Interviewer: What to know if you're considering a facelift. That's coming up next on The Scope.
Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.
Interviewer: Dr. Eric Cerrati is a plastic surgeon at University of Utah Health, and he specializes in cosmetic and reconstructive surgery of the face and neck. And if you're thinking about having a face lift, hopefully we'll answer some of the questions that you might have.
So why do patients consider a facelift? What kind of leads them to making the decision that that's something that they want to pursue?
Dr. Cerrati: So a lot of times it's a patient, middle aged and they're starting to notice the jowling or the extra skin that's kind of hanging down over the chin. That's really kind of the first signs that people are looking at.
Interviewer: And when one says facelift, is it generally the jowling that we're talking about that we're fixing, or does facelift encompass other things?
Dr. Cerrati: The most common thing is facelift will redefine the jawline. That's really the main target area, under the chin and along the jaw.
Interviewer: All right. And when somebody comes in and you do an evaluation, which is what you recommend, that you see a specialist, how do you help determine if they're a candidate for it or not?
Dr. Cerrati: So first and foremost, it is an elective surgery, so the patient needs to be medically fit for the procedure. Then as you look at body habitus to make sure the patient's not having weight shifts or that sort of thing, to make sure you can get him a lasting result and something that they're happy with. And a lot of it does have to do with patient selection. You want to make sure that their hopes and wishes is something that you can accomplish.
Interviewer: Sure that what they're asking for is something that can actually be done.
Dr. Cerrati: Exactly.
Types of Facelifts: Trust Your Surgeon
Interviewer: So what can't facelifts do? Do you get patients coming to you that say, "I want a facelift," and they're trying to accomplish something that just can't be done?
Dr. Cerrati: Absolutely. There's the anatomy of the neck and the way that the neck is structured that some patients are more, say, ideal candidates for a facelift and some that are not, in which case you can't get a very defined jawline.
Interviewer: So there are a lot of different types of facelifts and ways to do a facelift. When a patient comes in and starts asking you about those different things, how do you walk them through that process?
Dr. Cerrati: So you can go through all the different types of facelifts, skin only and addressing the underlying tissues and that sort of thing. But really, all these things are not necessarily important for the patient. The patient needs to be familiar with their surgeon and make sure the surgeon has the proper credentials. And if the surgeon has the same aesthetic and can achieve the goal that the patient wants, the approach that they use isn't necessarily the most important thing.
Interviewer: Got you. So a lot of times you're kind of explaining that, I'd imagine.
Dr. Cerrati: Exactly.
Surgery and Recovery Time
Interviewer: So somebody wants to get a facelift. What does that kind of look like? I would imagine there's not a lot of preparation if they are already healthy and whatnot. They would come in, have the procedure. How long does it normally take?
Dr. Cerrati: So the procedure can last anywhere between, I don't know, say two and a half to four and a half hours. All the incisions are really hidden behind the hairline and then around the ear. After a couple weeks, those incisions are very hard to see. And for me, I do do some planning pre-operatively to try to minimize any type of bruising and to help the patient throughout the whole process. At the end of the day, it is an elective procedure and these patients do not want to feel sick and have a long, drawn-out post-operative course.
So I do a lot of things before surgery to kind of help the patient get through that and minimize. I also don't like to use drains and prolonged dressings and those type of things, so patients can really get back to their daily lives as fast as possible.
Interviewer: Is there kind of a range in there? Does it really vary depending on what procedure's been done?
Dr. Cerrati: It really varies, but usually I tell people after two to three weeks they're really back to their pre-operative status.
Interviewer: And if you go back to work, are people going to be able to see visible signs at that point that you've had something done?
Dr. Cerrati: So after about two weeks, a lot of the swelling and bruising has pretty much subsided. The incisions may be slightly red, but patients can really get back to their normal routines after two weeks. At that time they can also. . . After the first week you can really apply makeup, so a lot of it can be hidden.
Lasting Results
Interviewer: Got you. And the results, do they last? For how long?
Dr. Cerrati: So depending on the approach, if you address the underlying deeper tissues, usually the results last about 10 years, is kind of the ballpark range. It's because the aging processing and with gravity, it's still going on. So even though you've had the procedure, the aging process continues.
Choosing a Surgeon
Interviewer: And picking the right doctor to do a facelift is really important, because it is your face. So how does somebody know that they have somebody that is going to really do a good job for them?
Dr. Cerrati: So the number one thing I would say is the patient should do their homework. They should look to see who the surgeons are, where they've done their training and what pathway they've taken in order to get to become a plastic surgeon who's operating on someone's face.
Interviewer: Are there some certifications in general that you should kind of make sure that the surgeon has?
Dr. Cerrati: Absolutely. So is there a residency in plastic surgery that's monitored by the American Board of Plastic Surgery. A fellowship by the American Academy of Facial Plastic and Reconstructive Surgery, and that's also a board certification as well. And those are really the two main ones.
Interviewer: And it's your opinion that you should look for somebody who has both of those?
Dr. Cerrati: Either one of those.
Interviewer: Oh, either one of those?
Dr. Cerrati: Those are two separate pathways.
Interviewer: They're two separate things. Got you.
Dr. Cerrati: So for myself, I did a fellowship by the American Academy of Facial Plastic and Reconstructive Surgery.
Interviewer: And if they don't have one of those pathways, then maybe be a little cautious?
Dr. Cerrati: I would raise a red flag.
Interviewer: All right. And ask some more questions at that point?
Dr. Cerrati: Absolutely. In addition to qualifications, you should really feel comfortable with your surgeon. Even after the initial consultation you don't have a great feeling, go back and visit the office again. And just make sure before you sign up for anything that it's something that you're happy with and that you're confident that the surgeon can give you the results that you want.
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