Yes, there are certainly options for patients that are not healthy enough to undergo general anesthesia specifically regarding their lower face. Standard facelifts or certainly extended SMAS deep place facelifts are typically performed in the operating room setting under either deep sedation or general anesthesia. Options for patients that are not healthy enough to undergo these types of anesthetic care would be mini facelifts, which can be performed under local anesthesia in the office and I have certainly performed these on patients that are not qualified for procedures performed in an operating room setting. Though this treatment is compromised compared to the more sophisticated and technically demanding extended SMAS deep plane facelift, they nonetheless get a very significant improvement in the lower third of their face and these patients are quite satisfied with the results of this type of surgery. A more advanced and newer technology that is available now for patient that are showing the early signs of aging would be Ultherapy, which is an ultrasound device that can target the deeper layers of the skin and this ultrasound energy is then focused on the deeper layers thus heating up the collagen and causing new collagen deposition, which in turn results in tightening of the deeper tissue and lifting of the facial structures. This can be performed in the area around the eyes to cause a nonsurgical brow lift. This can also be used to treat the midface, jowl, and the area under the chin to create the lift of a miniature facelift. There is no need for any anesthetic and there is absolutely no downtime as this is performed in a medical spa setting and the patient’s own healing creates the lift over a three-month period. This would be an excellent alternative for any patient with early aging that is not a good candidate for a standard facelift.
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Yes, mini facelifts definitely cost less than your standard facelift for several reasons. One reason is that mini facelifts are typically performed in an office setting under local anesthesia and therefore there is no need for the cost of a surgical center, hospital, or anesthesia provider. Secondly, a mini facelift is exactly what it sounds like, which is a miniature version of a standard facelift and as such typically takes much less time, is less technically difficult, and is not nearly as sophisticated as some of the more advanced techniques that I personally can perform in an operative setting. As such, the cost of a mini facelift is approximately half of what I charge for a facelift in the operating room. With that said, I personally feel that the more advanced techniques that I perform in the operating room, specifically the extended SMAS deep place facelift with platysmaplasty not only create a more rejuvenated look, but also last much longer than a mini facelift and as such, overall, is a much better value than a mini facelift. With that said, many patients find it advantageous to undergo a mini facelift due to its lower cost and the fact that they have slightly less downtime and do not have to undergo any sort of anesthesia in an operating room setting and certainly for patients with early signs of aging, I think this is a perfectly appropriate option for them and I personally perform mini facelifts on a very regular basis.
Yes, a mini facelift at age 41 would be perfectly appropriate assuming that you have the early signs of aging including early jowling and early submental laxity, which is excess skin under the chin. I have performed many minilifts in patients under the age of 40 simply due to the fact that they have early signs of aging including these early jowls and the laxity under the chin and this procedure is excellent in patients in that age group. In fact, patients with early signs of aging are really the best candidates for treatment with a mini facelift as this procedure really does an excellent job in rejuvenating the lower third of the face and I personally feel that the patients in an older age group or with more significant signs of aging are best treated with a more sophisticated extended SMAS deep place facelift, which will restore not only the jowling and laxity under the chin, but also lift the midface and improve the smile lines as well. The bottom line is that I recommend that patients undergo rejuvenation at the earliest signs of facial aging mainly due to the fact that the rejuvenation is more effective, it involves less downtime and less risk, and overall they will have a longer period of time where they can enjoy their rejuvenated appearance.
In experienced hands, jowl liposuction has very little risk; however, in inexperienced hands, jowl liposuction can cause irregularities or depressions that would be extremely difficult to correct. When performing jowl liposuction, one has to be very judicious regarding the amount of fat that is removed and one has to feather the fat removal along the edges of the proposed fullness to prevent any sort of a visual depression. There is very little risk to any sort of injury to major blood vessels or nerves as long as the liposuction is performed in the appropriate level, which is just below the skin. I find that many patients that feel they are a good candidate for jowl liposuction really are not as the majority of the jowl is not due to subcutaneous fat, but due to laxity of the midfacial structures over time. These patients obviously would benefit from a more surgical approach such as a minilift or extended SMAS deep plane facelift for adequate correction of this concern.