- The term "traditional facelift" leaves room for debate
- Facelift procedures that don't address all components of the aging face may provide compromised results, surgeon says
- Short-scar lifts most appropriate in younger patients with minimal sagging
Having performed more than 5,000 facelifts in his 37-year career, E. Gaylon McCollough, M.D., knows a thing or two about facelift surgery. He says if there's one thing he'd like the up-and-comers to know, it's this: There's no such thing as a one-size-fits-all facelift.
He recommends steering clear of those corporate-sponsored facelift courses and certification programs that use words such as "mini" and "quick," and instead focusing on learning the tried-and-true traditional facelift technique that has stood the test of time.
But even among experts, Dr. McCollough says, the term "traditional" facelift leaves room for debate. "To me, a traditional facelift is when one makes an incision that addresses all of the areas of the aging process; incorporates an appropriate amount of liposuction to remove excessive fatty tissue in the submental region and along the jawline; and addresses sagging muscles in all areas of the face — the neck, the cheeks, the brows and the forehead. You have to do the deep support first and then address the skin," he says.
Dr. McCollough says he's encountered others who define the traditional facelift as the short-scar lift.
"They are not going behind the ear to address the sagging tissues in the neck," he says. "Also, not everyone is addressing the muscles in the appropriate way — some are simply sewing fat to fat with sutures underneath, while others are actually tightening the muscles."
Whether short cuts are employed to reduce surgical time, recovery time or something else, Dr. McCollough says he suspects the patient is ultimately short-changed with suboptimal results.
A 67-year-old patient before (left) and one year and three months afterundergoing facelift (temporal, cheek, neck) as well as upper and lower blepharoplasty. Six months later she had full-face resurfacing using a combination of chemical peel and dermabrasion. (Photos credit: E. Gaylon McCollough, M.D., F.A.C.S.)
Dr. McCollough says surgeons see presentations at national symposia about these various new-and-improved facelift options and there is a great deal of confusion throughout the specialty. The patient pool has widened and become more diverse since facelifts first became commonplace and popular.
Younger women — and plenty of men — of a variety of ages are seeking facelifting procedures to retain or restore a youthful look, and there are an array of facelift options to address this diverse population. That doesn't make the traditional facelift any less effective for the patients to whom it was first introduced, however, nor does it make it any less of a viable option in today's cosmetic surgery practice, Dr. McCollough says.
A 61-year-old female patient before (left) and six months after undergoing facelift (temporal, cheek, neck with platysmaplasty) as well as lower blepharoplasty and functional septorhinoplasty.
BASIC TRAINING "Anatomy has not changed since facelifting came to be, so the tissues droop in the same manner that they have always drooped, and the same tissues droop now that have always drooped before," Dr. McCollough says. "The way to correct that is to address all the different parts of the face that are involved in sagging: the musculature underneath and the fascia that envelops the musculature of the face and neck, as well as addressing excessive fatty tissue that sometimes produces bulges along the jawline and under the chin and contributes to the heaviness of the face, thereby causing the droopiness to occur. Then, of course, you have the sagging skin — those are all the components in the aging face."