How To Make Certain You Get a Great Facelift

When it's time to have a facelift, how do you make certain you get a good one? Why do so many Hollywood stars look operated – and weird? How can you avoid it?

It's no wonder that cosmetic surgery can get a bad rap when so many celebrities act as unofficial ambassadors for bad surgery. Pulled, pillowface, windtunnel, trout pout: these are just some of the unflattering buzzwords associated with too many public figures who've had plastic surgery.

My patients tell me they want to look natural, like nothing was done. I agree—I personally would rather look old than weird! If your cosmetic surgery is the first thing people notice about you – not how young and good you look – then you haven't had good cosmetic surgery.

Fortunately, when you choose a good plastic surgeon, you don't have to make the choice between looking surgically “done” and looking old.

Here's what you need to know about how to get a facelift that doesn't make you look like you've had a facelift.

The number-one most important factor in getting a great result is choosing the right surgeon. 90%-95% of your cosmetic surgery result is predictable and is determined by the skill and experience of your plastic surgeon in THE PROCEDURE you are having. This goes for ANY PROCEDURE, and not just cosmetic surgery. For instance, a plastic surgeon whose practice focuses on reconstructive plastic surgery (breast reconstruction after mastectomy, hand surgery, burn surgery, etc.) is not as experienced at cosmetic surgery as plastic surgeons whose focus is strictly cosmetic surgery.

At the Austin-Weston Center, we encourage comparisons to other plastic surgeons. Did you know, for instance, that only 10% of plastic surgeons perform cosmetic surgery exclusively? My partners, Dr. Robert Sigal and Dr. Poindexter, and I are among that 10%. The Austin-Weston Center has focused just on cosmetic surgery since our founding in 1978.

When considering a plastic surgeon, don't be shy about asking about their experience. Do you prefer the plastic surgeon who performs 12 face lifts per year --the actual average number of facelifts performed per year by plastic surgeons who specialize in cosmetic surgery--or the surgeon who, like each of us at The Austin-Weston Center, does almost 100 face lifts per year?

A facelift is not like buying a car. You can get the same Honda from any car dealer, but all cosmetic surgery is not created equal. One plastic surgeon's facelift is not the same as another's.

The second most important factor in choosing your plastic surgeon is the design of your procedure. The execution is up to your surgeon, but you have to be the senior partner with your surgeon in what you want to accomplish. Take 100% responsibility for this. Point out the details of what you like and don't like to your surgeon and ask specific questions. Everyone would like to have a minimal procedure, with maximum results, a short recovery period, that doesn't cost much. I hear that promised in the media every day, but it doesn't exist. Do not focus on getting a short recovery period, and don't look for cheap. No one looks for the cheapest heart surgeon, so don't price shop for the cheapest cosmetic surgery, either. Look for superior care and superior results.

Visit plastic surgeons' websites to compare before and after photos from one surgeon to another. Plastic surgeons place their best results on their websites, so you can get a good idea of the quality of work from one surgeon to another.

When you decide to do your face, consider doing your WHOLE FACE at one time, including eyelids, brows, mouth, etc. But of course, don't have anything done that you don't want. Just remember, so called “lunchtime lifts” and “mini-lifts” give mini results and don't treat the whole face. If it sounds too good to be true, it probably is! After all, do you really want cosmetic surgery that describes itself as cheap, fast, and easy? That's good if you're talking about a drive-through at a fast-food restaurant—not about cosmetic surgery on your face, or any part of your body, for that matter!

There is a paradox exclusive to cosmetic surgery: the more you have done at one time, the less done it looks. The face doesn't age in one spot, it ages all over. And if you only treat the bottom half, as with a facelift, or the top half, as with eyelid surgery, it looks half done. You'll end up with a treated area next to an untreated area and it won't match!

Of course, it can be difficult to visualize all the changes your cosmetic surgery will make. The Austin-Weston Center uses computer imaging to show prospective patients the possible results of their surgery. Computer imaging can be very helpful in envisioning cosmetic surgery outcomes and designing your procedure– look for a surgeon who offers this tool.

Third in the steps to getting a great facelift is to ask your surgeon about risks, limitations, and tradeoffs so that you will have realistic expectations.

For instance, there will be incisions and subsequent scars that will be the tradeoff for a better shape and contour. Usually, you get a scar that can only be seen from inches away. But at normal conversational distance, these scars won't be apparent, especially as they fade with the healing process and over time. Still, you have to be ok with the tradeoffs. All flaws cannot be totally eliminated. Remember that the goal of cosmetic surgery is an improvement, not perfection.

I regularly see patients who come to me to have other surgeons' work corrected. These facelift flaws I see include elevated sideburns, deformed ears and earlobes, and a “pulled” look. Most of these flaws can be avoided by a highly skilled and experienced plastic surgeon. Patients don't realize that these flaws are even possible – but now you do! Let your plastic surgeon know during the consultation that you want to avoid them. The design of the surgery is the key here.

The photo below shows a sideburn that has been elevated above the ear. This can be avoided by lifting the cheek skin to the hair rather than including the hair in the lifted portion. It's simple to avoid, yet again, it's something I am called on to correct often.

This photo shows an unnatural appearing ear where the cartilage in front of the ear (tragus) has been flattened, and the earlobe is attached and pulled down (pixie ear.) The surgeon placed the scar “inside” the ear behind the tragus to hide the scar, pulling the thicker cheek skin over the tragus and flattening it. This is very difficult to correct. The earlobe is attached to the cheek unnaturally and with too much tension that allows it to pull down.

This photo shows a woman with a “pulled” appearance of the jowl area from a previous so-called “mini” facelift performed elsewhere. The ear looks unnatural because of the fold of skin in front of it and the earlobe that is attached oddly to the cheek. The corner of the mouth turns downward.

A corrective full facelift and midface lift were performed to lift the cheek more vertically rather than toward the ear. This eliminated the pulled appearance. The earlobe and the fold in front of the ear were corrected and the corner of the mouth was lifted.

This photo is of our staff member Ronna's facelift, performed by me. Notice the preservation of the sideburn and the natural appearance of the ear and earlobe. The point is that a facelift can be virtually undetectable if performed well.

Doing your homework is of the utmost importance. Don't be shy about doing your research and asking questions. The goal is to have a facelift that looks natural and beautiful.

I invite you to come to see me or one of my partners for a complimentary facelift consultation. If that's not possible, make sure that your plastic surgeon is by The American Board of Plastic Surgery and has before-and-after photos of their work they can share with you. And if, unfortunately, you have had a bad facelift, come in to see one of us here, and we can talk about your options to make it better.