Historically speaking, there is really no nonsurgical option that could accomplish what a facelift could accomplish or that could really even improve upon the areas that are treated by a facelift.  Historically, Thermage, which is a radiofrequency device, was touted as the nonsurgical facelift but, unfortunately, had an extraordinarily high rate of nonresponders and dissatisfied patients.  In fact, most studies performed showed the dissatisfaction rate to be in the high 70s as far as a percentage of patients who were not satisfied by the treatment.  Fortunately, today, there is a brand new technology available called Ultherapy that uses ultrasound to not only visualize deeper layers of the tissue but also to then target these ultrasound waves to specific sites within the tissue.  By focusing the ultrasound energy to a very precise spot, the tissue is heated to the point that the collagen denatures, which then starts the healing process and new collagen deposition.  This new collagen in turn causes tightening and lifting of the tissue, and this new Ultherapy device has now been granted FDA approval for browlifting and is now being used in the mid- and lower face and neck regions to provide not only lifting of the jowls but also improvement in the laxity below the chin as well.  We have seen dramatic improvements in the brow and crow’s feet area, and we have even seen very remarkable improvements in the lower eyelid region.  This is extremely exciting technology as the response rate appears to be in the 90-plus percent range.  We are just delighted to be able to have this device at Campbell Facial Plastic Surgery and Quintessa Medical Spa as, at the time of this blog, we were the ninth facility in the United States to obtain this technology, and we will be one of 25 for the phase I clinical release of Ultherapy. I would highly recommend anyone who is interested in the nonsurgical facelift to schedule a consultation at Quintessa Medical Spa so that we can perform a thorough evaluation and determine if you are a good candidate for this exciting new technology.  There certainly really is no other technology available that can provide lifting of the facial structures in a nonsurgical fashion.

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Absolutely, I truly believe there is a dramatic difference in various types of facelifting techniques and that is why I personally customize each and every facelift that I perform, whether it would be a mini style facelift that I perform in the office setting or a more sophisticated extended SMAS deep plane facelift that I would perform in the operating room setting.  Ultimately, every patient has different anatomy and every patient deserves a modified and customized facelift approach for their individual concerns.  I can personally show you patient photo after patient photo that shows the dramatic difference in rejuvenation between the SMAS style mini lift or lifestyle type lift or quick lift and the more sophisticated extended SMAS deep plane facelifts.  The most significant difference is in the cheek or midface area where the extended SMAS deep plane facelift will elevate the soft tissue of the cheek and restore the harmony of the midface creating more beauty.  A standard style SMAS lift or lifestyle lift or quick lift will not provide the elevation of the midface.  Another area that the more standard or miniature style facelifts fail is adequate rejuvenation of the area under the chin.  Many patients with fullness or bulkiness under the chin really require a rather aggressive and sophisticated approach to treatment of this area, which can only be performed through an incision under the chin and can really only be performed by a very experienced facial plastic surgeon as inadequate treatments in this area can lead to rather disfiguring problems.  By resecting excess platysmal muscle in that area as well as any excessive subplatysmal fat and then elevating this soft tissue and then bringing it back together in the midline with a very sophisticated suturing technique, I can create a beautiful shelf or flatness underneath the chin that is present in the youthful face and is lost as we age.  By rejuvenating this area so aggressively, I can then go back and finish the extended SMAS deep plane facelift and provide elevation of the jowl and midface area to complete the overall transformation into a more youthful lower half of the face.  These can be very dramatic changes but, due to the fact that they are so incredibly natural looking, the overall effect is just rejuvenating and certainly is not eye catching or surgical in any way.  So, in conclusion, I fully feel that the more sophisticated facelift techniques are well worth the extra effort and cost as you will not only get a far superior rejuvenation but it will also have a much longer lasting effect.  In all, I think that this is a much better value for patients due to the fact that they get this increased rejuvenation for a very extended period of time and, when you break the costs out over those extra years, the actual value is much greater with the more sophisticated facelift techniques, compared to lesser techniques.

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Absolutely not.  Standard-style facelifts or even the more sophisticated extended SMAS deep plane facelift that I personally perform do not take four to six weeks to heal.  The far majority of my patients look quite good in literally one week and most are back to work and performing relatively normal social functions in that amount of time.  For patients who want to look extremely good or want to go to close and personal social interactions, then I would recommend waiting approximately two weeks after these more sophisticated facelift techniques but, certainly, four to six weeks is way out of the standard recovery range in my personal practice.  In comparison, I tell my patients who have a mini lift to expect at the very least three to four days of downtime and most would require approximately a week before they return to work and social interactions as well.  Even mini lift patients also see a significant amount of improvement between the one- and two-week periods of time and, all in all, the recovery really is not that drastically different between a lifestyle lift type of a facelift and the more sophisticated and more rejuvenating styles such as the extended SMAS deep plane facelift.

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Well the answer to that question really depends on in what respect you are concerned with.  If you are asking whether they can rejuvenate as well as the standard facelift, I would have to say absolutely not but, are they more convenient and more cost effective than the standard facelift, then the answer would be yes.  Essentially, lifestyle lifts or quick lifts, S lifts, weekend lifts, or what I call a mini lift, is essentially a miniature version of a standard facelift.  The incisions may be shorter, the surgical procedure may be less involved but, in essence, what we are doing is we are lifting the deeper layers of the face into a more rejuvenated location and any excess skin is then removed, and the incisions are placed around the ear and closed with sutures that are removed in typically less than a week.  The limitations these techniques have is that, for patients with more advanced signs of aging or in patients with a significant amount of bulky fullness under chin, they would require a more sophisticated technique to address these problem areas, and a mini-lift or lifestyle or weekend lift will not correct these adequately.  Ultimately, I think it is extremely important to have a consultation with a surgeon who is extremely experienced in various forms of facelifting as I personally feel that a facelift requires extreme customization so that the problem areas of each individual patient can be fully addressed and the rejuvenation can be above the expectations of the patient, and we ultimately create an extremely natural rejuvenation without the telltale signs of a surgical procedure.  This can only be performed through customizing the facelift approach and frequently can only be performed by using extremely sophisticated surgical techniques such as extended SMAS deep plane facelifts and aggressive platysmal and subplatysmal surgical intervention to improve the area under the chin.  By seeing a surgeon who has experience in all different styles of facelifting, the appropriate technique can be recommended so as to maximize the rejuvenation for each individual patient.  If a person sees a surgeon only capable of performing lifestyle lifts or quick lifts or mini lifts or similar type surgeries, then the only technique that will recommended would be that type of a surgical facelift technique which, for many patients, is completely and utterly inadequate in providing a very natural rejuvenation.  Interestingly, these more sophisticated and technologically advanced procedures really do not add any significant amount of downtime to the patient’s recovery when compared to a more limited incision-style facelift.  Essentially all facelift techniques can be performed with approximately one week of downtime but I have certainly seen patients with any type of facelift technique take as little as a few days to up to nearly two weeks before they feel that they can go out into normal social situations.  So, though the minimal style facelifting techniques may tout a shorter recovery and overall, indeed, may save patients a day or two, there certainly is not the drastic difference that has been portrayed in the television ads regarding the more sophisticated facelift techniques.  I certainly personally would not allow the downtime of the procedure dictate my decision on what style of facelift would work best for me as, in reality, the downtime is really not going to be much different in the big picture.  I would, therefore, select the best technique of facelifting that would give me the most significant amount of rejuvenation and the greatest longevity for my personal anatomic concerns.  And, again, ultimately this requires an evaluation by a facial plastic surgeon that can perform these varied techniques.

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Well certainly if you are viewing results from another surgeon that are not your actual photos, then it is very important to have extremely consistent photography and very consistent poses in the before-and-after photographs so that you can assess the result properly.  It is also important to be able to view the nose from multiple different angles and, classically, rhinoplasty surgeons take six to seven different views of the patient in both the before and after photos.  Due to the large number of photographs, I typically do not show all of these different views on my website but they are certainly available for patients who are interested.  Otherwise, if you are actually viewing your own results after a rhinoplasty, I like to recommend that patients do what I consider a first impression approach toward their results, which means they look at themselves in the mirror, and their first impression should not be a noticeable nasal abnormality.  In other words, I expect the nose to not detract from their overall appearance, and they should really notice their eyes after a rhinoplasty.  With that being said, they could still have some minor irregularities that are actually visible after a rhinoplasty, and these irregularities may bother the patient and certainly may also bother the surgeon and require some sort of revision surgery.  These irregularities hopefully will not be so significant as to make the nose “noticeable” as the whole goal of a rhinoplasty is to create the nose that better fits the face and is therefore not “noticeable.”

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