Dr. Renato Calabria Offers Plastic Surgery Secrets The Scarless Facelift

Hi, I’m Renato Calabria, and this is Plastic Surgery Secrets: What Your Plastic Surgeon Will Never Tell You.

The topic of the day is the scarless facelift. It seems to be a hot topic these days, a lot of plastic surgeons are talking about it, and I want to give you my take on it, the truth and what is good and what is bad about the technique.

Basically, scarless facelifts are based on the idea that we can avoid the scar in front of the ear when doing a facelift. Basically with this technique, there’s nothing new; there’s nothing magic about it. We started doing it, the scarless facelift, back in the mid-90s with the introduction of endoscopic plastic surgery, which came from laparoscopic surgery.

Endoscopic plastic surgery is based on the fact that we can operate through tiny, small incisions. With the help of a scope projected to a camera, we can look at the image, and through small instruments, we can work and reposition and remove tissues. This is a great tool that we all have, and I was one of the pioneers of what we call mid-face suspension, or there are different names out there: the ponytail facelift, ponytail lift, the scarless facelift. Every plastic surgeon had put a name on it.

So, basically, endoscopic plastic surgery is based on this principle. But does it work, or does not? Again, a lot of plastic surgeons are using it as a gimmick to attract patients and claim they can do scarless surgery.

Now, it is true that we’re able to perform some surgery endoscopically, some facial plastic surgery, especially the endoscopic brow lift that is done with two small incisions in the hair, so the scars are completely not visible, and also some sort of mid-face suspension, which means we create a tunnel from the temporal area, with the small incision, endoscopically to the mid-face. We use a special instrument to pull a stitch in here and pull the cheek out. So, those are things that have been done for many years. I offered it, but they are geared to a younger patient population where the skin laxity is not a major player.

So, for younger patients, it is actually a great operation.

Now, for the older patient, let’s review what are the pros and cons? The pros, obviously, of doing endoscopically is that there are no scars in front of the ear. But, let’s look at the facts. The facts are that the scar in front of the ear, if it’s placed well and if it’s sutured well, will heal like a fine line, so it will be undetectable. The good part about placing the scar in front of the ear is that you remove and reposition most of the facial muscle. You obviously open, create a flap underneath, and can reposition the muscle as you wish. But, the most important thing is also that you remove the excess skin.

Don’t believe plastic surgeons that tell you that they can do that without removing the excess skin. It’s like the neck; it is the same thing. If you don’t remove the loose skin, the result will not last. The scarless facelift for an older patient is a gimmick. It doesn’t work. I have done it in younger patients, and it works beautifully well. But in older patients, it’s a gimmick. It’s a way to get you in the office, try to sell you something, but the results are not long lasting.

A lot of the surgeons show results at two months, three months, six months, at most a year, when you’re still swollen. And, of course, you look younger. Or they combine the scarless facelift in front with a regular neck lift in the back, but the truth is, it’s a classic neck lift with the scar behind the ears. And when they show the result, of course the neck looks perfect, but the face doesn’t look as well because the extra skin was not removed.

So, scarless facelift has a place in the armamentarium and a place in facial plastic surgery, but it’s limited. And the surgeon who does scarless facelift as well as I do it. I was one of the pioneers, they weren’t… Basically, what happened is, they try to compromise and not give you the best result that you can have by avoiding the scar in front. So you get a substandard result without trying to make it look like it’s the best option for you. So don’t believe it. This is my opinion. Again, I’ve been doing facelift for the last 20 years. I know what works, and what doesn’t work. I have done a lot of hundreds of these scarless facelifts in a selected number of patients.

But the bottom line is, you can’t use the same technique for every patient. You have to customize. You have to do something for a younger patient and something different for an older patient. Don’t fall for the gimmick of the scarless facelift.

If you’re younger, you may be a good candidate, but if you are older, you probably need a regular facelift, maybe a vertical facelift. And, remember, the scar in front of the ear will heal almost undetectably, so don’t fall for the gimmick of not having the scar and not getting a fantastic result just because you don’t want the scar.