Dr. Kelly is a board-certified Plastic Surgeon and partner in both Miami Plastic Surgery and MPS Medspa. He has been in practice over 25 years and has been recognized by his peers both nationally and internationally as one of the best plastic surgeons in the United States. In addition to being an expert on Cosmetic Surgery, his practice encompasses the entire spectrum of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radiofrequency. He also believes in giving back to our community, having served on the Village Council for eight years and volunteering as a coach for our youth sports programs.

You can email him questions at mkelly@miamiplasticsurgery.com.

Question: Hi Dr. Kelly, I am 50 years old and I have been doing injectables, but I think I am now ready for surgery. I really want to do a face and neck lift, but I am afraid of that pulled and unnatural look. How can I avoid that?

Answer: Great question! All of us have seen those unfortunate women who had “too much” done. Frequently, this is due to having multiple facial surgeries. But another problem with the older facelift and neck-lift techniques was that they focused primarily on tightening skin and muscle. Patients looked better, but they didn’t look natural.

What we have learned over the past few years is the most important factor in facial aging is loss of volume. The fat over the cheekbones, especially near the nose, tends to diminish with time, leaving a flat, aged look.  Making matters worse, lower facial tissues fall, creating jowls along the jawline. Tightening skin and fat doesn’t correct this loss of volume. Injectable fillers, which can be done in the exam room, temporarily address this loss of fat with synthetic substances called hyaluronic acid. The newest one is called Voluma and is specifically designed to treat the loss of mid-face fat. Voluma can last up to two years and as a temporary fix works great.

But for a more definitive, longer lasting improvement, the best results are seen with surgery. My approach would include a face and neck lift combined with fat grafting.  As part of the facelift procedure, fat is harvested from the abdomen, centrifuged, and the blood and serum is removed. The fat is then reinjected into the areas of facial fat loss to restore the volume that has diminished with the aging process. When you combine fat grafting to areas of volume loss with minimal removal of excess skin and gentle muscle tightening, you get a refreshed, natural look. The results of surgery beat any injectable result and it lasts 7-10 years.

Don’t get me wrong, Injectables work great and I use them all the time.  I love how they refresh my patients, and patients love the convenience of the quick fix. But surgery remains the gold standard for a lasting result. A facelift with fat grafting gives the best possible result, looks extremely natural, and is impossible for filler alone to beat.

 

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