The mere mention of the word ‘facelift’ is to many people a frightening concept that is best avoided. Beyond implying surgery, images of ‘perpetual surprise’, ‘wind-tunnel’ and ‘unnatural’ come to mind. It is these very misconceptions and fears that have led to a surge of procedures that have become broadly known as non-surgical facelifts.
Cleverly marketed as appealing improvements known as ‘lunchtime facelifts’ and ‘liquid facelifts’ , these facial procedures are hopefully performed in a doctor’s office with a combination of Botox, injectable fillers (such as Juvaderm and Radiesse), and light and laser treatments. They are tremendously appealing precisely because they are not surgery, and involve no scarring or downtime. And they are based on a recently appreciated anatomic understanding of facial aging which is that of volume deflation (loss of fat) and not just sagging tissues alone. ‘Re-inflation’ of the face is the result of these treatments, even if it is only temporary (there are no permanent injectable fillers).
Under the guise and enthusiasm of anything that is pain and recovery-free being better than a real facelift, a patient inquired about the ‘new’ Y-facelift published this past weekend in New York Times Sunday Magazine. Buried in the center pages of this magazine was a story entitled ‘Houston, We Have Facelift’. Reading this story got me thinking about everything that is both good and bad about the non-surgical facelift ‘revolution’.
The concept: Developed by a dentist who claims to have taken four years to develop this approach, the Y-facelift involves filling the face with large volumes of injectable fillers, molding it around with one’s fingers, and then treating the skin with radiofrequency treatments to tighten it. I am not sure what the Y means but some filling out of the face is most certainly achieved, without surgery, for a subtle improvement.
The bad:. It may be shocking for some that everything in New York isn’t always better (although always twice as expensive) and the New York Times Style magazine does not carry the same scientific clout, for example, as the New England Journal of Medicine. Cosmetic procedures are fraught with a common problem- marketing that frequently gets way ahead of proven science. This practice is so prevalent that doctors and companies alike have learned that appearing in Allure, Cosmopolitan and other beauty magazines with exaggerated and unfounded claims drives business better than a scientific discourse in any medical peer-reviewed magazine. (and much easier to get published) Even the pharmaceutical industry has this figured out which is why almost one-third of television ads today are for some prescription drug. The bottom line is the ‘Y-Lift’, while based on a few known plastic surgery procedures, is an unproven amalgamation which most likely benefits the treatment provider more than the recipient.
What matters: The debate between non-surgical or surgical facelifts can be debated ad nausem. Both may be appropriate for any patient under the right circumstances. The practitioners of both will hotly contest each one’s merits. But the non-surgical boom of cosmetic procedures speaks to an important issue that is rarely discussed…value. What does one get for what one pays? The non-surgical Y-facelift retails between $4,000 and $8,000 for results that will last one year, maybe slightly more. The price of non-surgery, when looked at long-term, is frequently more than that of actual surgery…with results that are not nearly as long-lasting.
There are many factors that go into deciding what is the best facial rejuvenation procedure. Never forget that the concept of value in plastic surgery, like any other retail purchase, is extremely important. But the medical merits of such procedures should not be determined by what is written in a trendy magazine whose sole intent is newsstand and ad sales, not satisfied and happy patients.
Dr. Barry Eppley