Time for a Lift
With cozy nights at home and days spent bundled up against the cold, winter is the perfect time to consider a cosmetic procedure. This spring, the pandemic caused most elective procedures to be postponed, but they have resumed, so a little downtime during these colder months could lead to a big “wow” when spring arrives. We talked with local experts about popular treatments this season.
“Winter has always been busy for surgery,” says Dr. Mike Nayak of Nayak Plastic Surgery. “There are fewer social obligations, it is easier to get time off work, and clothing trends like higher necklines and scarves cover the face to hide swelling or bruising.” According to SLUCare facial plastic surgeon Dr. Frank Simo, an unexpected side effect of the pandemic is that those seasonal benefits are compounded by social distancing and face masks, resulting in shorter downtimes. “A mask hides most of the surgical changes instantly, so people can be out and about more quickly,” he says.
Like with most things this year, Nayak says surgical consultations have gone virtual—at least in part. “Photo evaluations are a great way to prescreen for a surgery, and we can determine if it’s the right fit for you,” he says, noting that virtual consultation doesn’t work for every procedure. Simo adds that in-person evaluation is an important step of the process. “Meeting virtually can be done in the initial stages, but a surgeon really needs to be able to examine a patient and assess their skin,” he says.
According to Simo, between January and April is the most popular time for face-lifts. He says that a common misconception about the surgery is that it impacts the entire face. In reality, it is often targeted to the bottom half. “The procedure addresses aging changes that cause the jawline, neck and cheeks to look droopy and saggy,” he explains. “The focus is on the lower face, not everything from forehead to neck.”
Simo notes that a face-life won’t address skin damage, and it’s important for people to realize the main aim of the procedure is not to remove wrinkles. “Although it will help, it’s not going to fix everything,” he explains. “Some type of rejuvenation will be necessary as well.” The surgery can be combined with medspa treatments like chemical peels and microneedling to address fine lines. For heavier wrinkling, laser skin resurfacing may be necessary.
Simo says his face-lift patients do not require an overnight stay, and the next day, they return to his office to have their dressings removed and to receive instruction on basic wound care. “The day after surgery, people can return to their regular hygiene routine,” he notes. “The next week, the stitches come out, and they can resume low-impact aerobic activity. There are no restrictions after two weeks.”
As with any facial surgery, there is initial bruising and swelling after a face-lift. Simo notes that in general, the most severe and noticeable impact subsides in two to three weeks, but more subtle swelling can take two to four months to dissipate. “I like to call the residual effect ‘happy swelling,’” he says. “Rather than distorting the face, it fills in fine lines. I often see patients return to my office after it has gone down because they’ve noticed the wrinkles are back.”
Nayak says that the way neck-lift surgery is handled has changed greatly over the last five years. Rather than focusing on removing fat and tightening skin, the procedure is centered on resculpting underlying muscle. “By focusing less on the superficial layers of skin and fat, you build a more meaningful foundation, and the result is more natural and untouched in appearance,” he explains. “It requires more skill from the surgeon, but the outcomes are dramatically better.”
A neck-lift usually is not done in isolation. Nayak notes that for patients over the age of 40, it often is combined with a face-lift to address issues in the jawline. “If you do a nice job on the neck, problems in adjacent areas are going to be more apparent,” he notes, adding that a neck-lift also won’t address skin concerns. “A fitting analogy is like tailoring clothes. You can cut and sew a proper suit, but if the fabric is stained or wrinkled, it may still need to be dry cleaned.”
While no two procedures are the same, on average an isolated neck-lift takes around three hours, according to Nayak. When combined with a lower face-lift, the total time is closer to four. Usually, he recommends patients take two to three weeks of downtime so that they feel presentable when returning to social and professional activities. However, the pandemic has changed that. “With remote working, patients can schedule surgery on Friday and be back to work on Monday,” he says. “There’s also no problem going out because people are wearing face masks.”