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Selecting a Plastic Surgeon

Can you teach an old doc new tricks? Well, maybe – but you’d have to offer a pretty big bone. After so many years of practice with a particular technique, sometimes even doctors get in a rut routine. It’s human nature to resist change, and it’s not necessarily a bad thing in most circumstances. I mean, you probably dry off after a shower in the same way every day. You probably have used the same cereal to milk ratio for years.

But when it comes to plastic surgery and facelift procedures, patients would do well to search out a doctor who has experience, yes, but not too much experience, if you catch my drift. Facelift techniques are continuously changing and improving every year. Here’s a quick look at some Old School and New School differences:

Old School – High and Tight

In previous years, plastic surgeons made incisions around the ear and simply pulled the skin upwards and as tight as possible before redraping it and reattaching it. This was effective at smoothing wrinkles, but the results didn’t last and patients often had the dreaded “wind tunnel” look. 성형외과

New School – SMAS Adjustments

Today’s surgeons almost always combine skin tightening with SMAS adjustment during a cosmetic surgery facelift. The SMAS (superficial musculo-aponeurotic system) is a strong, thin layer found between the skin and the muscle. I often refer to it as the Saran Wrap of the face. During a facelift, the SMAS needs to be freed up and adjusted separately from the skin.

Skilled plastic surgeons employ several SMAS strategies to give the most natural and longest lasting results, and the best technique is determined based on the patient’s individual anatomy. The SMAS can be cut and then lifted and sewn to a stronger area such as the bone behind the ear or over the cheek. Other times the SMAS is not cut but simply tightened with sutures. However it is achieved, successfully adjusting the SMAS creates much more natural facelifts that last.

Old School – Wrinkle Rejuvenation

Older facelift techniques were mainly concerned with vertical movement. Mainly, eliminate wrinkles and sagging by pulling everything North. There was little attention paid to skin firmness or volume loss, two of the biggest indicators of advancing age.

New School – Total Rejuvenation

Many older surgeons are not up to date on the newer practice of combining a facelift surgery with facial liposuction and/or fat grafting. By removing unwanted fat around the jowls and neck area with liposuction (often in combination with a neck lift), a skilled surgeon can actually sculpt the face into a more youthful profile.

In addition, using fat harvested from another part of the patient’s body to replace lost volume in the cheeks, nasolabial folds, marionette lines and temples is a relatively new practice that yields outstanding results. Synthetic fillers made of hyaluronic acid, such as Juvederm, are great for patients who want a temporary, non-surgical option to replace volume. But facelift patients will achieve permanent results with a fat transfer.


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