Fat Strip Grafting, continued.

Thank you so much, Dr. Yang, I am so grateful to you for taking time out of your day to reply.

I am now confused as to why my surgeon referred to the procedure as a short scar facelift…he has said that the procedure will hardly address my neckline at all {as my neckline does not need to be tightened, and the procedure he has described seems to be very similar, if not the same as the MACS lift…the same incisions at least. Slightly above and into the ear.

A endoscopic midface lift is something that was never offered or discussed, though I am very curious about this procedure.

I had visited with 3 other surgeons before choosing one and 2 had suggested some sort of midface lifts all with the same incision sites, but though they had good reputations in my area, I was less than impressed with their photographs. The other surgeon I spoke with did recommend fat transfer only, but said that he did not believe in or perform “mid” face lifts and also said that I would have to “learn to love” the bit of extra skin I am starting to see in my cheek area {a fold or shadow that is becoming more and more visible when I smile}a comment I found to be a bit off putting….and referred me to the surgeon that I ultimately chose. So I suppose I have interpreted my surgeon’s explanation of the procedure to be a “mid face” lift all along when maybe it is not?

My surgeon did speak with me about micro fat grafting, but didn’t believe I would have a lasting result as opposed to the fat strip grafting…of which he said he had only performed a few times but each of those times had yielded “beautiful” results. I suppose my apprehension about the fat transfer is just that…that he has only performed this a few times and that it may look lumpy under my thin skin or unnatural.

Another area confusion for me…that his list of credentials is so long and impressive BUT does that mean that I should trust him to perform a procedure on my face that he doesn’t perform very often?

So I am a bit confused about how to proceed but this is why I wrote to begin with, to be as educated as possible about something that will affect my face for the rest of my life. I can always cancel the surgery and keep looking for a right “fit”. The surgery date is 3 weeks away. I suppose I will request another appointment with my surgeon to further discuss my options, as I would like to feel completely at ease. You have given me a lot to think about and a lot of good questions to ask myself and my surgeon.
Thank you so much.
Is there a surgeon that you would recommend in the midwest or St Louis area that specializes in endoscopic midfacelifts?

Hi Starla,

I don’t know of any plastic surgeon’s who are known for endoscopic midfacelifts in the midwest or St Louis, but there are many surgeons offering it in your area. It doesn’t mean that they are not experienced. I’m sure that many have been performing these procedures for years. It just means that they were not the pioneers of these procedures like Dr. Oscar Ramirez, for example.

I think that you are going about your surgeon selection in the exactly the right way. In addition to all of the key points when selecting a surgeon, i.e. education, credentials, board certification, satisfied patients that you know, etc, I wanted to point out the key points that you have done well for others who may come across this post.

You have gone to least 3 separate consultations. Finding a surgeon is like finding a husband. At least with a husband, you can divorce him and find a brand new one, but with your face you only have one. When you meet the right surgeon that you trust and like their results, you just know it. If you sign up with the first surgeon that you meet, then you may be missing out on someone else who may give you a better result or meet your expectations better.

You have looked at the before and afters of the different surgeons, and like the appearance that this surgeon gives to his patients. If you go to a well known, and well respected surgeon with great feedback from former patients, but you just hate the before and afters, then keep looking. Don’t just go to that surgeon, because of the testimonials and credentials, because chances are you will end up looking exactly like the before and afters that you didn’t like when you first saw them.

Be Picky
Its okay to be picky, since you only have one face. However, after seeing a several surgeon’s results, you may realize that some results may not be possible. That’s okay, because this gives you more realistic expectations, so that you won’t be disappointed later or think that a different surgeon may have been able to deliver on what you really wanted.

Speak up
Don’t be afraid to ask questions, or think that you don’t want to waste our time. I think that the root of all dissatisfied patients is miscommunication of some sort, whether it be on the physician’s part or the patient’s part, but in many cases both. If you have questions or concerns, and don’t ask them, the surgeon is not only busy, but is not a mind reader. So, please speak up (not you, Starla.)

Independent Research
You are doing some independent research on these procedures, and not just taking the surgeon’s word for it, to learn more about how consistent the results are, and what can happen.

Skepticism- “A grain of salt”
You are asking yourself, “What’s the catch?” with each procedure. Since there are no perfect procedures. For example, fast recovery => what’s the catch? => it doesn’t last very lone. Or vice versa, the results are very very long lasting => what’s the catch => the recovery can be more than a couple of weeks, may even several months. Anyway, you get the idea.

For each patient, if they can handle that “catch” (the potential risks, or complications of the procedure), then I feel that they have realistic expectations and can handle any potential post operative problem if it does occur. If the potential problems don’t happen, then that’s great, you get to have your cake and eat it, too. At least, you get to pick your poison and not let the plastic surgeon choose your poison for you.

One size fits all => NO . . .
the right procedure for the right patient
For example, for Patient A who may be still working, a fast recovery and “very” natural result is important, even if it may mean that the results are too subtle and may need tweaking in the future. While for an retired Patient B, who doesn’t care about a long recovery, since they are already retired, wants a long lasting and dramatic result, even if it means taking several months for the swelling and distortion to settle out, as long as the results last.

If Patient A ends up with a procedure better suited for Patient B and vice versa, you can imagine the potential unhappiness which would follow. And this example is just with the recovery issues, and not aesthetic issues.

You’re not hurting our feelings
The surgeon obviously likes the results, and many of his or her patients like the results, so why would the surgeon give you a different result when their “set” of procedures are making his/her patients happy. Do that surgeon a favor and choose someone else, not only will you be happier finding another surgeon who can deliver. It will also make the surgeon who can’t deliver your type of results happier, because patients who do like his results go to him, and patients who like a different result goes to a different surgeon. Less unhappy patients is good for not only the patients but also the plastic surgeons (less gray hair and ulcers.) Win-Win.

Making a Decision
You have to trust your gut instinct. It’s gotten you this far.

I can’t make the decision for you. It will have to be your own decision. I think that it is important for me to point out things for you to consider, which have not already been pointed out. You will be better equipped to make an educated decision, have realistic expectations (and not be mesmerized by the ability of the surgeon and realize that we are human and things can and do happen) and be mentally prepared for the recovery however easy or hard it may be. (Run-on sentence … sorry)


Dr. Yang