How much does running (daily, 4+ miles) affect the longevity of a facelift? Also, how does menopause affect the face?

Dr. Dean Kane Q & A. 

Q. How much does running (daily, 4+ miles) affect the longevity of a facelift? Also, how does menopause affect the face?

A. A facelift is a personal investment. To make it last longer, maintenance of weight with exercise including running and diet like other lifestyle improvements will maintain the quality your surgery.

​

​Running per se, is not the issue as it up-regulates the repair and anabolic pathways of our immune system. It is other factors which accelerate the passive aging of our skin, organs and glands. These include:

1. ​Dry  and harsh weather environments
2. ​UV light (sun and tanning lights)
3. ​Dehydration
4. ​Low protein, high carb diets
5. ​Lack of essential fatty acids
6. Menopause (due to lack of proper hormone stimulation including: estrogen, testosterone, thyroid, growth hormone and many others)
7. ​Many other factors.

Beyond the obvious reversal of the above list, you should consider a skin stimulation regimen such as the ZO Obagi Skin Health systems provided by a qualified and Board Certified Plastic Surgeon, Facial ENT Surgeon or Dermatologist. The use of retinols and non-retinols, hydroquinones and non-HQ's along with its anti-oxidants, UV blockers and many other protective plant compounds will assist in stimulating proper skin regeneration and rejuvenation. Sculptra injections has also been the most recent advancement in non-surgical firming and maintenance of facial skin and soft tissues.
​
​I hope this has been helpful. All the best!
​
​We often come to your most interesting and beautiful part of the world!

What is the downtime after a facelift?

Dr. Dean Kane Q & A. 

Q. What is the downtime after a facelift? I am doing a facelift on a Monday and need to return to work on a Thursday. I have long hair so my stitches will be covered. My doctor said I should be ok, but would like other opinions. I work as a receptionist and my job is not strenuous. I am worried my co-workers will notice that I had a facelift.

A. This is a universal concern and very reasonable question for all patients to understand.

​There is a dynamic and similar course of healing everyone goes through following surgery or an injury.
​
​Physiologically, any incision or puncture of the skin will cause bleeding and bruising. The length of the incision and amount of lift or undermining determine the magnitude of the healing to occur. More surgery means more bruising, swelling and potential side-effects or complications but the healing time is similar and that is because the "army" of healing cells and scar formation is the same for any injury.
​Please anticipate:

1. Swelling and bruising for 10 days to 3 weeks
2. ​Potential bleeding complications and incision concerns during the first 3 weeks
3. ​Under the skin firming, lumpiness and irregularity during the first 3 months

I separate 2 levels of activity for my patients.

1. ​ADL: activities of daily living; what you need to get by with daily rituals such as hygiene, breathing exercises and mobility. No stooping or bending and no lifting over 2 pounds as any increased activites may generate more swelling or bleeding. ADL's for the first 3 weeks.
2. ​Exertion: starting to do more than what is required such as exercise, sex or pulling and lifting suitcases. After 3 weeks.

In general, I have found scar formation and tightening to the point of restrictive movement and some skin irregularities for the first 3 months.
​Different and changing levels of massage as the healing process progresses such as:

​1 gentle pressure

​2 gentle lymphatic or "squeege" motion

​3 firmer lymphatic or "squeege" motion

​4 "rock and roll" or firm deep massage for lumps

Emotionally, patients go through a "roller coaster" of concerns and presentations. You can expect:

• 1-5 days: ​initial surprise: "I didn't expect this"
• 1-3 weeks: ​concern and a feeling of "did I do the right thing"
• 2-4 weeks: ​worry: "when is this swelling, bruising going to go away"
• ​4-12 weeks: more worry: "why am I forming lumps and irregularities"
• ​2-4 months: depression: "I have to look socially acceptable and I look deformed"
• ​3-4 months: sunlight: "it's getting better"
• 6 months: ​elation: "wow, I look good"
• 9-12 months: ​super-elation: "wow, I look hot!"
• 3-10 years: ​eventual disappointment: "where did it all go?"

Each patient and each physician interpret their changes and findings differently.
​
​Return to your treating physician and discuss what is best for you.

​All the best!

Three respected plastic surgeons had different opinions. Any suggestions?

Dr. Dean Kane Q & A. 

Q. Three respected plastic surgeons each had different opinions. 1. Facelift, neck lift, upper eye lift both eyes, fat grafts/transfers and dermabrasion around mouth. 2. Facelift, neck lift, upper eye lift on right eye only (said not enough extra skin on left eye), lower eye lift on both eyes and full face laser, 3. Facelift, neck lift (with very small incision under chin to liposuction), fat grafts and temple plasty for right eyelid. We did not discuss laser or dermabrasion. What should I do?

A.  ​​​​Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below and offered according to your anatomy, recovery time, budget, skills and availability of services offered by the surgeon.

​The 2 basic foundations to rejuvenation include:

1. ​Lifting  and suspension (with removal of skin excess if needed), and
2. ​Texture improvement (lines, pigment, laxity).

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.

Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.

The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin "Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin.Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!. Fat grafting is a wonderful option but consistency in survival of the fat and need for multiple procedures to achieve your "filling" results may disappoint.

Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Sculptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation. Dermabrasion is a older but tried and true technique to improve lines and tighten skin.

If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.

You may consider: a traditional face and neck lift, short scar face and / or neck lift.

The recent resurgence of the S-Lift (created in the early 1900's), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck.
​
​SMASplasty of the face and platysmaplasty of the neck will further enhance the suspension of deeper tissues.
​
​The 3 opinions you have received are very close in recommendations. Asymmetry or anatomic variations between one side and the other are adjusted for by well experienced surgeons.

Face lift and / or neck lift or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills. Choose who you trust will deliver a level of care you wish to receive.
​
​I hope this has been helpful. All the best!

What can I do to take years off my face?

Dr. Dean Kane Q & A.

Q.  After ten years of a very stressful life, I have decided to invest in me! I lost my only child at age nine to brain cancer medullablastoma then 13 months later lost my husband to a brain aneurysm then my brother passed with liver cancer and last March loss my dad. The toll on me is self evident, it is written on my face, please tell me what can be done to take away the imprint these losses have left me with. Not happy with what I see, I'm ready to write the rest of my story.

A.  ​​​I am sooooo sorry for your losses! Congratulations on pulling yourself up and moving on! Thanks for sharing your photos with us.
​
​Your best initial option will be a face and neck (with platysmaplasty) lift. Depending on the skills of the surgeon, a modified face and neck lift without platysmaplasy will be less expensive and give you a great new start.
​
​Thereafter, consider extending the outcome of your surgery with minimally and non-invasive options. I have added a long winded discussion....
​
​Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.

Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.

The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin" Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!

Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Scuptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.

If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.

You may consider: a traditional face and neck lift, short scar face and / or neck lift.

The recent resurgence of the S-Lift (created in the early 1900's), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the "quicker" procedure but not necessarily the quicker recovery or the improvement you desire.

Face lift and / or neck lift or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills.

​
I wish you the very best!​

Is it better to address skin rejuvenation before or after facelift surgery?

Dr. Dean Kane Q & A.

Q.  Is it better to address skin rejuvenation before or after facelift surgery?

A.  ​​Great question! This is a continuous source of confusion for ALL patients.

​First, you must know all the options under the categories for face, neck, eyelid and forehead enhancements. These include: surgical, injectible, non-invasive laser / peel and skin health.
​
Second, you must compare photos of yourself years ago identifying skin laxity, pigmentation, volume changes and expression lines you wish to rejuvenate.
​
​Third, obtain well seasoned, Board Certified Plastic Surgeon or Facial ENT evaluations with a diagnosis of your aging features.... NOT a single therapeutic recommendation but a management plan.
​
​4th, develop a budget and a timing of what features you wish to improve recognizing you will need 3 weeks to 3 months or longer for recovery.
​
​The following will be helpful:
​
​Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.

Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.

The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin"Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!

Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Sculptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.

If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.

You may consider: a traditional face and neck lift, short scar face and / or neck lift.

The recent resurgence of the S-Lift (created in the early 1900's), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the "quicker" procedure but not necessarily the quicker recovery or the improvement you desire.
​
​YOU'RE CORRECT, IT IS CONFUSING!  I advise my patients:

1. that ZO skin health and Sculptra begin and continue to rejuvenate the texture of the skin before and after and surgical and injectible procedures.

​2. If you have a particular social event for which you wish particular enhancements, consider the recovery period and any potential side-effects or complications.

3. Find a trusting well experienced, Board Certified Plastic Surgeon or Facial ENT Surgeon who offers ALL the skills and options you are considering so he or she may offer you a trusting unbiased recommendation.

I know this has been long winded but I hope it has been helpful.

All the best!