Dear Dr. Ostad: I Really Want to Start the New Year Off Looking Refreshed and Feeling Really Good About Myself.

Dear Dr. Ostad: I Really Want to Start the New Year Off Looking Refreshed and Feeling Really Good About Myself.


Dear Doctor Ostad,

I really want to start the new year off looking refreshed and feeling good
about myself. I am a woman in my late 60’s and think I may need a facelift, but I am afraid of going under-the-knife. Are there non-surgical facelift options that can help aged skin?

There are various options, both surgical and non-surgical. The use of Dermal fillers along with either Botox or Dysport have been commonly called a “liquid facelift”. I take this one step further and address both neck and chest laxity and crepe-y skin. It does not look natural to just focus on the face and forget the surrounding areas! Typically signs of aging are seen on the neck, chest and hands as well. I address this by using a laser treatment called Fraxel to address the sun damage and fine lines on all of these areas. The extent of the wrinkles will determine what depth of fraxel I will use. The next step would require dermal fillers to be injected in the face and hands to restore collagen and create a lift. I prefer to use Radiesse in the hands. When placed appropriately under the skin, signes of aging and more prominate vein are hidden and appear more delicate. As for the face, I use a combination of dermal fillers. This treatment will vary from patient to patient, as every facial structure is different. The most important thing to remember is to start with the cheeks first. Almost all sagging or lax skin starts with a loss of volume from the cheeks and cheekbones. As we age, we lose collagen and fat in our cheeks and our cheekbones resorb causing a loose appearance from the cheeks to the jawline. I prefer to start with either Sculptra, Voluma, Restylane Lyft or the patient’s own fat. Once the cheeks are restored, I focus on the nasolabial folds (laugh lines) or marionette lines by using either Restylane Lyft or Juvederm Ultra Plus. If the patient has fine lines around the eyes and mouth I will use a very fine filler such as Restylane Silk to soften these lines. Results last anywhere from 9-18 months.

Lastly, I use either Botox or Dysport to lift the eyebrows, smooth out the patient’s forehead and reduce crow’s feet. The right candidate is a patient who is does not want to undergo a surgical procedure and understands that they can achieve great results with Fillers and Botox/Dysport alone.

It is important to know that there are many advancements in cosmetic surgery that reduce the risk for complications. I have performed thousands of facial reconstructions and facelifts in my career under local anesthesia. There is no need for increased risk by placing a patient under general anesthesia if there are alternative treatment options. Removing general anesthesia from the surgery also allows for a faster healing process. Many of my patients are back to work within 7-10 days.

Another common concern often heard is the fear of looking “pulled” or unnatural. I pride myself on providing natural results so patients look rested.

Whether you choose a surgical or non-surgical treatment, it is essential to refrain from taking blood thinners, certain vitamins and drinking alcohol. Your physician should provide you with written instructions on what to omit prior to any procedure.
Be sure you see an experienced Board Certified Surgeon to discuss what option is right for you.