Dr. Niamtu’s Weblog

….on cosmetic facial surgery

Do I Need a Full Facelift?

I can’t tell you how many times that I (and every cosmetic surgeon) hear that question.  I think that the word “facelift” has more meanings to people than any other word in cosmetic surgery.  People ask about a “full facelift”, “half facelift”, “neck lift” and so on.  This can be very confusing to patients and some may forego treatment because of preconceived notions that are not true.

A “facelift” by definition is a procedure called rhytidectomy.  A rhytid is a wrinkle and “ectomy” means to surgically remove, so technically it refers to a surgical procedure with incisions removes skin to tighten wrinkles.  A traditional facelift includes hidden incisions in front of and behind the ear.  The skin is then separated from the underlying tissues and the deep layers are tightened.  Then the skin is pulled in a natural direction and the excess is removed.  Traditionally, the platysma (muscles in the central neck) are also tightened.

A traditional facelift does very little (or nothing) for the central oval of the face (brow, central forehead, eyes, nose and mouth).  It also does very little, if anything for tissues above the nostrils.  So, a “facelift” is more for the jowls and neck, in fact, all about the jowls and neck. Now you know what a facelift really is!

The “wrinkle” in this description (yes, pun intended) is that not all surgeons do the same surgery the same way.  Some surgeons omit the platysma procedure.  Personally I think that is short changing the patient, although very young patients may not need a platysmaplasty.  Also, some surgeons “invent” shortcut facelift procedures where they omit the incision behind the ear.  I am always leery about someone who takes a procedure that is 100 years old and puts his or her name on it, or even worse, a corporate name.  Again, facelift surgery has been around for a century and all the tricks have been attempted and abandoned because a short cut in surgery almost always translates to a short cut in result and longevity.  Some surgeons try to avoid several inches of incision behind the ear and end up doing a procedure that will begin to relapse in several years.  These types of shortcuts always claim easy surgery with fast recovery.  Remember, in cosmetic surgery, you always get what you pay for….not in terms of money, but in terms of recovery.  The cosmetic consumer should always be cautious about any surgery that deviates significantly from the standard of care in technique.  Just because something is new, does not make it better.  Obviously, we do make advancements in materials and techniques, but if and when that happens, it becomes widely adapted and the norm.  Any patient that is looking at a “new” or “miracle” procedure should ask the surgeon to see 20 pictures of patients that had this procedure by same surgeon and the pictures should be 1-2 years after the procedure.  If a surgeon can’t show you that (for any procedure) you better think closely about getting surgery that is different from the way most surgeons do it.  Cosmetic surgery patients often get the short end of the stick from hype delivered by companies, media and surgeons.  If it sounds too good to be true, it is!  If someone invents a new and radical improved facelift procedure, it won’t be in TV ads, it will be front page news.

So, back to the“facelift” definition.  Much of the confusion about the definition of the word comes from a patient’s experience.  A patient may have “rhytidectomy” but also have a brow lift, eyelid surgery, cheek implants, chin implant, laser skin resurfacing, etc.  So when this patient tells someone they had a “facelift” the listener may assume that a facelift includes all that additional surgery.  They would be wrong!  Rremember, a facelift primarily addresses the jowls and neck.  The patient merely had other procedures along with their facelift.  When you get your engine tuned up, it may include a wheel alignment at the same time, but technically, an wheel alignment is not part of a tune up.

The best way to keep this all simple is to divide the face into 4 segments:

  • Upper face
  • Midface
  • Lower face and neck
  • Face and neck skin

Each of these regions concerns separate cosmetic procedures to address the aging in that area and the facelift concerns the third item on the list.  Also facelifts come in three sizes; small, medium and large.  It is basically the same procedure in different versions.  Patients in their early 40’s may need a small lift, while patients with more aging need bigger versions of the same operation.

To find out more about cosmetic facial surgery by Dr. Joe Niamtu, III in Richmond, Virginia visit www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

http://www.lovethatface.com

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February 27, 2012 Posted by | Cosmetic Facial Surgery Consultation, Cosmetic Surgery Education, Facelift Surgery | , , , , , | Leave a comment

Niamtu Cosmetic Facial Surgery Course recieves 17.5 AMA PRA Category 1 Credits™

Dr. Niamtu has been training surgeons from multiple specialties with live observational cosmetic facial surgery courses since 2004.  Hundreds of surgeons from the USA and all over the world have come to Richmond, Virginia several times a year for this course.  We are honored to have been accredited through St. Louis University School of Medicine for continuing medical education credits.  This is an honor for our course and now eligible attendees can officially obtain CME credits.  This is truly a milestone for our course and underlines our committment to provide cosmetic facial surgery education to teach contemporary cosmetic facial surgical procedures to enhance patient safety and predictable outcomes.  For more information visit www.cosmeticsurgeryeducation.com

ACCREDITATION:  Saint Louis University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. AMERICAN MEDICAL ASSOCIATION: Saint Louis University School of Medicine designates this live activity for a maximum of 17.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

To find out more about cosmetic facial surgery in Richmond, Virginia by Dr. Joe Niamtu, III visit www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

http://www.lovethatface.com

February 22, 2012 Posted by | Academic Cosmetic Surgery, Cosmetic Surgery Education | , , , , , , | 1 Comment

Dr. Niamtu on NBC 12 discussing gauged earlobe repair

Click above to view video

I have written a blog on repair of gauged earlobes in the past ( https://niamtu.wordpress.com/category/earlobe-repair/) and was recently involved in a news story on NBC 12.  Anchor Curt Autry discusses the societal impact of earlobe expansion and interviews two female patients on what let them to expand their earlobes and why they had them surgically corrected.  The story provides good insight into the practice of earlobe gauging.

To find out more about cosmetic facial surgery by Dr. Joe Niamtu, III in Richmond, Virginia, visit http://www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

http://www.lovethatface.com

February 20, 2012 Posted by | Earlobe Repair, Gauged Ear Lobe Repair | , , , , , | Leave a comment

Joan Rivers and Cosmetic Facial Surgery

 

Lover her or hate her, Joan Rivers is funny.  She has become the self proclaimed poster child for cosmetic surgery and is the brunt of many jokes, but old Joanie actually looks pretty good these days.  Anyhow…..every day I do numerous consults and people have to decide how to budget get their cosmetic surgery around other expenses. I came across a Joan Rivers quote which is of her typical humor.

“Better to get out of an old car with a new face, than to get out of a new car with an old face!”

Wish it was that simple, but Joan has a way of putting things.

To find out more about cosmetic facial surgery visit www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

http://www.lovethatface.com

February 16, 2012 Posted by | cosmetic surgery addiction, Uncategorized | , , , , | 1 Comment

Dr. Niamtu’s Textbook Published in Spanish

 

One of the biggest honors of my academic life was being asked by Elsevier Inc. to publish a major textbook on cosmetic facial surgery.  Most textbooks are published by many authors, but I published the text by myself (except for one awesome chapter on nose surgery by Dr. Angelo Cuzalina) which was a nonstop two year project, of course in my “spare” time.

The textbook has done very well and has sold several thousand copies to date which are good numbers for medical textbooks.  I was excited when Amazon.com began offering my book in a Kindle version as that represents another milestone.

I was recently informed by the publishers at Elsevier that the book has now been translated to Spanish, which of course in a great honor.  Cosmetic facial surgery  is very popular in many Spanish speaking countries and it is a great feeling to know my work will contribute to international surgery education.

I have also been told that other translations are pending which of course makes me proud.

To learn more about cosmetic facial surgery visit www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

http://www.lovethatface.com

February 12, 2012 Posted by | Academic Cosmetic Surgery | , , , | 1 Comment