Question: I know my facelift will be a journey through the preparation, surgery, and recovery.  I do not want all that time and pain to go to waste by not taking maintenance steps.  Is there a regimen such as creams, foods, or vitamins that I should follow after my facelift?

Answer: Well, I certainly recommend that everyone after a facelift continue to lead a healthy lifestyle, which would include regular exercise, protection from the UV radiation from the sun, and drinking plenty of water.  I also recommend that patients go on a pharmaceutical-grade skin care line as well as Retin-A which will condition and enhance your skin prior to surgery as well as maintain the optimal results after your surgery.

I also ask that they consider getting regular maintenance treatments such as no-downtime microdermabrasion or no-downtime chemical peels at Quintessa Medical Spa even after they have had comprehensive facial rejuvenation.  This will maximize the longevity of the result and, ultimately, keep their skin healthier over a longer period of time.

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Question:  I want my eyes to look more open and awake but I am also interested in refreshing my facial tone.  Is it recommended that patients combine chemical peels with other facial surgery like a blepharoplasty? 

Answer:  I am not sure if I would say that it is recommended that patients combine these things as I typically form a very customized treatment plan for my patients.  In other words, some patients may benefit from combining chemical peels with blepharoplasty while others may not.  Everyone’s face is different, and I therefore customize my treatment plans for each individual’s facial anatomic particularities as well as the patient’s desires. 

 Many of my patients present with concerns for aging features, and we therefore discuss various rejuvenation options, some being very simple such as good skin care and sun protection and some being much more complex such as endoscopic browlifts, extended SMAS deep plane facelifts, and Erbium laser resurfacing. 

 I certainly routinely perform multiple procedures all at once on many of my patients so that we have a very significant rejuvenation but also retain facial harmony where all areas of the face go together and, therefore, the patient looks very natural, will have a very long-lasting result from these multiple procedures and, overall, just has a very wonderful rejuvenated appearance.

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Question:  I know it is a bad habit but I drink diet soda pretty much all day.  Recently, I have noticed an increase in fine lines.  If I reduce my intake of caffeine, will the lines fade away or is there no connection between these two factors?  If the fine lines do not fade, what is the best way to treat them? 

Answer:   There may be a small relationship between your caffeinated diet soda and fine lines and wrinkles but this will be a relatively mild association and, more than likely, if you discontinue the use of your diet soda, you really will not notice much change to your skin.  Nonetheless, I would recommend increasing your intake of water as opposed to diet soda and also would recommend a good medical-grade skin care line along with sunblock on a daily basis.  I would further recommend Retin-A, as this will be a nice way to improve some of the fine lines, speeds the natural exfoliation process and enhances collagen production which will help promote new skin cells for a firmer younger looking skin. Overall these recommended treatments will not only improve the condition of your skin but also prevent these aging changes from recurring. 

Obviously, over time, the skin is going to age and show these changes no matter what we do but we can at least potentially postpone the appearance of these fine lines and wrinkles and, when they do occur, we can start treating with rejuvenation-type treatments such as laser resurfacing.  I would also mention that, depending on where the fine lines are, Botox is a wonderful way to treat these lines and also to prevent them from recurring.

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Question:  What are the potential risks and complications associated with facelift surgery? I am 44 years old and in good health. 

 Answer:  Well, overall, the risks from a facelift surgery are exceptionally low when performed in experienced hands.  But risks would include blood collection under the skin, which is called a hematoma, which would need to be evacuated if this would actually occur.  Other risks include injury to a nerve that provides sensation in and around the ear that could result in permanent numbness of this area and, depending on the technique of facelift performed, other risks would include injury to the facial nerve that could cause weakness of the muscles of facial expression. 

All of these risks are rather low, especially the risk to any motor nerve or facial expression damage.  The risk of a hematoma is approximately 5%.  The risk of injury to the great auricular nerve is approximately 7%, depending on which article you quote but, in my own personal hands, I have never had a patient tell me that they had permanent numbness, and I have certainly never seen direct injury to the great auricular nerve during any facelift that I have performed.  Injury to motor nerves is exceptionally rare and, though I have seen a few patients with some temporary weakness after a facelift, this is due to some mild injury to the nerve due to cauterization of minor bleeding during the procedure itself.  These mild injuries eventually resolve and the full function of the muscles of facial expression have always returned within approximately six weeks.  This is a very unusual complication but fortunately, at least in my own personal experience, this has never been a permanent consequence of facelift surgery.  All in all, the complication rate is exceptionally low and, typically, these sort of mild complications are only temporary and will leave no lasting results.

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Questions:  I love the results that I have seen with facelift surgery.  I would like to know if a facelift will remove forehead wrinkles and wrinkles around the eyes. 

Answer: A standard facelift or rhytidectomy is the procedure that involves incisions around the ears, and it classically treats the lower third to lower half of the face.  When I personally perform surgical intervention on all areas of the face at once, I call this comprehensive rejuvenation as it involves a browlift, upper and lower lid blepharoplasty, facelift, and Erbium laser skin resurfacing.  Some people would call this comprehensive approach a facelift and, by that respect, it could treat the wrinkles of the forehead and around the eyes.  I personally feel it is more specific to describe each area of the face surgically and to treat the forehead wrinkles. I would call this an endoscopic browlift and, to treat the wrinkles around the eyes or excess skin around the eyes, I would call an upper and/or lower lid blepharoplasty.  Ultimately, a consultation with a board-certified facial plastic surgeon would allow you to learn about all of the different options that are available for the treatment of your concerns.

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