Dr. Zelken Talks About the Benefits of a Total Facial Rejuvenation

Hi everybody. It’s my favorite time of the month, time to discuss plastic surgery topics. If I had to choose one, the most pressing topic this month has been facelift, and she asked that I delve into the topic a bit. I suppose this letter is relevant to those seeking total facial rejuvenation. As I see it a facelift surgery is also a neck lift, browlift, eye lift, and browlift. That’s because the face is a single unit, and if you address one area without the others, the weakest cosmetic link tends to show through. It’s all about eliminating shadows.

A perfect example is a woman who came in today for her 6-month follow-up visit. She lives in Missouri and so I don’t get to see her too often. Let’s call her Susan. Susan opted to stage her facial rejuvenation journey, focusing on the top half, and waiting to do the bottom half later. Her nose was her biggest complaint. In February, I performed an open browlift to balance and raise her eyebrows, revision upper eyelid surgery, and revision lower eyelid surgery. I also performed revision rhinoplasty. As you can imagine, I addressed the top of her face, and just that.

The procedure took a good 5 or 6 hours, and she did very well with it. I was able to sort out the irregular bumps and crannies in her nose, balance her asymmetric eyebrows, and set back the clock a bit on her eyes. She is thrilled with the early result and the scars are nearly invisible. But she doesn’t look too much different to me. Why not, you ask? Because she still has the shadows cast along her lower face, jaw, and neck. And those are tell-tale signs of aging. Sure, her profile looks much better, but she does not look drastically younger. In my opinion, the untreated areas, though unchanged, become relatively more apparent.

“Susan”. This woman had a revision rhinoplasty browlift, blepharoplasty revision, and CO2 peel. Though her nose looks better, on the profile view she does not appear noticeably younger. A forthcoming neck and jawline enhancement will change that.

Not everybody needs a facelift, no matter how old or young. Most of my patients would prefer to do their eyes, and a laser peel, and they look spectacular. Botox and fillers are a superb standalone treatment in many cases. Still, “Susan” demonstrates such an important point. If you are considering total facial rejuvenation, it’s better to ask for a “facelift”. At least in my practice. Many surgeons parse out a facelift- you’ve heard it all before. The idea of a “mid” facelift, neck lift, and “jawline threading” all have their role, but their name alone illustrates the inherent neglect of surrounding features.

If you are considering total facial rejuvenation, we can chat about your particular goals and desires. No facelift is the same. Although you may sign a consent for “facelift, necklift, browlift, quadruple blepharoplasty, CO2 laser resurfacing, fat grafting to the cheeks and lip lift”, in my eyes, you have signed up for a facelift. A facelift should address all these features, in a conservative and elegant way. In the end, I want to restore your youthfulness, not change your appearance. The result should be subtle, so nobody really knows you had something done.

This woman is only 5 weeks out of a facelift, neck lift, dermaplaning, and mole removal over the eye. She did not choose to re-do her eyelids that were done years ago, elsewhere. The scars are already hard to see, and the jawline enhancement is subtle but realistic. In short, she appears like a younger version of herself. As I see it, this represents an excellent outcome.