Why Do Some People Look Like a Mannequin After a Face Lift?

Question

I have seen movie stars that look like they have that wax, plastic look after a face lift, why?

Kenneth Hughes, MD · Answer

Although this look can be created surgically, many celebrities have had very good facelifts that are obvious to many plastic surgeons due to their improvement and not their oddity. Hard to tell from the picture whether you would benefit from liposuction or neck lift.

Richard H. Tholen, MD, FACS · Answer

Unfortunately, in this age of high-definition, Hollywood stars show the effects of aging much more than even a generation ago! So when a star hopes to "stop the clock" of aging, especially with the aid of often-substantial wealth, "just enough" easily becomes "too much!" Michael Jackson's nose and face come to mind, as do Lisa Rinna's lips, and Kenny Rogers' face.

	The presence of wealthy celebrities trying to stay youthful-appearing attracts plenty of plastic surgeons (and plastic surgeon wannabees) to Hollywood, LA, and the entertainment suburbs; unfortunately, they are not always the best-trained, most-experienced, or ethically-minded ABPS-certified plastic surgeons.

	And while many stars and entertainers are brilliant, well-educated, and thorough in their selection of plastic surgeons, some are, well, you know!

	So, just like everywhere, there are less sharp tools in the shed, both on the consumer side and the provider side, plastic-surgical-wise! Hence, the results you see. (And the best ones you don't!)

	Always see one or more ABPS-certified plastic surgeons with plenty of experience in the area of concern. There is nothing so visible as your face, so choose carefully. Best wishes! Dr. Tholen

Jonathan Berman, MD · Answer

Facelift surgery should be performed by Board Certified Plastic Surgeons, and I certainly have seen patients who have been pulled too tight, and also some who have had multiple facelifts, both of which can create the look you’re speaking about.  I spend a great deal of time with my facelift patients preoperatively, explaining my techniques to them, and also familiarizing myself with their anatomy and determining their expectations, as I never want a patient to have an unnatural appearance. 

	Jonathan Ross Berman, M.D. , F.A.C.S.

William Portuese, MD · Answer

A waxy, shiny or pasty look is usually due to older style full face CO2 laser resurfacing. An overdone facelift simply looks too windswept and pulled. Neither one of these look natural , so it is very important to go to the right surgeon

Michael Law, MD · Answer

The specialty of Plastic Surgery has been undergoing a 'paradigm shift' in the approach to surgical treatment of facial aging changes over the last two decades. This shift has consisted of a departure from older 'subtractive' techniques to newer 'restorative' techniques.

	Surgery which consists mainly of removing (subtracting) skin and fat and pulling tissues tight will lead, in many instances, to a 'skeletonized' and therefore more aged (or "done") appearance. Facial soft tissues (and even the facial bones) actually lose volume and projection with age, and it is thus inevitable that surgery which focuses only on removing tissue will in some fashion 'age' the face.

	The contemporary approach to surgical rejuvenation of the face consists more and more of an attempt to restore facial volume and contour, in an attempt to emulate youthful facial features. My personal approach to facial rejuvenation is to first maximize repositioning and recontouring of facial aesthetic areas, and to remove only as much tissue as is necessary.

	I also find that structural fat grafting, using a patient's own fat from the abdomen or hips, is an extremely effective means to help restore the facial volume associated with a youthful appearance. The importance of restoring facial volume is readily apparent when I review with a patient a number of photographs from their twenties and thirties. The meticulous addition of soft tissue volume by means of fat grafting is one of the most powerful means now available for 'turning the clock back.'

Adam David Lowenstein, MD, FACS · Answer

Your question is a great one, and unfortunately many people see these highly publicized, bad looking face lifts and assume that is representative of all facial surgery.  This could not be farther from the truth.  

	Whether it is these eccentric people who request this overdone look or just bad plastic surgery, many experienced plastic surgeons such as myself will tell you that we have never performed facial surgery with results such as these. 

	In my practice, my emphasis is rejuvenation of the patient's natural appearance.  My reputation is based on natural appearing face lifts, and I cannot imagine overdoing someone in a manner that they appeared like a mannequin after surgery.

	When a face lift is performed, the skin should be raised to expose the underlying facial structures, and it is these structures (the SMAS and platysma muscles) that need to be reshaped and lifted to a more rejuvenated appearance.  The skin should be then be draped naturally to avoid an over pulled or plastic appearance.  If the skin is pulled too tight, or the underlying tissue is inadequately addressed, poor outcomes will result.

	It is important to find a plastic surgeon who will educate you on the manner in which he or she will plan your facial surgery.   Check his or her before and after photos, and emphasize your interest in a natural appearance.

James Motlagh, MD · Answer

Some people may look like a mannequin after a facelift for several reasons. I think the most common cause is because their particular surgeon has a particular vision of what looks good. In Hollywood this is fine because moviestars want to stand out and be noticed. In the real world however I think this approach can be a disaster. Most people are looking for a natural, refreshed look where other people find it hard to tell if they had any work done.

	Overall it is very important to ask the surgeon the question: how am I going to look after my facelift? Will I have the windblown or "deer in the headlights" look? He/she should be able to give you a reasonable basic answer.

Robert E. Zaworski, MD (retired) · Answer

A good facelift does not look done. You should look relaxed and natural. Consult with a Board Certified Plastic Surgeon for an evaluation to determine your needs. He should show you some before and after photos. Ask him if he does a conservative approach. It can't hurt to get a couple of opinions to see who you feel the most comfortable with.

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