Commonly asked questions about facial plastic surgery

Catherine Winslow, M.D. 

Featuring Dr. Catherine Winslow, MD, FACS

Q: I have a saggy jaw line—and my upper eyelids are baggy—is there one surgery that will fix all the droopy areas?

A: The “old” facelift used to attempt to fix all droopiness at once. The result was a very pulled and “operated on” look. Newer procedures are geared to address individual areas of the face. Each area and problem should be addressed independently to achieve the most natural and refreshed look as follows:

• UPPER FACE: Usually treated with an endoscopic brow lift and/or upper eyelid lift.
• MID-FACE/LOWER EYELID: Usually treated with an endoscopic or standard mid-face/lower eyelift.
• LOWER FACE/JAWLINE/NECK: Usually treated with a facelift, “tuck-up”, or neck lift.
• WRINKLES AROUND MOUTH/LIPS: Usually treated with injectables and implants.
• Individual “tweaks” can be discussed, such as facial resurfacing, ThreadLifting®, and other minimally invasive procedures that help in achieving the desired look.

Q: Is it better to have everything done at once or have several procedures spaced out?

A: That depends on your goals and desires. In general, the cost is less to combine the procedures and you only undergo one recovery period, instead of several. On the downside, recovery from combined procedures may result in a bit longer healing period.

Q: What is the expected recovery time? When can I go back to work?

A: Depending on the type of procedure, recovery is generally 7-10 days. Most patients can resume work after 1 to 2 weeks. Regular physical exercise may be slowly resumed after 7-10 days. Makeup can be used to help camouflage the areas that are bruised after one week. Social activities can be resumed after 3 to 4 weeks.

Q: How much pain can I expect?

A: Again, it depends on the procedure. Most patients have a headache after an endoscopic brow lift. Some discomfort and dryness after eyelid surgery is expected, and the swelling of the eyelids may impair visual fields for a day or two. A facelift is uncomfortable for the first 24 to 48 hours, after which most patients are surprised by the lack of pain. Pain will be controlled with narcotics until it is manageable with Tylenol. Pain is a unique sensation, and no two people will perceive it the same.

Q: Will scars result?

A: A scar is always a sequel of having surgery. However, scars can be placed so they are well camouflaged and very difficult to see. Any scar will be red during the healing period (generally 6-12 months) and after that are generally imperceptible.

Q: How long will surgery last?

A: Changes made to the tissues are permanent. However, your face will continue to age. Many patients will need a touch up after about 10 years, depending on genetics and the care they provide to their skin and body.

Q: What is the best age to get a facelift?

A: There is no perfect age. The younger the patient, the longer the results last and the less dissection is needed. In general, younger patients heal faster and have better results.

Q: Can a facelift be done on a man?

A: Absolutely. The incision is contoured differently for a man, but the ability to tighten the jaw line and the skin under the chin are the same as for women.

Q: What is the best procedure to tighten the jaw line?

A: Generally, only a facelift will pull and remove the excess skin that results in a tighter jaw line and elimination of jowling. Other procedures, such as a mid-face lift or ThreadLift® may improve the jowl somewhat.

Q: Will insurance cover the cost of surgery?

A: Usually not. Insurance will cover reconstructive procedures, but usually not elective cosmetic procedures. If vision is affected from extra skin hanging over the eye, insurance may cover an eyelift. Nose and sinus surgery is usually covered if problems with breathing or infections are documented.

Q: What about the no-downtime procedures and skin treatments?

A: In general, the more downtime you are willing to allow, the more dramatic the result that can be achieved. Certain minimal down-time procedures and facial treatments will help alleviate signs of aging, but dramatic and long-lasting results are best achieved through a permanent surgical change in the tissues. Newer procedures like Contour ThreadLifting® can achieve about 50-60% of what rejuvenative surgery can with a downtime of only several days. Adjunctive procedures like laser rejuvenation, Botox and injectables have minimal or no downtime as well.

Q: If a procedure like an eyelift does not cause much discomfort, why is the down-time a week?

A: All surgeries will cause bruising and swelling and result in an incision that needs care. Facial resurfacing (deeper chemical peel, dermabrasion or deeper laser treatments like CO2) will cause damage to the outer layer of skin, making the underlying skin raw. Wound care is essential for the first week, and lifting after any surgery or procedure is restricted to 5 pounds for the first week. Vision can be blurred from ointment, pain may require narcotics, and fatigue and nausea may result from medicine. The body heals faster if you take care of it. Certain things can help promote faster healing: protein loading before surgery, eating fresh pineapple after surgery, taking Arnica Montana (supplied to each patient) before and after surgery, stopping smoking, staying well hydrated and enjoying a healthy lifestyle.

Q: What does Board Certification mean?

A: Board Certification is a several day process of written and oral examinations that ensures your physician is qualified to be performing certain procedures. Many physicians performing cosmetic procedures and even surgeries are trained in Internal Medicine, Dermatology or other non-surgical specialties. Board certification in plastic surgery means a surgeon has completed an approved plastic surgery training program (although the experience in each training program will vary) and has passed examinations. These are the ONLY surgeons who should be performing body liposuction, tummy tucks, breast augmentation, and similar invasive procedures. Board certification in FACIAL plastic surgery usually comes through completion of a fellowship that specializes in ONLY facial plastic and reconstructive surgery. Applicants must be surgeons- usually head and neck (ENT) or plastic surgeons. Additionally, applicants MUST have a minimum number of facial plastic surgeries to become certified, as well as pass the oral and written examination. It is an arduous process that ensures that the surgeons operating on such a delicate area have the most experience possible. [Editor’s note: Dr. Winslow scored the highest in the nation on this subspecialty exam, and currently serves as a facial plastic surgery examiner.]

Q: What can Aesthetics do for me?

A: Aesthetics and good skin care can turn back the clock on the skin and maintain your appearance. Our Aestheticians can direct you to physician-grade products so you won’t waste money on empty promise products, as well as help you with mineral based cosmetics, permanent make-up, eyelash extensions, relaxing facials and massage, or just pampering! We all like that.

For more info: Dr. Catherine Winslow is one of the most experienced, qualified facial plastic surgeons in the country. She recently scored highest in the nation on the Facial Plastic Surgery Board examination. Dr. Winslow also served as a Consultant to the White House and still returns to lecture the White House medical staff when time permits. To  learn more about Dr. Winslow and the procedures offered at her state-of-the-art Winslow Wellness and Aesthetic Center, which includes Winslow Facial Plastic Surgery Center, please visit www.IndyFace.com or call to schedule a free consultation at 814-1104.