The Plastic Surgery Channel

Facelift Without That Stretched Look

Facelift patients often worry their skin will look pulled too tight as a result of plastic surgery. Dr. Daniel Man explains how a unique surgical technique can create more natural results in this video interview.

In today’s media-saturated culture, aging gracefully is a dying art. Women find themselves competing with images of young Hollywood starlets – or even erstwhile starlets who, now in their 40s, 50s and 60s, have undergone artful cosmetic procedures to maintain the image of youth. Consequently, more and more middle aged women – and men, too – are considering a little nip and tuck themselves to stay forever young.

But when a facelift goes wrong — and they often do — the mistakes are very visible. People on the lookout for signs of plastic surgery are familiar with the stretched skin, “cat-like” face that shows evidence of a surgeon’s tampering. And, few would volunteer to have the tightly pulled visage of a Jocelyn Wildenstein or Joan Rivers, or the perpetually surprised demeanor of Sly Stallone.

“There are reasons why these [things] happen, and there’s a way to prevent this from happening,” notes Dr. Daniel Man, a board certified plastic surgeon in Boca Raton, Florida. In his practice, Dr. Man strives to create a natural-looking face through surgery. And what he avoids, most often of all, is giving his patients the “pulled-skin look” that would draw attention to their time under the knife.

During an interview at the 2009 meeting of the American Society of Plastic Surgeons, Dr. Man explained the common pitfalls of facial plastic surgery, and shared some little-known trade secrets for avoiding them.

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During the typical facelift operation, the patient’s ears are subjected to a lot of tension, which causes some drooping of the ear canal, Dr. Man notes. And as the surgeon adjusts the patient’s facial skin and muscle during the face lift, the altered ear drops down, producing extra skin to deal with and dispose of. Patching the patient back up from this usually means producing the “pulled” look. Signs of surgery are conspicuous, as well.

“If they have a lot more skin to remove, the incision is longer,” he says. “And if it’s longer, it’s visible.”

Dr. Man’s method – published in July 2009 in the Aesthetic Surgery Journal – is to use a surgical technique that slightly elevates the patient’s ear and prevents it from drooping. From there, he uses a bit of the patient’s transplanted fat to build up the mid-facial area.

“So, we do two things,” he explains. “The ear is little higher and there’s more volume. We still do the muscle work, but is there less or more skin? There’s less. And if there’s less skin, the incision is shorter and can be hidden inside the ear.”

Dr. Daniel Man’s result: A facelift that doesn’t so strongly resemble a “lifted” face, and whose surgical evidence is well-concealed. It also offers the patient slim chance of ever being confused with the family cat.