1. Is a face lift performed under general anesthesia?

It depends. It is important to keep the blood pressure and heart rate low so that no bleeding occurs during the procedure. This is commonly performed under general anesthesia. Many face lifts, however, can be performed in an accredited surgical setting under monitored anesthesia care, also known as twilight anesthesia. The proper patient must be selected for this procedure, but it is routinely used and is quite safe. There are reports in China of surgeries, such as face lifts, being performed after only acupuncture anesthesia. This is not been assessed in the United States.


2. How long before I can resume normal activities after my face lift?

This depends on the technique used and, of course, the patient. The traditional face lift involves a rather deep dissection under the connective tissues of the face, which leads to bruising and swelling. The modern face lift which I perform is less invasive and weaves the connective tissue upwards rather than cutting underneath it. This is a perfect example of where non-traditional practices can help decrease bruising and swelling and shorten recovery time: preoperative acupuncture, holistic medical esthetics, and other modalities I have found have allowed my clients to resume normal activities in about 10 days.


3. How can I find a qualified surgeon in my area?

First, check to see whether the doctor is board certified and then in what specialty: The face lift specialists are board certified in either plastic surgery or otolaryngology (ear, nose, and throat). Many ENTs have undergone a fellowship in facial esthetic surgery. The next step is to go in for a consultation and see whether you feel comfortable that the surgeon will listen to you and take care of you, and that his staff is responsible. You can also ask for testimonials from some of his or her patients. Although reviewing a doctor' s training is usually a good idea, this can be confusing. Some plastic surgery training programs are little known but are fantastic and some famous institutions have mediocre plastic surgery training programs.


4. Who is a good candidate for face lift surgery?

Beyond being healthy and not smoking, the best candidates are those who have sagging in the cheeks and jowls, lateral to the marionette lines, which are the lines between the corners of the mouth and the chin. That sagging can really not be addressed with fillers, such as the liquid lift. Also, those with a loose neck are good candidates for a face lift: the modern face lift does not separate the neck from the jowls and the cheek, and instead treats it as one entire anatomic area.


5. Will a face lift eliminate all of my facial wrinkles?

No, a face lift will refresh and tighten the skin but the goal is not to eliminate all wrinkles and to make someone appear like a mannequin. The traditional face lifts have tightened the skin too much and have led to a windswept appearance. The modern face lift is more of a rejuvenation and refreshing technique: my goal is not to have someone say what a great face lift that person has, but instead, "Wow, that person looks fantastic," without really knowing whether they had anything done.


6. Am I too young or too old for a face lift?

It depends on what you look like: There are 40 year olds who are excellent candidates for face lifts because they have some drooping of the skin and for example, excess skin under their eyes. They are excellent candidates because they will sail into their 60' s looking very young and not needing a "touch-up" surgery until that time. They will recover from their surgery better than they would if they waited 20 years. Someone who is very wrinkled will require a more aggressive technique and their recovery will be longer than if they had come in several years earlier. There is no age limit on performing face lifts; it simply depends on the health of the patient. There are people who are in their 70s, who are extremely fit and healthy and they are excellent candidates for the surgery.


7. Will it be obvious I have gotten a face lift?

The modern face lift really does not cause a dramatic change in somebody with moderate facial sagging. Of course, during the recovery time it will be apparent that you have had surgery, but after several weeks most of my patients, when they go to family reunions, are always asked why they look so good because it is not possible to tell they have had a face lift. Again, this depends on what you look like before the surgery.