Frequently Asked Questions


Most commonly an individual who is a candidate for an upper eyelid lift or blepharoplasty is also a candidate for a lower eyelid lift or blepharoplasty.

Surgery should only be performed when and where it is necessary to do so.  If an individual only has findings that may be addressed with surgery in the upper eyelids, then only an upper eyelid lift or blepharoplasty should be performed.  Conversely, if the only findings that could be addressed with surgery are in the lower eyelids, then only the lower eyelids should be treated.

Most commonly,however, an individual who is a candidate for an upper eyelid lift or blepharoplasty is also a candidate for a lower eyelid lift or blepharoplasty.  The most natural appearing results arise when you address both the upper and lower eyelids in the event that the upper and lower eyelids both require attention.  Treating one and not the other in such a case can result in an incongruous appearance that may look strange and unnatural.

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A brow lift addresses drooping eyebrows. Often, injection of muscle denervating agents such as Botox® can accomplish a similar thing without the need for surgery and can look more natural when the eyebrows do not droop significantly. I tend to reserve surgical brow lifts for the most severe cases of eyebrow droop or descent.

An eyelid lift or blepharoplasty removes excess, stretched out skin in the upper and lower eyelids.  At the same time as the excess skin is removed, bulging tissues beneath the skin can be rearranged so that they appear smooth beneath the skin.

A brow lift addresses drooping eyebrows.  Often, injection of muscle denervating agents such as Botox® can accomplish a similar thing without the need for surgery and can look more natural when the eyebrows do not droop significantly.  I tend to reserve surgical brow lifts for the most severe cases of eyebrow droop or descent.

A brow lift can have an influence on the appearance of the upper eyelids, since elevated eyebrows “use up” more of the excess skin that may be present in the upper eyelids.  On the other hand, removing excess skin in the upper eyelids can actually result in lowering of the eyebrows, if someone were artificially elevating their eyebrows to “pull up” the excess skin in the upper eyelids, which can sometimes cause a “heavy” feeling.

“Bags” beneath the eyes can be the result of seasonal allergies, stress or even a simple lack of proper rest.

“Bags” beneath the eyes can be the result of seasonal allergies, stress or even a simple lack of proper rest.  If this is the case, addressing the root cause is the appropriate first step.  If the “bags” persist, a lower eyelid lift or blepharoplasty may be a good option.

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How long it takes before an individual who has had a face lift wishes to have another surgical procedure varies from one person to the next and depends upon the initial condition of the skin, weight fluctuations, past and future sun exposure, general nutritional status and one’s genetics.

How long it takes before an individual who has had a face lift wishes to have another surgical procedure varies from one person to the next and depends upon the initial condition of the skin, weight fluctuations, past and future sun exposure, general nutritional status and one’s genetics.  Whether or not one has injectable treatments following a facelift can also impact upon the longevity of the surgical results.  I believe that injectable treatments can significantly prolong the results achieved by facial rejuvenation surgery and recommend continued, judicious use of injectable treatments to all patients after facial rejuvenation surgery.     

In my practice, I have noted that a patient who has had a face lift develops findings that would benefit from another surgical procedure in a period of time that ranges from 5 to 10 years.  The variability in this time period is due to the same factors I described above.  The second surgical procedure is typically a “short scar” face lift.

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While a face lift can theoretically improve the appearance of some acne scars, whether it will do so and how well it will do so is unpredictable.

While a face lift can theoretically improve the appearance of some acne scars, whether it will do so and how well it will do so is unpredictable.  If the goal is making old acne scars look better, the optimal treatment would be facial skin resurfacing and soft tissue fillers to particularly deep “ice pick” acne scars. 

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Having Botox® injections to some facial areas prior to having surgery can enhance the healing of the scars that result from the surgery.

Having Botox® injections to some facial areas prior to having surgery can enhance the healing of the scars that result from the surgery.

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In my opinion, the optimal and most natural facial rejuvenation results are achieved with a combination of injectable treatments, such as Botox® and soft tissue filler injections and surgical procedures.

In my opinion, the optimal and most natural facial rejuvenation results are achieved with a combination of injectable treatments, such as Botox® and soft tissue filler injections and surgical procedures.  I also feel that the results of surgery are prolonged by continued injectable treatments.

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Extreme weight loss does not age the face per se, but it can result in sagging facial and neck skin if the skin is unable to shrink down to the smaller and thinner contour of the face and neck.

Extreme weight loss does not age the face per se, but it can result in sagging facial and neck skin if the skin is unable to shrink down to the smaller and thinner contour of the face and neck.  In this case, a patient would benefit from a face lift, eyelid lift or blepharoplasty and also a neck lift.

While the results of a facelift are permanent, the facial structure will continue to age as time passes. How long it takes before an individual who has had a face lift wishes to have another surgical procedure varies from one person to the next and depends upon the initial condition of the skin, weight fluctuations, past and future sun exposure, general nutritional status and one’s genetics.

While the results of a facelift are permanent, the facial structure will continue to age as time passes.  How long it takes before an individual who has had a face lift wishes to have another surgical procedure varies from one person to the next and depends upon the initial condition of the skin, weight fluctuations, past and future sun exposure, general nutritional status and one’s genetics.  Whether or not one has injectable treatments following a facelift can also impact upon the longevity of the surgical results.  I believe that injectable treatments can significantly prolong the results achieved by facial rejuvenation surgery and recommend continued, judicious use of injectable treatments to all patients after facial rejuvenation surgery.

Related Surgical Procedures:

Muscle denervating agents such as Botox® should be administered only as often as it is necessary to do so. I find that this ranges from every three to every six months, depending upon what is being treated and the general condition of one’s skin.

Muscle denervating agents such as Botox® should be administered only as often as it is necessary to do so.  I find that this ranges from every three to every six months, depending upon what is being treated and the general condition of one’s skin.  Having Botox® or a similar muscle denervating agent administered more frequently than that is not harmful, but I have not found that patients in my practice require that it be administered any more frequently than every three months.  More frequently, it can be administered less frequently, especially after one has had it regularly for several years.  On the other hand, it is my opinion that having Botox® injections administered less than twice yearly most often results in underperformance of the product.

When used properly, muscle denervating agents such as Botox® and soft tissue fillers can temporarily reverse changes in our physical appearance that occur naturally as we age but that others often interpret as our looking “tired.”

Looking less tired starts with being less tired just like a healthy look starts with a healthy lifestyle.  I would be remiss to not first recommend a regular sleep cycle of at least eight hours per night, a healthy diet and a regular exercise program to anyone wishing to look and feel their best.  Keeping well hydrated, avoiding smoking and even second hand smoke and being smart about sun exposure are additional things that have a very positive impact upon one’s physical appearance.

Beyond that, there are both surgical as well as non-surgical interventions that I offer that can address drooping facial tissues. 

When used properly, muscle denervating agents such as Botox® and soft tissue fillers can temporarily reverse changes in our physical appearance that occur naturally as we age but that others often interpret as our looking “tired.”  It is important to have muscle denervating agents such as Botox® and soft tissue fillers injected by a qualified and well trained practitioner.  Otherwise, the result can make individuals look more tired and unnatural than they did prior to the treatment.  In my practice, I perform all injectable treatments personally. 

Ultimately, there are changes in our facial appearance that are beyond the scope of injectable treatments.  Surgical procedures such as eyelid lifts or blepharoplasty, face lifts and brow lifts are indicated in such cases. 

An eyelid lift or blepharoplasty is a completely separate procedure from a face lift and as such, one can certainly be performed independently of the other. However, if an individual has a relatively equivalent amount of aging that could be addressed by surgery in the face and the eyes, then surgically addressing one area and not the other can result in an incongruous appearance that may look strange or unnatural.

An eyelid lift or blepharoplasty is a completely separate procedure from a face lift and as such, one can certainly be performed independently of the other.  However, if an individual has a relatively equivalent amount of aging that could be addressed by surgery in the face and the eyes, then surgically addressing one area and not the other can result in an incongruous appearance that may look strange or unnatural.  Typically, facial aging manifests around the eyes before it do so in the remainder of the face.  Therefore, a patient who has signs of aging that may benefit from a face lift is usually at the stage at which they may also benefit from an eyelid lift or blepharoplasty.  I see many individuals in my practice who want to first address surgically treatable signs of aging around the eyes.  If the surgically treatable signs of aging in such an individual’s face lag behind those around the eyes, as they often do, then operating on only the eyes is a good option.  If however, the face has significant signs of surgically treatable aging as well, then it is optimal to treat both.  If an individual only wishes to have surgery around the eyes but has significant signs of facial aging as well, the correction around the eyes can be performed in such a way that the final result is congruous with the face.  An optimal surgical correction around the eyes that is adjacent to notable aging that remains in the face is another result that looks incongruous and therefore may appear strange or unnatural.  These types of results are best avoided.

What are some of the advantages and disadvantages of a short scar face lift with regards to the neck and surrounding structures?

The most obvious advantage of a short scar face lift is the shorter scars.  Less skin scarring means less possibility of noting that an individual has had surgery.

 Another advantage is a somewhat shorter operative time, which can impact the cost of the procedure, and a somewhat quicker recovery period.  If however, an individual does not obtain a result with which he or she is happy, then the benefit of the shorter scars is all for naught.  In other words, these “advantages” can only be considered advantages if the short scar face lift can achieve a result with which an individual is happy. 

In my hands, a short scar face lift cannot fully correct the neck in individuals who have extreme laxity in the skin or muscles of the neck.  These individuals require some length of incisions in behind the ears in order to achieve an optimal correction of the neck.    Some correction of the neck is possible through short scar face lift scars, however, especially if I make a 3 to 4 centimeter incision below the chin instead of the 5 millimeter long incision that I typically make.

As such, in my practice, I reserve recommending longer face lift incisions for people who have extreme laxity of the skin and muscles of the neck.  This is a minority of patients in my practice.  Most of the patients that I see in my practice opt for the short scar face lift and achieve a result with which both they are I are very happy.

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What is the difference between a “short scar face lift” and the incision pattern of a “traditional” face lift?

The term “short scar face lift” is a general term that can refer to any face lift incision pattern that is shorter than a “traditional” face lift, which involves incisions in the temple, in front of the ear, around the earlobe, behind the ear and sometimes along the hair-line behind the ear. 

In my practice, when I perform a “short scar” face lift, it typically means that I am going to make incisions right at the hairline in the temples, in front of the ear and down to the base of the earlobe.  My typical “short scar” face lift technique avoids all incisions behind the ear.  I usually make a single five millimeter incision below the chin as well.  Through these abbreviated incisions, I perform the same elevation of the cheeks and jowls and the same contouring of the jawline as I would perform if I used “traditional” or longer face lift incisions. 

While a patient often (and rightfully so) scrutinizes the scars in the skin with which they are left after surgery, what the surgeon does to the tissues underneath the skin is what is important.  The scars are simply the cuts in the skin that give the surgeon access to modify the tissues beneath the skin, which is largely how the result is achieved.  I use the short scar face lift when I think I can achieve a result using them with which both I and my patient will be happy.

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