In our technology driven world, consumers are often drawn to the most recent and innovative products that utilize cutting edge advances in modern science. It is only natural for people to apply the same high standards to their cosmetic treatments. However, “the newer - the better” approach does not always work in plastic surgery.  Despite recent advances in technology and availability of multiple non-invasive treatments, a facelift still remains a “gold standard” of facial rejuvenation offering the most striking results and unparalleled longevity. Many people are still deterred from it by a long history of “unnatural” or “pulled” look that sometimes resulted from this procedure. However justified this fear was in the past, it is no longer the case today. Facelift techniques have come a long way in the last few decades resulting in a long lasting and natural appearing facial rejuvenation

We sat down with New York City facial plastic surgeon Konstantin Vasyukevich, MD to get the latest facelift updates.

NewBeauty: What does the facelift look like in 2019? How is it different than facelifts done in the 1990s or early 2000s?Dr. Vasyukevich: If I had to describe the difference between facelifts then and now in one word, I would say "natural.” The facelifts we perform today appear completely natural and our patients do not carry the stigma of the old-fashioned facelift (i.e. unnaturally pulled look).  In order to achieve this marked improvement, we had to change some of the fundamental principles of the facelift operation.



First, we have changed the very direction of the "lift" in facelift. Today, we reposition the sagging tissue of the face in a far more vertical vector as opposed to a more horizontal pull of the old days. With age, gravity pulls the facial tissue down, so one can presume that the most natural vector for a facial rejuvenation procedure should be up.

The second change that has made a significant difference in both the appearance and longevity of modern day facelifts is that the operation has become much deeper. By going underneath the fascia that envelops the facial muscles, we are able to release the ligaments that are resisting our efforts to lift the facial tissue. Once we released the ligaments, we are able to reposition the sagging tissue with very little tension. Avoiding excessive tension during a facelift is a major step in preventing a “pulled” look.

Other significant changes that happened in the recent years are improved safety, use of lighter anesthesia, significantly shorter (and a lot more comfortable) recovery time. The improvements in surgical technique and a more precise approach that targets aging changes without excessive surgical overcorrection allows us to get "more for less" and markedly improve both the results and patients' experience.

From a drastic operation that was performed in a hospital and required days of professional postoperative nursing care, modern facelifts turned into an easily tolerated procedure that could be done under local anesthesia with most patients typically going home within a couple of hours after their surgery.

NB: Are you seeing younger patients asking for facelifts?Dr. Vasyukevich: Facelifts are now safer, better and far less conspicuous. It is no wonder that more and more people in their thirties and forties are turning their eyes towards surgical rejuvenation. It is becoming commonplace to see patients coming for a facelift consultation with very early signs of facial aging.

NB: How has the selfie culture influenced the desire for facelifts?Dr. Vasyukevich: In today’s world, social media is a powerful force that significantly affects our perception of ourselves and influences the choices we make. When people take multiple photos of themselves, it makes them exceedingly aware of even minor flaws or the slightest aging changes to their face. The desire to look one’s best on social media can drive many people to facial plastic surgeons' offices.

However, there is a very strong positive aspect to the abundance of selfies on social media: The before-and-after photos of cosmetic procedures that many people post helps to educate and inform of the potential transformation that a well-performed facial rejuvenation procedure might bring. It also helps to create a very high-quality standard to which plastic surgeons performing cosmetic procedures have to aspire to, thus contributing to the overall advancement in the field.

NB: What are some other procedures that can be done for a facelift effect, without actually getting a full facelift?Dr. Vasyukevich: At this time there is really no good alternative to a facelift. Non-surgical tightening procedures such as Ulthera, Thermage or thread lifts in great many instances are unable to provide a sustainable correction of the aging changes in the lower face. The judicious use of facial fillers can mask some of the early signs of facial aging. However, once a noticeable laxity develops, the continuous reliance on the fillers can have a detrimental effect on facial aesthetics and cause an “over-injected” and unnatural look.

NB: When deciding to get a facelift, what should we look for in a great plastic surgeon?Dr. Vasyukevich: Number one, look for someone who specializes in facelifts. We live in an age where our appearance is so closely scrutinized that one cannot take chances with their rejuvenation procedure. Selecting a surgeon that is completely dedicated to his or her practice to surgical facial rejuvenation will ensure you are getting a real expert in facelifts.

Second, scrutinize the surgeon’s before-and-after photos. Fortunately, plastic surgeons who perform a lot of facelifts have no trouble posting them on their websites.

And lastly, I would recommend paying your surgeon a visit and trying to get a good feel for how they treat their patients and making sure you feel comfortable with their care and confident in their skills. I believe the human connection is very important, and if you don’t feel 100-percent confident, schedule a second visit, spend some time in the waiting room, watch the interactions between the doctor and the staff or between the staff and other patients. Ask yourself: Will I be happy as a patient here?

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NB: What are some other important things to consider before getting a facelift?Dr. Vasyukevich: Important, and often overlooked, consideration is a choice of anesthesia. Traditionally, facelifts were performed in Hospitals under general anesthesia. In recent years, however, much lighter forms of anesthesia became increasingly popular. Local anesthesia with mild sedation, sometimes called “twilight anesthesia” gained favor with patients and doctors alike due to it’s excellent safety profile and easier recovery. However, since preferences and sensitivities vary from patient to patient, it is definitely worth while to discuss the type of anesthesia that will be used with your surgeon prior to scheduling your procedure.

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