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Preparing the Canvas

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Facelift patients benefit from pre-surgery education and access to adjunctive skincare services.
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Preparing the Canvas

Facelift patients have great expectations for their surgery outcomes, but not all aging concerns of the face can be addressed with lifting alone. By combining surgery with pre- and post-operative skincare and thorough patient education, surgeons are finding that they can achieve better patient satisfaction and optimal, longer-lasting results. “Virtually 100% of people who are at an age where they are looking for a facelift to provide some improvement to the skin will benefit from pre-surgery care,” says Steven Pearlman, MD, owner of Pearlman Aesthetic Surgery in New York City, and past president of the American Academy of Facial Plastic and Reconstructive Surgery.
“This is [an area] where understanding skin types and skin care is very advantageous,” says Gabriel Chiu, MD, owner of Beverly Hills Plastic Surgery in California. “You can prepare the patients and manage their expectations as to the recovery and the healing process based on their individual skin type and condition.”

PRE-OP SKINCARE

Because facelifts address only the effects of gravity and loss of elasticity, surgeons often offer adjunct treatments to address additional concerns, including poor skin texture, pigmentation problems and fine lines.
“Just like some people can’t exercise on their own and may need a trainer, estheticians play an important role in consulting and treating my patients to correct their skin problems,” says Dr. Chiu.
At Saltz Plastic Surgery and Spa Vitoria in Salt Lake City and Park City, Utah, estheticians are part of the treatment team that works with founder and plastic surgeon Renato Saltz, MD, to evaluate patients prior to surgery and make recommendations regarding care. “I think what you’re seeing is really fascinating,” says Dr. Saltz. “There’s a new transformation in aesthetics for getting a healthier result.”
Cynthia Steele, a licensed esthetician with Advanced Aesthetics of Arkansas, an adjunct business to Arkansas Plastic Surgery in Little Rock, regularly provides pre-surgery skincare services for facelift patients. “It’s a mistake to think that a facelift can pull the skin so tight that all of the facial imperfections will be smoothed out,” she says. “We offer treatments on a cellular level to optimize the skin surface so we can match the improvements that are made below the surface during surgery.”
To prepare skin for surgery, Steele performs either dermaplaning or microdermabrasion followed by a light Jessner’s peel to stimulate collagen production. “We do this one month prior to surgery,” she says. “We have to be careful about introducing new skincare regimens right before surgery in case the patient has sensitivities or allergies. So we start well in advance and continue with skincare post-operatively.”
Claudio Pinto, master esthetician and board member of the Society of Plastic Surgery Skincare Specialists (www.spsscs.org) also recommends light chemical peels prior to facelift procedures. “Chemical peels are great because the patient sees very good improvement right then and there,” he says. “The other thing we always try to incorporate is Retin-A. The dose and concentration depends on the condition of the patient’s skin. The thicker the skin, the more aggressive you can be. For sensitive skin, you have to be a little more gentle.”
Pinto performs the chemical peel first in order to improve the penetration of the Retin-A. “If the patient has some hyperpigmentation, we use some hydroquinone,” he says. Pinto has patients stop the Retin-A about three days prior to surgery. “Because the skin can be more sensitive,” he says. “The other thing we do is have the patient continue with the Retin-A postprocedure, because it will help with the healing, and the condition of the skin will continue to improve.” Patients who undergo a full facelift wait a month after surgery to restart the Retin-A. For Lifestyle Lifts, he recommends that patients wait two weeks.

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