May 6, 2025
Facelift Series #2: Does & Doesn't w/ Dr. Kylie Edinger
Drs. Bass and Edinger break down what a facelift can and can’t do.
Facelifts are great for tightening loose skin, lifting jowls, and restoring volume in the face and neck—helping you look more refreshed and youthful. But they don’t address everything. Wrinkles, sun damage, and changes around the eyes and brows usually need other treatments.
There’s a big difference between how facelifts are described online and how surgeons talk about them. The doctors break down that language gap so you know what those buzzwords actually mean.
Bottom line: A facelift is the gold standard for sagging skin, but knowing its limits is key to getting natural-looking results.
Find out who’s a good candidate for a facelift, how long the results typically last, and whether combining it with other procedures might give you the outcome you're really looking for.
Learn more about facelift surgery
About Dr. Kylie Edinger
Dr. Kylie Edinger is a plastic surgeon currently spending a year training as an aesthetic plastic surgery fellow with Dr. Bass and a host of other world class plastic surgeons at Manhattan Eye, Ear, and Throat Hospital in New York City. She’s part of the prestigious Northwell Health program—one of the top aesthetic plastic surgery fellowships in the country. Before making her way to NYC, Dr. Edinger completed her plastic surgery residency at the University of Wisconsin.
Follow Dr. Edinger on Instagram @kylieedinger
About Dr. Lawrence Bass
Innovator. Industry veteran. In-demand Park Avenue board certified plastic surgeon, Dr. Lawrence Bass is a true master of his craft, not only in the OR but as an industry pioneer in the development and evaluation of new aesthetic technologies. With locations in both Manhattan (on Park Avenue between 62nd and 63rd Streets) and in Great Neck, Long Island, Dr. Bass has earned his reputation as the plastic surgeon for the most discerning patients in NYC and beyond.
To learn more, visit the Bass Plastic Surgery website or follow the team on Instagram @drbassnyc
Subscribe to the Park Avenue Plastic Surgery Class newsletter to be notified of new episodes & receive exclusive invitations, offers, and information from Dr. Bass.
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Welcome to Park Avenue
Plastic Surgery Class,
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the podcast where we explore controversies
and breaking issues in plastic
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surgery. I'm your co-host, Summer Hardy,
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a clinical assistant at Bass
Plastic Surgery in New York City.
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I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,
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educator, and technology innovator.
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Today's episode is the start of
a new series about the facelift.
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What are we talking about
in this episode, Dr. Bass?
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To put it in simple terms,
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Dr. Edinger and I are going to
talk about what the facelift does
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and what the facelift doesn't do.
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So overall, what does the facelift do?
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The facelift is really a
procedure that number one chases
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skin laxity in the face
that's loose or hanging
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skin.
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It's also a face shaping
operation and increasingly is
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associated with facial volume
restoration through things like
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fat grafting. So in
general, in this series,
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when we say facelift,
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we'll be referring to the most
commonly performed procedure,
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which addresses features
in both the face and the
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neck.
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And in medical terms might
be called cervical facial
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plasty. So that's neck and face.
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That's what most patients are having,
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except in selected circumstances
very early in the game
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or late in the game or after a
previous lift where only a portion
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needs to be redone.
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So we'll get to all of these
subdivisions elsewhere in this series,
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but we'll focus most on what
patients at most ages are
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having done.
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There's a big difference in
the terminology that beauty
magazines and internet
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marketing use and the terminology that
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surgeons use medically when
talking to each other about
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facelifts, that's probably
more technically accurate.
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So Dr. Edinger and I will
try to relate commonly used
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terminology on the internet with
what that technically translates
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into in the surgery to the
extent that that's possible.
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Okay, that makes sense.
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So who's the patient who should
be thinking about a facelift?
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So that's another way of saying
what does the facelift fix?
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Because if you have the
things the facelift fix,
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then maybe you should be
thinking about facelift.
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And that's really the
point of this episode.
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We're talking about what a facelift does,
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what it can fix or improve
and what it doesn't.
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So a facelift is really a surgical
procedure that's performed in the skin and
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the muscular layers of the face and
neck with a goal of restoring midface
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volume, eliminating jowling,
softening nasal labial folds,
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and then also creating a cleaner
and sharper neckline for patients.
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And basically when you think
of these different areas,
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I mean the jowl sits along the jawline.
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There's also fullness in an area
above the jowl just to the side of the
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corner of the mouth that's not
necessarily well corrected by a facelift.
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That jawline irregularity,
as Dr. Edinger said,
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is sharpened up and a number of
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things in the neck get chased.
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Things like vertical bands that
may come from muscles hanging
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skin under the chin and under the jawline.
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And also the angle between
the vertical part of the
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neck that goes from our Adam's apple
down or a little bit above that,
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and the horizontal part that's
under our chin that gets more
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oblique or obtuse as we age in
sharpening what we medically
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call the cervicomental angle is
an important part of the left.
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So all of those changes in the neck
softening the nasolabial folds and
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marionette lines as Dr. Edinger said.
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And part of that is done
by resuspending the midface
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and upper face tissues, but
particularly the midface tissues.
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And this takes some of that
slack out of the nasolabial area,
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but it also brings the
tissues back up over the cheek
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where they came from and helps
to shape the cheek back to
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that youthful uniform shape rather than
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individual sags and bags
and flattened areas.
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Okay. And how does the
facelift achieve these changes
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basically?
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To really simplify things,
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facelift addresses both the overlying
loose skin that we develop as we age,
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and it also addresses that deeper muscular
layer of the face and neck that Dr.
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Bass was talking about.
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There are several surgical techniques to
tighten that muscular layer of the face
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and neck, which we'll
address in later episodes,
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but all of them serve the same purpose.
And for storing your midface volume,
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tightening those deeper structures,
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removing excess skin and trying to put
things back where they first started
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before the aging process kicked in.
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And so this draws heavily on
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understanding what changes
take place during aging,
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and we're going to discuss
that in an upcoming episode.
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What changes in the face as we age,
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but we're trying to take things
that shrank and maybe fat graft
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them, take things that have
spread out or descended,
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bring them back both at
the skin level and at
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the muscle and muscular fascia level.
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And that mass layer is basically
connective tissue that sits between the
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skin and the muscles themselves.
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So modern facelift generally
involves repositioning
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and working on all of
these tissue planes as part
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of the procedure, as Dr. Edinger
said, different ways to do that.
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Kind of like saying more
than one way to skin a cat.
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Not necessarily a best way,
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but a variety of ways
which we will discuss,
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but repositioning those things
in a vector back where it came
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from,
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which increasingly is up
not back like in historic
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facelifts,
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although it's not as simple as that
because different layers may and in
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different parts of the face and neck,
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the direction of draping needs
to be somewhat different.
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Got it. So when is it the time for
the facelift? Is there a best age?
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Well, our statistics tells what's
happening in the United States population.
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According to a 2023 statistic
from The Aesthetic Society in
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collaboration with CosmetAssure,
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8% of patients are in the
35 to 50 year age range,
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48% of patients, the majority,
are in the 51 to 64 age range,
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and 44%, just less than the majority,
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are in the 65 age range and up.
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So that's kind of the answer
to your question Summer by age,
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but it's also really about findings
because everyone ages according to
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a standard kind of process. There are
things that to all of us as we age,
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but when those things happen
is a little different.
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Some people age prematurely,
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most people are aging with the herd,
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with the whole group of
other folks their age,
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and some folks are lucky and
they're aging more slowly.
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So if you are noticing a lot of changes,
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you can confirm with a plastic
surgeon and they'll tell you what they
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think. If they think it's too early,
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you're taking your big playing card
of the facelift and using it too soon,
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they'll tell you that.
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And if they think you should have
been in five or 10 years ago,
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they'll tell you that as well.
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But those ages give you a general
sense of who's doing facelifts.
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And this is a lot different than
when I first went in practice.
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When I first went in practice,
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facelift age was much
younger on average than
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is today.
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And part of the reason
that age has moved to
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older numbers is because we have healthier
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lifestyle. We smoke and
drink less, we exercise more,
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hopefully we try to eat better,
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but also we have all of the nonsurgical
treatments that help reverse early
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aging changes and help slow facial aging.
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So I think that's pushed the age up below.
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Now we're seeing a trend back
towards younger ages a little bit,
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but what those numbers tell you
is that very few people in their
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thirties need a surgical lift. And if so,
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it would probably be some kind
of a mini lift. Sometimes actors,
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models, newscasters,
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people that make their living in front
of a camera or lifting in their late
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thirties, but forties
lifting really begins.
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Fifties is a hot time for lifting.
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But for people in their sixties and
beyond who may not have gotten to it
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previously,
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you can see that 44% are 65 or older,
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so it's not too late if you
didn't get a chance to do it
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previously.
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And that's still a common age
group for surgical lifting.
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Absolutely,
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and I think deciding when to have a
facelift like Dr. Bass was saying,
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is a very personal choice.
There's no set point,
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but it's the same for every patient or a
magic number that patients should shoot
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for.
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The best time to do a facelift is when
you start to notice those changes in your
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appearance and they start to bother you
specifically regarding loss of volume in
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your cheeks, steepening
of those nasolabial folds,
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the jowling along the neckline,
loose skin in your neck,
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and then banding in your neck as well.
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These are all signs of aging that can be
addressed whenever they start to bother
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you and whenever you decide you want to
do something about them to restore your
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appearance, and confidence again.
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Yeah, I think that's
exactly right Dr. Edinger.
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If it doesn't bother you yet,
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you may know you don't look
the same as 25 years old,
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but maybe it doesn't bother you much yet,
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then it's probably not time
to have a facelift right then.
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However,
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if it's starting to really bug you every
time you're fixing your hair or putting
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makeup on or getting ready to
go out and look in the mirror,
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you notice some of those changes or every
time you see yourself in a photograph,
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you see that saggy area
and it's bugging you,
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that's telling you that maybe
it's time to start chasing it.
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Okay. So I think I have the idea
of the what, when and how now,
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what is it that the facelift does not do?
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So if we think about features
that are not treated,
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they basically fall into
a couple of categories.
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There are some things that
will have a little bit of
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impact when you have a facelift,
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but if it's your primary concern area,
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you should probably be doing a
different treatment or procedure.
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And then there are some things that
the facelift simply doesn't address.
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They're just not part of either the
anatomic area the facelift works in
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or they're not part of what the
facelift is changing because of how the
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facelift works.
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And so you need a separate treatment
either done at the same time,
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because we often do a
few procedures together,
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which can be safely done and does
not have a big impact on recovery
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time or sometimes treatments that
need to be done at a separate sitting
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or separate office visits.
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So things like skin quality facelift is
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going to reposition the skin,
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but your skin is still decades
older than it was in your twenties,
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and you're going to need separate
treatments to make that skin
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quality look better,
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even though the facelift puts the skin
back where it came from. That's pretty
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logical.
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Things that are outside the anatomic
area of the facelift are things like
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eyelid bulging fat or hanging skin
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drooping of the eyebrow,
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lip wrinkles like lipstick,
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bleed lines and crepey changes,
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which are analogous to wrinkles
in the lip that occur in the lower
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eyelid area and wrinkles like
crow's feet at the side of the eye.
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So those are things the
facelift does not explicitly
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chase and need to be addressed
often with an additional
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procedure done at the
same time as a facelift.
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And then there are things on
the face that the facelift
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helps you with, as I said,
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but if you're really
concerned about that feature,
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it's probably going to
take a separate treatment.
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So facial volume by
positioning and shaping the
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volume, you get some
restoration of youthful shape,
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but you have lost volume,
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and that sometimes needs to be boosted
with fat grafting. Wrinkles on the
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face will look a little less
prominent as that skin is
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redraped, but that's really a wrinkle
in the fabric of the skin and just
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repositioning the skin
doesn't eliminate that.
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So things like laser
peels, chemical peels,
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or some other options like
that are a typical option.
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Nasolabial and marionette
lines, as Dr. Edinger mentioned,
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these do improve and that's a good thing,
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but if you sit and look in the
mirror and pull those lines,
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pull your facial skin
until those lines go flat,
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you'll see that your face looks distorted.
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And that's exactly what we're
not trying to do with a facelift.
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We don't want any distortion
or change in appearance.
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So predictably,
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the facelift is not going to
completely eliminate those features,
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and that's part of the reason why American
industry developed fillers that are
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injectable and why we pursue
things like fat grafting.
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And the last one that I would
mention is transverse lines or
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side to side lines on the
lower part of your neck. Again,
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redraping some of that skin helps
them look a little less noticeable,
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but those lines are very
tough to completely eliminate,
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and that takes energy treatments
that do skin resurfacing
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that's safe for the neck,
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or sometimes active dermal
matrix fillers that can
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stimulate collagen and try
to fade those lines somewhat.
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I agree with all of those things.
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I just want to reiterate
something that Dr. Bass said,
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which is something that the facelift
doesn't do or should not do,
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which has changed the way you look and
make you unrecognizable or no longer you.
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A facelift should help reset the clock
and restore your youthful appearance,
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but you still want to look like you and
you want the features that make your
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face who you are. So a refresh version
of yourself, but not something distorted.
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Okay. All of that makes a lot of sense.
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So what can you tell me about
the durability of the facelift?
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This is also an answer that
varies from patient to patient.
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We typically tell patients that a
facelift will reset the clock by about 15
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years,
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but you're going to continue to age as
you normally did after your facelift.
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Some patients age slowly, they may only
need one facelift in their lifetime.
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Others may age at a more rapid rate,
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may require another facelift 10 to
15 years after their first facelift.
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00:16:19,610 --> 00:16:22,640
It depends on many factors
including your skin quality,
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00:16:23,120 --> 00:16:27,890
your skin elasticity and
collagen composition, your
genetics and other factors.
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So it's variable from person to person.
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That's a great point,
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and the important thing to
remember is aging never stops.
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We would like it to, but it doesn't.
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That's just a reality. However,
having done a facelift,
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you'll never look as old as
you would have had you done
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nothing. So even 10 to 15 years later,
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if you didn't have a facelift,
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you would look 10 to 15 years older from
where you started before the facelift.
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00:16:59,540 --> 00:17:00,920
And having a facelift,
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00:17:00,920 --> 00:17:04,670
you'll always look better than what
you would've looked like without the
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facelift.
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And then what do patients say or ask in
a consultation where they often don't
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understand the limitations of a facelift?
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For me,
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my experience is that patients often
don't understand that all of the
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wrinkles on the face are not going
to be eliminated by facelift.
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00:17:24,560 --> 00:17:29,390
Again, that's typically a laser
resurfacing or a chemical peel,
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00:17:29,480 --> 00:17:31,490
and that will minimize wrinkles,
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00:17:31,490 --> 00:17:35,060
but not necessarily eliminate all of them.
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00:17:35,060 --> 00:17:37,820
Areas like the nasolabial
folds, I mean, first of all,
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00:17:37,820 --> 00:17:42,800
we're not trying to eliminate them
because 15 year olds have nasolabial
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00:17:42,800 --> 00:17:45,830
folds. So that's a natural facial feature.
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00:17:45,830 --> 00:17:49,400
We just want it to be
very gentle and minimal,
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00:17:49,650 --> 00:17:53,400
but that's commonly done
with fat grafting or fillers.
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It will improve with facelift,
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00:17:56,640 --> 00:18:01,230
but not be fully corrected and
upper facial areas like the
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areas we typically put Botox in,
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00:18:03,930 --> 00:18:08,040
the lines between the eyebrows,
lines in the forehead,
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those are not treated by facelift.
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It's outside the anatomic area where
the surgery is taking place and
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00:18:16,200 --> 00:18:20,430
changes likewise in the
eyelids themselves and the
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00:18:20,430 --> 00:18:25,050
eyebrow. The other thing I would
say about what the facelift
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00:18:25,050 --> 00:18:29,490
won't do for what needs to
be done is that a lot of
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00:18:29,490 --> 00:18:34,380
patients come in and they feel
like they only have a little
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00:18:34,470 --> 00:18:35,880
drop of aging change,
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00:18:35,880 --> 00:18:40,050
and partly it's the plastic surgeon's
job to try to show them where some of the
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00:18:40,050 --> 00:18:44,730
changes are, and we do this with
photography during the consultation,
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00:18:45,300 --> 00:18:49,200
but if you are in your seventies
and you never had a lift,
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00:18:49,770 --> 00:18:53,820
there's not just one little spot
in your face or your neck that's
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00:18:53,820 --> 00:18:58,050
aged. You're squarely
in facelift territory.
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00:18:58,140 --> 00:19:02,310
And chasing that skin laxity
and getting it reasonably
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00:19:02,340 --> 00:19:06,660
corrected is an important
part of looking your best.
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If it concerns you, and
if it doesn't concern you,
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then you go out and enjoy your life.
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The other thing is to recognize, again,
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00:19:15,150 --> 00:19:19,860
just that there are all these different
aging changes and the tendency
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00:19:19,890 --> 00:19:24,870
of a lot of what's happening out
there in internet, social media,
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00:19:24,990 --> 00:19:29,280
beauty magazines is to squash
all these changes together.
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00:19:29,430 --> 00:19:33,180
And the really important
thing is to do the opposite,
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00:19:33,240 --> 00:19:34,920
to tease these out,
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00:19:35,250 --> 00:19:39,600
identify which features
are concerning to you,
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00:19:39,960 --> 00:19:44,400
and then determine with your
experienced plastic surgeon,
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00:19:44,640 --> 00:19:49,440
what procedure or treatment is going
to correct those features that you're
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00:19:49,440 --> 00:19:50,520
concerned with.
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00:19:51,360 --> 00:19:54,600
Okay. And before we end
this episode, Dr. Edinger,
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do you have any takeaways
for our listeners?
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00:19:57,390 --> 00:19:59,820
Yeah, I couldn't agree more
with what Dr. Bas just said.
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00:20:00,210 --> 00:20:03,390
The biggest things are that you've just
got to do your research and you have to
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00:20:03,390 --> 00:20:07,290
know the limitations of the facelift,
what it can do and what it can't do.
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Hopefully this episode helps
with that. And then again,
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just remembering that these changes
are happening to each of us and when we
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decide to do something about them as
dependent on the patient, remember,
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00:20:17,100 --> 00:20:20,580
the goals are to restore a natural
appearance and just do a more refreshed
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00:20:20,580 --> 00:20:21,630
version of yourself.
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00:20:21,690 --> 00:20:24,060
We're not trying to change who
you are or what you look like.
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Just trying to reset the clock for you.
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And Dr. Bass, can you
share your takeaways?
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00:20:29,670 --> 00:20:33,030
Well, I think Dr. Edinger
summarized it beautifully,
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00:20:33,120 --> 00:20:35,160
but I'll take a shot at it.
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00:20:35,970 --> 00:20:38,940
So facelift is about skin laxity.
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00:20:38,940 --> 00:20:43,440
It's the big facial reset
in restoring your aging
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00:20:43,440 --> 00:20:46,890
face. It has the biggest
impact of anything we do,
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00:20:46,890 --> 00:20:51,490
and the gold standard for
correcting facial and neck
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00:20:51,490 --> 00:20:53,080
skin laxity,
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00:20:53,320 --> 00:20:58,150
the greatest degree of correction
and the greatest durability.
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00:20:58,150 --> 00:21:01,090
We chase hanging skin in
the neck and under the
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00:21:01,090 --> 00:21:05,050
chin, neck banding and
jawline, irregularity,
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00:21:05,050 --> 00:21:08,620
jowls and flattening of the cheeks.
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00:21:08,860 --> 00:21:12,430
This is never going to be a
hundred percent correction,
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00:21:12,730 --> 00:21:17,590
but most of the time we get
most of it. As I mentioned,
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it doesn't fix all things.
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00:21:19,870 --> 00:21:24,190
All of our treatment options
really focus on particular
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00:21:24,310 --> 00:21:25,690
aesthetic features.
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00:21:25,810 --> 00:21:29,740
So you may have a mild defect
on a whole bunch of features,
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00:21:29,740 --> 00:21:34,570
but you're primarily going to
chase the laxity and restore facial
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00:21:34,570 --> 00:21:38,980
shape. Skin quality in
particular, pigment,
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00:21:39,370 --> 00:21:43,900
pigment, irregularity, brown spots,
redness, wrinkles, rough texture,
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00:21:43,950 --> 00:21:48,220
or things that really have to
be treated with other kinds of
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00:21:48,280 --> 00:21:49,330
interventions,
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00:21:49,330 --> 00:21:54,220
not the facelift and
other aging changes in
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00:21:54,220 --> 00:21:58,780
other anatomic areas in the
neighborhood like the eyes, the eyebrow,
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00:21:58,840 --> 00:22:03,070
need separate procedures, and
it's okay to leave those off,
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00:22:03,400 --> 00:22:06,910
but you don't want to leave them off and
then be looking at them after you have
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00:22:06,910 --> 00:22:11,590
the beautifully restored face and be
back in three months to do another
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00:22:11,590 --> 00:22:15,280
procedure. It would've been
better to do it all at once.
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00:22:15,610 --> 00:22:19,450
If you don't think you'll do it
any time in the next several years,
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00:22:19,450 --> 00:22:20,470
reasonable to leave it off.
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00:22:20,710 --> 00:22:23,770
So as I mentioned earlier in the podcast,
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00:22:23,770 --> 00:22:28,240
it is very common to do additional
treatments at the same time as the
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00:22:28,240 --> 00:22:33,190
facelift to maximize the result. Things
like fat grafting, chin implants,
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00:22:33,490 --> 00:22:38,410
and some of the associated procedures
for skin quality or other areas of the
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00:22:38,410 --> 00:22:39,700
face like eyelids.
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00:22:40,090 --> 00:22:43,990
But things like fat grafting
and hin implants in particular,
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00:22:44,050 --> 00:22:48,220
can help with that mission
of restoring facial shape and
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00:22:48,220 --> 00:22:52,990
maximizing the redraping
of the skin. So finally,
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00:22:53,020 --> 00:22:57,520
your aesthetic concerns mated
with the advice of an experienced
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00:22:57,550 --> 00:23:01,960
facelift surgeon is an
important partnership
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00:23:01,990 --> 00:23:06,040
in you achieving your
beauty goals successfully.
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00:23:06,040 --> 00:23:10,660
So this is a theme you'll hear again
and again from both me and Dr. Edinger
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00:23:11,020 --> 00:23:12,280
during this series.
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00:23:12,970 --> 00:23:13,300
Thank you,
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00:23:13,300 --> 00:23:17,410
Dr. Edinger and Dr. Bass for getting
this series off to a great start with a
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00:23:17,410 --> 00:23:20,650
discussion about what the facelift
does and what does not do.
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00:23:21,070 --> 00:23:24,610
It really focuses my attention on
the content to come. I can't wait.
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00:23:25,600 --> 00:23:29,710
Thank you for listening to the Park
Avenue Plastic Surgery Class podcast.
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00:23:29,740 --> 00:23:32,410
Follow us on Apple
Podcasts, write a review,
383
00:23:32,410 --> 00:23:33,940
and share the show with your friends.
384
00:23:34,090 --> 00:23:37,630
Be sure to join us next time to avoid
missing all the great content that is
385
00:23:37,630 --> 00:23:41,200
coming your way. If you want to
contact us with comments or questions,
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00:23:41,200 --> 00:23:42,400
we'd love to hear from you.
387
00:23:42,490 --> 00:23:47,140
Send us an email at
podcast@drbass.net or DM us on
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00:23:47,140 --> 00:23:48,880
Instagram at @drbassnyc.
00:00:01,080 --> 00:00:03,600
Welcome to Park Avenue
Plastic Surgery Class,
2
00:00:03,690 --> 00:00:07,350
the podcast where we explore controversies
and breaking issues in plastic
3
00:00:07,350 --> 00:00:10,170
surgery. I'm your co-host, Summer Hardy,
4
00:00:10,200 --> 00:00:13,380
a clinical assistant at Bass
Plastic Surgery in New York City.
5
00:00:13,710 --> 00:00:17,580
I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,
6
00:00:17,610 --> 00:00:20,700
educator, and technology innovator.
7
00:00:20,710 --> 00:00:24,240
Today's episode is the start of
a new series about the facelift.
8
00:00:25,110 --> 00:00:27,510
What are we talking about
in this episode, Dr. Bass?
9
00:00:28,050 --> 00:00:29,940
To put it in simple terms,
10
00:00:29,940 --> 00:00:34,830
Dr. Edinger and I are going to
talk about what the facelift does
11
00:00:35,040 --> 00:00:36,720
and what the facelift doesn't do.
12
00:00:37,920 --> 00:00:40,500
So overall, what does the facelift do?
13
00:00:41,700 --> 00:00:46,680
The facelift is really a
procedure that number one chases
14
00:00:46,680 --> 00:00:51,090
skin laxity in the face
that's loose or hanging
15
00:00:51,090 --> 00:00:51,923
skin.
16
00:00:52,440 --> 00:00:57,060
It's also a face shaping
operation and increasingly is
17
00:00:57,060 --> 00:01:01,770
associated with facial volume
restoration through things like
18
00:01:01,770 --> 00:01:05,610
fat grafting. So in
general, in this series,
19
00:01:05,610 --> 00:01:07,530
when we say facelift,
20
00:01:08,010 --> 00:01:12,000
we'll be referring to the most
commonly performed procedure,
21
00:01:12,030 --> 00:01:16,740
which addresses features
in both the face and the
22
00:01:16,740 --> 00:01:17,550
neck.
23
00:01:17,550 --> 00:01:22,110
And in medical terms might
be called cervical facial
24
00:01:22,110 --> 00:01:24,930
plasty. So that's neck and face.
25
00:01:25,170 --> 00:01:27,630
That's what most patients are having,
26
00:01:27,930 --> 00:01:32,790
except in selected circumstances
very early in the game
27
00:01:32,790 --> 00:01:37,530
or late in the game or after a
previous lift where only a portion
28
00:01:37,530 --> 00:01:38,880
needs to be redone.
29
00:01:39,510 --> 00:01:44,250
So we'll get to all of these
subdivisions elsewhere in this series,
30
00:01:44,640 --> 00:01:49,440
but we'll focus most on what
patients at most ages are
31
00:01:49,440 --> 00:01:50,280
having done.
32
00:01:50,550 --> 00:01:55,110
There's a big difference in
the terminology that beauty
magazines and internet
33
00:01:55,110 --> 00:01:59,490
marketing use and the terminology that
34
00:01:59,490 --> 00:02:03,840
surgeons use medically when
talking to each other about
35
00:02:03,840 --> 00:02:07,140
facelifts, that's probably
more technically accurate.
36
00:02:07,650 --> 00:02:11,910
So Dr. Edinger and I will
try to relate commonly used
37
00:02:11,910 --> 00:02:16,530
terminology on the internet with
what that technically translates
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00:02:16,530 --> 00:02:20,190
into in the surgery to the
extent that that's possible.
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00:02:21,600 --> 00:02:23,280
Okay, that makes sense.
40
00:02:23,370 --> 00:02:26,760
So who's the patient who should
be thinking about a facelift?
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00:02:27,150 --> 00:02:31,740
So that's another way of saying
what does the facelift fix?
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00:02:31,950 --> 00:02:35,400
Because if you have the
things the facelift fix,
43
00:02:36,060 --> 00:02:38,400
then maybe you should be
thinking about facelift.
44
00:02:38,790 --> 00:02:40,770
And that's really the
point of this episode.
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00:02:40,770 --> 00:02:43,530
We're talking about what a facelift does,
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00:02:44,190 --> 00:02:47,100
what it can fix or improve
and what it doesn't.
47
00:02:47,730 --> 00:02:51,690
So a facelift is really a surgical
procedure that's performed in the skin and
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00:02:51,690 --> 00:02:55,500
the muscular layers of the face and
neck with a goal of restoring midface
49
00:02:55,500 --> 00:02:59,890
volume, eliminating jowling,
softening nasal labial folds,
50
00:03:00,160 --> 00:03:03,640
and then also creating a cleaner
and sharper neckline for patients.
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00:03:04,120 --> 00:03:07,600
And basically when you think
of these different areas,
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00:03:07,630 --> 00:03:10,390
I mean the jowl sits along the jawline.
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00:03:10,420 --> 00:03:15,250
There's also fullness in an area
above the jowl just to the side of the
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00:03:15,250 --> 00:03:19,870
corner of the mouth that's not
necessarily well corrected by a facelift.
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00:03:20,620 --> 00:03:24,400
That jawline irregularity,
as Dr. Edinger said,
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00:03:24,400 --> 00:03:29,230
is sharpened up and a number of
57
00:03:29,230 --> 00:03:31,570
things in the neck get chased.
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00:03:31,600 --> 00:03:36,040
Things like vertical bands that
may come from muscles hanging
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00:03:36,040 --> 00:03:39,790
skin under the chin and under the jawline.
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00:03:40,600 --> 00:03:45,430
And also the angle between
the vertical part of the
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00:03:45,430 --> 00:03:50,140
neck that goes from our Adam's apple
down or a little bit above that,
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00:03:50,470 --> 00:03:54,760
and the horizontal part that's
under our chin that gets more
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00:03:54,760 --> 00:03:59,440
oblique or obtuse as we age in
sharpening what we medically
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00:03:59,440 --> 00:04:03,160
call the cervicomental angle is
an important part of the left.
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00:04:03,730 --> 00:04:08,530
So all of those changes in the neck
softening the nasolabial folds and
66
00:04:08,530 --> 00:04:10,960
marionette lines as Dr. Edinger said.
67
00:04:11,440 --> 00:04:16,120
And part of that is done
by resuspending the midface
68
00:04:16,330 --> 00:04:21,010
and upper face tissues, but
particularly the midface tissues.
69
00:04:21,340 --> 00:04:25,750
And this takes some of that
slack out of the nasolabial area,
70
00:04:26,740 --> 00:04:31,540
but it also brings the
tissues back up over the cheek
71
00:04:31,840 --> 00:04:36,670
where they came from and helps
to shape the cheek back to
72
00:04:36,670 --> 00:04:41,260
that youthful uniform shape rather than
73
00:04:41,260 --> 00:04:45,040
individual sags and bags
and flattened areas.
74
00:04:45,740 --> 00:04:48,160
Okay. And how does the
facelift achieve these changes
75
00:04:51,320 --> 00:04:53,320
basically?
76
00:04:53,320 --> 00:04:53,320
To really simplify things,
77
00:04:53,320 --> 00:04:57,340
facelift addresses both the overlying
loose skin that we develop as we age,
78
00:04:57,820 --> 00:05:01,510
and it also addresses that deeper muscular
layer of the face and neck that Dr.
79
00:05:01,510 --> 00:05:02,380
Bass was talking about.
80
00:05:03,130 --> 00:05:06,700
There are several surgical techniques to
tighten that muscular layer of the face
81
00:05:06,700 --> 00:05:09,010
and neck, which we'll
address in later episodes,
82
00:05:09,760 --> 00:05:14,050
but all of them serve the same purpose.
And for storing your midface volume,
83
00:05:14,050 --> 00:05:15,430
tightening those deeper structures,
84
00:05:15,880 --> 00:05:19,420
removing excess skin and trying to put
things back where they first started
85
00:05:19,420 --> 00:05:21,520
before the aging process kicked in.
86
00:05:22,510 --> 00:05:26,290
And so this draws heavily on
87
00:05:26,290 --> 00:05:30,430
understanding what changes
take place during aging,
88
00:05:30,430 --> 00:05:33,670
and we're going to discuss
that in an upcoming episode.
89
00:05:33,670 --> 00:05:36,010
What changes in the face as we age,
90
00:05:36,580 --> 00:05:41,470
but we're trying to take things
that shrank and maybe fat graft
91
00:05:41,470 --> 00:05:44,800
them, take things that have
spread out or descended,
92
00:05:44,800 --> 00:05:49,510
bring them back both at
the skin level and at
93
00:05:49,510 --> 00:05:52,780
the muscle and muscular fascia level.
94
00:05:52,780 --> 00:05:57,560
And that mass layer is basically
connective tissue that sits between the
95
00:05:57,560 --> 00:06:00,110
skin and the muscles themselves.
96
00:06:00,500 --> 00:06:05,390
So modern facelift generally
involves repositioning
97
00:06:05,390 --> 00:06:10,340
and working on all of
these tissue planes as part
98
00:06:10,340 --> 00:06:14,660
of the procedure, as Dr. Edinger
said, different ways to do that.
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00:06:14,960 --> 00:06:17,750
Kind of like saying more
than one way to skin a cat.
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00:06:18,110 --> 00:06:20,210
Not necessarily a best way,
101
00:06:20,510 --> 00:06:23,600
but a variety of ways
which we will discuss,
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00:06:23,600 --> 00:06:28,400
but repositioning those things
in a vector back where it came
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00:06:28,400 --> 00:06:29,233
from,
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00:06:29,360 --> 00:06:34,130
which increasingly is up
not back like in historic
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00:06:34,130 --> 00:06:34,963
facelifts,
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00:06:35,240 --> 00:06:39,860
although it's not as simple as that
because different layers may and in
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00:06:39,860 --> 00:06:41,900
different parts of the face and neck,
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00:06:42,170 --> 00:06:45,890
the direction of draping needs
to be somewhat different.
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00:06:46,760 --> 00:06:50,840
Got it. So when is it the time for
the facelift? Is there a best age?
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00:06:51,200 --> 00:06:55,520
Well, our statistics tells what's
happening in the United States population.
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00:06:55,520 --> 00:06:58,640
According to a 2023 statistic
from The Aesthetic Society in
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00:06:58,640 --> 00:07:00,440
collaboration with CosmetAssure,
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00:07:00,800 --> 00:07:04,940
8% of patients are in the
35 to 50 year age range,
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00:07:05,150 --> 00:07:10,010
48% of patients, the majority,
are in the 51 to 64 age range,
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00:07:10,430 --> 00:07:13,130
and 44%, just less than the majority,
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00:07:13,640 --> 00:07:15,530
are in the 65 age range and up.
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00:07:16,640 --> 00:07:21,500
So that's kind of the answer
to your question Summer by age,
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00:07:22,280 --> 00:07:27,080
but it's also really about findings
because everyone ages according to
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00:07:27,350 --> 00:07:32,240
a standard kind of process. There are
things that to all of us as we age,
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00:07:32,630 --> 00:07:36,020
but when those things happen
is a little different.
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00:07:36,020 --> 00:07:38,150
Some people age prematurely,
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00:07:38,150 --> 00:07:41,210
most people are aging with the herd,
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00:07:41,210 --> 00:07:43,760
with the whole group of
other folks their age,
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00:07:43,760 --> 00:07:48,290
and some folks are lucky and
they're aging more slowly.
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00:07:48,290 --> 00:07:52,160
So if you are noticing a lot of changes,
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00:07:52,340 --> 00:07:56,900
you can confirm with a plastic
surgeon and they'll tell you what they
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00:07:56,900 --> 00:07:58,910
think. If they think it's too early,
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00:07:58,910 --> 00:08:03,410
you're taking your big playing card
of the facelift and using it too soon,
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00:08:03,410 --> 00:08:04,490
they'll tell you that.
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00:08:04,820 --> 00:08:08,870
And if they think you should have
been in five or 10 years ago,
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00:08:08,870 --> 00:08:10,520
they'll tell you that as well.
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00:08:10,910 --> 00:08:15,620
But those ages give you a general
sense of who's doing facelifts.
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00:08:15,950 --> 00:08:20,540
And this is a lot different than
when I first went in practice.
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00:08:20,540 --> 00:08:22,370
When I first went in practice,
135
00:08:22,370 --> 00:08:26,030
facelift age was much
younger on average than
136
00:08:26,030 --> 00:08:26,870
is today.
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00:08:27,200 --> 00:08:31,730
And part of the reason
that age has moved to
138
00:08:31,730 --> 00:08:36,050
older numbers is because we have healthier
139
00:08:36,050 --> 00:08:40,310
lifestyle. We smoke and
drink less, we exercise more,
140
00:08:40,610 --> 00:08:42,500
hopefully we try to eat better,
141
00:08:42,650 --> 00:08:47,540
but also we have all of the nonsurgical
treatments that help reverse early
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00:08:47,540 --> 00:08:50,750
aging changes and help slow facial aging.
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00:08:51,020 --> 00:08:53,030
So I think that's pushed the age up below.
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00:08:53,030 --> 00:08:57,690
Now we're seeing a trend back
towards younger ages a little bit,
145
00:08:58,020 --> 00:09:02,880
but what those numbers tell you
is that very few people in their
146
00:09:02,880 --> 00:09:07,650
thirties need a surgical lift. And if so,
147
00:09:07,650 --> 00:09:12,630
it would probably be some kind
of a mini lift. Sometimes actors,
148
00:09:12,630 --> 00:09:14,340
models, newscasters,
149
00:09:14,340 --> 00:09:18,420
people that make their living in front
of a camera or lifting in their late
150
00:09:18,420 --> 00:09:23,160
thirties, but forties
lifting really begins.
151
00:09:23,400 --> 00:09:26,940
Fifties is a hot time for lifting.
152
00:09:27,240 --> 00:09:31,170
But for people in their sixties and
beyond who may not have gotten to it
153
00:09:31,170 --> 00:09:32,040
previously,
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00:09:32,040 --> 00:09:36,180
you can see that 44% are 65 or older,
155
00:09:36,180 --> 00:09:40,350
so it's not too late if you
didn't get a chance to do it
156
00:09:40,350 --> 00:09:41,340
previously.
157
00:09:41,670 --> 00:09:46,020
And that's still a common age
group for surgical lifting.
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00:09:47,010 --> 00:09:47,520
Absolutely,
159
00:09:47,520 --> 00:09:50,520
and I think deciding when to have a
facelift like Dr. Bass was saying,
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00:09:50,520 --> 00:09:53,460
is a very personal choice.
There's no set point,
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00:09:53,460 --> 00:09:56,520
but it's the same for every patient or a
magic number that patients should shoot
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00:09:56,520 --> 00:09:57,353
for.
163
00:09:57,390 --> 00:10:00,660
The best time to do a facelift is when
you start to notice those changes in your
164
00:10:00,660 --> 00:10:04,860
appearance and they start to bother you
specifically regarding loss of volume in
165
00:10:04,860 --> 00:10:07,890
your cheeks, steepening
of those nasolabial folds,
166
00:10:07,950 --> 00:10:12,030
the jowling along the neckline,
loose skin in your neck,
167
00:10:12,030 --> 00:10:13,650
and then banding in your neck as well.
168
00:10:13,710 --> 00:10:17,640
These are all signs of aging that can be
addressed whenever they start to bother
169
00:10:17,640 --> 00:10:21,240
you and whenever you decide you want to
do something about them to restore your
170
00:10:21,240 --> 00:10:22,073
appearance, and confidence again.
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00:10:23,100 --> 00:10:24,750
Yeah, I think that's
exactly right Dr. Edinger.
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00:10:27,600 --> 00:10:29,550
If it doesn't bother you yet,
173
00:10:30,090 --> 00:10:33,480
you may know you don't look
the same as 25 years old,
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00:10:33,480 --> 00:10:35,970
but maybe it doesn't bother you much yet,
175
00:10:35,970 --> 00:10:40,650
then it's probably not time
to have a facelift right then.
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00:10:41,490 --> 00:10:42,450
However,
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00:10:42,510 --> 00:10:47,460
if it's starting to really bug you every
time you're fixing your hair or putting
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00:10:47,460 --> 00:10:51,690
makeup on or getting ready to
go out and look in the mirror,
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00:10:52,020 --> 00:10:56,790
you notice some of those changes or every
time you see yourself in a photograph,
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00:10:58,230 --> 00:11:02,010
you see that saggy area
and it's bugging you,
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00:11:02,700 --> 00:11:06,180
that's telling you that maybe
it's time to start chasing it.
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00:11:07,320 --> 00:11:11,580
Okay. So I think I have the idea
of the what, when and how now,
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00:11:11,580 --> 00:11:13,740
what is it that the facelift does not do?
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00:11:14,910 --> 00:11:18,780
So if we think about features
that are not treated,
185
00:11:18,870 --> 00:11:22,530
they basically fall into
a couple of categories.
186
00:11:22,890 --> 00:11:27,120
There are some things that
will have a little bit of
187
00:11:27,120 --> 00:11:30,240
impact when you have a facelift,
188
00:11:30,540 --> 00:11:33,900
but if it's your primary concern area,
189
00:11:33,900 --> 00:11:37,830
you should probably be doing a
different treatment or procedure.
190
00:11:38,190 --> 00:11:42,180
And then there are some things that
the facelift simply doesn't address.
191
00:11:42,180 --> 00:11:47,070
They're just not part of either the
anatomic area the facelift works in
192
00:11:47,460 --> 00:11:52,050
or they're not part of what the
facelift is changing because of how the
193
00:11:52,050 --> 00:11:53,280
facelift works.
194
00:11:53,530 --> 00:11:58,030
And so you need a separate treatment
either done at the same time,
195
00:11:58,030 --> 00:12:00,910
because we often do a
few procedures together,
196
00:12:01,090 --> 00:12:05,770
which can be safely done and does
not have a big impact on recovery
197
00:12:05,770 --> 00:12:10,630
time or sometimes treatments that
need to be done at a separate sitting
198
00:12:10,630 --> 00:12:12,520
or separate office visits.
199
00:12:12,730 --> 00:12:17,710
So things like skin quality facelift is
200
00:12:17,710 --> 00:12:20,380
going to reposition the skin,
201
00:12:20,740 --> 00:12:24,970
but your skin is still decades
older than it was in your twenties,
202
00:12:25,180 --> 00:12:29,440
and you're going to need separate
treatments to make that skin
203
00:12:29,440 --> 00:12:31,480
quality look better,
204
00:12:31,810 --> 00:12:36,370
even though the facelift puts the skin
back where it came from. That's pretty
205
00:12:36,370 --> 00:12:37,203
logical.
206
00:12:37,600 --> 00:12:42,520
Things that are outside the anatomic
area of the facelift are things like
207
00:12:42,730 --> 00:12:46,570
eyelid bulging fat or hanging skin
208
00:12:46,990 --> 00:12:49,180
drooping of the eyebrow,
209
00:12:49,720 --> 00:12:52,240
lip wrinkles like lipstick,
210
00:12:52,240 --> 00:12:56,320
bleed lines and crepey changes,
211
00:12:56,320 --> 00:13:00,850
which are analogous to wrinkles
in the lip that occur in the lower
212
00:13:00,850 --> 00:13:05,590
eyelid area and wrinkles like
crow's feet at the side of the eye.
213
00:13:05,590 --> 00:13:09,970
So those are things the
facelift does not explicitly
214
00:13:10,180 --> 00:13:14,710
chase and need to be addressed
often with an additional
215
00:13:14,710 --> 00:13:17,440
procedure done at the
same time as a facelift.
216
00:13:17,950 --> 00:13:22,480
And then there are things on
the face that the facelift
217
00:13:22,750 --> 00:13:24,670
helps you with, as I said,
218
00:13:24,790 --> 00:13:28,000
but if you're really
concerned about that feature,
219
00:13:28,000 --> 00:13:30,250
it's probably going to
take a separate treatment.
220
00:13:30,250 --> 00:13:35,200
So facial volume by
positioning and shaping the
221
00:13:35,200 --> 00:13:39,550
volume, you get some
restoration of youthful shape,
222
00:13:39,730 --> 00:13:41,500
but you have lost volume,
223
00:13:41,500 --> 00:13:46,390
and that sometimes needs to be boosted
with fat grafting. Wrinkles on the
224
00:13:46,390 --> 00:13:50,710
face will look a little less
prominent as that skin is
225
00:13:50,980 --> 00:13:55,780
redraped, but that's really a wrinkle
in the fabric of the skin and just
226
00:13:55,780 --> 00:13:59,110
repositioning the skin
doesn't eliminate that.
227
00:13:59,470 --> 00:14:02,860
So things like laser
peels, chemical peels,
228
00:14:02,860 --> 00:14:07,120
or some other options like
that are a typical option.
229
00:14:07,480 --> 00:14:12,040
Nasolabial and marionette
lines, as Dr. Edinger mentioned,
230
00:14:12,040 --> 00:14:16,120
these do improve and that's a good thing,
231
00:14:16,240 --> 00:14:21,100
but if you sit and look in the
mirror and pull those lines,
232
00:14:21,130 --> 00:14:24,220
pull your facial skin
until those lines go flat,
233
00:14:24,490 --> 00:14:26,890
you'll see that your face looks distorted.
234
00:14:26,890 --> 00:14:31,060
And that's exactly what we're
not trying to do with a facelift.
235
00:14:31,450 --> 00:14:34,930
We don't want any distortion
or change in appearance.
236
00:14:35,350 --> 00:14:37,360
So predictably,
237
00:14:37,360 --> 00:14:42,250
the facelift is not going to
completely eliminate those features,
238
00:14:42,250 --> 00:14:47,080
and that's part of the reason why American
industry developed fillers that are
239
00:14:47,080 --> 00:14:51,010
injectable and why we pursue
things like fat grafting.
240
00:14:51,500 --> 00:14:56,210
And the last one that I would
mention is transverse lines or
241
00:14:56,210 --> 00:15:00,740
side to side lines on the
lower part of your neck. Again,
242
00:15:00,980 --> 00:15:05,210
redraping some of that skin helps
them look a little less noticeable,
243
00:15:05,480 --> 00:15:09,350
but those lines are very
tough to completely eliminate,
244
00:15:09,350 --> 00:15:14,330
and that takes energy treatments
that do skin resurfacing
245
00:15:14,450 --> 00:15:16,220
that's safe for the neck,
246
00:15:16,400 --> 00:15:20,780
or sometimes active dermal
matrix fillers that can
247
00:15:20,780 --> 00:15:24,950
stimulate collagen and try
to fade those lines somewhat.
248
00:15:25,770 --> 00:15:27,110
I agree with all of those things.
249
00:15:27,110 --> 00:15:29,420
I just want to reiterate
something that Dr. Bass said,
250
00:15:29,930 --> 00:15:32,690
which is something that the facelift
doesn't do or should not do,
251
00:15:32,690 --> 00:15:37,310
which has changed the way you look and
make you unrecognizable or no longer you.
252
00:15:37,310 --> 00:15:40,640
A facelift should help reset the clock
and restore your youthful appearance,
253
00:15:40,640 --> 00:15:43,580
but you still want to look like you and
you want the features that make your
254
00:15:43,580 --> 00:15:48,050
face who you are. So a refresh version
of yourself, but not something distorted.
255
00:15:48,590 --> 00:15:50,900
Okay. All of that makes a lot of sense.
256
00:15:51,290 --> 00:15:54,290
So what can you tell me about
the durability of the facelift?
257
00:15:54,950 --> 00:15:57,800
This is also an answer that
varies from patient to patient.
258
00:15:58,310 --> 00:16:03,020
We typically tell patients that a
facelift will reset the clock by about 15
259
00:16:03,020 --> 00:16:03,500
years,
260
00:16:03,500 --> 00:16:07,520
but you're going to continue to age as
you normally did after your facelift.
261
00:16:08,300 --> 00:16:12,320
Some patients age slowly, they may only
need one facelift in their lifetime.
262
00:16:13,010 --> 00:16:14,840
Others may age at a more rapid rate,
263
00:16:14,870 --> 00:16:18,950
may require another facelift 10 to
15 years after their first facelift.
264
00:16:19,610 --> 00:16:22,640
It depends on many factors
including your skin quality,
265
00:16:23,120 --> 00:16:27,890
your skin elasticity and
collagen composition, your
genetics and other factors.
266
00:16:27,890 --> 00:16:29,780
So it's variable from person to person.
267
00:16:30,410 --> 00:16:31,640
That's a great point,
268
00:16:31,730 --> 00:16:36,620
and the important thing to
remember is aging never stops.
269
00:16:37,100 --> 00:16:39,470
We would like it to, but it doesn't.
270
00:16:40,580 --> 00:16:44,600
That's just a reality. However,
having done a facelift,
271
00:16:44,600 --> 00:16:49,220
you'll never look as old as
you would have had you done
272
00:16:49,220 --> 00:16:52,700
nothing. So even 10 to 15 years later,
273
00:16:53,120 --> 00:16:54,770
if you didn't have a facelift,
274
00:16:54,770 --> 00:16:59,180
you would look 10 to 15 years older from
where you started before the facelift.
275
00:16:59,540 --> 00:17:00,920
And having a facelift,
276
00:17:00,920 --> 00:17:04,670
you'll always look better than what
you would've looked like without the
277
00:17:04,670 --> 00:17:05,503
facelift.
278
00:17:06,290 --> 00:17:10,820
And then what do patients say or ask in
a consultation where they often don't
279
00:17:10,820 --> 00:17:13,340
understand the limitations of a facelift?
280
00:17:13,700 --> 00:17:14,533
For me,
281
00:17:15,140 --> 00:17:19,670
my experience is that patients often
don't understand that all of the
282
00:17:19,670 --> 00:17:24,110
wrinkles on the face are not going
to be eliminated by facelift.
283
00:17:24,560 --> 00:17:29,390
Again, that's typically a laser
resurfacing or a chemical peel,
284
00:17:29,480 --> 00:17:31,490
and that will minimize wrinkles,
285
00:17:31,490 --> 00:17:35,060
but not necessarily eliminate all of them.
286
00:17:35,060 --> 00:17:37,820
Areas like the nasolabial
folds, I mean, first of all,
287
00:17:37,820 --> 00:17:42,800
we're not trying to eliminate them
because 15 year olds have nasolabial
288
00:17:42,800 --> 00:17:45,830
folds. So that's a natural facial feature.
289
00:17:45,830 --> 00:17:49,400
We just want it to be
very gentle and minimal,
290
00:17:49,650 --> 00:17:53,400
but that's commonly done
with fat grafting or fillers.
291
00:17:53,400 --> 00:17:56,310
It will improve with facelift,
292
00:17:56,640 --> 00:18:01,230
but not be fully corrected and
upper facial areas like the
293
00:18:01,230 --> 00:18:03,750
areas we typically put Botox in,
294
00:18:03,930 --> 00:18:08,040
the lines between the eyebrows,
lines in the forehead,
295
00:18:08,250 --> 00:18:11,130
those are not treated by facelift.
296
00:18:11,340 --> 00:18:16,200
It's outside the anatomic area where
the surgery is taking place and
297
00:18:16,200 --> 00:18:20,430
changes likewise in the
eyelids themselves and the
298
00:18:20,430 --> 00:18:25,050
eyebrow. The other thing I would
say about what the facelift
299
00:18:25,050 --> 00:18:29,490
won't do for what needs to
be done is that a lot of
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patients come in and they feel
like they only have a little
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drop of aging change,
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and partly it's the plastic surgeon's
job to try to show them where some of the
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changes are, and we do this with
photography during the consultation,
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but if you are in your seventies
and you never had a lift,
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there's not just one little spot
in your face or your neck that's
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aged. You're squarely
in facelift territory.
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And chasing that skin laxity
and getting it reasonably
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corrected is an important
part of looking your best.
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If it concerns you, and
if it doesn't concern you,
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then you go out and enjoy your life.
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The other thing is to recognize, again,
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just that there are all these different
aging changes and the tendency
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of a lot of what's happening out
there in internet, social media,
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beauty magazines is to squash
all these changes together.
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And the really important
thing is to do the opposite,
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to tease these out,
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identify which features
are concerning to you,
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and then determine with your
experienced plastic surgeon,
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what procedure or treatment is going
to correct those features that you're
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concerned with.
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Okay. And before we end
this episode, Dr. Edinger,
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do you have any takeaways
for our listeners?
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Yeah, I couldn't agree more
with what Dr. Bas just said.
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The biggest things are that you've just
got to do your research and you have to
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know the limitations of the facelift,
what it can do and what it can't do.
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Hopefully this episode helps
with that. And then again,
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just remembering that these changes
are happening to each of us and when we
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decide to do something about them as
dependent on the patient, remember,
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the goals are to restore a natural
appearance and just do a more refreshed
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version of yourself.
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We're not trying to change who
you are or what you look like.
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Just trying to reset the clock for you.
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And Dr. Bass, can you
share your takeaways?
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Well, I think Dr. Edinger
summarized it beautifully,
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but I'll take a shot at it.
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So facelift is about skin laxity.
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It's the big facial reset
in restoring your aging
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face. It has the biggest
impact of anything we do,
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and the gold standard for
correcting facial and neck
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skin laxity,
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the greatest degree of correction
and the greatest durability.
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We chase hanging skin in
the neck and under the
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chin, neck banding and
jawline, irregularity,
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jowls and flattening of the cheeks.
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This is never going to be a
hundred percent correction,
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but most of the time we get
most of it. As I mentioned,
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it doesn't fix all things.
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All of our treatment options
really focus on particular
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aesthetic features.
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So you may have a mild defect
on a whole bunch of features,
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but you're primarily going to
chase the laxity and restore facial
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shape. Skin quality in
particular, pigment,
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pigment, irregularity, brown spots,
redness, wrinkles, rough texture,
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or things that really have to
be treated with other kinds of
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interventions,
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not the facelift and
other aging changes in
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other anatomic areas in the
neighborhood like the eyes, the eyebrow,
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need separate procedures, and
it's okay to leave those off,
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but you don't want to leave them off and
then be looking at them after you have
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the beautifully restored face and be
back in three months to do another
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procedure. It would've been
better to do it all at once.
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If you don't think you'll do it
any time in the next several years,
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reasonable to leave it off.
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So as I mentioned earlier in the podcast,
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it is very common to do additional
treatments at the same time as the
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facelift to maximize the result. Things
like fat grafting, chin implants,
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and some of the associated procedures
for skin quality or other areas of the
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face like eyelids.
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But things like fat grafting
and hin implants in particular,
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can help with that mission
of restoring facial shape and
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maximizing the redraping
of the skin. So finally,
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your aesthetic concerns mated
with the advice of an experienced
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facelift surgeon is an
important partnership
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in you achieving your
beauty goals successfully.
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So this is a theme you'll hear again
and again from both me and Dr. Edinger
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during this series.
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Thank you,
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Dr. Edinger and Dr. Bass for getting
this series off to a great start with a
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discussion about what the facelift
does and what does not do.
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It really focuses my attention on
the content to come. I can't wait.
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Thank you for listening to the Park
Avenue Plastic Surgery Class podcast.
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00:23:29,740 --> 00:23:32,410
Follow us on Apple
Podcasts, write a review,
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00:23:32,410 --> 00:23:33,940
and share the show with your friends.
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00:23:34,090 --> 00:23:37,630
Be sure to join us next time to avoid
missing all the great content that is
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00:23:37,630 --> 00:23:41,200
coming your way. If you want to
contact us with comments or questions,
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00:23:41,200 --> 00:23:42,400
we'd love to hear from you.
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00:23:42,490 --> 00:23:47,140
Send us an email at
podcast@drbass.net or DM us on
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00:23:47,140 --> 00:23:48,880
Instagram at @drbassnyc.
Plastic Surgeon
Dr. Kylie Edinger is a plastic surgeon practicing in Bozeman, Montana. During the creation of this facelift series, she was training as an aesthetic plastic surgery fellow with Dr. Bass and a host of other world class plastic surgeons at Manhattan Eye, Ear, and Throat Hospital in New York City. Part of the prestigious Northwell Health program, this is one of the top aesthetic plastic surgery fellowships in the country. Dr. Edinger completed her plastic surgery residency at the University of Wisconsin.