“In human society, we all make quick decisions about people based on their faces.”
- Ralph Waldo Emerson
According to Ralph Waldo Emerson, it is important to put your best face forward. In terms of the reasons that patients have stated why they want a facelift, they are widely individual. Very often, people feel that their face looks older than how they feel. It´s no secret that appearing older and less energetic has an impact on one´s professional and social life. Some of Dr. Prasad’s most enthusiastic clients have been salesmen, celebrities, accountants, Wall Street financiers, and computer software engineers. Image is very subtly important in just about anything that we do. Most importantly, most of our clients feel a renewal in their self-confidence by looking better after their facial rejuvenation. Increased confidence has led to most of our clients feeling more productive in their professional and personal lives.
Facelift surgery is used to lift the sagging skin on the face. A cosmetic procedure, known as rhytidectomy, gives a youthful appearance by the surgical removal of wrinkles. Over the past century, facelift surgery has undergone many changes. In fact, techniques which were standard as far back as the late 1990s have been developed to ensure safety and quicker recovery. Facelift surgery was traditionally performed on people who were older and had developed significant sagging. It frequently involved hospital admission and general anesthesia.
What Constitutes Enough Experience in Facelifts?
I plan a facelift in January. I interviewed two docs, one oculoplastic surgeon the other a general surgeon who is board certified in plastic surgery and attended a prestigious medical school for that training. He is young and has only done 20 or so of these surgeries. Initially he wanted me to have oral anesthesia but I am not comfortable with that and would like a twilight type. Would you send your wife to him? Cost is
lower than any.
Thank you for your question!
You may not realize it but you are asking an extremely loaded question at a time where there are incredible amounts of specialty rivalry. So I’m going to share with you some basic rules of thumb that I generally recommend especially because I’ve been practicing cosmetic surgery for 20 years with an oculofacial plastic surgery background and board certification in facial cosmetic surgery, having a lot of experience in facial aging particularly face lifting. I can certainly share with you my opinion on the question you’re asking: what number of procedures do you need to establish competency.
First of all, I recommend that you first be comfortable with whoever it is you’re going with. And that comfort level should be based on a few things. At a minimum, your doctor should have adequate training in order to perform that procedure. Now adequate training to perform a procedure, and then being at a level where you are a master, or you’re really able to do a procedure, with all the different kinds of variability that occurs, is a range.
So, first of all, when you ask a question about someone who’s done about 20 of these face lifting procedures and private practice and wants to do it under oral anesthesia versus another surgeon who didn’t specify the level of experience. I’ll tell you how people end up choosing someone like me and come to my office. First, as someone who’s had a lot of experience, I have a reputation. So people who I’ve done face lifting surgery on recommend other people who decide that they like the way they look and they want to come to me. So I say, one of the best ways to make a decision is through a referral and knowing the quality and style.
Every surgeon has a different style in doing surgery. And no two surgeons would agree on a hundred percent on how they do a facelift. I practice on the upper east side where some of the most famous plastic surgeons well known for doing the most famous people in the 80’s and 90’s practice, and I have to say that from my aesthetic sense, I really don’t like that style of look that’s very tight look, that very thin-faced look. It’s just not what I like. I prefer a more natural look and I wrote a book about this called The Fine Art of Looking Younger, and a youthful face should have a nice defined jawline.
So when you submitted your photos, I looked at your photos and I have to tell you that overall your procedure must be straight forward. And someone with a minimum level of training should have some comfort in being able to do a good job. Now to do an exceptional job is a whole other level. And for example, when I look at your face, I noticed in the neck area, you have these two little bands and these are called Platysmal bands. Now because you have a relatively thin neck, it’s not unlikely in my hands that I would do anything resembling liposculpture because there’s no fat really to reduce. I would actually simply do something called a plastysmalplasty and tie those muscles together. And when I looked at the side view of your face, I noticed that the jawline needs a little bit of definition and there’s a little bit of sagging. Basically, you have a relatively thin face. And so your skin quality is at risk at looking a little bit pulled, a little bit tight. You could even get pleats. You know, there’s a little bit of forgiveness in that respect.
Now the other side of this is that there’s not a lot to lift. There’s actually a modest amount of skin and muscle work to be done to get you a good result. Now I can tell you this because I have all of these experiences.
So when I recommend people to look for a cosmetic surgeon for face lifting, I would suggest that in addition to having the training background, experience and artistry are the most important factors when it comes to getting really nice results. Because frankly, when you’re a younger surgeon, you get experience and you learn and you build on that experience. So anyone who has done cosmetic surgery for more than a few years know that they continuously improve and they build a foundation and have the experience to improve their style and a certain point, hopefully, they come to a master level.
So, choose your surgeon based on your gut feeling. I think it’s gonna be very hard to make distinctions based on specific board certification. As a specialist, I’ve done revision work on board certified plastic surgeon’s work, facial plastic surgeon’s work and oculofacial plastic surgeons. And it’s not because anyone of them was particularly not good at what they did, but it’s just that there’s a variation in a way that people approach the surgery as well as sometimes the way the person healed.
So you can’t depend on one specialty as being the best in this field. There’s a lot of variability in that. So to help you again to experience artistry, technical skills are important to understand, looking at before and after procedures, seeing if you could identify people who are actually that surgeon’s patients and you could related to as looking similar to yourself.
And one of things that are also a good sign is just the overall atmosphere and mood of the staff. In my practice, my staff is very enthusiastic. We’re very clear about the things we do well. And that enthusiasm and honesty and integrity is felt by people who come and see us. So I think, you know, at this stage, when a surgeon reaches a point where they do something particularly well, their own staff will stand behind the work and feel like they can really recommend. And of course, like in my own office, many of my staff members and their family members have also become patients.
So, I’m basically sharing with you a personal perspective of what it takes to be a really good facelift surgeon and I hope you take that into consideration and it’s helpful to you. So, thank you for your question.
Today, people do not wait until they look “old” before pursuing cosmetic surgery. They want to keep the face they have, but they want a more natural and enhanced appearance. The goal is to look young throughout your life. Facelift surgery is now routinely performed under local anesthesia with light sedation as an outpatient in our accredited operating rooms located in our two New York locations in Manhattan and Garden City, and with significantly reduced downtime and quicker recovery.
The Solution to Facial Aging
Facial aging causes sagging skin from the cheek bone to the jaw line and the upper part of the neck. A properly performed facelift addresses the drooping skin and sets the clock back on someone’s appearance by ten to fifteen years.
Former Sun Worshipper. Looking Old Way Before my Time. I Used to Be Pretty. I Am Tired of Looking TIRED and ANGRY?
My friends and family tell me that I don’t look my age. They are just being kind. In less than a year I have had a hystrectomy and an excisional breast biopsy. I look ten years older than I did just a year ago. Depressed to the point that I have contemplated the unthinkable. Time for a facelift? I am only 44. Please be kind.
Thank you for your question!
I really understand your frustration. My practice, I specialize in facial aging and I actually wrote a book, “The Fine Art of Looking Younger.” And certainly, you are a very company with other women who had a hysterectomy and feel like their facial volume, they just look older. Yes, a lot of people would feel that it has accelerated their aging process and their desperate to understand which way to go. Unfortunately, they’ll get conflicting ideas and information. Some will say that the dermatologist recommended that they get injectables and the plastic surgeon says they get a lift.
So what I explain in my book, “The Fine Art of Looking Younger,” is the basic, simple principle of facial aging is two processes. One is descent or sagging and the other is volume loss. So you’ll lose bone, muscle and fat. You mentioned in your question that you look tired and angry. And with the many photos you submitted, you notice when you smile, the cheek area looks so full and you look younger. Your jawline looks more defined and everything looks good. So without prescribing or recommending that you smile all day, but it gives you an idea of the shifting that happens when you move things upward and when the cheek volume goes from low to high and how much impact it has on your face.
I think most likely, you would benefit from the modern combination of volume loss options including fillers such as Restylane. For the dermal lines, radiesse. Sculptra for the deeper volume loss as well as botox and dysport for the frown lines and other areas where the dynamic activities of the muscles are causing these lines to occur. Now if at rest, if you lift your skin, your jawline looks better and your neck looks better, then you may be a candidate for some type of lifting procedure, some type of face lifting procedure. You need to clear your mind that one set of procedures does not displace or replace the other set. The art of helping people look young and look the way they do in the outside, the way they feel on the inside is balancing surgical, non-surgical or minimally invasive procedures in a way that retains the character of your face and allows people to interpret you the right way. So you don’t look tired and you don’t angry.
Other options that we offer that I have used successfully include fat transfer. People use the term stem cells a lot these days and in my opinion, I think a lot of this field’s future lies in stem cells and hormone replacement. But that’s a different type of discussion. The point is that we have technology and you are at this stage of your life, you will probably respond very well because the tissue and the material is still stronger to handle this type of treatment. So fat transfer such as moving fat from one area and placing it into the cheeks, these are all options.
So what I tell my patients is that I’m not only a technically capable surgeon but I’m their beauty doctor. And I try to guide them through the waters of all their options. You know if you watch television or you read magazines, there’s so much hype that easy to get confused. Even when you ask a question, you’re going to get a lot of different answers. So a lot of my patients feel like I’m their primary care doctor for beauty. So I think that’s what you kind of need at this point is you need someone who I feel has all the capabilities to do the non-surgical, the minimally invasive and the advanced surgical procedures so that there’s no intrinsic bias and prejudice and agenda which unfortunately, physicians are more and more guilty of advocating using the phrase “to the man with the hammer, the world is a great big nail.” Non-surgical physicians only advocate non-surgical treatments so you have to be careful these days because of the popularity of aesthetic procedures.
So find a doctor that you resonate and connect with who understand you, provides you with the time you need and helps guide you. You don’t necessarily have to do everything at once. But prioritize and maybe little steps will accumulate over time at a schedule that you get the result that makes you happy. So I hope that was helpful, I wish you the best of luck and thank you for your question.
Procedures To Accompany A Facelift
The facelift procedure can accompany other procedures, such as a neck lift, a eyebrow lift or eyelid lift, or the fractionated laser. A neck lift raises the loose skin from the jaw line to the lower part of the neck. Although a facelift does not include lifting of the eyebrows or eyelids, it can be accompanied by eyelifts and eyebrow lifts at the same time. An eyelid rejuvenation technique can complement the facelift by achieving a desired shape and balance to the face. The new Micro Fractional CO2 Laser Treatment can also help on achieve remarkable results when combined with little downtime. The Micro Fractional CO2 laser technology diminishes the appearance of wrinkles, scars (such as acne), and discoloration (such as from sun damaged skin) while it smoothes and tightens the surface of one’s skin, and boosts collagen production for up to six months.
Benefits of Facelift Surgery
Aging is inevitable. Facelift surgery can improve one’s appearance by reversing the aging clock by up to 15 years younger. A good facelift can boost one’s self-esteem and confidence both socially and professionally. Studies have shown that looking good has a direct correlation to higher pay. A facelift will:
- Remove Sagging or Loose Skin of the Face or Neck
- Tighten the Facial Muscles
- Improve Contour of the Face
What is the Best Facial Procedure to Address the Drooping Corners of the Mouth?
It looks like I am sad and frowning due to my mouth corners falling down. I have tried injectables and fat transfer with little success. Would a mid facelift or cheek lift address this?
Thank you for your question!
You’re asking a very common question in our practice and as a specialist in facial aging, people are constantly coming to us to address this exact problem. And essentially, it’s a problem called a deep nasolabrial fold. So before we come up with a solution and you asked about some procedures like the mid-face lift and the cheek lift, let’s understand some basic concepts so that we understand how solve the problem.
First of all, what is happening? Well, facial aging especially in the lower third of the face, is significant in that it manifests a lot of volume loss. And what is the amount of volume loss that occurs with facial aging? Well, we lose volume in bone, muscle and fat as well as the thickness of the skin. And so imagine it’s like everything is just collapsing inward. In addition, we also have loosening of the tissue that was formally in a higher position and so we call that facial descent or facial sagging.
So when you look at the mirror and you hold up your face, you wonder how can we lift this so that it stays that way and keeps things in this area much more youthful.
Well essentially, what you’re dealing with is a two part problem. Because the aging process may affect everyone a little bit differently. Most people it’s first volume loss that manifests in this area and then eventually a little bit of sagging.
So in my practice, my general approach is first to understand what would make the patient happy. Will they be happy with some improvement of this deep nasolabial fold or sometimes we refer to as the marionette line or do they want a definitive maximal improvement. In other words, something that really reduces as much as we can do for them.
So a lot of times, we do a combination of a facelifting procedure combining it either during the surgery with a procedure like fat transfer, where we take fat from one place and placing it under the skin to help plump up the skin. Or we’ll do the facelift first, allow the patient to heal and then the patient and I decide together whether we want to add some volume filler such as radiesse or a combination of a radiesse and hyaluronic acid like Restylane. And why do we use a combination? Because the volume loss is a combination. It’s bone muscle and fat and skin. So when people have very light nasolabial folds, then we can sometimes get away with just a little bit of Restylane or doing a moderate amount of radiesse where we go under the skin.
So there are levels of improvements that we can address you in terms of the volume loss but if a lot of this fold is due to descent, then I find that face lifting will actually address a considerable amount. I always tell my patients, imagine that you’re trying to fill this area but you have an avalanche of skin and soft tissue pushing downwards. And when I lift up and I show that there’s still a line here because there’s also volume loss, then it makes a lot of sense.
So depending on what the skin elasticity is and your physical examination, this is how you’ll make this decisions. So, I suggest that you find a qualified and experienced surgeon and learn about your options and decide how much you wanna see an improvement. If you wanna go for maximum improvement then you may wanna be aggressive. If you wanna take little steps, then you may wanna consider starting with fillers and non-surgical procedures and see how you like it and ultimately make a decision as you see fit. I hope that was helpful and thank you for your question.
Considerations Before Facelift
A facelift improves one’s appearance and can boosts one’s self-esteem, however it is not for everyone. Good candidates for a facelift have:
- Sagging or loose skin on the face or neck
- Good overall health
- Skin elasticity and suppleness
- Strong bone structure
- Realistic expectations
What Do You Recommend for Facelift/necklift?
Hello! I am a 43 year old actress. I am also divorced and interested in someone who is in his mid 30′s. Here are three photos of me with no makeup, just eyelash extensions. Anyway, the things that bother me the most at this point are around my mouth area (sagging) and my neck area (sagging). I would like to get surgery this summer. Initially, I just wanted a face lift but surgeons have recommended more even a nose job. What would your opinions be? Thank you so much!!
Thank you for your question!
At the age of 23 and being an actress and is interested in someone who is younger than you is certainly a situation or scenario that we’re very familiar in our practice in New York. What is also not surprising about your question that all though your perception is about lifting, you had surgeons recommend everything including rhinoplasty.
I wrote a book years ago called “The Fine Art of Looking Younger” and what I focus on is when a person comes to me who want improvement in appearance is to understand what is actually is changing. And what you’re describing with face lifting has to do with sagging. So two thing happens as we get older. We lose volume and we have elastic changes. The skin gets loose, the tissue under the skin, the support tissue called the SMAS which is an acronym for superficial muscular aponeurotic system or the support structure under the skin gets loose. So when people come to me, I try to understand what is really concerning them. Very often, people like yourself, come into the office and just basically lift up the skin and say “I think it’s time for a facelift.” And that may be very well the right procedure for you.
I want to at least take in consideration the advice which is don’t let surgeon push you to do something that you are not prepared to do. And my feeling is that every face has character. And specializing in facial aging, I really enjoy helping people look younger. But at the same time, I love helping people look in the mirror and really seeing themselves the way they see themselves in their mind’s eye.
So when you’re talking about rhinoplasty, you’re really talking about really changing the over-all appearance of your face in my opinion. I think you having a prominent nose that certainly draws the surgeon’s attention can also be look at a different perspective. If the cheeks are getting more hollow, it makes the nose look more prominent. So perhaps the strategy of lifting or volume enhancement in the cheek area is worth considering. When I show some people the mirror, I tell them to smile, and when they smile, the cheeks get full and you look younger.
So remember what kind of appearance you want to have and I wouldn’t say that you just jump into procedures like rhinoplasty cause that’s a conservative procedure when it comes to facial aging of being approached. Typically, my approach would be lift if the lift is indicated to place everything in the right place and fill to have the right volume. Now sometimes you can buy some time by just filling by adding volume in the right places.
Now you get a lot of opinions so what you should really be in charge of is really what’s your priority. Everybody has their own priorities that when they address, their number one priority is that they are happy with their result. Patients who are very unhappy with their results and come to me for a second opinion and say that their kids don’t recognize them or people or their family say what did they do. It’s because there’s been a separation of their character with their facial appearance. And so preservation of the character is important to you, be very cautious about making that decision.
So in summary, I think it’s reasonable to consider a lift. The one thing I can’t do is examine you so if you physically lift the skin and see there’s an improvement then face lifting is worth consideration. Balance that out with some volume enhancement and if you feel like you look 5 years younger, I think that might be what you are really aiming for in terms of getting a fresh look.
I hope that was helpful and thank you for your question.
Some patients might be able to reach their aesthetic goals with a less invasive procedure, such as a chemical peel, microdermabrasion, or the Micro Fractional CO2 Laser. Some patients might need to combine face lift surgery with other procedures, such as a neck lift or a brow lift, in order to achieve their optimum results. Patients who understand both the possibilities and limitations tend to be happier with the results that can be achieved by a facelift. A proper consultation with Dr. Prasad will help determine if you are a candidate for a facelift surgery.
With Dr. Prasad’s Quick Recovery Facelift procedure, the recovery time is about 1 week. With significantly less downtime than traditional facelift methods, patients are able to return to their normal lifestyle.
State-of-the-Art Facilities in New York City
Prasad Cosmetic Surgery has two locations in New York where we can perform facelifts in our own surgical facilities: Manhattan and Garden City, Long Island. Our facilities are Joint Commission Certified, and designed for your safety, comfort and convenience.