Thank you for your question.
You submitted your question without a photo but in your question, you’re basically asking
how do you maintain the tightness of a facelift and does the Vampire Facelift® or Vampire
Facial® have a potential role in maintaining this tightness.
Well, I can certainly share with you my guidance to my patients about this concept of maintaining
the results after a facelift.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Facelifts have been a very significant part of my practice in my 20 years as well as other
non-surgical procedures such as Structural Volumizing, injectable fillers and things
like that to help people with facial aging.
In fact, this has been a significant focus in my practice.
And there has been a continuous evolution in the strategies of helping people with facial
aging and addressing this very concept of maintenance and whether tightness is actually
the objective.
So to begin with, it’s important to understand that facial aging is not just about skin getting
loose over a structure that remains the same.
In fact, facial aging is a progression of bone loss, muscle and fat loss, changing of
this dimension of the very structure and foundation of the face as well as weakening and stretching
and changes in the quality and elasticity of the tissue.
So before there were injectable fillers to the level that we have right now, essentially
the gold standard of cosmetic surgery for facial aging was of course the facelift.
And I recall how we were all, as surgeons, trying to unlock the secret to maximizing
the longevity of a facelift procedure and it became almost a race to who can do more
aggressive deeper types of surgeries, frequently termed as deep plane and it was all with the
intention to try to maximize the longevity because the challenge was that as good as
people can look right after a facelift, depending on their age, skin type, degree of change,
there is always a certain amount of regression or laxity.
So when it comes to understanding what is maximizing one’s appearance, it is always
about a balance of volume and tone of the skin when it comes to looking natural.
One of the things that people objected to particularly in the mid to late 90s was that
places in the Upper East Side of Manhattan, people of significant wealth would walk around
looking tight and very pulled.
Some of the best surgeons in the world were doing this and yet for some reason, they didn’t
look young.
And the reason was very straightforward.
In principle, a youthful face is not a pulled and tight face.
A youthful face has balance, it has volume and the last thing a youthful face looks like
is someone who is pulled.
So, it has been my observation and my conclusion at this point that for people who we used
to steer to face lifting surgery, let’s say people in their mid 40s to mid to late
50s, these patients have now, because of better understanding of the issues with volume loss,
many of those patients I actually steer towards Structural Volumizing.
Structural Volumizing is a method of using a long lasting filler such as a Juvederm Ultra
Plus or Juvederm Voluma and placing it in the bone structure level to help restore volume
and essentially creating the desired appearance of a facelift.
And in fact, because volume is being restored, I would argue that many a time, these results
actually look much better than a facelift.
When a facelift is being done, we are restoring tissue that is sagging and we are making the
underlying structure more defined.
However, if there is a volume deficit in the underlying structure, then there is still
an opportunity to make that difference.
Now of course at a certain point when there is significant jowling and there is significant
laxity of the skin in the neck and loss of volume or the position of the soft tissue,
then the face and neck lift procedure is appropriate.
Once that’s done, yes, it’s important to think about how to maintain that as long
as possible.
So the goal is to maximize the quality of the tissue so that the acceleration of any
aging process through other variables is diminished.
So of course, protecting the skin from excess sun exposure, avoiding smoking and proper
diet and exercise.
Basically, what’s good for your health is good for your skin.
However, the aging process does march on.
So what I’ve also concluded at a certain point after the face lifting surgery, in the
past when someone would be reaching that point anywhere from 5-10 years after facelift where
they feel like they’re ready for their next facelift, I find that Structural Volumizing
can actually be a substitution for another facelift because the volume loss in my opinion
and my observation is actually is more significant a factor than it is about sagging.
And people are learning to realize that the sagging is because the underlying structure
is diminishing.
So then our friends, the injectable fillers can actually play a very important role.
So it is often said that an ounce of prevention is worth more than a pound of cure.
So if you can of course avoid those factors that can cause your tissue to age more and
employ other strategies to restore volume then you will achieve more likely what is
the true objective of a facelift.
Objective of a facelift typically is to improve the jawline, to improve the cheek position,
to restore some definition, to restore proportion, the Golden Ratio of the upper face to the
lower face and these other relationships.
So basically learn about this type of concept and do everything that you can to take good
care of yourself.
And yes, PRP can play a role in improving and maximizing skin quality but the skin is
only 2 millimeters in thickness and below that skin is a layer of fat which can also
benefit from PRP.
And that can help complement this idea of improving and maximizing skin quality through
prevention and through certain types of regenerative technology for maintenance.
There’s a value in that but it doesn’t mean that your bone structure and everything
else will not continue to age.
But essentially, it’s about maintenance.
So I hope that was helpful, I wish you the best of luck and thank you for your question.