Options for Deeper Face Lifts?

I found the right surgeon who fully qualified, with twenty five years experience. The only trouble is, he only offers the MACS and PSP lifts, but I want a longer-lasting and deeper lift. I also found this surgeon to be quite abrupt in his manner. With all this experience, I can't understand his reluctance to perform the facelift I want, and instead wants to refer me to another surgeon. What are your thoughts on this? Do I have other options to get the face lift I want?

Doctor Answers 12

Abrupt is not what you want..but don't tell your doctor what to do either

It sounds like you need another doctor if you found him to be abrupt. You should have a good raport with anyone who is going to operate on your face!

There are many facelift techniques and the long term result is more dependent on the surgeon's skills and artistry, and your skin elasticity and bone structure than on the "name" of the technique being used. This has been well demonstrated in the famous twin studies done several years ago where the facelift gurus of America each operated on different members of sets of identical twins to prove that "their" technique was clearly superior to others. The opposite was shown, namely that the talent and artistry of the surgeon made the most difference, not the depth of dissection or the name of the technique used.

So don't get too hung up on the name of the procedure and avoid any minilifts since these really don't last long enough to be worth it for most patients.

Lastly, go to someone whom you trust and whom you can work with. Don't dictate to them what to do - after all, they have been trained to do this and you have not. Look at many pictures of their patients and ask to talk to some to see if they are happy. Then go forward. Good luck to you!

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Consider further consultations before deciding on Dr. Right

You may still end up loving your first surgeon once you have had several consultations. However there are many fine surgeons who specialize in facelift surgery and revision facelift surgery you could talk with. When you meet the right person, chances are you will feel immediately comfortable with the doctor and the plan, and never look back.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

Deep (or "deeper") plane facelift techniques

Your surgeon may have had other reasons why he was reluctant to do a deeper plane lift. It sounds like you need to meet with a few more doctors until you feel comfortable with the surgical plan. This is part of the process. It is of course, important that you have a good relationship with whomever you choose.
See the attached video for an explanation of facelifting techniques--you may find this helpful.
Good luck to you,

Sam P. Most, M.D.

Sam Most, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Relationship with your facelift surgeon

I think it is of critical importance to relate to your plastic surgeon in some way. You have experienced an unfortunate disconnect with yours since he doesn't do the surgery that you seek. For the record, you're on the right track seeking out a procedure that is long lasting and needs to be done once to set the clock back on your aging process. Good for you and good luck on your search. Consider coming to the US for your surgery, you wouldn't be the first to come overseas for this!


Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 120 reviews

You need to find a better match!

Hi Susie,

Experience is wonderful, but there are a lot of talented surgeons available to you. If you are put off by an abrupt manner, and the surgeon doesn't feel comfortable performing the procedure you, there is a clear disconnect.

It is important that you communicate to your potential surgeon your goals - and it sounds like long lasting is a key for you. I think it's best to define your desires and together come up with a plan to make that work, and in your case a more extensive procedure beyond a MACS would be the case. I wouldn't try to have a surgeon perform a procedure he is either unexperienced with or doesn't believe in. You both may end up unhappy.

Seek a second or third option. When you've found the right surgeon, you'll know it.

Hope this helps.

Dr. K

David L. Kaufman, MD
Folsom Plastic Surgeon
4.9 out of 5 stars 62 reviews

MACS versus SMAS Facelift

The challenges with MACS and other superficial facelifts that do not address a lot of the deep layers aging problem nor do they restore facial fat augmentation of the depleted fat compartments. They are much shorter lasting, in my experience, or they do not address facial aging problems to the degree that is needed to provide for a long lasting natural looking appearance. The goal is to do deeper layers with SMAS elevation with facial fat compartment refilling and rejuvenation, a “Lift & Fill” facelift.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 64 reviews

Deeper Facelifts Worth The Fuss?

Few surgeons perform deeper facelifts.  Deeper facelifts are technically more demanding, require more anatomic knowledge, and require experience (measured in number of quality facelifts performed not years in practice.)  The payoff for patients with a deeper plane facelift is more robust results lasting longer.  

If a surgeon did not learn a deeper plane facelift during his/her training, the surgeon will likely not offer this as a choice in facial rejuvenation.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 166 reviews

Surgeon is reluctant to perform deep plane facelift

Don't take your surgeon's reluctance to perfrom a facelift that you want personally. Most surgeons like certain techniques because either they are easier to perform (MACS lift much easier technically than deeper lift) or they are not familiar with a requested technique. Most surgeons would simply tell you their reasons for preferring one technique over another (for example, maybe you need less of a lift for now, so he is recommending something less invasive). However, a combination of reluctance and an abrupt manner probably mean that he just isn't the surgeon for you, whatever the reason.

As for deep plane lifts, they are ideal for producing a great result in experienced hands, as long as the indications are there for them. They are far superior in my opinion to more superficial lifts, but take longer to perform and to heal from. You have to ask yourself if you can tolerate a week of more swelling for what will ultimately be a longer-lasting and more effective lift in the appropriate patient.

Minas Constantinides, MD
Austin Facial Plastic Surgeon
3.9 out of 5 stars 7 reviews

Facelifts and surgeons

Different surgeons perform different facelifts. This can be for a variety of reasons from comfort level to the belief that some of these other operations do not achieve the aesthetics that the surgeon is looking for. Your surgeon may be the latter. I am not a big fan of the deep plane facelift because I think it treats only certain areas and makes the face appear very wide. Almost masculine.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Options for deeper face lifts?

 You have real options that have LONG lasting results.  Unfortunately, you live in England and I cannot refer you to someone there.

So that you can be exposed to what is available, take a look at my website.  I think you'll understand.

Michael Kulick, MD, DDS
San Francisco Plastic Surgeon
4.3 out of 5 stars 12 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.