Almost everyone Dr. Michael Wojtanowski, of The Ohio Clinic for Aesthetic and Plastic Surgery, sees wants to look younger.
“When we do cosmetic surgery on the face, we take an individual and enhance that face,” he stresses. “We are not taking that individual and trying to make them look like another person — or unnatural.”
Most of us don’t age like Catherine Zeta-Jones or Sharon Stone, two examples of women who seem timeless, says Dr. Gregory Fedele. “Christie Brinkley looks amazing even though she is around 50,” he adds.
Today there are a number of techniques, noninvasive and surgical, that can erase time’s footprints without the two-week downtime traditional face-lift procedures usually require. “Face-lifts are trauma to your face, and you have to recover from swelling,” says Dr. Lu-Jean Feng, medical director of The Lu-Jean Feng Clinic in Cleveland.
Most swelling settles two weeks after surgery; by six weeks, the majority of swelling is gone. “There are other procedures that are easier to do,” Feng says. “Because a lot of people can’t take the time off.”
Dr. Fadi Abbass, of The Face Institute in Chagrin Falls, agrees that “everyone is looking for less downtime and more bang for the buck.” Though, he reminds, that less invasive facial procedures, such as threading, are not as effective as the face-lift. In threading, barbed thread is inserted into an incision in the skin and passed through the face, Abbass describes.
“Threading is intended for people who have some early changes and who are looking for minimal improvement,” Abbass says. “The barbs allow you to reposition the skin,” he adds, noting that they are left under the facial tissue and will eventually decompose.
But this procedure is not for everyone. Those with thick skin, full neck or significant signs of aging will not benefit from threading, Abbass says.
Feng prefers face-lifts to this procedure. “How would you create a beautiful cheekbone or smooth skin under the eye or a smooth jaw line?” she asks. “How would you create a beautiful swan neck? You have to lift the tissue up, tighten it and move tissue into the cheek area. When you age a lot of the soft tissue in the cheek thins out and accumulates at the bottom of the neck.”
Patients don’t like the “jowls,” Feng adds, comparing facial restoration to making a bed. “You straighten out the sheets and reposition them to where they used to be,” she relates. “That is why I study pictures of patients’ faces when they were younger — when they were 29.”
[Once the typical patient was age 60 or so. today, people in their 40s and 50s are getting face-lifts (www.webmd.com). 2005 was the first year face-lifts didn't make the top five surgical procedures performed, according to the American Society of Plastic Surgeons (www.plasticsurgery.com).]
Noninvasive Procedures — For patients who request noninvasive face rejuvenation, Feng presents alternatives such as Fraxel and Thermage. Both will minimize signs of aging, but neither are as effective as a face lift. Thermage uses radio frequency waves to treat 2 millimeters below the skin, in the “fatty zone.” “The microwave energy burns skin [underneath the surface] and stimulates collagen to form,” Feng describes.
Fraxel is a four-time procedure, in which patients are exposed to CO2 lasers that heat up underlayers of skin and causes collagen to remodel, Feng says. When skin grows back, it is tighter. This procedure is ideal for patients with some wrinkling, acne scars or dark spots. Downtime is a few days, compared to the old CO2 procedure, which burns off a layer of skin and requires two weeks for recovery.
But these procedures still don’t restore youth like the face-lift. “A Thermage treatment can’t move [skin] the distance that a face-lift can,” Feng says. “I can move Point A to Point B more than 2 centimeters with a face-lift. With Thermage, I can tighten the face, but movement is in millimeters.”
Get the Facts — No matter which type of facial rejuvenation a patient prefers, Dr. Steven Goldman warns against believing marketing gimmicks. Though new-and-improved formulas designed to restore youth sound appealing, consider the information source and always investigate procedures and surgeons. “Patients don’t want to be guinea pigs,” says Goldman, of University Plastic Surgery in Cleveland. “They want procedures that are safe, effective and proven.”