Controversies in Facelifting

Fred G. Fedok, MD, FACS

It is a great pleasure and privilege for me to guest edit this issue of Facial Plastic Surgery entitled “Controversies in Facelifting.” In this issue, you will find some of the most pertinent issues regarding the discipline of facelifting. Our efforts, as surgeons, in facial rejuvenation are increasingly in demand by patients in a widening age range. In the not too distant past, “facial rejuvenation” could only be offered via a relatively short list of techniques and technologies. Facelifts, liposuction, browlifts, eyelid surgeries, chemical peels, and dermabrasion encompassed the vast majority of the interventions that could be realistically offered. In retrospect, many of these procedures were less effective, more expensive, and could only be reasonably offered to a narrower cross-section of the population than who we can engage today. There are now requests for rejuvenation from patients both younger and chronologically older than what we saw in the past. So, what happened? What made this change and expansion of services possible and desirable?

Innovation, invention, and analysis have allowed us to better understand the anatomy and biological processes of aging and to develop more tools to remedy. An increasingly active and older population seeks these remedies to complement their better health. The younger patients see opportunities to forestall, if not avoid, many of the less desirable attributes of aging. We now have an expanded palette that includes energy-based devices, biologicals, injectables, and cosmeceuticals, thus allowing the treatment of a wider range of age-related issues.

In many respects, the facelift is the central jewel in the potential rosette of possible interventions. A “facelift,” however, is not a singular entity. Instead, there are several facelift technique variations and adjuncts that allow the surgeon to select and customize the approach to each patient's anatomic nuances. The individualized application of techniques and technologies is essential as one approaches a broader range of ethnicities in their practice. Armed with this spectrum of appropriate options, the modern facelift surgeon is best equipped to offer lasting, effective facial rejuvenation to their patients.

I trust you will find helpful the observations and recommendations in the pages ahead. The discipline and science of rejuvenation continues to move forward; it is the authors' and my goal to assist in your evolution. Be well and best regards.

Publication History

Article published online:
31 August 2020