Patrons1 in Henderson, NV asks:
I had a face lift and a neck lift a month ago. As a result, I now have what appears to be a small rope around 1/2 of my neck. Additional my right side of my face is far more doopy than my left, ( which is good). I go back to the Dr. in 10 days for my 6 week evaluation. Is this something that he should fix?
It has been approximately five weeks since the procedure and generally at this time healing issues, bumps and lumps and “ropey” appearance problems have resolved. However in a small percentage of individuals this can be a persistent manifestation. Bumps and lumps and ropey appearance can last longer than five weeks, even into the three month mark. Generally, according to the appearance of the picture, there is no evidence of infection and this is simply an area that is going to take longer to heal. The reasons this happens is sometimes unexplainable, sometimes related to the way bandages are placed or it can occur with slow accumulation of fluid and/or blood into the tissues underneath the skin. Ongoing observation is still the mainstay of treatment. Massage can be beneficial I believe and sometimes ultrasound treatment to the area can help accelerate the wound healing process.
FILIGREE1 in FLORIDA, USA asks:
A regular facelift or separate procedures cost so much more, but I’ve been told that the effects last 5-10 years if you don’t smoke, or experience weight changes. How long can I expect the effects of a Lifestyle Lift to last under similar conditions?
The important component of a Lifestyle Lift is tightening of the deeper structures of the face, the SMAS/fascia and muscle structures. This tightening provides a real improvement in the overall appearance, particularly in the neck and jowl area. It is impossible to attribute an exact time period to which you turn back the clock, however as a general rule Lifestyle Lift and/or facelift provide around eight to ten years loss of appearance of aging. It is true that standard facelift procedures do cost more, but Lifestyle Lift provides an efficiency that translates into saved dollars for the individual who desires real aesthetic improvement. Essentially when undergoing a Lifestyle Lift or a facelift by an experienced surgeon, one will expect to achieve a good improvement in appearance and aesthetic youthfulness and decrease in the overall appearance of aging changes. This is a turning back of the clock. We can’t stop the clock, we can’t stop aging, but we can back it up several notches with a lift procedure. As time goes on, ongoing aging will occur.
Ohiokat from Ohio asks:
My surgeon said I’d be able to wear my hair pulled back after my mini lift, as the sutures would wrap in and around my ears. Post surgery, I’ve found that the sutures also extend back from behind my ears into the hairline about 2.5 inches. I’m upset. Is this typical, to find that incisions were made beyond what was specifically described pre-surgery?
The amount of incision performed behind the ears is variable depending on the operating surgeon. Some incision types such as a “S-lift” there are limited or no incisions beyond the postauricular crease. However it is more common to have incisions extend beyond the postauricular crease into the hairline or along the hairline. The distance traveled can be anywhere from a few centimeters to several inches. Overall there is a tendency for minimal inhibition for putting one’s hair in a ponytail many weeks after the surgery as the wounds tend to blend in and heal nicely. Essentially understanding exactly what type of procedure and incision to be performed is essential in the preoperative consultation. But it is common to have incisions going backwards from the postauricular crease.
TJR in Savannah, GA asks:
“If you had too much fat removed from submental liposuction and it caused your muscle bands to show and indentations how would you go about correcting this problem? If you are a PS what would you recommend to fix something like this and what sort of reasonable expectations should a person have in terms of having a normal looking neck again? I am scared and upset so any insight would be appreciated.”
Correction of the described problem can be addressed in several different ways. Specifically it is important to really get an anatomical evaluation and overall sense of what the underlying issues are. It is not an uncommon problem/complication to have “too much fat removed in the neck area” as liposuction is a component of facelift surgery commonly. But also residual band laxity is also not too uncommon. Bands are the platysmal muscle bands that can remain lax after surgery.
A number of treatments are available including repeat platysmal band tightening. This will often times resolve the problem by itself. Other supplemental treatments include fat injections as needed if there is significant contour deformity. This procedure is less common than a simple platysmal muscle repeat tightening. Nonetheless this area can be addressed commonly and long term permanent problems is something not seen too often.
msmmi in sf in Pleasanton, CA asks:
2 months ago I had 4 qaud eye lift, brow lift, full facelift and lipo of the neck. I had some nasolabial folds before surgery, and the doctor assured me these procedures would correct the problem. However, the fold on one side is still there, and never seemed to get better. I feel the malar fat pad may not have been lifted as much as it should have been. I am not into fillers that don’t last, after spending all this money for a more lasting fix. what should be done?
It is now two months after the procedure and there has been a number of procedures performed, including your eyelift and brow lift and facelift, liposuction and neck lift. These are a lot of procedures and even though it has been two months there is still some reasonable amount of healing that needs to occur. Most people desire resolution of all their swelling and healing problems by a week or a month, but essentially three and six months or more is required.
Therefore assessing the nasolabial folds is somewhat premature at this phase, but a number of things can be discussed at this time. Facelift procedures can soften the nasolabial folds, but rarely get rid of the significant concerns of the nasolabial folds. Fillers are the best answer. There are a number of fillers; the temporary ones are beneficial. If you are interested in a “lasting fix” then more permanent type fillers are helpful, including Artifill and Sculptra, as well as fat grafting. Fat grafting tends to be the best answer in many instances due to its reliability and the fact that it comes from your own body to begin with.
So the best answer to your question is to wait a little bit of time, at least three months if not six months, and assess things and consider fillers after that period of time. Fat grafting would be my first option, Sculptra would be a second answer.
msmmi in sf in Pleasanton, CA asks:
”Should a patient with botched plastic eye and brow lift be required to repay the surgeon for a revision?”
Each individual plastic surgeon has his/her protocol in their office. Common protocols include not charging for a second procedure. Many offices and plastic surgeons require a facility fee. Less often full price is charged.
When it comes to the need for a revision procedure, which is a little bit different than “botched surgery”, repeat procedures are common. A certain percentage of patients who have a rhinoplasty or facelift surgery for instance, require touch-up or revision procedure. This can be in the range of 10 to 15% of patients sometimes. Due to the fact that this is not too uncommon, this possibility should be discussed prior to the procedure.
In the instance of a “botched” surgical procedure, a good trusted second party is needed to assist with defining the real true problems. A trustworthy second opinion would help to define whether there truly is a permanent complication or whether there is simply something else such as not getting the results that one desires, or a wound or swelling that should get better with time, etc. Going back to the primary surgeon, getting his/her opinion followed by a second opinion will best assess whether there is a true problem that needs fixing.
Commonly good ethical physicians will provide assistance for correcting surgical related complications at minimal or no charge. But there is no requirement to do so. Your best answer is to try to do the best you can with the primary physician/surgeon to see if he/she will provide correction of a true surgical complication at a reduced fee.
Tankie in Victoria, BC asks:
“Problem: I am suffering from painful dry eyes due to Lagophthalmos. My oculoplastic surgeon recommends a gold implant placed in the upper eyelid of each eye.
Symptoms: – Pain in both eyes, right eye hurt me most – Unable to 100% close eyes unless I try hard – Also have droopy right upper eyelid – Unable to wink with right eye, however can wink with left
Treatments: Lubricating ointment & eye drops before bed and 6+ times per day What alternative options exist? Thank you, I need help.”
Lagophthalmos is a not too uncommon medical condition of the upper eyelids. Common causes include post surgical, as well as other neurologic conditions. The eyelids are extremely important to protect the eyes, keep them moist and prevent irritation. With lagophthalmos this protective mechanism is compromised. Treatment options include artificial tears and lubricating ointments. Gold weight implant is an excellent option to help protect the eye by providing greater ability for the eyelid to close. The important thing is to obtain a weight that is correct for your particular eyelid and condition. Often times 1 mg is utilized, but careful measuring can determine whether its more or less of this weight required for satisfactory treatment. Implantation of the gold weight is quite easy. There is a slight bulge to the eyelid that sometimes can be subtly visible and is somewhat of a downside. The good news is that gold weights can be removed quite easily as well.
Additionally, sometimes lagophthalmos is a temporary problem that with time will get better but this depends on the underlying cause of the problem.
Disappointed & Scarred in Los Angeles, CA asks:
“Im a 30yr old model(female-caucasian/hispanic). 6wks ago had facelift (modified volume adjusting) & lateral brow lift. My cheek elasticity was lax & brows were drooping (wanted both to be lifted & tightened). Dr is trying to convince me I look better, but Preop pics & video show very little difference & I still have same issues-lax skin & droopy brows, plus a bad brow scar (not sure why it was done so prominently knowing my line of work). Will time lift it more & make tighter? What about scar?”
“Hi I am 20 years old, when I smile or laugh my mouth opens very wide so it seems that my smiel goes from ear to ear! is there anyway to fix it so when I’m laughing, my mouth won’t open as much?”
This is a significantly delicate and tricky proposed concern. Overall there is not a recommended surgical procedure. However, based on your anatomy there is a possibility that some expertly placed small degree of Botox can diminish some of the widening of the smile. However, nonetheless this has to be done, performed and assessed by a physician who does a significant amount of Botox treatments. Overall, I think that it is important to get a good opinion from a physician as to whether anything, if at all, should be done. Try to trust the opinion of the physician that you consult with and if you have a trustworthy physician and a physician who is well recommended and if this physician says don’t have any procedures done then importantly you should listen to this recommendation.
Rebric in Albertville, Al asks:
“I will be taking one hydrocodone/apap 7.5/500mg tablet and one diazepam 10 mg 1/2 hour prior to the surgery and given a local numbing injection. Do you know from your experience if this a comfortable option compared to general sedation? Plus have you performed this surgery without the protective eye lens cover?”