Doctors with Differing Opinions on Facelifts

Dr. Yang
You offered some good advice on my post on the facelift forum–it was titled Dr. Yang – What Kind of FAcelift is This. At that time I had seen one surgeon who said he would put a scar in front of the ear and take it behind ear–taking only lower face skin-no muscle. He also said he would put radiess in crease under chin. Well, I had just a little sagging, no sagging on neck and thin face. When I went to second surgeon he said same thing except he was going to inject fat in chin crease. When I asked him about the muscle, he said I didn’t need a midface lift. I have already taken your advice–no facelift surgery for me. I am going to have some perlane injected into the small marionette lines –if I like it then maybe down the road I will have something more permanent for volume and lines. Sorry to go on but basically I am kind of amazed that neither doctor didn’t comment on my thin face and how it would or could drastically change my face to a very obvious pulled look facelift. Because of you and a few other posters, I did a complete turnaround. Thank goodness. Do they just think that it is better to get rid of any sag no matter how slight at any cost? Thanks a lot for all the excellent advice on this board. By the way, it always bothered me when I would pull back my face and look at how little skin there was to tuck behind or pull.



I think it may depend on how you ask the question, and on the plastic surgeon. If you asked them the above question, at least you would know their rationale. For example, there are a few well known facelift surgeons who perform facelifts on very young patients in the 30-40′s and don’t tell them to go away for several years before coming back, while most of the other well-known facelift surgeons will turn away patients who they feel do not have enough “sagging” to benefit from a facelift. These are the well-known plastic surgeons. They have enough business, that whether you sign up for surgery or not, their surgery schedule is still booked for several months. One more, one less, it doesn’t matter to them; they don’t need to sell you, they are already too busy.

Other plastic surgeons who are not in this situation, may have a different point of view. They do care if you sign up. It’s like a court case. The two lawyers put out their best arguments and try to win. Since a prospective patient (AKA “prospect”) usually has a 50% chance or less of signing up (some surgeons have a much higher rate others a much lower rate) but for arguments sake, let’s say 50%. Isn’t it in the surgeon’s best interest, to try their best to convince you to have surgery? Even if they do a good job convincing (selling) you, half still don’t sign up.

The people who don’t agree with the PS won’t sign up and the one’s who agree will sign up. I think that with that “strategy” some of the people who actually thought the surgeon does good work may actually be “turned off” by the surgeons “aggressive” style, and not sign up because of lack of skill, but of lack of trust. Some patients want to hear how fabulous they will look and the more expensive the suit and the fancier the office, this must mean that the surgeon is “so great” that they can afford such a nice office. Some these patients who sign up may not be the best candidates for the procedures offered, but they believed the “sales pitch” and since no one is putting a gun to their head to sign up for surgery, they must know that they want the procedure. They are in fact adults.

I have a slightly different perspective. I am amazed that women, including my own wife, are willing to spend a lot of money on the “skin care product of the month.” Its a multi-billion dollar industry, converting a few cents worth of chemicals and creams and selling it at a several hundred percent mark-up. The more PR a product gets, and the more expensive it is, it seems to sell even better. I think that if you offer any thing that will somewhat make a woman look younger, it sells itself. The problem is that skin care products don’t cost thousands of dollars, and if you are allergic or the product doesn’t work, most people don’t even bother to return it.

Plastic surgery is not the same. The improvements are not without some pain/suffering. Some people have almost none, others have a lot more, and even fewer have permanent issues after their plastic surgery. So these are serious procedures and should not be sold as if it were like the latest “wrinkle-erasing skin cream.” The buyers remorse for skin creams is nothing like for plastic surgery.

My goal is to try to screen out patients who have a high likelihood for “buyers remorse.” Who are these people? People who have unrealistic expectations of results or recovery (“You’re going to make me look 30. right?”) People who think that plastic surgery is going to change their lives (“I’m going to win back my husband by having all this plastic surgery to look 30 again.”) Patients who are not ready for the procedures that they are requesting (Too young, too heavy, too light, still smoking, too much sun, … etc.) If they are not ready their results will be in the category of People who may have too little result (“I spent all this money and I look the same.”)

Will I still have some of these patients during my career? Most likely, but if I am looking out for these people, it should be much less likely to happen than if I take the other approach.


Dr. Yang