What should I expect with my facelift surgery?
Facelift surgery is the most powerful of facial cosmetic surgeries you can undergo. Although we say it in practically every blog entry, in this instance it is more true than ever; choose a doctor who is experienced, up-to-date on the latest techniques, and skilled at performing facelifts. The procedure for facelift has changed significantly in recent years. What is clear is that there is not added benefit for the higher risk, deep plane facelift.
When it comes to choosing the best facelift for you, there is no right answer as to which method is the most effective, natural looking, or successful. A customized treatment plan, established by you and your doctor and based on your features and desires will significantly influence the outcome of your procedure. A facelift will always be a procedure of intelligent choices.
Where is surgery commonly performed and what type of anesthesia?
Typically facelift surgery is an outpatient procedure, but overnight stays may be recommended after deep sedation or general anesthesia. For certain individuals, your doctor can perform your facelift in the office, while you are awake and under local anesthesia. But for most, general anesthesia or deep sedation is the best choice. For cases requiring deep sedation and general anesthesia, Dr. Steinsapir performs surgery at the UCLA Ronald Reagan Medical Center and usually recommends an overnight stay at the surgery center.
Recovery and physical restrictions
A facelift takes approximately four hours. Usually there is minimal discomfort afterward; managed with either over-the-counter or prescription pain medications. You may experience moderate swelling around the eyelids and other areas of the face, but this is normal and is not cause for concern. Most find taking 7-10 days off from work about right. This time frame can depend on the precise nature of you work.
Common complications after surgery
Facelift surgeries performed by a skilled and experienced surgeon rarely have complications. The deep plane facelift mobilizes the tissue under the facial muscles and can injure these motor nerves causing facial weakness. The incidence is small but not zero. The risk amounts to only a very small percentage of individuals who receive this treatment experiencing this complication, but there is just no reason to risk this nerve damage when other methods of facelifts are available. In fact, there is essentially no cosmetic benefit to the deep plane facelift compared to other lifting methods. Other complications can include significant bruising and very rarely infection.
The time frame before full recovery
Recovery periods for facelift procedures vary greatly depending on the type of facelift surgery your physician and you decide on. Typically however, you can expect to return to work after 6 to 10 days. After 2-3 weeks, others are unlikely to detect that you just had surgery. Facelifts are not considered fully healed until about 6 months after. Once you have recovered fully, the results of surgery are very long term.
About Dr. Steinsapir
Dr. Steinsapir is on active staff at the UCLA Hospital and Medical Center at the David Geffen School of Medicine as an associate clinical professor of Ophthalmology in the Division of Orbital and Ophthalmic Plastic Surgery. UCLA is consistently rated the best hospital in the West and ranked at the top with a handful of medical centers in the United States. Many surgeries are performed on an outpatient basis at the Surgery Center at the UCLA Medical Center. Dr. Steinsapir addresses a broad array of oculofacial reconstructive concerns. Contact us today to schedule a personal consultation with Dr. Steinsapir.
What should I expect with my forehead surgery?
Forehead lift surgery, also referred to as a brow lift or eyebrow lift, is designed to achieve a younger, more refreshed look by smoothing the forehead, reducing frown lines, and elevating the eyebrow line position. In some cases, it’s preferred over upper eyelid surgery for achieving rejuvenation. Although the forehead lift elevates the eyebrows, it differs from eyelid surgery because eyelid surgery deals with the height of the crease, the crease structure, and eyelid and lash ptosis. Although eyelid surgery can freshen your look as well, the forehead lift addresses one of the focal points of your face–one that can make the difference between looking tired and run down and looking youthful and refreshed. In some instances, combining a brow lift with eyelid surgery will provide the total facial rejuvenation you are seeking.
Different types of forehead surgery
There are three major types of cosmetic forehead lifts; endoscopic, also called closed forehead lift, open forehead lift, and thread, or suture lift. Of these three types, endoscopic forehead surgery is the safest, most effective, and most natural-appearing surgical solution. Both the open and closed forehead lifts are long-lasting, with the open forehead lift showing no clear advantage in any area and some clear disadvantages. Healing time for the endoscopic forehead lift is about five times faster, so you’ll see improvements sooner, and your risk of forehead lift complications is greatly reduced.
The thread lift, or suture lift is often advertised as a cheap alternative to the facelift. The thread lift is a procedure in which a barbed suture is threaded through the face. This is supposed to lift the face with minimal surgery. It costs less than a facelift, and sometimes recovery time is shorter, but this procedure doesn’t last and can have associated complications. Most cosmetic surgeons do not perform thread lifts because they feel that they are ineffective. For cosmetic purposes, Dr. Steinsapir primarily performs endoscopic forehead lifts, or closed forehead lift. The endoscopic forehead lift offers many advantages to other alternatives.
Where is surgery commonly performed?
A forehead lift, whether open or closed is a surgical procedure and cannot be performed during an in-office visit. Surgery is typically performed in an outpatient surgery center. Dr. Steinsapir performs this procedure at the UCLA Outpatient Surgery Center where he is on staff as an Associate Clinical Professor and Attending Surgeon. An endoscopic forehead lift requires intravenous sedation but general anesthesia is typically not needed. This means that you have surgery with minimal drug exposure contributing to a faster recovery.
What is the typical recovery course and physical restrictions?
Swelling and bruising following an endoscopic forehead lift can last for several weeks. However, most women find that after 7 to 10 days and a little makeup, they can go out and about without calling attention to themselves. Most men find they can return to their work routine without makeup at 7 to 10 days.
Endoscopic forehead lifts involve a relatively short recovery process and patients usually experience minimal discomfort. Smaller incisions mean less healing and a faster recovery and is associated with few complications compared to the open forehead lift technique. Numbness of the scalp, which was universal with the open forehead lift, is rare with the endoscopic forehead lift. There is very little if any hair loss with a small incision forehead lift.
What are some common complications and how are they addressed?
An endoscopic forehead lift offers faster healing time and fewer negative effects like scalp numbness, hair loss, or a long scar. Although a few who insist on continuing to perform the open forehead lift may say that the resulting scar from the open forehead lift can be “hidden” underneath your hair, the reality is that this breaks up the natural hair growth pattern. The untrained eye will recognize that something looks slightly “off” about your hair line―even beveled incisions that allow some hair to grow through the scar can look wrong. In hair grafting circles, this is referred to as “compression.” Natural hairlines do not have compression. Many who have had this procedure also do not like the long term numbness that results from cutting large sensory nerve in the scalp. The open coronal forehead lift can also be associated with permanent hair loss along the incision line. These complications are not seen with the small incisions used for the endoscopic forehead lift.
What is the time frame before full recovery?
Following endoscopic forehead lifts, the forehead needs to be supported while the body heals. This support is called brow fixation and there are several options for brow fixation. The two most common options in this practice are the Coapt endobrow Endotine or microscrew fixation. The Coapt device is a small plate that is used in pairs. The plate is fixed to the forehead bone and supports the forehead. The device is completely covered and over time will dissolve. The other method for supporting the forehead after surgery involves three or four small microscrews that poke out of the scalp. A small staple behind each post supports the forehead. The posts and the staples are removed about three weeks after surgery. Again, these are hidden in the hair and are generally not noticeable to others. Dr. Steinsapir allows a return to the gym in 10-14 days, however even the day after surgery you will be encouraged for go out for a walk. Most find that they can resume business by telephone, email, and computer the day after surgery.
Is Dr. Steinsapir available for a personal consultation regarding this surgery?
Dr. Steinsapir believes strongly that there is not substitute for a personal consultation to determine if a particular surgery is right for you. Dr. Steinsapir performs this consultation himself so he can get to know your medical history and personal concerns. He will perform a detailed examination. After assessing the totality of your personal situation, he will discuss with you his opinions, concerns, and recommendations. This will include a through discussion of risks, benefits, alternatives, and likelihood of success. Call today for your personal consultation.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
How good are the cosmetic surgeries advertised on television?
Advertisements on television offer compelling bi-lines and a lot of hype about cosmetic surgery procedures. In today’s media-driven world where television personalities and movie stars seem to be always under the knife, it’s easy to become carried away with the notion that cosmetic surgery is simple, painless, and as easy as walking into the nearest cosmetic surgeon’s office and walking out with a new look. In reality, television greatly skews our understanding of what it means to undergo a facelift, lid lift, or even a BOTOX® injection. In truth, satisfactory cosmetic surgery results do not come from the best price, the flashiest advertisement, or the most recently famous surgeon; they come from a dedicated surgeon who is an expert in his or her field who will listen carefully to your needs and offer you the safest and most effective treatment plan for you.
Reality vs. Reality Television
When it comes to cosmetic surgery reality shows, the term “reality” becomes a very loose term. These programs have ridden (some would say helped to stimulate) the wave of interest in cosmetic surgery, yet they provide only a very distorted view of the practice of cosmetic surgery. The consultation becomes a sound bite and in the process minimizes the risks and appropriate concerns that must be addressed. So many procedures are performed on some of these shows at one time that the surgery becomes unnecessarily life threatening. No one should be placed in a position of choosing between their beauty and their health. Of course there are risks with any surgery and anesthesia. However, these risks can be managed and reduced by using the most appropriate anesthesia, operating in the proper setting, and limiting the amount of surgery performed at a given time.
Choosing the right doctor
By playing on your desire for a “quick fix,” advertisers are reinforcing the misconception that cosmetic surgery is just another quick trip to the doctor’s office; like receiving a flu shot. But just as a flu shot comes with risks, so too does cosmetic surgery. Although there are risks with any surgeon and procedure, an expert surgeon will guide you through these risks helping you to make an informed decision. Offices that gloss over these concerns are trying to take advantage of your lack of expert knowledge. It is the job of the surgeon and their staff to educate you and help you make the right decision, not hustle you into having surgery. At the end of the day it is essential that you trust your doctor. It goes without saying that your doctor should make sense, listen to you, and treat you with respect and dignity. The office staff should also listen to your concerns and treat you with respect. Don’t be intimidated by the doctor’s reputation. That reputation is meaningless if the doctor doesn’t treat you like a human being. Before and after pictures are also extremely important. This is generally a doctor’s best work. If you don’t like what you are seeing, it is a mistake to think your results with that particular doctor will be better than what you are being shown.
Consultation is key
Whether you decide to seek help from a clinic advertised on TV, or to take the recommendations of a friend or family member, it’s important to first attend a consultation with your chosen physician. That consultation should also include meaningful time with the surgeon who will be doing your surgery. If the surgeon is not detailed during your consultation, is it reasonable to assume they will be detailed in performing your surgery? To get the most from a consultation, do your homework. Have a good idea of what you are trying to accomplish. Be open to an approach that is different from what you thought you needed. Choose your surgeon based on his or her expertise, not based on media hype or discounts. If you don’t like what you are being told, don’t try to convince the surgeon to do something they have just advised you to avoid. Instead, consider seeking a second opinion to ensure your surgeon is giving you the options that he or she is most comfortable with and the safest possible plan-of-action. The good news is that in most cities, there are lots of options for cosmetic surgery care. No one person has all the answers. If all the other doctors you have seen recommend against a particular course, think long and hard about allowing that surgeon to perform your surgery.
About Dr. Steinsapir
Dr. Steinsapir is a board certified ophthalmologist and fellowship trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX, DYSPORT, Restylane and Perlane, and advanced eyelid and facial surgery, which can be a vital part of your evidence-based treatment plan.
Which is better; surgery in a private center or a large outpatient surgery center like the Ronald Reagan Medical Center at UCLA
It is hard to improve on the staff and resources available at the UCLA Outpatient Surgery Center at the Ronald Reagan Medical Center at UCLA. UCLA is consistently rated the top medical center in the Western United States and one of the top five medical centers in the country.
Private surgery centers
Accredited surgery centers run by your surgeon’s office are generally safe, but Dr. Steinsapir believes there is inherent security offered by major medical centers that is difficult to duplicate in small surgery centers. Dr. Steinsapir notes that, while it is certainly more profitable and convenient for a surgeon to run his or her own surgery center, patient safety is a central focus of major medical centers, and therefore they are often a safer option for the patient. One of the great advantages of a major medical center is increased peer scrutiny and clinical resources. There are simply more people looking over the surgeon’s shoulder. At a private operating room, there is a single anesthesiologist and perhaps two nurses, or a nurse and a nurse anesthetist working with your surgeon. There is a very low incidence of issues in operating rooms, however, if an issue does arise, the available staff members and attending physicians are limited. Who is around to assist your surgeon and their anesthesiologist?
UCLA Surgery Center
The UCLA Surgery Center is not only staffed with numerous anesthesiologists, nurse anesthetists, respiratory therapists, and critical care nurses, but all staff members are up-to-date on the latest techniques. The anesthesiologists are not community-based. UCLA Surgery Center anesthesiologists are also academic faculty members actively involved in the latest developments in anesthesia as well as teachers of the next generation of anesthesiologists; they know their business. The surgery center is on the campus of the Ronald Reagan Medical Center with all the resources that modern medicine has to offer. You might inquire if your surgeon’s office-based operating room has a plan should something go wrong, but at UCLA you know you are in good hands.
Cost benefits of UCLA Surgery Center
Your surgeon’s private surgery center offers a convenience if your surgeon is local, but UCLA Surgery Center offers remarkably competitive facility and anesthesiology fees. In many cases, the rates are lower than those of many private surgery centers (in some cases, much lower). It is comforting to know that the safety of the UCLA Medical Center is within financial reach for your cosmetic surgery.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
