Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

In this day and age, we have a “gotta have it yesterday” mentality.  Information is sent around the world in microseconds, packages are shipped overnight, and we can even microwave dinner in three minutes.  We’re always on the go, multitasking, working even more than before. We are taking the kids from school to soccer practice, music lessons, and home for dinner, and then we have our regular tennis leagues.

I see many patients who are concerned about facial aging.  They look older than they feel and want to stay youthful and, in many instances, competitive.  They often look for quick fixes.  When I was a plastic surgery resident 25 years ago, the only treatment methods for the aging face were a facelift, forehead lift, and eyelid surgery (blepharoplasty).  Patients were either a candidate or not.  Since that time, our understanding of facial aging has increased dramatically.  We now understand that over one’s lifetime, you can lose as much as 50% of your facial fat.  In addition, the skin becomes lax and the cells are unable to retain water.  This all contributes to the face sagging, with the development of jowls, loose neck skin, prominent nasolabial folds, bags under the eyes, and drooping eyebrows.

Physicians are now not only resecting the loose skin, but also adding volume to the face, with different types of fillers including fat, hyaluronic acid, and collagen.  In addition, the face lifting procedures have expanded in techniques, to include limited dissection facelifts, thread lifts, and multi-plane facelifts.  This not only gives the patient many alternatives but also contributes to confusion as to what is the best choice.

As I have mentioned before, it’s important to seek a qualified plastic surgeon if you are a candidate for a facelift.  There are many practitioners, who are not board-certified plastic surgeons, offering “nonsurgical facelifts” as well as limited facelifts that they advertise will give you the same result as the more traditional surgical facelifts.  Ask them what their qualifications are, if you can see before and after pictures, and if you can speak with some of their former patients.  The more traditional facelifts will last 7-10 years.

The limited facelifts and “liquid facelifts” will not give as effective a result, nor will they last nearly as long.  In my practice, I utilize 3-4 different types of facelifts, depending on the patient’s needs, and I often will complement the facelift procedure with dermal fillers, Botox, and laser resurfacing. Some patients really do not want surgery, even though that may be the best treatment method.  In this situation, I explain to them alternative treatments and their limitations. There is no “one-size-fits-all formula” to treat the aging face.