Can you go nonsurgical or….do you need a facelift?

Dr. Irwin. I have just turned 70. I am seriously considering a facelift and injections, etc. I simply don't know who to trust, and I don't have friends that have had procedures done. I consulted with the dermatologist in Dallas that you recommended and he was very nice and knowledgeable, but I was NOT impressed with the Dr. that he referred for a facelift. I had a VERY full face and have lost the volume in cheeks and have lines around the mouth and on cheeks. My skin has thinned! I REALLY want to consult with someone that will tell me the TRUTH about what should be done. Is it possible to fly to Seattle and have a consultation with YOU! I called your office, but I don't think the lady understood that I wanted a consultation with you. Possibly, YOU don't consult with patients and only perform procedures? I don't know. Could you please tell me if you do consultations with people from out of state. Thank you so much for a reply!

Thank you for this question.  I think I’ll do this in 2 parts.  This part about facelifts.  And the next one, in a week or so, on … do you find a doctor you trust.

On facelifts:

At our clinic, we are not opposed to them, as long as they are the safest, most cost-effective way to solve one of our patient’s problems.  We also consider what the results might be both short and long term. We know several excellent plastic surgeons in Seattle and in Los Angeles who do great work.  So we generally refer to them, when we refer.

We consider the general skillsets of that particular surgeon and the goals our patient is trying to attain.  Here though are some of my thoughts:

  • There is some risk, especially with general anesthesia, and especially after the age of 65.  Also, consider your general health.
  • Scars don’t always turn out well. They can be too visible.
  • We are asymmetric to start with, and surgery often seems to aggravate this problem.
  • If they pull up too much, the face doesn’t look younger, it just looks windblown.
  • If they pull up too little, the face often looks natural, but then the facelift seems to last only about 5 years.
  • If the person is a thinner, and a low body weight person, the pull tighter can actually make the bones in the face TOO visible and skeletal.
  • If a fat transfer is done, it may not be even, and can “wear off” differently on each side.
  • Second and third facelifts rarely turn out better, in my opinion.

Most importantly, we can now improve most problems nonsurgically with less risk, and a more natural look.

Bottom line:   If you really have your heart set on a facelift, then get at least 2-3 opinions, until you find the surgeon you trust and feel comfortable talking to.  Also, see my next blog on how to find a doctor that you trust.

Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
Follow my skin tips and travels on Instagram!


Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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