The New Facelift Procedures: Surgical Vs. Non-Surgical Facelift

Main Category: Cosmetic Medicine / Plastic Surgery
Also Included In: Dermatology
Article Date: 29 Oct 2008 - 3:00 PDT

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The Three Ways of Facial Aging - Facial aging has always been associated with the visual signs of sagging skin. For decades, the favored treatment of this sagging skin has been a facelift. When aging recurred, another facelift was done, and so on. After a second or third facelift, the individual no longer looked natural, and instead had a "tight or pulled" appearance.

Over the last 10 years, there has been a general "awakening" and acknowledgment among plastic surgeons as to how aging really occurs. Aging in the face occurs in three ways:

1. There is a loss of fat or volume in the face.
2. There is photo damage from the sun's harmful rays
3. There develops an abundance of hanging excess skin.

So what do each of these components look like?

-- Loss of fat or volume in the face leaves a sallow, hollow or deflated appearance. Areas most commonly affected by fat loss are the tear trough (the groove that forms below the lower eyelid fat bag), the cheeks, temples, lips and upper eyelids.

-- Photo damage is caused by solar radiation. The sun's radiating rays physically break the elastic fibers in the skin and damage the DNA of the skin causing cells to grow with abnormal coloration (sun spots and freckles) or even to develop skin cancer. Those who have spent too much time in the sun will manifest the sun damage as fine wrinkles around the eyes and lips, sun spots and freckles, and a dull leathery texture to the skin.

-- Aging, the sagging skin, is seen as large hanging bags under the eyes, eyebrows which hang so low as to hood the eyes, hanging jowls, and loose skinned necks.

From the 1960's through the 1990's, each of these three distinct signs of aging was solved with one procedure: the facelift. At the time, this procedure was complex, fairly risky and had a 3-6 month recovery time. In more recent years, a shift has been made to more natural rejuvenation of the face, including a host of non-surgical facial procedures. Anyone who has looked into these new procedures knows that the options seem endless - surgical and non-surgical treatments, "liquid facelifts", Botox, fillers, peels, lasers, dermabrasion, mini-facelift, lunch time-facelift... the list goes on. The big question is, how do you choose?

Dr. Gilbert Lee, a renouned plastic facial surgeon based in San Diego, recommends that you treat all three of the aging factors that affect your skin. "All these options allow you to treat specific issues in a much more natural and lasting way," he says. Dr. Lee recommends that you "start with the aging factor is most apparent."

The Natural Volume Facelift

If an individual has a gaunt, sallow face, then fillers or "volumizers" are the appropriate pick me up. Do people inject fat into their face to look younger? Yes! In fact, the procedure of removing fat from another area of the body and injecting it into the face is not only a popular one, but also considered to be very natural. "We normally take the fat from the tummy," says Dr. Lee. He explains that to treat loss of fat or volume in the face, it's best to use fillers or fat injections. The alternative to fat injections are fillers such as Sculptra (the "liquid facelift"), Radiesse, Juvederm and Restylane. These fillers are used to plump up the skin, "filling in" smaller sections or single creases.

Sculptra Liquid Facelift is a synthetic injectable material known as poly-L-lactic acid. Once this bio-stimulator is injected below the surface of the skin, it helps your body regenerate its own collagen. Sculptra is used to plump up larger surfaces of the skin, creating an overall smooth appearance without any scarring. Its effect will last years.

Botox is a muscle relaxer and is not a filler. Botox is best at treating expression lines because it relaxes the muscles underneath the wrinkle site, therefore relaxing or eliminating the wrinkle. What you choose is very much dependent on what you want to correct, how long you want your results to last, and how much you are willing to spend. A trained plastic surgeon can guide you through the myriad of options.

Facelift via Laser Treatment or Skin Resurfacing

To treat the effects of too much time spent in the sun (ie. freckles, sun spots, leathery skin texture), the options include strong topical treatments (medications), laser peels, dermabrasion, Intense Pulsed Light (IPL) and other laser treatments.

One of the more interesting laser treatments is called Fraxel Laser Treatment. This treatment performed under a topical anesthetic produces thousands of tiny laser columns that reach deep beneath your skin. These lasers eliminate old epidermal pigmented cells and cause new collagen growth and tightening within the dermis. Because the laser lays down laser columns of energy, it leaves skin in between laser spots unaffected and intact. This "fractional" treatment allows the skin to heal much faster than if the entire area were treated at once. And, with the newer laser technologies, there is little to no downtime.

A New Kind of Surgical Face Lift

If loose or excess skin is your top aging factor, the best option for you may be a surgical facelift. Unlike facelifts of the past, advancements in facelift techniques now allow plastic surgeons to work faster, safer and in some cases less expensively. With this new kind of facelift, smaller incisions are made, which not only result in less swelling, but also in less visible scaring. Depending on the patient and the procedure they are having done, doctors may be able to use a local anesthetic. Using a local anesthetic is often safer and can save you several thousand dollars in operating room and anesthesia fees.

The modern day facelifts offer more options delivered in less time. There are even more new procedures on the horizon. But, whether you choose fillers, lasers or lifts, the results you'll likely receive are going to be safer, more natural, and, if you're really lucky, less expensive. The best advice may be to treat each of the three signs of aging separately, pick what works best for your skin (and for your wallet), and ask lots of questions.

Dr. Gilbert Lee is triple board certified, including certifications by the American Board of Plastic Surgery, and the American Board of Surgery. He has been voted one of the Top Plastic Facial Surgeons in San Diego by the San Diego County Medical Society in 2007 and 2008. Find more information on facial surgery in San Diego by Dr. Lee, facelift before and after images at www.changesplasticsurgery.com.

Written by Constanze Scherer