When people are considering a facelift, they ask, “how long does it last?” This question baffles me. Not because it doesn’t make sense to me that people want to know an answer. And not because I am unaware of the evolution that occurs for my patients after facelift surgery. The question baffles me because I don’t know what they mean by “last”. Everyone readily accepts the basic premise that lifting surgery is not permanent. No one contests the idea that the benefits of a facelift are slowly lost over time. Yet, people ask about the duration of the results and I don’t understand what measurement they would use to determine “last” versus “not last”. Sometimes, I start the answer by asking if they mean that “lasting” is the time period until they are back to where they were before surgery. Often, people will respond, “OK, sure- until then”. So I’ll oblige and reply that it generally takes 10 or more years to be back a pre-surgery state. I then quickly add that, within one month after surgery, no one cares what they looked like prior to the procedure. I say that it would be disengenuious of me, knowing how people react after a facelift, to pretend that this 10+ year answer means anything to patients after the procedure is over. People don’t remember what they looked like before surgery, nor do they care. So again, I ask what does “last” mean? The plastic surgery studies evaluate the gradual return of jowling, nasolabial folds, marrionette lines, and lax neck skin, in an attempt to rate the duration of facelift improvement. But this doesn’t help me answer the patients’ question because I still don’t know what they mean by “last”.
I believe what people are asking is, “when will I be dissatisfied with my appearance again?” And if I’m correct, their is no way for me to know when this will be, even if I’ve done the best face lift possible. The most honest answer is that a facelift lasts until a person doesn’t like the way he or she looks any more and there’s no way to predict which endpoints would create this personal conclusion. Therefore, we can’t know when the parameters will be reached for each person to deem the results, “no longer lasting.” If I do the exact same facelift on identical twins and they get the same results, they may have completely different perspectives on the duration of the improvement depending upon their individual mindsets. Even when I know precisely how my patients would look each year after a facelift, I simply can’t predict when they will no longer enjoy their results.
So how do I answer this puzzling question without getting overly-philisophical about the human condition? Just as I have done above. The benefits of a facelift are lost with time at a variable rate depending upon each person’s skin elasticity, etc. But the duration of happiness someone enjoys from their results is dependant upon a mindset that is only truly understood by each person, and me, after surgery. All I can do is turn the clock back in the most natural and safest way and hope that my patients find the experience rewarding for many, many years.
Dr. Steven Vath