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Had a medium facelift in August. My jowls descended about 3 wks after surgery. Went back to the surgeon recently and he agreed I need a re-do. He said most pt's need re-do's. I have lost confidence in him. After my surgery I also lost a lot of facial fat in my cheeks and they look sunken in. He says he can fill my cheeks with sculptra, artecoll, or radiesse. I have read they all can lead to unwanted side effects. Should I return to him and let him re-do my face or invest more money with another surgeon and hope for a better result. Also which fillers do you recommend for the cheeks. Thank You
I had a MFL that failed after a few weeks too, and there is no way I would ever let the original surgeon touch me again...if he cant get it right the first time, I would be asking him what he intends to do differently this time. I would be collecting my notes from him and moving on. Choose really really carefully this time. See at least 4 other docs for opinions. Dr Steinsepir's site has quite a bit of info about fillers.
I agree. Revision's may be needed several years later if your skin laxity is horrible or if you lost a lot of weight after the surgery but to say "most patient's need redo's" is ridiculous.
You should not have become more hollow after surgery. You either needed more volume from the start and he should have discussed this with you prior to your initial surgery or he removed too much fat. In either case, avoid Artecoll to the cheeks. Artecoll or Artefill is good for minor areas but not for significant volume. Fat, implants or safer fillers should be used.
See a few others but make sure you wait a year at least before another surgery. If you need a minor tuck up then you may consider Thermage or Ulthera to see if you can avoid another surgery but if the jowls are too heavy then you may need a revision.
Do you live in Tampa. I think all the reject Drs. practice here. When I look up "find a Dr" none of them are in Tampa. Did you have one of those mini lifts? I had a medium one. My face shape is like the screamer. I'm scared of getting fat grafts, I read they have many complications. Glad that didn't happen to you.
First of all there are good and bad doctors everywhere. The good doctors do good work and their patients move on with their lives and you rarely hear about them and if you saw these patients on the street you wouldnt know they had cosmetic surgery because good cosmetic surgery should look natural and go unnoticed.
There are many different ways of doing the same surgery as far as the incision, the dissection, the sutures, the handling of the tissue by the surgeon, the maneuvers during surgery. Add to this each patient's unique bio-physiology and healing mechanisms and you will see why there is such great variation out there.
But the fact is some surgeons do great work and obtain GOOD TO GREAT RESULTS and some surgeons do very poor work and obtain LOUSY TO OK RESULTS!
disruption of dermal attachment fibers during a facelift or fat grafting procedure can potentially accelerate the aging process. But there are so many variables involved that another surgeon cannot comment on without seeing you. And even if I could see and examine you, I would still not be able to tell how meticulous or how rough your surgeon was during the surgery. I hope this makes sense.
Thanks for responding. I'm not sure what the Dr. did to make my cheeks so sunken in. I have pic's of one day before and my cheeks were fine. I think he used the lipo on the wrong area, taking the fat out of my cheeks instead of my jowls. I know I need the whole thing re-done and I am upset because I took out my IRA money to have the surgery. It was all I had. Plus I have multiple sclerosis, most of the really good surgeons only use general anesthesia so I had to find someone willing to do it under a local in his office. I tried for the best but they turned me away. Now I look even older than before.
I'm so sorry to hear that about your MS and about your IRA. Using retirement money or any type of life savings to undergo elective cosmetic surgery is a very tough decision and one that I would not recommend to my patients. However, if you have become hollowed out then the answer is fat injections, facial implants, sculptra or fillers. Again I have not seen you to be able to tell you what to do and while I have written the facelift and revision facelift chapters in two of our textbooks in the past, my practice is dedicated near exclusively to Rhinoplasty. Seeing a good honest and skilled facial plastic or plastic surgeon who does lots of aging face surgery would be best to DIAGNOSE the problem even if you dont treat it now. I wish you the best.
OK so here is the deal: There are thousands of small fibers vertically connecting your face skin down to the deeper muscle, soft tissue and even bone in certain areas. As we get older, these weaken and stretch. One of the tests of "if you need a facelift" is to bend your head forward and see if your skin "slides" forward. If you have a 16 year old do this, nothing really changes but it you have a 60 year old do it, his or her skin will slide to a certain extent.
Now during a facelift, the plastic surgeon cuts through these fibers with his scissors. Then sutures and your own scar tissue end up "holding" things up in a better more youthful position. However, scar tissue only ever is 70% as strong as normal tissue even after healing is complete. Therefore in a person who really didnt NEED a facelift, you can accelerate aging but in a person who did need it, things should look better afterwards no matter what.
I do not appear to make very big scars. In fact you cannot even see where my face lift scars were, a year later. I also have thin skin. I am guessing the fact that I do not make significant scarring could be a factor as to why my work is not holding up? BTW I am so sorry there are a few unpleasant people on this board who make it difficult for you. You are providing such a valuable service.
Thank you for the kind words. The small handful of angry, narcissistic, self-entitled, suspicious, mean people doesn’t bother me. The internet just gives them a voice where 20 years ago no one would sit around and listen to their nonsense. I like helping patients on makemeheal as well as the patients who I see and treat in my office and that is what makes it all worthwhile.
As far as your scar issues the skin incision scar is different than the fibrin glue subcutaneous scar underneath the skin flap that holds things together. The fact that you dont really see your incision scar is a good thing and it means your surgeon didnt put too much tension on the skin flap and didnt pull it too tight. Thin skin will usually show more laxity and wrinkles than thick skin. Improving your skin elasticity is important with peels, lasers or even things like Ulthera or Thermage. While these procedures never give "face lift results" they can help with collagen synthesis and improvement of skin elasticity to that facelift results may last longer.
You are right, Dr Naderi. The world is and has always been full of those kinds of people, but they have never had a voice until the invention of the internet! It is a pity that the small handful tries to spoil things for the many nice people on this board.
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