So if you’re ready for a little ‘face-lift,’ so to speak, should you go non-invasive or consider a longer-lasting procedure that most certainly would entail surgery? “We can do a lot with lasers to erase sun damage, and there are some very good skin products available, but surgery is still the gold standard,” says Dr. Michele Koo of the Aesthetic Surgery Institute.
She reports noticing an increasing number of patients asking for minimally invasive procedures with very quick recovery periods. To meet this demand, many surgeons now perform highly targeted procedures that address specific problem areas. For instance, Koo performs individual surgeries that focus on enhancing cheeks, jaws, eyebrows and eyelids. “In the past, we could do only a complete face-lift,” she says, “but using these new techniques, the final look is rested and subtle, not overdone.”
These results require surgeries involving very small incisions in very specific locations, Koo explains, sometimes requiring no sutures. In many cases, Koo performs the procedure in her office using only local anesthetic. She says her patients appear rejuvenated after such targeted procedures and often return for additional ‘targeted’ surgeries on other facial areas. “This is the age of instant messaging and immediate information, and people want instant face-lifts, too,” she says. “But people are also realizing that less is more, and they want a natural look. We can remove bags, jowls, wattles and wrinkles, and we can stage these procedures to fit the patient’s time and financial situation.”
Eyelid surgery is among the most popular of the minimal surgeries, Koo reports, removing excess fat, skin and muscle from the upper and lower eyelids. She makes incisions in the creases of the upper lids, just below the lashes on the lower lids or inside the lower eyelid, leaving no visible scars. She notes that the surgery can be combined with Botox treatments to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes.
“Done properly, these minor procedures can really help patients maintain a youthful appearance,” she says. “Don’t be afraid to consider them.”
During that consideration process, Dr. Alan Londe of Tempo Surgical Inc., reminds patients to ask how long results are expected to last. “A lot of doctors are promoting ‘lifts before lunch’ or ‘mini-lifts,’ but most people actually need a longer-lasting solution,” he says. “I find that the old-fashioned face-lift is often still the best solution.”
If a patient does not want a complete face-lift, new non-surgical techniques may offer relatively long-lasting results without the risks or expense of surgery at all, Londe adds. He particularly likes the recently FDA-approved facial fillers Juvederm Ultra and Juvederm Ultra Plus, which can last as long as a year. By filling in lines around the mouth, for instance, Londe says, patients may be satisfied with their appearance without undergoing surgery.
Dr. Judith Gurley, a plastic surgeon in private practice in Chesterfield, agrees that fillers and other non-surgical treatments can be excellent options in addition to or instead of surgery. “I really can’t overemphasize the effect of adding volume to the face,” she says. “Loss of fat in the face is a major concern, and just pulling the skin up doesn’t fix that.”
Gurley has watched trends change over the years and says that current wisdom calls for the least invasive procedure that will offer the most dramatic results. “We’re seeing a combination of traditional and new techniques, which allows surgeons to tailor their approach based on each patient’s individual anatomy and skin texture,” she says. While this individualized approach takes more time up-front for surgeon and patient to explore all available options, the results are worth it, she adds.
“The techniques may change, but I think this individualistic philosophy in plastic surgery is here to stay,” Gurley notes. “There aren’t any more cookie-cutter approaches, and the outcomes are more refined and artistic than ever before.”