Mini-facelifts are becoming one of the hottest topics we hear about at Atlantic Coast Aesthetics. One example is this week’s ACA Question of the Week, which we received from one of our Twitter followers. She asks, “I’m 46 & unsure if I am ready for a mini facelift or other surgery? Currently use Botox in forehead and some restylane.” Dr. Thomas Pane, our founder and Chief Medical Officer, chose this question because it gave him an opportunity to delve into what criteria would make a patient a suitable candidate for a mini-facelift, or indeed any facelift-type procedure.

Dr. Pane observed that based on the photos the patient enclosed, she has kept her skin in very good condition for her age. The skin is firm, with minimal sagging and jowling, especially when the face is at rest. He did observe that there is some mild skin crinkling around the lower eyelids, but again, this is not abnormally visible. If the crinkling, sagging or jowling was very pronounced, Dr. Pane said he might consider it, but given the obvious care the patient takes with her skin, he would say that at this patient’s age, any kind of facelift procedure would probably be best left for the future, when it would confer a more obvious benefit than it is likely to at this stage.

While the mid-forties is not abnormally young to be looking into facelifts or other surgical intervention, usually a pronounced or abnormal amount of sagging, jowling and crinkling is a primary indicator that a facelift may be appropriate. When and where possible, especially in cases where these conditions are minimal or appear to be absent in photographs, Dr. Pane said he would be more likely to advocate for less invasive treatment options such as Botox injections or other dermomuscular relaxing agents to help smooth out the problem areas. If the patient is truly set on surgery, a lower labroplasty to correct the skin laxity around the lower eyelids would be about the only surgical methodology he would consider at this stage, and even then an in-person clinical evaluation would be required to be sure that is an appropriate option.

To correct the skin and give it a more youthful appearance, Dr. Pane said either fractional or ablative CO2 laser treatments might be a better option for this patient. The benefit of these treatments would be a reduced downtime and less risk of complications as compared to a facelift-complex procedure. This would also improve the skin’s tightness without requiring the more invasive methodology of a full surgery. Again, this would be difficult to gauge properly without having actually seen the patient in person, because there is only so much a photograph can show and it does not allow the tactile inspection necessary to properly gauge the skin quality.

Any surgical procedure carries a certain risk of complications with it, and as Dr. Pane has noted previously, in South Florida in particular there is always someone who will swear a patient is a “great candidate” for any given procedure, whether or not this is actually the case. When and where possible, Dr. Pane prefers to avoid surgical intervention if other, less drastic measures will achieve approximately the same or better results with less downtime, expense or risk to the patient.

In some cases, surgical intervention may be appropriate. When and where this is the situation, a direct examination of the problem area in a clinical setting may suggest an alternative that addresses the issue directly rather than trying to “kill a fly with a cannon.” However, with the exception of relatively rare and unusual cases, it is highly unlikely that a patient in their late thirties to early fifties is likely to derive the same benefit from more aggressive surgical techniques than someone in their later years, who has lost an unusual amount of weight or where there is another problem present.

If you have a question related to cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics welcome the chance to discuss your concerns and options with you. Simply follow us on Twitter and Facebook, email us at https://acplasticsurg.com or call us at (561) 422-4116. Your question could be ACA’s next Question of the Week, to be answered live by Dr. Pane in an upcoming Google Hangout and letting us educate others with the same concerns and issues you have. Remember, at ACA, we believe the only bad question is the one you don’t ask!