OK, you have decided that you want a facelift.  Easy enough, but now you are worried.  Should you have the Lifestyle Lift or maybe the Quicklift or possibly the Acculift?    These procedures can be viewed on slick advertisements with glowing testimonials on TV and in print ads.  Of course, all of these are names for facelift type of procedures.  Why are they named?  Well, it’s the new (pardon my pun) wrinkle in cosmetic surgery, the copyrighted procedure!  The government in its wisdom has, appropriately so, prohibited the use of patent restriction of any surgical procedure.  However, anyone can take an existing surgical procedure, alter it or not alter it and give it a name, which is then copyrighted.  What this means is, any doctor who performs facelift procedures, can do any procedure on you but cannot call it by the name that has been copyrighted.  Only a franchise doctor can use the copyrighted name.  This then is an advertising and promotional gimmick.  There is no secret magic to the surgical procedure.

So you ask, what is different when evaluating these cleverly named procedures?  All facelifts are not the same.  Most of the procedures currently performed were developed over many years, by a variety of contributors.  Traditionally cosmetic surgeons named the procedures with rather unsexy but descriptive names such as the SMAS  facelift, the deep plane facelift or the minilift.  Facelift procedure techniques  have always been reported upon at professional meetings and in medical journals.  Techniques evolved because of the willingness to share knowledge and to further the skill sets of both cosmetic surgery colleagues and new physicians.  In the current advertising market,  old techniques are renamed and branded as spanking new techniques that may only be performed by a select few doctors.  The truth is that any real plastic surgeon that is certified by the American Board of Plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgery has been well trained in all of these techniques, regardless of whether or not he utilizes the cool new name.  The choice of which technique would most benefit the individual patient is what is truly important.  In my industry, one size does not fit all.

The facelift procedure by any name is designed to rejuvenate your facial appearance.  The problem with your facial appearance may be skin, muscle and/or neck laxity possibly combined with fat excess and/or atrophy.  Some patients may need only a skin tightening procedure.  Others may need a procedure that tightens both skin and muscle or possibly the neck bands.   Of these,  some may need an extremely limited procedure and some may need an extensive procedure to achieve maximum benefit.  The skin itself may need to be resurfaced to correct aging changes.  The facial skeletal structure may need to be supplemented with fat or a dermal filler,  or perhaps a chin or cheek implant.   The bottom line… multifactorial facial aging changes means one procedure does not serve all needs.

If you go to a heavily advertised facelift mill or copyright promoted surgeon and receive only the promoted procedure, you are generally receiving a minimally invasive procedure that does little more than skin tightening (often costing more than the same procedure with your local plastic surgeon).   The allure of many of these promoted procedures is that there is minimal downtime,  minimal cost, rapid recovery and can be done under local anesthesia.  This sounds wonderful.  It’s kind of  cheap and quick with no anesthesia risks, and I can go back to work in a couple days.  Who would not want that?  Cosmetic surgeons who are well-trained and aware of all the variables that are involved in achieving an optimal outcome, would be doing these lesser procedures without the copyrighted name on every patient,  if indeed they were all you needed.  Also,  in my many years of performing cosmetic surgery in Marin County, I rarely have seen a facelift that does not require at least a week of downtime to look socially presentable.

In some of the TV and print ads that I’ve seen  for procedures with copyrighted names, the results as shown were wonderful.  However, most often the individual in these ads  has obviously also had a brow lift, a blepharoplasty (eyelid lift) , dermal fillers,  fat removal and/or repositioning and a neck band revision.  The cost of these additional procedures  would certainly exceed the baseline advertised price.  The time involved to perform the additional surgeries would monumentally add to the  complexity of the case.  The advertised 1 hour procedure would certainly be extended to  four or five hours, making it virtually impossible to perform the procedures comfortably or safely on a patient without general anesthesia.  Is this a bait and switch?  Consider this as well, if you read the fine print on the bottom of the TV screen, the advertising physician is not the one who has performed the surgery on the individual shown.  And, your chances of getting the doctor who did perform the surgery that you are admiring are slim to none.  You have seen a great before and after that was not performed by the doctor advertised.  Also, if you have the surgery at that facility, you may never see the doctor who operated on you again.  Follow-up, even if you have problems, may be done by ancillary personnel.

If you are considering responding to ads that you’ve seen, I would ask that you first see a local board-certified plastic surgeon (names readily obtainable from the ASAPS online).  During this consultation, have the doctor explain what needs to be done:  skin, muscle, fat, fillers, resurfacing.  Ask specific questions regarding scar placement and what your anticipated recovery time will be.  Remember that just because an ad makes a claim, reality may look very different.  Make sure that you view before and after photos of actual patients that have had a procedure performed by the doctor that you are considering.  If your budget is limited, tell him what you can afford and ask what his recommendations would be.  Remember, if a surgical procedure is quick, minimally invasive, and cheap;  you usually don’t get much no matter where you have the procedure.  You may indeed benefit if you need  minimal correction from less of a procedure.  However, if the procedure will do little or nothing to correct your concerns (example:  sagging neck skin),  it is unethical for the doctor to take your money.  The maximum benefit that you will receive is best called, a wallet lift.

For the past 11 years, liposuction has always been the top surgical procedure.  This year breast augmention has taken over with liposuction as 2nd, eyelid surgery 3rd, rhinoplasty 4th and abdominoplasty 5th.  Botox continues to lead the nonsurgical procedures as most popular with  laser hair removal and hyaluronic Acid dermal fillers in popularity.

The top 2 procedures for women were breast augmentation and liposuction.  The top 2 procedures for men were liposuction and rhinoplasty, with eyelid surgery following the top two for both sexes.    At my Marin County cosmetic surgery practice, I would probably designate vaser liposuction and eyelid surgery as my top 2 requested  procedures.  Often, different areas are addressed at the same  time surgically,  particularly with mommy makeover  (breast and tummy)  and facial surgery.  Of  interest this year is the increased usage of dermal fillers and Botox for patients interested in correcting minor facial issues with little downtime.