Whether it is fear of surgery or the stigma of having surgery, almost everyone who comes in to my plastic surgery office tells me they want to look younger but they do not want a face lift.

Recent technological advances resulted in new light based skin tightening devices which are being marketed as the non surgical face lift or non-surgical face lift. While skin tightening technology is impressive, and does work, the results of skin tightening to date hardly qualify as a face lift, non-surgical or otherwise. Skin is tightened but best results are about 20% to 30 % of what a traditional surgical facelift can achieve.

The new skin tightening is called non-ablative to distinguish the new skin tightening technology form the old CO2 laser resurfacing, the Gold Standard for Wrinkle Removal.

To ablate means to surgically remove, and the CO2 laser resurfacing ablated or removed old damaged skin and new skin grew to replace the old. In the process of Laser Resurfacing, heat generated by the laser injured the deeper skin layers and when they healed, with new collagen, the skin was contracted or tightened.

The newer skin tightening technology uses radiofrequency energy or infrared energy to heat the deep layers of the skin to cause contraction and tightening but first cools the skin before the energy is applied to prevent injury and ablation of the superficial skin by the heat energy. Thus the skin is tightened but the surface is not ablated, thus non-ablative skin tightening. There is no down time foillowing non-ablative skin tightening unlike the older CO2 laser resurfacing skin tightening.

Several new skin tightening machines are available. The LuxIR by Palomar, and the Titan by Cutera utilize infrared energy for skin tightening. The Aluma by Lumenis and Thermage utilize infrared energy for skin tightening. Refirme by Syneron uses a combination of light energies with radiofrequency for skin tightening.

All of the machines achieve about similar results when used properly. Generally there is less discomfort with the Infrared skin tightening machines. Complications have been minimal although some serious complications occurred with Thermage skin tightening early on.

In my practice I find that non-ablative skin tightening is most helpful for younger patients who do not have severe aging changes and significant sun damage, people in their 30’s and 40’s who want to correct or tighten early skin sagging along the jaw line or jowl area, neck and cheeks. I use the LuxIR on these larger areas. For skin tightening around the eyelids I use the Aluma which has a smaller treatment head and a suction device that will pull the delicate peri ocular skin into the treatment chamber for skin tightening.

The field of non-ablative skin tightening is in its infancy and will definitely become more effective in the years ahead. The companies are improving their products frequently. For now however the people who benefit most from the skin tightening machines today are younger people who still have thick healthy skin with early aging changes.

The use of the term non-surgical facelift to describe non-ablative skin tightening is an overstatement with technology available for skin tightening today. At best a 30% result is possible when compared to a traditional face lift.

To learn more read Save Your Face or contact me.

Dr Seckel

Concord, Massachusetts

Boston, Masachusetts,

978-369-4499

The eyes are the “window to the soul” and our most frequently viewed facial feature and unfortunately the first feature to show the signs of facial aging. Usually by the 30’s we begin to see crow’s feet, wrinkles, eye bags, dark circles under the eyes, and the start of eyelid hoods or hooding of the eyes.

(Contact Dr Seckel)

Traditional plastic surgery called the blepharoplasty can reverse many of these eyelid aging changes however newer methods using laser blepharoplasty and other laser eyelid rejuvenation techniques are vastly improved methods for eyelid rejuvenation. Newer, non-surgical eyelid rejuvenation techniques such as Botox and non-surgical eyelid skin tightening techniques such as the Aluma radiofrequency skin tightening device can improve and help prevent eyelid aging changes such as eye hooding, wrinkles, eye bags, and dark circles under the eyes.

The laser eye lift, which I call the “modern blepharoplasty”, combines new laser and non-surgical skin rejuvenation technology to produce dramatic eyelid rejuvenation without many of the drawbacks of traditional blepharoplasty.

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The laser eye lift combines the advantages of nearly bloodless laser incisional methods with non-surgical skin tightening and skin peeling methods for removal of wrinkles and tightening and freshening of the eyelid skin. For the first time we can achieve total eyelid rejuvenation, not just removal of eye bags and hooding of the eyes, but smooth young looking eyelid skin with fewer wrinkles and less sun damage and aging changes and removal of dark circles under the eyes.

In addition by using the laser to make a tiny incision on the inside of the lower eyelid (the transconjunctival blepharoplasty) we can avoid a visible scar on the outside of the lower eyelid. The transconjunctival blepharoplasty technique also avoids any change to the beautiful lower eyelid shape, a common and troublesome complication of traditional scalpel blepharoplasty with an external eyelid incision. In addition, with the transconjunctival blepharoplasty it is possible to release the arcus marginalis and thus truly remove dark circles under the eyes.

Advantages of the laser eyelid rejuvenation are:

1. Faster Surgery
2. Less bleeding
3. Less Bruising
4. Quicker Recovery
5. No visible scar on lower eyelid
6. No change in lower eyelid shape
7. Removal of Puffy Eyes, Eye bags, and Dark Circles Under Eyes
8. Freshening of Lower Eyelid Skin with Skin Tightening and Wrinkle Removal

The laser eyelift consists of 4 steps:

1. Laser upper blepharoplasty for removal of hooding of the upper eyelid
2. Transconjunctival lower blepharoplasty with arcus marginalis release and repositioning or grafting of fat to remove the dark circles and bags under the eyes
3. Laser tightening of the lower eyelid and a procedure called canthoplasty to tighten the lower eyelid and remove eye bags
4. ActiveFX Laser eyelid skin peel to remove wrinkles, sun damage , and tighten lower eyelid skin

The combination of these 4 steps provides truly total eyelid rejuvenation for the first time, something which the traditional scalpel blepharoplasty just cannot achieve. Furthermore with the advantages of less bleeding and bruising, recovery time is usually shorter than with traditional scalpel blepharoplasty.

During step 1of the laser blepharoplasty, the laser is used to remove the loose upper eyelid skin which is creating the eye hoods. After the loose skin is removed access is gained to the canthal ligament, which supports the lower eyelid, through the upper eyelid incision, so that the lower eyelid may be tightened in step 3 to restore the shape of the lax lower eyelid.

Step2, the transconjunctival laser blepharoplasty removes bags under eyes, puffy eyee, and dark circles under eyes. The conjunctiva is the pink portion of the inner lower eyelid, thus when the laser incision is made on the inner side of the lower eyelid it is called a transconjunctival incision. This approach avoids a visible scar on the outside of the lower eyelid. In addition, the supporting skin and muscle of the lower eyelid is not violated and thus the beautiful shape of the eyelid is not changed. One major drawback of traditional scalpel blepharoplasty is weakening of the lower eyelid and a downward turn of the eyelid referred to as an ectropion, also called the sad eyed look or hound dog eyes. The transconjunctival blepharoplasty avoids this complication.

During step 2 the eyelid fat which is causing the eye bag in either removed or repositioned so that it no longer causes the puffy eye bulge or eye bag. In addition, the arcus marginalis, a condensation of eyelid tissue which tethers the lower eyelid skin and causes the dark circle under the eye, is released allowing the dark circle to ‘open up”. In addition fat is placed beneath the dark circle to plump the dark circle. The combination of fat repositioning and arcus marginalis release remove the dark circles under eyes.

Step 3. During step 3 the laser is used to tighten the lower eyelid skin by shrinking the lower eyelid tissues through the transconjunctival incision. In addition, the canthal ligament, which supports the lower eyelid, is tightened with a suture placed through the upper lid incision, a procedure called a canthopexy. These two procedures tighten the lower eyelid and also provide a small amount of upper cheek lift.

Step 4. Step 4 involves refreshing, smoothing, and tightening of the lower eyelid skin using the ActiveFX laser eyelid peel. This new high tech procedure allows for rejuvenation of the skin surface of the lower eyelid and thus total eyelid rejuvenation. In the past with traditional laser blepharoplasty, hoods and bags were removed but the eyelid skin remained wrinkled and old looking. With today’s new laser blepharoplasty and eyelid rejuvenation techniques a truly fresh and rejuvenated eyelid appearance is possible.

The laser eye lift is the modern blepharoplasty approach which provides total eyelid rejuvenation. For further information read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

978-369-4499

If you are considering a face lift or any facial rejuvenation procedure it is important to understand what a facelift can and cannot achieve and the many variations of the face lift technique that are designed to correct individual variations in facial aging that appear on different faces. Your face is unique and your face lift or facial rejuvenation procedure needs to be customized to create a pleasing result on your face.

Excellent results and beautiful rejuvenation can be achieved safely with modern face lift techniques:

Most important for you is the skill and experience of your doctor. Honest expert evaluation of your face and a clear explanation of the procedure that is best for you are essential. I have written a book called Save Your Face and in chapter 10 you will find an important guide on how to choose a plastic surgeon, questions you should ask, and warnings about potential situations that I think you should avoid.

What a face lift can achieve

· Restoration of a full youthful cheek

· A smooth tight jaw line

· A youthful smooth neckline

· Some elevation of the lateral brow

· Removal of jowls

· Correction of loose skin around the mouth

· Improvement in Marionette lines and Nasal labial fold lines

What a face lift cannot achieve

· Wrinkle removal

· Eyelid rejuvenation

· Removal of crow’s feet

· Removal of eye bags

· Removal of eyelid hooding

The different Types of Face lift Procedures

There are so many different names used to describe the face lift that it can be very confusing for you the patient. Terms like week end lift, mini lift, S lift, non-surgical face lift, thread lift, lifestyle lift are often used and it is hard for you the patient to know what these terms mean. Below I will try to describe the variations of the face lift procedure hopefully shed some light on this subject for you.

The Standard Face lift

The standard face lift involves an incision around the ear and undermining or freeing the loose facial skin from the deeper facial attachments. Once the skin is free to move it is drawn tight back to a more youthful and normal position on the face and the excess skin is removed from the area around the ear and the incision is closed. This relatively straightforward operation can produce excellent results and has “stood the test of time”. Elements of the standard facelift are used in virtually all of the facelift variations listed below. The main difference is that the underlying “musculo-aponeaurotic” tissues are not always tightened.

One common variation of the standard face lift is the SMAS Plication which involves tightening the deep layers with a stitch rather than actually excising or removing some of the deep tissue layer. The standard face lift with “SMAS Plication” is the most common face lift I perform. Published reports document the superiority and effectiveness of this technoique.

The SMAS Face lift

The SMAS face lift involves dissecting, and tightening the deeper tissue called the SMAS layer in addition to the standard facelift dissection of the skin. This is done to provide additional tightening of the face and presumably provide a longer lasting result. Studies have cast doubt on whether SMAS lifting provides a longer result, but most face lifts today include some modification of the SMAS.

The SMAS stands for “superficial muscular aponeurotic system” and describes a firm fibrous tissue layer beneath the facial skin that attaches the facial skin to the underlying facial muscles. When this tissue is tightened during a face lift additional facial tightening is achieved.

The classic SMAS face lift involves dissecting beneath and elevating the SMAS layer, excising some of the excess and suturing the SMAS layer to tighten it.

I achieve the same effect by “plicating “the SMAS layer which means I do not dissect beneath the layer but fold the layer on itself with a suture to tighten the SMAS.

I do not dissect beneath the SMAS because the facial nerves run below the SMAS and I fear damage to the facial nerve. In my experience the placation provides the same result and is safer

The Extended SMAS Face lift

The extended SMAS face lift involves a more extensive dissection beneath the SMAS layer in an attempt to get a more extensive tightening of the facial skin especially down around the mouth. In my experience I am able to get this correction by undermining skin only and plicating the SMAS.

I avoid the extended SMAS face lift because in my opinion the facial nerves are more exposed to injury by this technique

The Deep Plane Face lift

The deep plane face lift involves a more extensive dissection beneath the SMAS layer and some of the facial muscles such as the orbicularis occuli. Proponents argue a more effective correction of cheek laxity and lower and mid face correction especially around the mouth. Longer lasting results are reported and this technique is purported to be safer for people who have smoked in the past.

Beautiful results have been achieved by the originator of this procedure, Dr Sam Hamra of Texas. Others have experienced an increased incidence of nerve injury. My own experience is that while excellent results are possible, some patients find an objectionable change in the appearance of their mouth.

Some studies have shown that the SMAS Plication technique mentioned above provides superior cosmetic results.

Subperiosteal Face lift

The subperiosteal face lift involves undermining beneath the deepest facial layer adjacent to the bone. This technique is designed to elevate and tighten all of the lax soft tissue on the face. Theory holds that undermining in the area next to the bone, deep to the nerves, also helps avoid nerve injury. Nerves still can be injured by this blind deep dissection. The subperiosteal face lift is an extensive operation and in my experience offers no advantage over the standard face lift with SMAS placation

The Lateral Brow Lift

The lateral brow lift is a modification of the face lift to treat laxity and sagging of the upper third of the face, the outside portion of the eyebrow and the upper cheek. An incision is made in or on the hairline on the side of the forehead, the skin is undermined, pulled tight and the excess removed.

This technique can be effective when only the side or lateral potion of the eyebrow and the upper cheek are lax. However care must be taken to avoid displacement of the hairline and injury to the frontal branch of the facial nerve, which if injured can cause the brow to droop.

The Forehead Lift

The forehead lift is a procedure I rarely do since the advent of Botox. Proper use of Botox can correct most forehead laxity caused by contraction of the frown muscles and the standard face lift corrects most lateral brow laxity of the outside portion of the eyebrow.

A forehead lift requires and incision within or at the hairline all the way across the forehead. The results can be excellent if you are willing to accept the scar. One problem however is that for a long lasting result the frown muscles must be removed and this can result in a permanent depression or contour deformity in the mid forehead in the frown area. In the past the frown muscles could be neutralized through an upper blepharoplasty eyelid incision, but again Botox has made this operation unnecessary for most people who want to correct laxity of the middle portion of the forehead.

The Mid face or Cheek Lift

The mid face lift or cheek lift is designed to tighten the cheeks and help improve the nasal labial fold lines. This is a modification of the face lift which involves an incision along the crease in front of the top part of the ear extending up onto the hairline.

The cheek lift or mid face lift is effective for people who have laxity in the cheek and nasal labial fold lines but have no laxity along the jaw line and neck.

The cheek lift or mid face lift is becoming very popular among younger patients who have early facial laxity in the midface. Cheek sagging is often the first facial aging change to occur, and younger patients are choosing to have a cheek lift or midface lift before further facial sagging extending to the neck and jaw line occur.

The Neck Lift

The neck lift is designed to tighten sagging neck skin below the jaw line and chin. The neck lift is a good choice for younger patients who only have loose skin beneath the chin and jaw line.

In some cases the neck lift can be accomplished through a small incision beneath the chin which is well hidden. This procedure is also called a platysmaplasty or corset platysmaplasty. In some cases with more extensive neck laxity an incision behind the ear is also required.

The Short Scar Face lift

The short scar face lift describes a face lift performed through an incision which runs only in front of the ear in the skin crease. The incision behind the ear and above the ear in the hairline is avoided.

Some authors show very impressive results showing improvement in face and neck laxity with this technique. This procedure is effective for younger patients with mid face laxity and less extensive neck and forehead laxity. The smaller incision is advantageous cosmetically and should require less healing and down time.

The Mini Lift

The mini lift or mini face lift means many things to many people. Most commonly the mini lift term is used by patients who want a face lift but don’t want to call it a face lift!

To me a mini face lift is a smaller procedure than the standard face lift and is useful in patients who have early facial laxity in the cheek and jaw line who do not have extensive neck laxity.

Usually I can use a short scar or an upper scar along the upper portion of the ear crease into the hairline.

The mini lift or mini face lift is a less extensive procedure and works well for younger patients and older patients with minimal facial laxity.

The Lifestyle Lift

I include the lifestyle lift here because so many people ask me about it. I only know what I read. I have not trained in nor have I ever done or seen a lifestyle lift performed. I have seen patients who claim they have had a lifestyle lift. As advertised the lifestyle lift is done without general anesthesia or IV sedation and claims are made that recovery is less than a traditional face lift.

The Non-surgical Facelift

When most people use the term non-surgical face lift they are talking about skin tightening with the various new skin tightening machines. Some misuse this term by applying it to extensive soft tissue filler injections

The newer skin tightening technology uses radiofrequency energy or infrared energy to heat the deep layers of the skin to cause contraction and tightening but first cools the skin before the energy is applied to prevent injury and ablation of the superficial skin by the heat energy. Thus the skin is tightened but the surface is not ablated, thus non-ablative skin tightening. There is no down time following non-ablative skin tightening unlike the older CO2 laser resurfacing skin tightening.

Several new skin tightening machines are available. The LuxIR by Palomar, and the Titan by Cutera utilize infrared energy for skin tightening. The Aluma by Lumenis and Thermage utilize infrared energy for skin tightening. Refirme by Syneron uses a combination of light energies with radiofrequency for skin tightening.

All of the machines achieve about similar results when used properly. Generally there is less discomfort with the Infrared skin tightening machines. Complications have been minimal although some serious complications occurred with Thermage skin tightening early on.

In my practice I find that non-ablative skin tightening is most helpful for younger patients who do not have severe aging changes and significant sun damage, people in their 30’s and 40’s who want to correct or tighten early skin sagging along the jaw line or jowl area, neck and cheeks. I use the LuxIR on these larger areas. For skin tightening around the eyelids I use the Aluma which has a smaller treatment head and a suction device that will pull the delicate peri ocular skin into the treatment chamber for skin tightening.

The field of non-ablative skin tightening is in its infancy and will definitely become more effective in the years ahead. The companies are improving their products frequently. For now however the people who benefit most from the skin tightening machines today are younger people who still have thick healthy skin with early aging changes.

The use of the term non-surgical face lift to describe non-ablative skin tightening is an overstatement with technology available for skin tightening today. At best a 30% result is possible when compared to a traditional face lift.

Result Oriented Face lift

A face lift can create a truly beautiful and refreshed look to your face:

The important components of a beautiful Face lift result are:

• A smooth, firm neck and jaw line
• A full elevated cheek high on the cheek bone
• A normal appearing ear lobe
• Hidden scars
• A normal “unoperated” appearance
• Looking “like you” just younger

The Face lift is one of the most enjoyable surgeries that I do. After 25 years in practice I usually achieve the result you want and it is a joy for me to share your happiness and enthusiasm for your new refreshed look.

The Face lift requires experience and skill and is a complex procedure which requires both artistry and a clear understanding and shared image of the final look you hope to achieve.

Your Consultation

When we meet I will talk with you and ask you to explain to me the specific facial rejuvenation goals you hope to achieve. I will examine you and tell you my findings and describe the areas where I think improvement can be made. I will demonstrate on your face the appearance that I believe the face lift will create on your face.

I will then recommend the procedure I feel is best for you. I will discuss the procedure, your recovery, and expectations and answer your questions. Photos of your face will be taken. You will be given an estimate or quote of the cost of the procedure. Financing plans are available.

The Face lift procedure

I perform different types of Face lifts designed to meet your specific needs for your unique face.

A Full face lift elevates and firms the entire face and neck, including the lateral brow, the cheek, the jaw line and the neck. A neck lift just tightens the neck and lower jaw. A midface lift or cheek lift tightens the cheeks and nasal labial folds. An upper face lift or brow lift elevates the outside of the eyebrow and the upper face.

A mini face lift is a less extensive full face lift which is appropriate for people who have minimal facial laxity and need only minor facial tightening or tuck. The mini lift is usually appropriate for younger people in their 30’s and 40’s, or those lucky people in their 50’s and up who have very little facial laxity.

A good face lift result requires tightening of both the skin and the deeper facial tissues which also sag with age. I tighten the deep layers of the face; the SMAS face lift, which tightens the deeper muscle like layer of the face. This is necessary to achieve a good result that lasts. Minor lifts that are advertised as being quick, easy and with no down time usually only involve skin removal and they do not last, often only a few months. A well done SMAS lift should last years.

Face lift Vectors

A very important concept in face lifting is the Vector. The vector is the direction of pull required to lift the face to a younger more attractive look. The appropriate face lift vector is unique to your face and the face lift must tighten your face along the appropriate vector if you are going to achieve the result you want.

When you see a person who has had a face lift and has the surprised look, or looks too tight, unnatural or like a “weasel”, it usually means that their surgeon did not tighten the face along the appropriate vector.

I always examine your face, determine the best most natural vector for your face and draw the vectors on your face before I make my lines to mark my planned face lift procedure. This helps to assure a natural looking face lift result.

Scars

No one wants scars on their face and everyone is concerned about face lift scars.

Usually face lift scars are not visible to those around you. 75% of the face lift scars are behind the ear or in the hairline and people do not see them unless they closely inspect you and look for them. Yes your hairdresser will know, but he/she is likely the only one other than your partner.

The 25 % of the scar that is in a visible location is also hidden. This scar is placed into the fold in front of your ear. It is usually not visible and is easily covered by your make up.

Your Ears

In my opinion, the worst sign of a bad face lift by an inexperienced surgeon is the “Spock ear” or “elf ear” deformity. This occurs when the ear lobe is fused to the cheek and pulled down to where it looks like the ear is attached to the angle of the jaw.

I have developed a very specific technique for creating a normal looking ear lobe following a face lift-check my photos; you will not see the “Spock ear”.

Pre OP

The pre operative visit is the time when we will sit down and clearly define your face lift goals. We will discuss what you hope to achieve and what I believe I can achieve with your face lift. I will try to give you an honest image of what you can expect for a result.

You will also undergo a history and physical exam to make certain that you are healthy and have no medication allergies or contraindications to surgery. An EKG (electrocardiogram) may be done if you have a history of heart problems or have reached a certain age. You will also be given prescriptions for post operative medications. You also will be asked to read and sign surgical consent forms which outline the risks, potential complications, limitations and expectations of face lift surgery.

The Operation

A full SMAS face and neck lift usually takes me about 90 minutes to 2 hours. If I am doing eyelid rejuvenation or 4 lid blepharoplasty at the same operation, as is often the case, then the surgery can take 3 hours. Mini lifts, neck lifts and cheek lifts usually take only an hour.

You are asleep during the surgery. I have very experienced superb anesthesiologists who will be taking care of you. Safety is our first concern. We use modern, very safe anesthesiology techniques, and take precautions to avoid nausea after surgery.

Following your surgery you will go to the recovery room where a nurse will take care of you and make sure you are comfortable.

Some patients prefer the comfort of an overnight stay in the hospital. In this case I will examine you the next morning, remove two tiny drains from behind your ear, remove your bandage, and have you shower and comb out your hair, and then discharge you. When you go home a small scarf placed over your head and a pair of sunglasses will usually hide the fact that you have had surgery.

For those of you who want to go home the same day after surgery, you will spend about 2 hours in the recovery room with a nurse taking care of you. As soon as you are comfortable, able to drink and eat a bland food such as crackers or cookies, and able to go to the bathroom, you will be discharged. The nurse will escort you by wheel chair to your car.

We require that someone bring you to the surgery center and take you home, and that you have someone staying with you the first night after your surgery.

Post op- What to expect

My patients do not always complain of pain following a face lift. Your face and neck will feel tight, which means that I have done my job correctly. After a few days the tight sensation will go away as the facial tissues relax. If you have had a blepharoplasty for eyelid rejuvenation you will have ice packs on your eyes to reduce swelling and bruising.

I place a bandage around your face which comes off the next day and you may shower and wash your hair on the first day after surgery. I usually place a tiny drain behind each ear which is removed the first day after surgery.

Bruising on the face is unusual; bruising when it does occur is usually on the neck and upper chest and is usually minimal and easily covered with make up.

Usually after 1 to 2 weeks you will be comfortable being seen in public and will be back to most normal activity. I ask you to wait 3 weeks before heavy weight lifting or aggressive work outs.

I have you take an herbal supplement called Arnica Montana before and after surgery which helps reduce bruising. I also have excellent mineral cover up make up to cover any visible bruising.

Consultation with Dr Seckel

I can tell you a great deal more about face lift and how it would work for you if I see you in person. Call me or contact me by email. If you would like to email me your photos I can email you my thoughts about how I think a Face lift would work for you. For more information on face lift read my blogs on face lift.

I look forward to meeting you.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

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I believe the amazing popularity of face lift procedures marketed under a different name supports my opinion. Many people who do not want a face lift willingly consider a lifestyle lift, mini face lift, week end face lift, face tuck, thread lift, or any other type of face lift which is not called a face lift.

This is understandable considering the significant psychological pressure that one feels when considering elective surgery that one does not have to have done and the well meaning advice of friends and family who say “you don’t need a face lift”. However the end result for many people is that they make a bad decision based on the name of the procedure instead of a carefully thought out plan by an experienced and skilled surgeon.

Each individual face is unique and ages in a very individual way based on their particular anatomy, genetic predisposition and lifestyle. No one procedure works well to properly lift or rejuvenate all faces. The most important factor for a happy face lift outcome is proper diagnosis of your unique facial aging changes and the knowledge and skill of the surgeon you select in achieving the result you desire. Simply stated, if you think you need or want a face lift, find the best surgeon with a good track record and a personality you trust and feel comfortable with and let the surgeon recommend a treatment plan to achieve the result you desire. Do not be mislead by fancy marketing terms that call a face lift some minimalist name that belies what the goal is, restoration of a youthful facial appearance, safely, with a positive impact on your self esteem.

There are however several important basic issues and concepts which everyone who is thinking about a face lift should know and consider when trying to decide if they want to have a face lift. I will discuss them below using the most frequently asked questions I receive from my patients considering face lift surgery.

Will I look natural after a face lift/ I don’t want the “windblown” or unnatural “too tightened” look.

Everyone has seen famous entertainment personalities who have a very unnatural look after a face lift. People who look unnatural after a face lift either have had “bad surgery” or have had multiple face lifts. These are unusual cases and do not represent the usual result after a properly executed face lift on an appropriate candidate done by a skilled experienced plastic surgeon. A properly done face lift by an experienced skilled surgeon should create a beautiful, youthful natural looking face that looks like the face you saw in the mirror 10 or 20 years before. The face should look natural, not “operated on”. The key to a natural looking face following a face lift is proper technique.

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Every face is different, unique, and the direction of pull and tightening must be done in the appropriate direction and with appropriate tension. Before a face lift I analyze and plan the “vectors”, the correct direction of tightening for each segment of the face to recreate the appearance of the face before aging and laxity. When this is done properly a face lift will restore a natural youthful appearance to the face.

How long will I be out of work, what is the recovery time following the face lift?

The quick answer is 2-3 weeks but I have had patients who are back to near normal activity in one week. Do not believe that you can “return to work the next day” after any face lift that provides meaningful facial improvement that lasts-it does not happen in spite of the advertisements that promise this.

The major factor in a happy outcome following a face lift is having realistic expectations of not only the result but also of the post operative recovery. Recovery from a properly done face lift is not terribly difficult for most people who have a skilled surgeon and who have realistic expectations. The worst thing is to have time pressure when you are recovering from surgery. Plan at least 2 weeks when you have no significant responsibilities and can be at rest with the support of a friend or loved one. You will be up and around day 2, able to eat, go to the bathroom, and visit your doctor, but you should not do lifting, housework, or other strenuous activity or have social obligations or work obligations for the first 2 to 3 weeks.

Even though some patients feel recovered after 5-7 days I do not recommend return to normal activity. My worry is that they will exert themselves and “pop a stitch” or otherwise disrupt their healing process.

Will I have pain after my face lift?

Surprisingly my patients do not complain of pain following a face lift. Patients tell me that that their face feels “tight” after a face lift, but they do not feel pain. This is most likely due to the fact that many of the nerves which carry pain sensation are disrupted during the face lift so pain is not perceived; actually the cheeks and the area around the ear are numb after a face lift. Usually the facial sensation or feeling returns after a period of months.

How will I look after my face lift?

The morning after a face lift I remove the dressing and usually a small drain placed to collect any fluid from beneath the skin, and then have my patients take a shower, comb out their hair and the wear a scarf. The face looks tight and patients can see the dramatic improvement in the cheek, jaw line, and neck. There may be some bruising usually in the neck and slight swelling along the cheek and jaw line, but most patients are very pleased with how they look the first day. I have all of my patients sleep with their head elevated so that bruising and swelling can drain down into the neck where the swelling can be removed by the lymph nodes in the neck. As the days progress the bruising moves downward into the neck.

I use a natural herb Arnica which is taken in pill form and in my experience bruising is less using this regimen. Some patients undergo a face lift and have very little bruising and swelling.

Will my friends be able to tell I have had a face lift?

I tell my patients to not tell anyone other than close friends or family that they are having a face-lift. Your friends and casual acquaintances will notice that you look good, refreshed, but after a good face-lift people will not pick up on what is different about you.

No one studies your face as carefully as you do when looking in a mirror. They scan your face in a much less careful manner. To see that you have had a facelift requires careful inspection of the area around your ear and few people get that close to you other than your hair dresser.

Your face lift is your private business and if you do not tell people most of them will not know, will only see that you look rested and fresh. I tell my patients to tell friends they have been on a new diet, working out, or have been on a great vacation-that is all that is usually necessary.

What can go wrong with a face lift?

Complications can occur with any surgery and it is very important that you receive proper informed consent from your doctor before having a face lift. Fortunately complications are unusual following a face lift performed by an experienced board certified plastic surgeon.

The most common complication is that some loose skin beneath the neck or chin is not fully tightened or recurs after a short period of time. Rarely bleeding can occur after a face lift and if drains were not used, the blood has to be removed from beneath the skin. Numbness of the face is common but usually the sensation returns, although in some patients the ear and skin around the ear can be permanently numb after a facelift.

The most serious problem is injury to one of the facial nerves. Statistically this happens in 2% of cases but fortunately the nerve injury is reversible in 75% of cases. This can be a very noticeable and distressing complication but fortunately it is unusual and can usually be avoided by careful face lift technique.

Scarring is usually well hidden and not noticeable, however in some cases the scar, particularly behind or above the ear can be red or widened. Hair loss can also occur especially right above the ear, but usually this is covered well by the surrounding hair.

Fortunately these complications are rare but when they occur it is very difficult for the patient. The most important thing is having a doctor you can trust who is supportive and can help you through your recovery.

Am I a good candidate for a facelift?

The answer to this question depends first on your general state of medical health and secondly on your unique facial anatomy and facial aging characteristics. Generally speaking you should be in good health with no medical problems if you are going to have a face-lift. Uncontrolled high blood pressure, heart or vascular disease, smoking, and any condition that results in poor wound healing such as severe diabetes or immune deficiency diseases are contraindications for a face lift.

The face lift can tighten loose sagging skin on the face and neck, improve jowls, nasal labial fold lines, marionette lines, and sagging cheeks, but the face lift cannot remove wrinkles. People with strong jaw lines and high cheek bones get better face-lift results although lack of these features can be corrected by facial implants. People with dark thick skin generally get better and more long lasting facelift results than those with very fair thin skin with a lot of sun damage.

Equally important is that the patient have reasonable and realistic expectations, a good support system, and appropriate time to recover without time and work pressure after the facelift.

Should I have a non-surgical facelift?

Recently with the many technological advances in non-surgical facial rejuvenation and skin tightening, the concept of a non-surgical facelift has emerged, and more and more people are asking me about the possibility of a non-surgical facelift as opposed to a traditional facelift. There are many procedures which are advertised as a non-surgical facelift, but the most widely mentioned are the various skin tightening procedures using infrared and radiofrequency energy to heat the deep layers of the skin causing the collagen in the skin to shorten and thus tighten the skin. The more popular of these skin tightening technologies are LuxIR, Aluma, ActiveFX Laser, Refirme, Titan and Thermage.

These new skin tightening procedures, which are called the non-surgical facelift, are expensive, averaging about $4000.00, they are new, and while subtle skin tightening is possible with the non-surgical facelift, results are not comparable to those achieved with traditional facelift surgery. Thus it is very important for prospective patients to understand their goals and expectations and have a realistic understanding of what the non-surgical facelift can and cannot achieve.

I have had a lot of experience with the non-surgical facelift and can tell you that the best results with current technology are about a 20-30% tightening of the facial skin with some improvement in skin texture and wrinkling especially around the jaw line. While these results are definitely visible when you review pre and 6 month post treatment photographs, most patients in their 50’s, who have significant skin laxity in the face, jaw line, and neck are disappointed. The cost of the non-surgical facelift or skin tightening procedure is about a third of the cost of a facelift. Although non-surgical facial rejuvenation and skin tightening techniques have improved and are getting better I believe they are more appropriate for younger patients in their 30’s and 40’s who have minimal facial laxity and have younger skin which responds better to skin tightening techniques. In my experience most patients with significant facial skin laxity in their late 40”s and older get a better result and are happier after a facelift done by an experienced skilled plastic surgeon.

The decision to have a facelift is a very personal one. If you are healthy and having a youthful looking face is important to you, and a qualified, experienced, skilled board certified plastic surgeon thinks you are a good candidate, and you can afford a two week recovery time then a facelift is a good option.

If you decide to have a facelift by all means the most important factor is to find an experienced skilled plastic surgeon. Ask friends or relatives who have had a good experience for a recommendation. Ask the surgeon to show you pictures of patients who have had a facelift with the doctor. Ask to speak to prior patients who have had a facelift.

I believe in Result Oriented Plastic Surgery, find a doctor who will listen to your goals and help you achieve them.

If you would like to learn more about facelift, facial rejuvenation, prevention of facial aging, or non-surgical facial rejuvenation read Save Your Face or contact me.

Dr. Seckel,

Boston, Massachusetts

Most people start to worry about facial rejuvenation or a face lift after skin aging changes have already occurred on their face.

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This is only human nature, but as with every other aspect of your health and well being, if you took a preventative approach to your face and facial skin, you would be so much better off. Boston has so many fair skinned people of Northern European extraction, and although our northern climate affords some protection to the face, we still go to the shore in the summer and the mountains in the winter and sun exposure to the face takes its toll.

The skin of all faces begins to show aging changes in the early 30’s and if serious preventative and corrective facial and skin protection and facial rejuvenation techniques for wrinkle removal are started in our 30”s we can prevent further damage.

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Those early signs of aging on the skin of the face are facial wrinkles and fine lines like crow’s feet around the eyes, frown lines, worry lines, and sun spots, brown pigmentation on the cheeks, forehead, and around the eyes. These latter facial aging changes are more noticeable on the left side of the face because as we drive a car, the sun shines through the car window and hits the left side of the skin of the face.

It is never too late to start, but the earlier you start protecting and rejuvenating your face and skin the better. Remember, you are not only helping your face look younger, you are also taking steps to prevent skin cancer, so face protection is a serious health issue, not just a beauty treatment.

Modern technology and medicine have provided us with so many options to save your face that truly revolutionary preventative and non-surgical facial rejuvenation techniques are available for everyone. The field of facial rejuvenation has changed so dramatically in the past few years that I have written a book called Save Your Face which teaches what causes facial aging, how to prevent facial aging, how to recognize the signs of facial aging, and how to correct facial aging non-surgically, with a patented truly revolutionary 6-step non-surgical facial rejuvenation program. If you want to avoid needing plastic surgery when you get older, whether for a facelift or removal of a facial skin cancer, then I encourage you to read the book.

Prevention of an aged face involves several basic steps which any of us can do ourselves without seeing a doctor and without spending a lot of money:

1. Wear Sun Screen-every day-an SPF 30 or higher is best-re-apply every hour when at the beach or in direct sun
2. Avoid smoking and excessive alcohol intake-these two factors cause very serious free radical damage to your skin and are a direct cause of wrinkles on the facial skin
3. Exercise- Moderate exercise stimulates endorphin release and has been shown to prevent aging-include both aerobic and weight training
4. Eat a healthy diet rich in anti-oxidants and low in animal fats-the average American diet causes aging and the free radical load of fatty food directly damages the facial skin and causes wrinkles and facial skin laxity and sagging.
5. Avoid and release emotional stress-it has been proven that stress, by way of the adrenal hormone Cortisol release, accelerates aging of the whole body but also specifically the destroys the collagen in the dermis of your skin, damage that causes wrinkles and sagging facial skin. Yoga, meditation, whatever it takes, get your stress level down

None of the above is expensive and all are something you can do yourself. Remember, you want to stay healthy, young looking and feeling, and you want to avoid plastic surgery on your face.

Even if you already have facial aging changes like wrinkles, fine lines, brown spots, loose skin, jowls, marionette lines, nasal labial folds, loose neck skin, or other aging signs on the face, it is not too late to start. There are many truly revolutionary non-surgical facial rejuvenation methods available today that can reverse those facial aging changes and give you a new start without the need for costly plastic surgery. They are all outlined in my book Save Your Face and are part of the 6-step facial rejuvenation program. The 6 essential non-surgical facial rejuvenation program steps are:

1. Exfoliation of the facial skin- This is deep cleansing of the skin to remove dead facial skin cells and stimulate shiny new fresh facial skin and wrinkle removal. There are many non-surgical methods available including topical creams like RetinA and Vitamin C, microdermabrasion, dermasound, skin peels with Glycolic Acid, and more aggressive laser peels like microlaser peel and the ActiveFX laser peel.
2. Stimulation of new collagen production in the facial skin- loss of the collagen in your skin is what makes the face look old. The collagen is damaged by the UV radiation of the sun and the free radicals released by an unhealthy diet and smoking and too much alcohol. Think of your skin like a fresh plump plum. Put a plum in the sun for too long, the water evaporates and you have a wrinkled prune. Sun damages your facial skin and causes the collagen to be removed, your face skin loses volume and wrinkles are formed. Non-surgical facial rejuvenation requires plumping the face skin with new collagen for effective wrinkle removal. There are many non-surgical ways to stimulate new collagen formation. Topicals like Retin A help as do all forms of exfoliation. IPL or Photo facial, new Laser treatments such as Lux1540 and Fraxel are all very beneficial.
3. Remove Pigment and Vessels on the face- Bleaching creams, Obagi Skin Care products, microdermabrasion, IPL or Photo facial treatments can be very useful.
4. Relax Muscles of Facial Expression-Botox removes wrinkles such as crow’s feet, worry lines, frown lines, and can be used on lip wrinkles and even be used to help the folds under the chin or neck. Hopefully we will soon have a cream that works like Botox
5. Camouflage deep facial lines-fillers like restylane, radiesse, juvaderm, sculptra, cosmoderm, cosmoplast and other can help hide the nasal labial fold lines and marionette lines.
6. Tighten facial skin- New technology such as LuxIR, Titan, Aluma, Refirme, and Thermage can be used for non-surgical facial skin tightening, but they are not a non-surgical facelift. This technology is improving every day. many of these treatments not only tighten facial skin but have wrinkle removal effects as well.

As you can see there are many ways to promote your health and prevent or reverse aging changes to your face and most are non-surgical facial rejuvenation techniques that do not require plastic surgery. The key of course, as it is with all other aspects of your health is to start early, protect yourself and live a healthy lifestyle. For buffing away those facial aging changes you have already there is my 6-step non-surgical facial rejuvenation program. I have given it to you in a summary form above so you don’t even need to buy my book. However if you want to really understand how to prevent and reverse aging of the face read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

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Traditionally a facelift is done to correct these facial aging changes, however in the past few years the concept of a non-surgical facelift has evolved prompting many who would never consider facelift surgery to inquire about the possibility of non-surgical facial rejuvenation and skin tightening.

While many people undergo plastic surgery to correct eyelid aging with a procedure called a blepharoplasty,

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the third most common plastic surgery procedure in the United states, most are reluctant to consider a facelift to correct facial aging changes. Nearly every person I see who is concerned about facial aging tells me they want to look younger but “do not want a facelift”. Many people are willing to have surgery but only if the procedure is called something else, such as a mini lift, tuck, week end lift, or anything other than a facelift.

Recently with the many technological advances in non-surgical facial rejuvenation and skin tightening, the concept of a non-surgical facelift has emerged, and more and more people are asking me about the possibility of a non-surgical facelift as opposed to a traditional facelift. There are many procedures which are advertised as a non-surgical facelift, but the most widely mentioned are the various skin tightening procedures using infrared and radiofrequency energy to heat the deep layers of the skin causing the collagen in the skin to shorten and thus tighten th skin. The more popular of these technologies are LuxIR, Aluma, Refirme, Titan and Thermage.

These new skin tightening procedures, which are called the non-surgical facelift, are expensive, averaging about $4000.00, they are new, and while subtle skin tightening is possible with the non-surgical facelift, results are not comparable to those achieved with traditional facelift surgery. Thus it is very important for prospective patients to understand their goals and expectations and have a realistic understanding of what the non-surgical facelift can and cannot achieve.

I have had a lot of experience with the non-surgical facelift and can tell you that the best results with current technology are about a 20-30% tightening of the facial skin with some improvement in skin texture and wrinkling especially around the jaw line. While these results are definitely visible when you review pre and 6 month post treatment photographs, most patients in their 50’s, who have significant skin laxity in the face, jaw line, and neck are disappointed. The cost of the non-surgical facelift or skin tightening procedure is about a third of the cost of a facelift.

I repeatedly advise that the most important factor in deciding to have a facelift or non-surgical facelift or any other facial rejuvenation procedure is your rapport with and the skill and experience of your plastic surgeon. The various names that are marketed on the web, mini facelift, min-tuck, lifestyle lift, and others are names used to market individual variations in the face lifting technique. The most important factor behind that name is the skill and experience of the doctor who will be performing your surgery or non-surgical procedure. A facelift is a surgical procedures and the success of a surgical procedure is dependant on your particular anatomy, medical condition, and skin type and on the skill and experience of the doctor.

My quick answer to the question “should I have a facelift or a non-surgical facelift?” is to pick your doctor first and let him/her pick the procedure that is most likely to achieve the result you want. The facelift is a very complex procedure which requires skill and experience to perform and no internet description or marketing term can compensate for that basic fact.

Having said that there are general guidelines that can be helpful to consider when you are considering any facial rejuvenation procedure such as a facelift or non-surgical facelift. Almost everyone who has seen their facial skin sag on the cheek, jaw line, and neck has looked into a mirror, placed their hands on their face and pulled the skin up. I do this frequently and I always look better and younger when I pull the skin of my face up. This is what a facelift does, it pulls the facial and neck skin back to a firmer more youthful appearance. Skin tightening, the non-surgical facelift simply cannot tighten the skin to the same degree, at least at this stage of development.
It is crucially important however that the facelift tighten the facial skin in a natural direction and to a natural appearing degree of firmness and tightness. There is a perfect appropriate direction and degree of tightness for every individual face, I call this the vector and I determine the appropriate vector for each individual face when I make my markings for a facelift just before surgery. If this is done incorrectly the result of the face-lift will be unnatural and the patient will be unhappy and look “operated on”. It is very unusual for the face to be tightend too much during a “first facelift”, but the too tight face look is common when a second facelift is done, especially by an inexperienced or less skilled surgeon. Determining the appropriate vector and degree of pull in the various facial areas requires skill, aesthetic judgement and experience-there is no substitute. Thus again, the skill and experience of your surgeon is the most important determinant of a satisfactory outcome following a facelift.

The second important component, in my opinion, is the technical detail of the facelift operation. The skin covering the face and neck is all attached to the same musculofascial structure called the SMAS which stands for Superficial Musculo Aponeurotic System and after 30 years of research and study most, but not all, experts agree that tightening the SMAS layer as well as the facial skin during a facelift produces a better, more lasting, and safer facelift result. In my opinion the SMAS should be tightened during a facelift, and any mini facelift which only tightens the skin and ignores the SMAS will not last as long as a standard SMAS facelift. Furthermore, since the facial skin moves and sags as a unit, that is brow, cheek, jaw and neck all sag together, doing a mini lift on one area such as the cheek will not produce the same harmonious facial tightening that a standard facelift will produce. Since in my experience most people who decide to have a mini or other lift instead of a standard facelift do so to save money, I think it is true that “you get what you pay for”. A standard SMAS facelift takes time and skill; taking short cuts gives sub standard results. That is why I say pick an expert surgeon you feel you can trust and follow his or her advice.

The next important factor in determining the outcome of a facelift is your facial skin type. Patients with very fair, thin skin that never tan and always burn and who have blue eyes and blonde or red hair can have an excellent facelift result, but generally the facial tightening does not last as long as other skin types. Patients with this skin type, which we call Fitzpatrick Type 1 skin, age earlier and more severely than people with darker skin. In addition thinner skin has less elastic tissue and is less resistant to sagging. Consequently aging will continue after the facelift and the result will not last as long. Tightening of the skin and wrinkle removal can be enhanced in these patients by laser procedures which increase the collagen in the skin after a facelift has been done, and improve the results of the facial rejuvenation achieved by the facelift.

Conversely, patients with darker thicker skin age less rapidly and have more skin elasticity, thus a facelift in a darker skinned person who always tans will last longer, often a satisfactory appearance of 10 to 15 years.

Another important consideration when contemplating a facelift is your general state of health. A facelift is a surgical operation, and surgery is safest in people who are in good general health. High blood pressure can cause bleeding and should always be under very good control before considering a facelift. Severe diabetes or anything that impairs wound healing poses a serious risk during and after a facelift. Patients who smoke cannot have a facelift unless they have been free of nicotine in any form for at least 8 weeks. I have seen patients who have not smoked in 20 years still have slow wound healing after a facelift.

You will need help and support after a facelift. Although many people can have a facelift as day surgery someone must drive you home and stay with you at least the first night. You will need help negotiating stairs, getting to the bathroom etc. Don’t believe what you read about returning to work the next day. Even after having a facelift with local anesthesia you are not going to be able to work the next day. I tell my patients to plan to take at least 2 weeks off of work after a face lift. You will be up and around with make up after 4 to 5 days, but you are not going to feel like a full day’s work and you are not going to want your fellow employees to see you. Generally I take some stitches out at day 5 or 6 and the remainder, those in the hair out at day 12-14.

Surprisingly most of my patients who have had a facelift do not complain of pain. They tell me the face feels tight but not painful. I believe this is because when the facial skin is lifted it is removed from the underlying nerves, and in fact the cheek is often numb for several months after a facelift.

You see a youthful face right away after surgery! I always ask my patients to look into a mirror when I see them the morning after a face lift. You can always see the results immediately, the nice tight neck and jaw line and full cheek. There is swelling and slight bruising but bruising usually does not show up for a day or two and then mostly in the neck. I also have my patients shower and wash out their hair the next morning so they can put on a scarf and dark glasses and draw less attention as they go home. Most patients have a small drain placed under the skin which I remove the next morning. Men, because they have more blood vessels in the face because of their heavy beard, are more likely to bleed, thus I leave their drains in longer.

Scarring is usually not a problem with a properly executed facelift. Only 20 % of the scar is visible, as 80% is hidden behind the ear and in the hair. The visible portion is placed in a crease immediately in front of the ear and is not visible to most people. A person would have to look closely at your ear to see it.

The decision to have a facelift is a very personal one. If you are healthy and having a youthful looking face is important to you, and a qualified, experienced, skilled board certified plastic surgeon thinks you are a good candidate, and you can afford a two week recovery time then a facelift is a good option.

If you decide to have a facelift by all means the most important factor is to find an experienced skilled plastic surgeon. Ask friends or relatives who have had a good experience for a recommendation. Ask the surgeon to show you pictures of patients who have had a facelift with the doctor. Ask to speak to prior patients who have had a facelift.

Although non-surgical facial rejuvenation and skin tightening techniques have improved and are getting better I believe they are more appropriate for younger patients in their 30’s and 40’s who have minimal facial laxity and have younger skin which responds better to skin tightening techniques. In my experience most patients in their late 40”s and older get a better result and are happier after a facelift done by an experienced skilled plastic surgeon. To learn more or ask a question, contact me.

Dr. Seckel

Boston, Massachusetts

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but no one wants to have a face lift or plastic surgery; everyone is looking for the non-surgical face lift.

In recent years technological advances such as Botox, and fillers like Restylane and Radiesse, and new Lasers, IPL and skin tightening machines like Thermage®, Titan®, LuxIR®, and Aluma®, have improved the plastic surgeons ability to rejuvenate the face non-surgically, but none have been able to deliver the often promised non-surgical facelift. Improvement in jowls, neck laxity, nasal labial folds and marionette lines have all required a surgical face lift. The best results of non-surgical skin tightening, the so called non-surgical facelift have achieved about a 30 % tightening of the facial skin. Dramatic results have been achieved in wrinkle removal when proper techniques have been applied, but true lifting or tightening of the facial skin, the non-surgical face lift has been modest at best

The new LaserLyte Lift™ is a laser face lift and a photo face lift and promises to achieve a much more significant rejuvenation and lifting of the face with a new non-surgical multi-modality technique three phase procedure which not only tightens the facial skin but also removes wrinkles and other aging changes on the surface of the skin—all achieved non-surgically with minimal or no down time, a true non-surgical face lift.

This new non-surgical high tech face lift or facial rejuvenation procedure is based on the theory that all of the skin layers must be treated and rejuvenated to accomplish true facial rejuvenation and is based on the principles of the 6-step non-surgical facial rejuvenation program outlined in my book Save Your Face.

The important changes in the facial skin which lead to an aged appearance occur predominantly in 3 layers-the epidermis or outer layer that you see in the mirror, and two deeper layers-the superficial and the deep dermis—the pink part of your skin you see when you scrape your knee.

As we age, the sun’s UV rays, and other age related factors damage all 3 layers of the skin. We see these changes in the form of wrinkles, brown spots and dry skin-changes in the Epidermis or outer layer. However the major changes causing wrinkles and sagging skin is damage to the 2 deeper layers of the dermis.

The result of aging changes in both layers of the dermis is the loss of collagen. Collagen plumps the skin and gives the skin its tone and elasticity. When we lose collagen from the dermis the skin loses volume and becomes wrinkled-the same way a plum turns into a prune when it loses water after drying. In addition when we lose collagen we lose elasticity, the skin does not snap back when we pull on it and release it, and the skin sags.

The key to non-surgical facial rejuvenation or a non-surgical facelift is to remove the superficial aging changes from the superficial epidermis and restore new collagen and thus volume and elasticity to both the superficial and deep layers of the dermis

Contemporary non-surgical methods such as laser, IPL or Photo Facial, Radiofrequency (Aluma®, Thermage®), and Infrared (LuxIR®, Titan®,) energies are capable of treating the surface of the skin and the deep dermis, but do not treat the middle layer of the dermis and thus cannot achieve complete non-surgical rejuvenation or a non-surgical face-lift.

New technology has finally enabled us to treat both the middle and deep skin layers to plump and tighten the sagging facial skin. Thus we are now able to treat all three skin layers affected by aging, removing surface irregularities such as wrinkles, brown spots, and dry skin, and restoring collagen and thus plumping volume and elasticity to the middle and deep skin layers.

Thus we can achieve a true non-surgical facial rejuvenation or non-surgical face lift for the first time addressing all three layers of the aged skin.

This procedure is called the Laserlyte Lift™ because Laser and other forms of light (lyte) energy are used to treat the three skin layers. The procedure takes time, as it requires multiple treatments scheduled several weeks apart over a time course of several months. However the results are striking-you can see them and believe them—you don’t have to try to convince yourself that they are there as you have with so many “miracle wrinkle cures” you have tried in the past.

The Laserlyte Lift™ the true laser face lift or non-surgical face lift involves three treatment protocols or phases.

Phase I begins with the important first 2 steps of the 6-step non-surgical facial rejuvenation program deep exfoliation and stimulation of new collagen growth near the surface of the skin. This phase removes wrinkles, brown spots and restores the skins shiny glow. This is the Laserlyte peel achieved with the Lux2940 ablative fractional laser. This peel is performed with a topical skin anesthetic, takes 25 minutes, and leaves you pink for 4-5 days. Some people only need one peel others may need 2 or 3. These peels are scheduled 6-8 weeks apart

Phase 2 begins about 6 weeks after your first ablative laser peel and is the start of your skin plumping and skin tightening regimen through stimulation of new collagen growth in the middle and deep dermal layer by the application of laser and Infrared or other energy which penetrates through the epidermis and superficial dermis to the mid and deep dermis, to restore collagen and elasticity and tighten the facial skin. I use the Lux1540 and  LuxIR Skin Tightening Technology by Palomar. Treatments are spaced 4 weeks apart and at least 4 sessions are required.

The start of Phase III, deep sub dermal skin and fat tightening provides significant firming and lifting of the facial skin. The new Palomar Aspire sub dermal laser stimulation provides powerful tightening of the of the deep dermal and sub dermal layers. This maneuver also tightens and lessens the fat beneath the skin which adds to the aged facial appearance. If you only need one peel Phase 3 can begin as early as 2-3 months and be alternated with Phase 2 at 2-week intervals. If you need 3 LaserLyte Peels then Phase 3 will not begin until 5-6 months.

While the Laserlyte Lift™ , the laser face lift or true non-surgical face lift, takes time it is the only method of non-surgical facial rejuvenation to actively treat all three layers of the skin and thus the only method to achieve an effective non-surgical facelift. In fact, the Laserlyte Lift™ achieves more thorough facial rejuvenation than a surgical facelift. A surgical facelift only tightens the skin, after a facelift you have tight “old” skin. The Laserlyte Lift™ renews and rejuvenates all three skin layers, thus when you are finished your face truly looks younger as well as tighter, a true facial rejuvenation and a real non-surgical facelift, and remember, you are avoiding surgery and its dangers and discomfort. More importantly you are achieving true facial rejuvenation with wrinkle removal and new collagen, which plumps and tightens your skin to a truly youthful appearance.

As technology advances we undoubtedly will be able to achieve results is less time. However at present the Laserlyte Lift is the only method for an effective non-surgical facelift and rejuvenation of all three skin layers and it takes

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More importantly, with early intervention and new facial anti-aging techniques most people can prevent skin aging and facial aging and maintain a youthful skin and facial appearance and avoid looking older.

However, the shear number of new, heavily marketed facial skin rejuvenation techniques and the often-complex methodologies involved can be very confusing for the lay reader and physicians alike. To better understand the new facial rejuvenation treatments it is very helpful to first understand facial skin aging changes and then review how these changers can be reversed and the skin rejuvenated.

Facial Skin aging – Is that my mother I see looking back at me in the mirror?

The earliest skin aging changes most of us notice on our face, are fine lines and wrinkles around the eyes often referred to as crow’s feet and later deep furrows on our forehead called the frown lines and worry lines. These changes occur for most of us in our 30’s. We also begin to see brown spots and red spots or small blood vessels on our face and around the nostrils of our noses. Later the skin becomes dryer and loses the fresh glowing appearance of our youth. These superficial or surface changes are called type 1 skin aging or facial aging changes and are caused by sun damage and free radical damage from other inflammatory agents in our diet and environment and our heredity.

Later, in our late 40’s and 50’s we begin to see sagging facial skin. Usually the first sign is loose skin beneath our chin on the neck often called the turkey wattle. Later we see loose folds beginning along the jaw-line, often called jowls. As the skin sags we begin to see deep lines on either side of the mouth, called the nasal-labial fold lines and marionette lines. Aged skin also can begin to droop over the eyes and the eyebrows can begin to fall. These later skin-aging changes are called type 2 facial aging changes and are caused by the loss of skin elasticity. Sun damage, inflammation from free radicals released by our diet, and our heredity are the basic causes.

6-Step Facial Skin Rejuvenation – Help is on the way

Today we do not have to stand by and helplessly watch our skin age. With sun block, a healthy diet and lifestyle and new facial skin rejuvenation technology we can prevent or correct most skin aging changes. But first let’s understand what is meant by the term “skin rejuvenation.

To rejuvenate means to “make young or youthful again or restore to an original state”. To me this means correcting or removing not only wrinkles, but also the brown spots, red spots and dry skin, but also tightening sagging skin that is all of the facial aging changes, not just one or two. Wrinkle removal is only part of the process.

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True facial skin rejuvenation is possible with today’s new technology, but skin rejuvenation must be performed in a logical, comprehensive, step-by-step process that addresses all of the major skin aging changes. Most skin rejuvenation treatments offered today only address one or two changes and as a result are ineffective. A laser can remove brown spots and blood vessels, but the skin is left with wrinkles and sagging skin. A face-lift can tighten the facial skin but leaves you with a tight old looking face.

For effective modern skin rejuvenation I offer my patients a 6-step facial rejuvenation program® which addresses each of the facial aging changes described above. The result is true facial skin rejuvenation that makes the face truly look young or youthful again. The 6 steps to non-surgical facial rejuvenation are:

Exfoliation – removes dead dry skin cells and superficial pigment restoring a youthful glow to the skin and helping removewrinkles.

Stimulation of new collagen production – New collagen must be restored to replace the collagen damaged by sun and aging. New collagen plumps the skin, helps remove wrinkles and firms the skin

Removal of pigment and blood vessels - This step removes the brown spots and red spots or blood vessels from the facial skin

Relax muscles of facial expression – Frown lines, worry lines, and crow’s feet are caused by the pull of some of the facial muscles. When these muscles are relaxed, the lines disappear and wrinkles are removed.

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Fill deep facial lines – The deep nasal-labial fold and marionette lines are plumped up to make them less noticeable. These are deep lines, not wrinkles.

Tighten facial skin – The facial skin is tightened to improve the jowls, sagging brow and neck skin. Skin tightening also helps with wrinkle removal.

This 6-step facial rejuvenation program® is a comprehensive, scientific medically proven method for true facial skin rejuvenation, wrinkle removal and skin tightening.This is modern non-surgical method for effective true facial skin rejuvenation. The details of the program are carefully outlined in Chapter 5 of my book Save Your Face. For further information contact me.

Dr Seckel

Boston, Massachusetts

Facelift-Contact Dr Seckel

While Plastic Surgery is truly a much more comprehensive field including reconstructive surgery following burns, cancer surgery, and birth defects, the image most often projected in the media is that of image or beauty enhancement and non-surgical and surgical facial rejuvenation of otherwise normal people by surgery.

Blepharoplasty-Contact Dr Seckel

Revolutionary technological advancements in the past decade have significantly impacted the field of Plastic Surgery creating a shift from traditional surgical procedures to new non-surgical methods for correcting aging changes and improving appearance.

Laser Resurfacing-Contact Dr Seckel

Today Botox® injections can remove crow’s feet, frown lines, worry lines, and help lift the sagging brow. Prior to Botox® major facial surgery such as a brow lift and blepharoplasty (eyelid lift) were performed to correct these aging changes.

Botox-Contact Dr Seckel

New fillers such as Restylane® and Radiesse® are injected into the nasal-labial fold, lips, and marionette lines, those deep lines running from the lips down around the mouth and chin. Previously, a face lift was performed to correct these lines.

Fillers-Contact Dr Seckel

Skin tightening technology such as aluma, ActiveFX, LuxIR, Titan® and Thermage® are becoming better and can improve facial sagging in 30% patients if used early before the sagging is severe. Many patients choose to have one of these techniques rather than a face-lift. Many other new exciting techniques for laser restoration of skin collagen (Laser Genesis®) and improvement in skin wrinkling, removal of pigment, and removal of red spots and blood vessels on the face are already in use today.

These dramatic advances coupled with increasing public awareness of the importance of sun protection, a healthy anti-inflammatory diet, exercise, stress reduction, and a healthy lifestyle undoubtedly will impact the Plastic Surgery practice of the future. The Plastic Surgeon of the future will still have to be a highly skilled, knowledgeable surgeon, but I predict he/she will need to be an expert in the newer laser, light, pharmacological, and lifestyle therapies as well.

Plastic Surgery is becoming more non-surgical with every new technological advancement. The 6-step facial rejuvenation program encompases all the new non-surgical facial rejuvenation techniques. For questions read Save Your Face, or contact me.

Dr Seckel

I use this exciting new technology to treat fine lines, sun damage, brown spots, blotchy pigment, uneven skin tone, and acne scarring with excellent results.

Unlike so many widely advertised non-ablative, photofacial laser and IPL treatments that require 5-7 months to see a result, the results of the MicroLaserPeel are evident immediately. Better, the beneficial effects of the MicroLaserPeel, new collagen formation, and softer more uniform younger looking healthy skin continue for months after the treatment.

MicroLaserPeel removes the outer dead skin cells from the face and stimulates the deeper skin layers to from new healthy young skin cells and new collagen in the deeper skin layers. The result is fresher looking, glowing new skin with fewer fine wrinkles and fewer brown spots and pigment irregularities.

The first step in any skin rejuvenation program is exfoliation, the removal of the dead skin cells covering the outer surface of the facial skin. None of the many non-ablative laser and IPL therapies offered today provides this important first step. Only the MicroLasaerPeel using the Erbium laser provides this important basic first step facial rejuvenation process, in a uniform manner, with minimal down time.

The MicroLaserPeel is the perfect minimal down time alternative to the “gold standard” laser resurfacing for facial rejuvenation.

Contact my office via e-mail, or call 978-369-4499 for more information on any of the above procedures, or read Save Your Face.

Dr Seckel

Boston, Massachusetts