Quicklift FAQ

Not all mini facelifts were born equal.

With current increased popularity of Minimally invasive procedures, a few new names and techniques appeared on the market. For the majority of consumers and very commonly for Plastic Surgeons, including myself, sometimes it is difficult to separate what represents a reasonable procedure with durable and stable result and what is a marketing gimmick and a new trade name.

Over the years, over 200 techniques of facial rejuvenation had been described. From thread lifts and endoscopic laser tightening to multilayered and composite lifts.

Most patients walking into our office do not request a facelift. They usually pull up on the neck and ask me to do as little as possible to get a smoother neck and cheek, as well as a more defined jaw line. Immediately after that they usually state that they do not want a facelift as they have a friend, a neighbor, or a relative who had it and looks just too pulled and un-natural. The name of Kenny Rogers comes up a lot lately in that content.

It appears that the word FACELIFT itself acquired a negative connotation and today equals to unnaturally pulled looking faces.

The goals of a facial rejuvenation are not to look 18 and very tight, but to look more refreshed, more youthful, but still natural. More aggressive facelift techniques can produce excellent results, but some of them take 6-8 hours, 3-4 weeks of recovery, prolonged swelling up to 3-6 month and may cost $12,000 to $50,000 (yes, this is not a typo).

Most of my patients have 1-2 weeks they can take off and $6,000 to $10,000 to spend. In my experience, to achieve a durable, reliable and consistent result, deeper tissues (SMAS) need to be treated.

I am a big supporter of MACS type lifts (Quicklift and so on). It allows excellent deep tissue support, has much lower risk of nerve injury, limits surgery time to 1-2 hours and recovery to 5-14 days (on average 7-10). It can be performed under local anesthesia alone, though for most patients we recommend sedation too.

Skin-only procedures take less time, can be done in under an hour, but they do not provide enough deep tissue support and therefore are less durable. The cost for these procedures is $4,000 to $6,000. There are people who are reasonable candidates for these lifts, but not everyone.

For sake of completeness, I will mention Thread Lifts. I do not believe in them and do not perform them.

In summary, Not all the Mini lifts produce Mini results. Our practice had shifted to Mini Facial rejuvenation surgery. I have been using this technique for the last 5 years with very consistent results and very high patient satisfaction.

The keys to successful facial rejuvenation surgery are to:

• Find an experienced Plastic or Facial Plastic Surgeon - not a casual facelift doc, but someone who does them routinely, in my mind at least 1-2 a week
• Establish a good and open relation with the doctor, so that he or she understands your goals
• Have your procedure customized to your facial features
• Have it done at a safe place; usually it means an in-office accredited surgery suite or ambulatory surgery center
• Ask questions and use common sense

There are 2 parts in your question: options for the neck lift and how to increase the longevity of your facelift or neck lift.

First, let's talk about the facelifts. If you are in your late 50s, it is very difficult if not impossible to create a good result with the neck lift alone. Our faces age not only at the neck level but also on cheeks, brows and so forth.

We used to think that the whole issue of aging was very dependent on gravity. So the gravity pulls our faces down in most sensitive areas, creating jowls, neck laxity and neck lines. The truth is that there is more to ageing than just gravity. Most of us lose elasticity if the skin and volume of the face in addition.

The key to successful facial rejuvenation is attempting to restore skin tightness, higher position of the structures on the face and make it manageable from the standpoint of recovery and affordability.

The anatomy of the neck is such that it is very intimately connected to deep facial structures. The neck muscle (platysma) that causes neck bands actually continues as the deep fascia (SMAS) on the face. Pulling on the neck alone will create very un-attractive and un-natural creases on our faces. If combined with lifting of the face, it produces nice and natural looking results.

For most of my patients it is not necessary to have a full traditional facelift. Some mini face lifts, like Quicklift, can produce very comparable results in less time, with faster recovery and less downtime.

In some patients with heavy necks or prominent jowls, a small amount of liposuction or liposculpture, or Smart Lipo, can be done to better define a jaw line and neck. Some patients with prominent neck muscle lines will benefit from neck muscle tightening.

The longevity of results depends on techniques of surgery - skin-only based procedures will not be as durable as deeper ones - your skin quality, skin care regimen, skin relaxation.

The sad thing is that we start getting older the very minute the last stitch is placed. We all produce 2-3 mm of extra skin per year in our 50s. Even though there is no way to stop the ageing process, there are ways to slow it down and maintain your skin longer. Once a year Thermage provides additional tightening after a facelift. Some people are quite skeptical about Thermage, but if used after the facelift, it produces more effective result than instead of one procedure.

Skin care regimen is very important. Have your skin consistency and quality examined and have your skin regimen tailored to your skin type.  Botox, laser treatments are good additions to the post-facelift regimen.

As a plastic surgeon I get this question a lot. For me, it does not matter how many sutures I place. I place a many as I need to get the desired result.

Lets talk about this question a bit more. A few years ago I had read a study that compared 2 groups of patients. One had a small incision covered with a Band-Aid and the other the same incision covered with a big bulky dressing. The patients from the first group had less pain complaints and recovered faster.

Perception may not be everything but it is very important. Some patients feel that the more sutures we place, the more complex and more extensive the surgery was. In Plastic Surgery we tend to use smaller sutures and smaller needles that are more gentle on the tissues. So, in most cases I would place more sutures in the wound than, say, a primary family doctor. No offense to your family doc.

I feel that smaller sutures placed closer to each other bring the tissues together better and as such creates better and smaller looking scars. But this is just an opinion.

However, there is a more important issue to discuss. When we bring deep tissues together with sutures that dissolve on their own, we rely on the body's ability to dissolve them. Some patients are unable to fully dissolve some suture materials and start "spitting stitches" after surgery.

That is why for facial cosmetic surgery we try to use enough of those deep sutures to hold the tissues in place but not too many to overwhelm the body's ability to dissolve them.