Dear Dr. Seckel, I am 40 years old and am beginning to see some loose skin on my neck and a little bit of looseness on my jaw. My skin is good, I don’t have many wrinkles. I really don’t want a face lift. I have read that there are laser face lifts called non-surgical face lifts. Do these work well on the neck? Am I too young to have a face lift? Thanks, Claire, St Louis, MO.
Dear Claire,
The early skin aging changes you see on your neck are very common and are often the first sign of facial aging that prompts people to consider some type of facial rejuvenation. Fortunately for you, you just have early skin laxity and don’t have many wrinkles, thus non-surgical facial skin rejuvenation will be more effective for you and easier to accomplish. The age at which a person has a face lift is a personal choice and there is no set age for a face lift. It depends on your choice and the opinion of a reputable, ethical plastic surgeon as to whether a face lift is appropriate, safe and can achieve the result you desire.
There are so many facial rejuvenation options available today it is very important that you understand what is meant by the many terms you see advertised. Mini lift, mini face lift, Lifestyle lift®, weekend lift all refer to some modification of the standard face lift which is less extensive. These “lesser” procedures can be very effective for people who are younger and have minimal skin excess IF they are done by an experienced, talented, board certified plastic surgeon. I recommend you read Chapter 10 of my book Save Your Face entitled “Don’t Let Just Anyone Touch Your Face” to learn how to find the right doctor.
The term non-surgical face lift is widely marketed and in my opinion is misleading. A face lift, also called a rhytidectomy, is a surgical procedure designed to lift and tighten lax facial skin. Most of the procedures called non-surgical face lift are skin tightening procedures which tighten but do not lift the skin. Most of these procedures can only achieve a small correction, often 30% at best, which does not compare to the beautiful tightening and rejuvenation possible with a face lift. Another group of procedures called non–surgical face lift is the Thread lift, Feather lift or Contour Lift®. These are procedures, which use a small thread placed beneath the skin to tighten and lift the face. While these thread lift procedures do lift the skin, they are SURGICAL procedures and should not be called a non-surgical face lift. Results of the Thread lift procedures have not been satisfactory for many people; you should read my other blogs about these techniques.
The laser face lift or laser lift refers to full face laser resurfacing, a very different but effective technique. Laser resurfacing is not a laser face lift. Rather a laser, usually a CO2 or Erbium laser is used to remove damaged skin from the face and stimulate the deeper skin layers to make new collagen. This is a surgical procedure and your face will be red and raw for several days and you will need 2-3 weeks to recover. However after healing the skin is fresh and tighter. In the right person the laser resurfacing produces an excellent result. However, laser resurfacing or laser face lift as it is called, is best for people who have many facial wrinkles and very fair skin. This is not the right procedure for you since you do not have wrinkles and only have minimal neck laxity.
Finally there is a new type of skin tightening procedure, which is also called a non-surgical face lift, which may be appropriate for you. In the past three years new skin tightening technology has become available using radiofrequency or infrared heat energy to tighten facial skin. These procedures are known as Thermage®, Titan®, Aluma with FACES® (which stands for functional aspiration controlled electrothermal stimulation), LuxIR, and Refirme.
Thermage® and Aluma with FACES use radiofrequency heat energy and Titan® and LuxIR use infrared heat energy, Refirme uses a combination of different energy sources. These technologies work by a very complex mechanism. Your facial and neck skin is starting to sag because the skin loses its elasticity as we age. The elasticity is lost because the collagen and elastin, which give your skin elasticity, in the deeper layer of your skin called the dermis is damaged.
When the damaged collagen and elastin are heated to 66 degrees centigrade the collagen will shorten and remodel. After a period of time the newly shortened and remodeled collagen will tighten the skin. Thermage®, Titan®, LuxIR, Refirme, and Aluma withFACES® are used to heat the collagen in the deeper dermis to 66 degrees centigrade to cause collagen to remodel and shorten and tighten the skin. The trick is to heat the deeper layers of the skin but not burn the skin surface as the radiofrequency or infrared heat energy is passed through the skin. Each of these machines has a sophisticated cooling device to prevent injury to the skin.
While Thermage®, Titan®, LuxIR, Refirme, and Aluma with FACES® are exciting new skin tightening techniques they are not a face lift and should not be called a non-surgical face lift. They achieve about 30% improvement in most people and are most useful for people like you, who are younger and have minimal skin laxity.
As you can see Claire, your question is a very complex one. I would guess from your description, that one of the new skin tightening procedures such as Aluma with FACES® might work for you. I also am sure that a mini lift done by a talented board certified plastic surgeon would give you an excellent result. The advantage of the mini face lift is that it provides maximum tightening and is done all at once. The skin tightening machines require 3- 4 treatments and you will not see the final result for 4-5 months. In the end the cost is very comparable between the mini face lift.
The most important thing for you to do is to seek consultation with a board certified plastic surgeon who is very experienced in all facial rejuvenation techniques. Consult at least 2 surgeons and find doctors who have a good reputation and have treated people you know. Many doctors do not understand the new technology, so you have to ask questions of your doctor. Be sure to consult a doctor who can offer you options. See a doctor who can do it all and who can fit the therapy to your unique face. Don’t let a doctor fit your face into the only type of therapy that he/she has available.
I hope this answer helps. For further information visit my Boston Plastic Surgery Practice, read Save Your Face or contact me.
Boston, Massachusetts
Peabody, Massachusetts