When Your Face Can’t Hold Cosmetic Fillers, a Facelift is Appropriate

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A woman is going to be 48 in a few weeks. She wants a younger appearance but wants a procedure that is not obvious that she had something done.

Dr. Amiya Prasad is a board certified cosmetic surgeon specializing in face lifting surgery. He is also a cosmetic oculofacial plastic surgeon who specializes in surgery of the face and eyelids. In his practice, he does a lot of facelifts and has made a lot of observations as to what are the common concerns of patients. He wrote a book about facial aging and explained how to determine what the right procedure is for someone based on the unique facial aging process. He explains that facial aging involves volumetric loss of muscle, bone, fat and soft tissue. There’s a phase in one’s life where volume correction can be very effective, which tends to be in the 30s and early 40s depending on genetics. The other part of facial aging is sagging and descent. This is where restoration of the physical position of the face and soft tissue is so important.

Fillers are usually used to treat facial aging, but there is a limit of their use. In facial aging, the skin and soft tissue under it called the SMAS or superficial musculo aponeurotic system sags. It becomes frustrating for patients to use a filler because the support tissue isn’t there anymore, so the fillers eventually just get lost. A face lifting procedure will probably benefit cases like this woman’s. Unfortunately, with the lack of photos that this woman submitted such as the side view, Dr. Prasad cannot fully determine if a neck lift is appropriate.

Currently, Dr. Prasad says that there are a lot of different types of facelifts in the market. There are different surgeons who deliver one type of facelift such as a deep plane facelift. The truth is, anyone who knows face lifting surgery is very aware of the customization of face lifting. Some of that customization happens when the surgeon is working under the skin. The surgeon determines the best way to lift the soft tissue and the key element is to do something with the SMAS. This includes several things such as SMAS flap, high SMAS or SMAS plication or deep plane face lifting.

It is important that patients make their decisions about face lifting by the artistic style of the surgeon. The patient and the surgeon must have the same perspective of the desired outcome. When Dr. Prasad sees patients who are referred and are unhappy with their face lifting surgery, it’s not necessarily a technical issue on the surgeon’s part but rather a miscommunication between the expectation of the patient and the doctor. A good, thorough consultation like what he does in his practice is important. Dr. Prasad spends a lot of time with his patients. He [...]

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