Australian cosmetic surgeon offers international perspective on facelifting

To Australian plastic surgeon Bryan C. Mendelson, M.D., a facelift isn't just a facelift; it's a social equalizer of sorts. In a discussion about what's new and noteworthy regarding the surgery's evolution, Dr. Mendelson says, "We are entering a major sociologic change where facial rejuvenation is no longer limited to the wealthy few, but to the masses worldwide — they will be united by the ability to conceal aging."

He is known globally for his Melbourne cosmetic surgery practice, the Centre for Facial Plastic Surgery. According to Dr. Mendelson, "The world of facelifts is going through an extraordinary phase, as there is progress occurring on several different fronts simultaneously. First, the leading surgeons are now performing absolutely beautiful surgery. The exact aesthetic objective varies in different parts of the world and even in different parts of the same country, such as the difference in styles between cutting-edge Los Angeles and the more conservative New England," he says.

What Dr. Mendelson says he finds particularly significant in today's facelifting landscape is that the best surgeons are able to obtain for their patients a refreshed appearance, so that they do not look as though they have had surgery.

Dr. Mendelson says that after proper internal support surgery, the rate of future aging is slowed. "There have not been any scientific studies to verify this, but this associated benefit is obvious to surgeons who operate at this level," he says. "Accordingly, when looking naturally youthful is the objective, then slowing the rate of aging of the face is the best way, and therefore, the choice of technique becomes significant."

'LESSER' LESSONS The second area of advance, Dr. Mendelson says, is in minimally invasive, or as he refers to it, 'lesser' facelifts.

"Their attraction is the convenience they provide for the patients who are willing to sacrifice the ultimate result because that is a lesser priority," he says. "The reality is that a large proportion of surgeons are being forced by the marketplace into performing these lesser facelifts, and in general the patients attain sufficient improvement and do not realize the difference from the best facelifts. The lesser benefit of these facelifts is enhanced by complementary procedures performed at the time, specifically augmenting facial volume using either fat injections or synthetic fillers."

Dr. Mendelson says the third area of advancement is in avoidance of surgery altogether. "The nonsurgical alternatives for rejuvenating the face by enhancing facial volume, mainly with fillers, with or without skin tightening is growing in popularity," he says. "Not only is there a worldwide trend for people to have facial rejuvenation using fillers, but they are commencing this at an increasingly younger age, when the earliest traces of aging first appear."

Dr. Mendelson says fillers work well, but are expensive in the long term. "The consumer reality is that people are motivated by a desire to avoid surgery and are willing to pay more for less in order to have the result now. The potential problem is in the nature of the aging process, as it continues unabated with exponential, not linear, progression, while all along the filler is concealing it," he says. "Eventually, there is the requirement for more and more filler volume, for a less and less natural look."

On the up side, he says, "Continuous improvement in fillers is inevitable from the companies who stand to make fortunes out of having the preferred product used worldwide."