There are many magazine articles as well as TV shows that discuss “nonsurgical facelifts”, “minimal incision facelifts”, “lunchtime lifts”, “lifestyle lifts”, “quick lifts” and “thread lifts”. Some of the photographs show dramatic results with minimal pain and minimal downtime. It makes it sound as easy as going for fast food during lunch.

Most board-certified plastic surgeons are trained to perform many different facial rejuvenation procedures including brow lifts, blepharoplasty (cosmetic eyelid surgery), and facelifts. The most common procedures involve elevating the skin of the cheek and neck area and tightening up the fascia layer which overlies the facial and neck muscles. The skin is then redraped over the incision and the excess is removed. I tell my patients that a properly done facelift should last 5-7 years.

Over the years there have been developments of more extensive facelift techniques which basically lift all the facial soft tissue off the bones and reposition it. These, in my opinion, result in a prolonged postoperative period, more swelling, and the possible complication of facial nerve injury. At the opposite end of the spectrum, more patients are interested in less invasive procedures with less downtime. When I was a resident 25 years ago the usual facelift patient was 55-65. We’re now seeing women and men in their 40s who are looking for facial rejuvenation before they get to the point that they need the traditional facelift. One of the more common procedures I use is the MACS lift, a procedure that was developed in Belgium. It requires less dissection and works nicely for smoothing out the neck and cheek. It’s for patients that have mild to moderate sagging.

As I have said many times in my posts, let the buyer beware. As reimbursements for health care have decreased, many healthcare providers (I won’t call all of them medical doctors) have gotten into the cosmetic surgery business. It’s a “cash up front” business and includes nonsurgical procedures such as Botox and dermal fillers, as well as surgical procedures for facial rejuvenation. Family practice physicians, gynecologists, dermatologists, dentists, and chiropractors to name a few, take a weekend course and all of a sudden become “board-certified cosmetic surgeons”. They operate out of their office because they certainly couldn’t get hospital privileges for these procedures.

I’m seeing patients in my practice, who have had some of the less invasive procedures performed and have been disappointed in the results. Many of the weekend-trained practitioners do very little “deep layer work” and their results don’t achieve near what the photos show. Lifestyle Lift, a national chain of walk-in facelift centers, was fined $300,000 by the NY Attorney General, based on a complaint of deceptive advertising. QuickLift is a procedure taught in the US by an ER physician in Pittsburgh. You can take a 2-day course that he teaches for about $2000 and become an “expert”. Buyer beware, indeed.