Norman Leaf MD FACS

Sep 04 2015

Why is “Facelift” a Dirty Word?

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Why is “Facelift” a Dirty Word?

In my practice I do a lot of facelifts, and I truly enjoy helping to reverse the stigmata of aging, smoothing sagging jowls, removing double chins, and lifting self-esteems and improving selfies. But it is an odd fact that most of my patients don’t like to think of having had a facelift. They prefer to call it a Neck Lift, a Mini Lift, a Tuck, a Cheek Lift…anything to avoid mentioning facelift. It’s like my grandparents who would whisper the word cancer rather than saying it out loud. Not for polite conversation.

I see this time and again with patients who are consulting with me for...well…

face work. In giving me their past history, they often say something like “I had my neck done 10 years ago” or, “I had a mini-lift in ’95.” Maybe 20% will say outright that they had a prior facelift. Of course, when I examine them, I see clearly the scars of a facelift. I know where to look. The scars may be well-crafted, very fine and hard to detect, or they may be plainly obvious and not very pretty, usually depending on the skill of their surgeon.

When I make my suggestions for what I would recommend, I have found that there is commonly a pushback when I suggest a facelift per se. I have learned to phrase my ideas more carefully. If the neck is the major concern, which is quite common, I suggest that we tighten the neck, and also bring up the lower cheek area just enough to match the neck. In truth , it’s hard to do a really good necklift without tightening the deep structures and the skin of the cheek area. By the way, that operation is called a facelift. I could use the term rhytidectomy, which translated means resection of wrinkled skin. But that’s just obfuscating the reality, and most patients don’t like such big Latin terms.

I generally prefer to be direct, and say what I mean. But to temper the blow, I may call it a lower facelift, meaning nothing on the forehead or brow. Trouble is, it’s often a great idea to do browlifting at the same time, and perhaps the eyelids as well. And then there’s the possibility of fat grafting to fill in the hollow areas of the cheeks or marionette lines. And let’s not forget about the laser…this is often necessary to smooth the very fine lines, especially around the mouth. And so it grows…

Eventually, most patients understand what I’m driving at, and usually will accept it. But I know, two to three weeks after surgery, when they’re out amongst their friends, if anyone mentions that they look really good, and ask what they did, most will say “Oh, I had a little necklift.”

The 28th Amendment to the United States Constitution: Congress shall make no law prohibiting any citizen from prevaricating, fibbing, or just plain lying about their plastic surgery.


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