The Surgical vs. Non-Surgical Facelift

There has been much news in the media about the “non-surgical facelift.” It requires no recovery time, there are no scars and can be done during a lunch break. Well if something sounds too good to be true, it usually is. Make no mistake there is quite a difference between surgical and non-surgical facelifts. Each has its place and merit, but basically a non-surgical facelift is a temporary fix that affects moderate issues of aging and can last from three months to two years, while a surgical lift addresses more severe sagging and drooping and can last up to 10 years or longer.

Non-Surgical Facelift Techniques

The non-surgical facelift employs fillers such as Restylane and toxins such as Botox to reverse signs of age. Botox is used to paralyze small muscles that cause frown lines, crow’s feet or other wrinkles, and is typically used on the forehead and around the eyes and mouth. The toxin acts as a muscle block to immobilize the underlying cause of the unwanted lines which result from muscle contractions, thus preventing wrinkle formation. Since the muscle can no longer make the offending facial expression, lines gradually smooth out from disuse and new creases are prevented from forming. The procedure takes about 15 to 30 minutes and in most cases, the results last for four to six months.

Fillers are used to plump out the skin where wrinkles or furrows have set in such as the nasolabial fold or the cheeks. Depending upon the area to be filled, an absorbable (temporary) or non-absorbable (permanent) filler will be used. Absorbable fillers are made of hyaluronic acid, a substance that occurs naturally in the body. I have used absorbable fillers for superficial lines and moderate wrinkles and furrow with great success. Most temporary fillers have an immediate effect with results that last an average of nine to 10 months – nasolabial fold corrections seem to last longer than lip and marionette line corrections.

Surgical Facelift Options

As patients enter their 40s, 50s and 60s, the temporary solutions offered by toxins and fillers may no longer be satisfactory. At this point a surgical facelift can be considered. The extent of surgery is always customized to each individual patient and depends on the amount of aging and the desired effect – patients can choose between a full face lift, mid-face lift or lower face lift. With all three I use three key pioneering technologies: lifting from a deep plane under muscles to get a more natural effect, using 3-D endoscopes to better visualize the procedure and minimize scaring and using tissue glues to encourage a rapid recovery.

These advanced techniques lead to smaller incisions and faster recovery. Most patients can return to work within week of facelift surgery. Scars are carefully concealed and the hairline preserved. Results will last up to 10 years or even longer in many instances.

How to Choose

As you can see surgical and non-surgical facelifts have very different procedures, healing time and effects.

Facelift/Necklift Longevity
Dr. Sam Rizk chooses techniques which create natural appearances and also give long lasting results. Sadly, Dr. Rizk sees so many patients in his new york practice for revision facelifts who have overtightened faces and loose necks. This gives a very unnatural appearance. Dr. Rizk focuses his techniques on a defined jawline. A defined jawline is an important sign of beauty and youth across cultures. A Harvard psychologist, Nancy Etcoff, in her book, Survival of the Prettiest, did a cross cultural study and found that the perception of beauty is linked to a defined jawline and robust cheeks across all cultures.

So how does Dr. Rizk achieve this defined jawline?
First he tightens a muscle in the neck called the platysma differently than other surgeons and is able to do so using his high definition telescope system to better visualize the neck from a small incision under the chin. Because Dr. Rizk is able to see with this system lower down into the neck from the middle from a small incision under the chin, he is able to tie this muscle (which create those so-called cords when the platysma is loose) lower down into the neck-This gives the necklift longevity because he ties cords (platysma) all the way down in middle in neck, and also ties it the sides behind the ears as well.

What is it about Dr. Rizk's facelifts that creates a more beautiful face?
As Dr. Rizk lifts the jowls from the deeper areas and repositions it back into its original more youthful home on the cheek-this does 2 things -
1. The jawline becomes very defined.
2. The cheeks look fuller and more youthful.
This contrasts to more superficial lifts which give a tight unnatural appearance. By going deeper under jowls, the face appears more defined, more natural, and the "tight" face unnatural look is avoided.

Can nonsurgical facelifts be combined later with surgical facelifts?
Yes, nonsurgical facial rejuvenation with fillers and botox are appropriate in 30's but eventually gravity, sun-damage, and genetics overcomes the face and the sagging skin and muscles over the jawline and neck are no longer improved with fillers. When this happens, as it starts in the late 30's, and early 40's then a surgical necklift or a partial lower facelift addressing the jowl area may be appropriate. Doing Botox and fillers does not preclude doing a surgical facelift and both can be combined. In fact, Dr. Rizk will sometimes more permanently rejuvenate the cheek region with stem cell autogenous fat transfer to add more volume that the patient has lost. Dr. Rizk typically does this stem cell fat transfer either with a jowl/necklift or as a separate procedure, when patients want more volume that is unattainable with synthetic fillers that have to be repeated every 6 months.