Question: How likely is it for a facelift to cause nerve damage? What would this do to the face esthetically?

Answer: If you read the scientific literature nerve damage from a facelift can be as high as about 5% or 1 in 20 facelifts. The far majority of these will be temporary injuries called a neurapraxia which will spontaneously resolve within the first year of surgery, most of them within the first 6 weeks. I certainly have seen patients present to my office having had a previous facelift with permanent nerve damage but this fortunately is extremely unusual. The nerve damage causes the inability to move a certain portion of their face, usually just on one side so that they end up having a little bit of a crooked smile or occasionally when they smile they will partially blink their eye on one side which is called synkinesis. Unfortunately these types of injuries are unable to be treated after the fact and once they are completely healed. Obviously the best option is to select a surgeon with extensive experience in facelifts so that you will minimize the risks of any sort of facial nerve injury. Obviously there is a risk with anything that we do in life and there is still an extremely small risk of nerve injury even in the most experienced hands but fortunately in those circumstances the risk is exceptionally low. I have personally seen a few patients have temporary weakness in portions of their face most likely due to cauterizing a small blood vessel near a nerve but fortunately I have never seen anyone with a permanent nerve injury due to any sort of esthetic procedure that I have performed.

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Question: I have dimples in my cheeks that I am very fond of. If I get a facelift will they go away?

Answer: Your dimples should not be affected by a facelift due to the fact that dimples are simple an area where muscle has inserted into the skin and when you smile it pulls on the skin and creates the dimple. As long as the surgeon does not go across this area during the procedure your facelift should in no way affect your dimple.

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Question: I have heard people say that Ultherapy is the big, new, noninvasive procedure currently available. What does it do and is it as promising as it sounds.

Answer: Ultherapy is a relatively new nonsurgical approach to facial rejuvenation. It is an ultrasound-based device that uses these ultrasound waves in a very precise and focused manner to heat up the deeper layers of the tissue of the face which in turn causes new collagen deposition which causes tightening and lifting of these structures. It is FDA approved for brow lifting and it is the only nonsurgical device ever to be given a lift indication by the FDA. At Quintessa Aesthetic Center we use it to treat early jowls and laxity under the chin as well as use it to elevate the cheeks and brows and the area around the eyes. It is extremely precise in the way that it delivers this energy and therefore is extremely consistent in its ability to generate new collagen. It is, however, a nonsurgical, no down time treatment and really is not able to provide the improvements that surgery can but considering that there is absolutely no downtime and no risk involved with this type of procedure it is quite amazing what it can provide.

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Question: Is it true that Ultherapy gives you the results of a facelift without surgery?

Answer: No, I really do not feel that Ultherapy is going to give you the results of a facelift without surgery but I do feel that Ultherapy will give you the best option for facial rejuvenation in a nonsurgical fashion.

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Question: How are facial implants used to treat the signs of aging?

Answer: Well, during the aging process we not only have laxity occur in the face where things start to droop showing signs of aging such as jowls and laxity under the chin but we also lose volume in the cheeks and frequently a weak chin can start to droop a bit as well. The midface or cheek volume can be enhanced by facial implants or malar implants and a droopy chin can be enhanced by a small chin implant placed at the same time as the facelift. This volumetric enhancement of the face often times synergistically rejuvenates the face along with other more standard procedures such as facelifts and eye lifts. Ultimately I feel that facial rejuvenation requires a very customized approach so that patients get the best and most nature result possible.

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