Composite facelift

Abstract

Because of the great demand in the last several years for aesthetic surgery and because of the impact of managed care in medicine in the USA, there have been many unforeseen changes. Managed care with its long-reaching problems has encouraged surgeons and doctors from other specialties to perform cosmetic procedures without adequate training. In addition, the need for marketing has sold the public on the advantage of short and simple procedures in facelifting that may allow only a few days of convalescence. With more public awareness of poor results, there appears to be less enthusiasm for facelift surgery as there has been a progressive drop in the number of facelifts in the USA for the past 50 years as compared with the increased popularity of breast implants, liposuction and other nonfacial techniques. Unfortunately the steeper learning curves for more sophisticated techniques make widespread use of these techniques impractical. However, surgeons with adequate facelift practices and experience can learn composite facelifting, which is a simple application of the principles of soft tissue surgery that most well-trained surgeons can easily perform. Suboptimal results following body contouring or breast surgery do exist but are usually guarded as a personal problem with no public awareness. The ability to create a harmonious and attractive result with composite facelifts may well be the ideal marketing tool since these unique results are obvious to the patient and others as well. A surgeon who learns composite facelifting will be served well by performing primary and secondary procedures since the composite facelift appears to be the only documented and published procedure that can correct problems created by conventional techniques. While facelift deformities are not the fault of the surgeon but are unintentional sequelae of older techniques, it is therefore the techniques which must be examined and changed. Composite rhytidectomy as a primary procedure will create a harmonious facial rejuvenation which will disallow the appearance of unwanted deformities. © Springer-Verlag 2007.