Undergoing a Facelift: Beyond the Basics
Embarking on a facelift is a weighty decision, entailing not only a considerable financial outlay and time investment but also carrying significant expectations. The procedure can often be perceived as an all-encompassing solution – the idea that going under the knife will always yield more substantial results than less invasive options seems intuitive, right? Theoretically, yes... but there's a catch. Combining a surgical intervention with complementary non-surgical treatments might ultimately lead to superior outcomes. "People fret that if they undergo multiple procedures, everyone will instantly notice they've had plastic surgery, but that's not the reality," remarks Dr. David Gilpin, a board-certified facial plastic surgeon based in Nashville, Tennessee. "You're likely to appear more naturally revitalized if you combine treatments rather than relying solely on surgery, as there are numerous elements that can complement a facelift," he elaborates. (For reference, he reveals that he performs standalone facelifts only approximately 10% of the time.)
The crux of the matter is that, despite its efficacy, a facelift has its limitations. "It's crucial to grasp the constraints of a facelift. While it can enhance the contour of the jawline and neck, it won't enhance the skin's texture. Surgery simply doesn't accomplish that. The advantage of concurrent procedures is that you're addressing diverse problem areas that a single treatment can't," elucidates Dr. Catherine Chang, a board-certified plastic surgeon in Beverly Hills, California. And by the time someone is prepared for a facelift, it's highly likely that there are additional issues that demand attention, she adds. Dr. Lucas Bryant, a double board-certified facial plastic surgeon in Mt. Juliet, Tennessee, concurs: "Imagine a facelift as the cake. You want the cake to be excellent, but these other elements are like the sprinkles and frosting that make the cake even more exceptional."
Beyond enhanced results, there's a substantial convenience aspect. You're consolidating the recovery periods from two procedures into one, making this an attractive choice for those with a busy schedule and an aversion to repeatedly sacrificing time from their social engagements, as Dr. Chang points out. Of course, there's also the aspect of pure comfort. Many of the treatments commonly coupled with a facelift (more on those shortly) can be profoundly uncomfortable or even excruciating, frequently requiring local anesthesia or IV sedation. Completing everything while under general anesthesia creates a far more effortless and pleasant experience.
So, which procedures pair best with a facelift? Based on the experts we consulted, here are three of the most prevalent.
Fat Grafting
"A facelift doesn't add volume. Fat grafting does," asserts Dr. Chang, who adds that she incorporates it in approximately 90% of the facelifts she undertakes. It's a suitable option for the majority of patients; most individuals over 30 are noticing some form of volume loss, so restoring it during the lift leads to a more rejuvenated outcome, she explains. In addition to addressing volume deficiency, there's another advantage to fat transfer. You're not only transferring fat but also growth factors and native stem cells, all of which contribute to improving the texture of the overlying skin, highlights Dr. Gilpin, noting that he observes a notable difference in patients who undergo both procedures simultaneously.
While extracting fat from a site on the body – the abdomen, the medial thigh – is common, Dr. Bryant adds that during a facelift is the ideal moment to harvest excess buccal fat (assuming the patient has an adequate supply). Although not scientifically validated, he finds using facial fat rather than body fat in the face to be more effective, both in terms of the amount of fat that survives the transfer and its behavior over time. (He typically adds it to the lips or under the eyes.)
CO2 Laser
"Visually, the recovery from a CO2 laser can nearly be more challenging than with a facelift, so synchronizing them is advantageous," states Dr. Bryant. Dr. Chang concurs, noting that the CO2 laser can entail 7 to 12 days of recovery time on its own, which can easily fit within the two weeks typically needed after a facelift. A CO2 laser is also the premier choice for targeting uneven skin texture and wrinkles, especially in troublesome areas such as around the mouth and eyes, remarks Dr. Gilpin. That said, this efficacy comes not only with significant recovery time but also considerable discomfort, which is why performing it while under general anesthesia makes perfect sense. Similarly, this also provides the opportunity to be more aggressive – ultimately achieving a more pronounced result – than a provider could if the patient were conscious, says Dr. Bryant. (However, there are some surgical subtleties. Depending on the type of facelift being performed, you might not be able to be as forceful in specific areas of the face, notes Dr. Chang.)
RF Microneedling
Options like Morpheus8 and VirtueRF might not require as lengthy a recovery period as some of the more potent lasers, yet they can still be quite uncomfortable, notes Dr. Bryant. While the tightening effects might not be essential for the lower face areas addressed by the facelift, they can be beneficial for other regions, such as around the eyes. Similarly, Dr. Gilpin mentions that he also adds radiofrequency microneedling treatments to other surgical procedures, such as blepharoplasties, to target areas like the jawline. Additionally, the microneedling component is excellent for addressing textural changes in the skin.
The Conclusion
While all the experts we conversed with concur that there are definite benefits to complementing a facelift, they also unanimously emphasize the fact that it's by no means compulsory and you shouldn't feel compelled or pressured to do so. "Ultimately, a facelift is purely optional. It should focus on addressing your concerns and undertaking treatments you're prepared for," says Dr. Chang. "If you weren't previously contemplating or concerned with other matters, then don't proceed with additional treatments," adds Dr. Gilpin. Dr. Bryant also echoes their sentiments, noting that the optimal course of action is to have an in-depth consultation with your physician to convey your concerns and better understand precisely what your treatment options are and what each can and cannot address.
