Apr 9

Mini-Facelifts: Big results from a small surgery?

There is a lot of talk these days about minimally-invasive facelifts of every kind. And each one seems to have a catchier name than the last; whether it’s the mini-lift, S-lift, J-lift, Weekend lift, Lunchtime lift, Executive lift, Lifestyle lift, Quicklift Md and the list goes on and on. Each of these lifts declares itself new, unique, and exciting, with outstanding results attainable at minimal risk. Very often they are accompanied by very impressive patient photos that seem almost too good to be true. But is the hype surrounding these lifts for real?

Well, the truth is that these lifts are not new nor are they very distinct. They are all variations on a theme. As Shakespeare said, “That which we call a rose by any other name…” holds true here. These lifts are actually well-entrenched in surgical history and are only recently being newly minted and repackaged for modern consumption. “Inventing” the next big (Insert name here) Lift has become something of a cottage industry in plastic surgery today. When, in fact, these procedures have been performed in nearly the same way for 30 years! They are all modifications of what is called a Short-flap facelift. This was originally popularized many years ago as a “tuck-up” procedure done commonly one to several years after a facelift in which only skin was removed.

Does aggressive marketing of the latest and greatest mini-lift make for great sound bites? Sure.

But, do they really work? Well, the answer depends on what you expect them to do for you. A recent consumer satisfaction survey by consumer plastic surgery review website Realself.com showed that only 49% of patients undergoing a Lifestyle Lift said it was “worth it” compared to 86% undergoing a more traditional facelift. The average procedure fee paid for the Lifestyle Lift was $4293 compared to $8284 for a traditional facelift. Now, this survey was not scientifically designed and is not a perfect way to evaluate the worth of a procedure.  We also found this link interesting,   http://www.infomercialscams.com/scams/lifestyle_lift_complaints

Mini Facelift

And as facial plastic surgeons we take the results seriously because there are lessons to be learned here.

Does this poor showing mean that this type of mini-lift is a bad procedure? Not at all. Again, it all depends on a patient’s expectations of the results. The problem lies not in the procedure but in the person at the end of the mouthpiece. Many articles, advertorials, newscasts, and websites promote “dramatic results” that are seen “immediately, before leaving the office” without the “trauma and downtime of extreme plastic surgery.” This is claimed to be the “complete opposite” of “the old way” where you “don’t look like yourself for months, even years.” But what exactly do these lifts do and just where does the hype end and the truth begin?

In this procedure, the skin in front of and just below the ear is lifted to a limited extent. The incisions are somewhat shorter than a traditional facelift in that they do not extend into the hairlines at the temple or behind the ear. The deeper layer of tissue under the skin called the SMAS may be tightened with one or two sutures. Finally, the excess skin is removed. All of these processes are performed more extensively in a traditional lift. Because the dissection is more limited here, the procedure offers several real benefits:

It is shorter in duration than a traditional lift

It is offered and can usually be done under local anesthesia with or without sedation

It has potentially fewer risks

It causes less tissue trauma resulting in a more rapid recovery

Because it can be accomplished more quickly, the fees are usually a fraction of a traditional lift

But, like everything in life, you get what you bargained for. No one should publicize nor should you believe that the results achievable are nearly as good as a more extensive lift. And the upsides in terms of recovery are often oversold. Yes, it’s true that the convalescent period may be shorter by a few days to a week with less swelling and bruising as a rule. But, are you doing this over your lunch break or dancing at your wedding the next day? Absolutely not! Remember, this is still surgery, no matter what you hear on the six-o’clock news.

And the downsides are just as real. In a recent study published by us, we found that, for the same patient, in the operating room, we could obtain twice the amount of lift with an extended facelift as compared to a mini-lift procedure (See our publications page for details or to read the article). So, for someone undergoing a mini-lift, this can mean:

The improvements may be less than expected or desired

The improvements may be shorter-lasting

There is still potential for complications

There is potential for resultant dissatisfaction

So, where should mini-facelifts fit in to the surgical spectrum for improvement of age-related facial changes? For us, this question is answered during our Imaging Consultation once we have gauged the degree of aging and skin laxity among other factors, and weighed these against your needs, desires, fears, and limitations. You may be a good candidate for a mini-lift if you:

Are younger with good skin elasticity and early signs of aging

Have cosmetic concerns limited to the jowl, jawline, and neck area

Would be happy enough with a reasonable, as opposed to optimal, cosmetic improvement

Have significant time restrictions or are extremely risk-averse

Have medical problems that would prohibit general anesthesia or a “bigger” procedure

Are older but have residual or new cosmetic concerns after a previous facelift

So, the final word is that, for the right patient with reasonable and clear expectations of what can be achieved, the mini-lift has the potential to be a highly satisfying procedure. But, if you’re being promised the moon for a song, you may want to consider looking elsewhere.

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