surgeon or surgeons that you are considering are certified by the American Board of Plastic Surgery and are active members of the American Society of Plastic Surgeons (ASPS). ASPS members are also eligible for membership in the exclusive American Society of Aesthetic Plastic Surgeons (ASAPS), the premier professional association of board-certified plastic surgeons with a specialty practice in cosmetic surgery
Selecting a plastic surgeon should always start with board certification by the American Board of Plastic Surgery, but it doesn't end there.
Choosing Your Surgeon
There is endless information about plastic surgery available online, some of it helpful, some of it hogwash. Many patients learn about treatment options and narrow their search for a plastic surgeon with the help of their computer. And then they make one or two or more appointments, and on the basis of these encounters decide on a surgeon. Some patients already have a particular plastic surgeon in mind, based on the recommendation of satisfied patients or the surgeon's reputation.
Regardless of how you decide who you see, ask yourself the following questions after your consultation appointment(s):
Is this surgeon qualified to perform the surgery I am considering?
Do I like this person? Will I enjoy seeing them over the course of my surgery and recovery?
Was my complete medical history taken and examined in detail?
Did this physician truly listen to me as I explained my thoughts about the improvement I am seeking?
Does this physician share my aesthetic sensibility? Do they understand me and are they able to provide exactly what I am looking for?
Was I provided with a thorough understanding of all options available (both surgical and non-surgical)?
Was I shown photographic examples of surgical outcomes that give me confidence?
Was the office staff professional, friendly and accommodating?
Was I pressured in any way to proceed with surgery?
Does this surgeon perform aesthetic surgery exclusively or is aesthetic surgery a small percentage of the pratice?
Listen to what your heart and your gut tell you when you are evaluating your consultation experience. Only move forward if you can do so with confidence about the experience you expect to have in a given plastic surgery practice, and about your ultimate outcome as a surgical patient.
Your experience with the consultation process is a good indication of what you are likely to receive as a surgical patient in any practice. If the process is well-organized and enjoyable, the staff is respectful and efficient, and the physician takes adequate time to understand your individual needs and communicates effectively, then you have a very high likelihood of being treated in a similar fashion if you become a surgical patient of that practice. If the process is disorganized or rushed, if the staff is discourteous or unprofessional, or if the physician does not give you confidence that your needs will be met, then don't expect things to get any better once you are a surgical patient.
You must be absolutely certain that your plastic surgeon's aesthetic sensibility matches your aesthetic goals. I have a very particular aesthetic vision, and I do not pretend to be the plastic surgeon for everybody. I strive to produce surgical results that are natural-appearing, results that do not advertise a trip to the operating room. For example, I do not perform breast augmentation for patients that are seeking an overly large and distinctly `done' breast appearance. And I have a particular distaste for cheek implants, as I think they rarely produce natural-appearing cheek contours, and instead prefer to enhance facial volume by means of structural fat grafting. Make sure that your plastic surgeon's philosophy and preferred approaches are consistent with the goals that you have in mind.
Adequate communication is obviously invaluable, and you should be able to communicate clearly and easily not only with your doctor, but also with your doctor's staff. Over the course of preparing for and recovering from aesthetic surgery, your doctor's staff will have an important and active role. Make sure that your interaction with the staff gives you confidence that you will receive the care and attention that you expect, and deserve, postoperatively.
Verify that major surgical procedures are performed in an accredited surgery center and that anesthesia care is provided by board-certified M.D. anesthesiologists. If you are most comfortable with overnight observation after surgery with the bedside care of an R.N., verify that this is available to you. Look up your surgeon on your state's Medical Board website to verify that they are in good standing and have no public record of sanction or limitation of their license to practice.
Be confident enough to ask some `difficult' questions. Feel empowered to ask any physician questions like: What are your complication and reoperation rates for this procedure? Has a cosmetic surgery that you performed ever resulted in a lawsuit? Have you had any serious complications and unplanned hospitalizations after cosmetic surgery? Have you ever been disciplined by a state medical board? I am never offended by these kinds of questions, and no competent and qualified surgeon should be. In my opinion it is actually the savvy prospective cosmetic surgery patient who does this kind of `due diligence'.
We flat out don't know what produces freakish facelift results
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.
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.
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Communication, expectations, and surgeon selection
Thank you for the question. My definition of an ideal face lift result includes in part not having anyone assume you have had a face lift procedure. I think a patient that desires improved appearance but wants a natural, non-operated result will have to communicate this to his or her prospective plastic surgeon but also seek out a board certified plastic surgeon that prefers to achieve these type of results. The face ages through a combination of changes including volume loss, skin changes, and soft tissue drooping. When facial rejuvenation is desired all of these changes must be addressed. Therefore, fat grafting, a face lift, and skin resurfacing frequently must be combined to accomplish a natural result.
All the best,
Dr. Remus Repta
Have realistic expectations and do not get upsold!
Anonymous73: I agree that any cosmetic surgery patient should not be wearing someone else's vision of themselves. Celebrities are not immune to being blindsided. While it is possible to dramatically change with facial procedures, the question is whether this is ultimately in your best interest. Review photos of yourself, so you know where you're coming from, so you know where you're going. Consider carefully what is being proposed, so that you remain somewhat in control. I have been most satisfied with results when patients remarked that their inner circle complimented them but were uncertain what had been done. good luck.
A facelift is a complex procedure where the deeper tissues of the face are repositioned to a more youthful position. Facelifts which appear "done" or "windswept" are often the result of aggressive skin only facelifts where the skin is stretched in an unnatural vector. When the face is swollen, the windswept look is not as apparent. However, as the face relaxes over time, a "windswept" or lateral sweep deformity can be seen.
Avoiding a done look with a facelift involves lifting the deeper tissues of the face so that tension is avoided on the skin. This type of lift requires more expertise and anatomic knowledge.
Avoiding unnatural facelift results
There are many different styles and types of facelifts performed with varying results depending upon the physician that the patient goes to. The hallmark of an excellent facial plastic surgeon is to turn the clock back and without changing the whole look of the patient’s face. This can be done through minimally detectable incisions, freshening a patient’s appearance without having had the overdone look. Always communicate to your surgeon your desires and examine before and after photos.
Experience matters, PR does not
Avoiding "freakish results" is a common concern for both Patients and Surgeons alike.
Reading through the posted answers you have already received some excellent advice.
Having a practice focusing on facelift surgery, I have this conversation with prospective patients everyday. A clear line of communication and working with an experienced Surgeon who will appreciate your anatomy and be able to provide the widest and most applicable options to you will keep you away from "freakish looks".
Lastly, PR should always be taken with a grain of salt -- and surprisingly many celebrities who should know better don't. Sadly, some celebrities, in an effort to keep their privacy about their procedures, will try non-traditional care providers and the results can be very dissappointing.
Do your research, look for experience and clear communications from the beginning and you should do do well!
Facelifts can have natural results
The most natural results from facelift occur from making sure that the subcutaneous tissue (fascia and muscle) vectors of pull as well as the skin vectors are appropriate to result in the desired contour of the face and neck. The skin layer should never be pulled tight. The best contours are achieved by employing these principles along with a meticulous symmetrical dissection, redraping and closure technique.
Avoiding bad Facelift results
The first step is a detailed consultation with your plastic surgeon. During the consultation be sure to look at before and after photos of face lifts to get an idea about your doctors style and results. Facelifts should place most of the tightening on the deeper tissues which elevates and smooths them and then the skin is redraped over this "new" foundation with only slight tightness and hence leaving you with a natural appearance.
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.