Bulletin Board for Patient's Questions and Answers
Facelift / Neck Lift (Rhytidectomy - Rhytidoplasty) 2

Explore what others have to say about cosmetic face and neck surgery with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

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Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Facelift

Subj: Re: Face/eye lift

Dr. Bermant,

Hi, I am a 36 yr old male. Over the last few years I have noticed that my face underneath my eyes has begun to sag, probably my facial muscles. Also this has resulted in the area beneath my eyes as becoming whiter than the rest of my face. It is making me look older than I would like. This has begun to really bother me.

Is there anything I can do for this condition? Would the new endoscopic surgery be an alternative? Any advice would be greatly appreciated.

Thank you.

B

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

The face does show aging. The face is what we and others look at and shows that aging early. Sagging structures often look lighter due to illumination and shadows. Without an evaluation and examination there are just too many possibilities that any E-mail could ever do justice to. Endoscopic surgery is one method of operating through smaller incisions and is of use in certain cases. Set up an office consultation to start the learning process to see what your options are. It is one of the best methods of patient education.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Subj: Re: Facial surgery

Dear Dr. Bermant:

I am 34 and no matter how much weight I lose, I seem to have a double chin, sort of, and I had a really nice jaw line, but it seems as I'm getting older it's just not as defined as I would like it to be. so... can you please give me some info regarding plastic surgery for this problem? Like what can you do for me, how long the surgery may take, how long will I have to take off of work, will I have visible scars while it's healing or whatever, how long does something like that take to heal and last of all how much can this cost, approx.

I will be so grateful for your help. I live in ..., VA, and I like what I have seen in your credentials. I hope you can help me. Also, there are couple of other facial problems I would like to correct, but this is my first priority. ?

Thank you.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

There are two different problems that can result in a double chin.:

    • excess skin
    • excess fat

The excess skin comes from gravity doing its job and pulling the skin down the face into the neck region. The extra fat is from our eating habits. Losing weight sometimes does not affect certain regions as much as we would like.

Each problem has slightly different solutions, sometimes both problems coexist. Excess fat alone can be treated by liposuction. Excess or drooping skin is treated by a combination of neck and or face lift. Here are photographs of a case where I used a facelift, neck lift, and liposuction. The type of surgery for your problem would depend on what your problem is. There are many types of face lifts with different extents of surgery depending on the problem treated. Writing a long detailed explanation of all possibilities is beyond the scope of what is appropriate. Your best next course for your education process of what might be available for you is a consultation. That is where we continue our patients' learning experience of what plastic surgery has to offer.

Typical costs for the more extensive operation (face lift and neck lift) range from $4500 - $6500 for the surgeon's fee, $900 for the operating room and about $850 for anesthesia. Costs can go much lower or higher depending on what the problem we are treating. We can give a much better idea of the costs after an in office consultation. For instance a minimal face lift under local anesthesia would not need an anesthesiologist and have a lower OR and surgeon's fee.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Subj: Re: facelift

Dear Dr. Bermant,

I am a 23 year old male with a few questions about how plastic surgery can help me. I am not satisfied with the shape of my face. When I was in high school I lifted weights and worked out my neck constantly. The muscles in my neck bulged tremendously by the end of my senior year. Little did I know that, 5 years later, these muscles would sag and give me a "doughy" look. I want a more defined chin and cheeks that are more cut than they are now. Is this taken care of with a "face-lift"?

Also, I think I have a pigmentation problem with my skin. Even when my skin is acne-free I have reddish/pinkish discolorations that look like shadows of acne. I am curious to know if you have any procedures that can handle this problem or if you can point me in the right direction.

Finally, I want to ask you about money. How much would a consultation run me? I am a Marine stationed in Quantico, Va, and I would be more than happy to make the drive to see you. Also, can you give me a ball-park figure on what you charge for a face-lift? I know that the government will not support me on an "elective surgical procedure," but I have access to money.

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

It is extremely uncommon for a facelift to have value for a 23 year old face. This operation is usually best to restore the effects of gravity and aging. Facial features can be accentuated with surgical implants placed near the boney layers. We generally do not offer such cosmetic implants because I feel that the risks outweigh the benefits. I do use such implants for trauma and tumor reconstruction.

It is hard to comment about the skin condition without seeing you. The best resource however for such problems is a dermatologist. I usually refer my patients for such assistance when I am not certain what would be best for them.

We pride ourselves in patient education. Learning that surgery is not necessarily the best option can be a very valuable experience. My surgeons fee for a facelift $5000. Other charges depend on anesthesia, where surgery performed, and other issues.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Subj: Re: face lift

I recently had plastic surgery done on the brow, my eyes and a face lift. It has been 15 days and I seem to be healing well according to my Dr.. I had all staples in my head but around the hairline in the back and the sides, where I had stitches I have a lot of scabbing. The scabbing went all the way out in to my cheeks. I'm glad I had another week off at work. I talked to my cousin who had the same done and she had no scabbing. What caused this on me?

Dr. Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Good question for your doctor. Hard to tell which of many factors could have contributed to such "scabs" as you describe. Possible causes can include (other causes are possible):

    • blood not cleaned from suture lines
    • cleaning techniques used
    • excessive after surgery bleeding from wounds
    • how well the skin was put together (approximated)
    • your own healing nature
    • healing problems

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Subj: Re: facelift elevating malar pads

Dear Dr Bermant:

I am a 65 year old male considering a facelift. Dr "Smith", the most recommended in my NJ metropolitan area does a conventional lift and tell me the nasolabial folds will be improved 50%. Dr "Jones" (ASPS, PLS, excellent credentials), not as well known, tells me by raising the malar pads, the nasolabial folds will be impoved 80%. This is a relatively new procedure. Dr Jones cannot show me before and after pictures because of patient confidentiality (understandably). The deep naso folds are what bothers me most. I am in a quandry. Do you have any suggestions? Is raising the malar pads a proven superior technique?

Costs are relatively high in my area. If I go out of state (or out of country) for lower costs, how can I be assured of the skill of the surgeon? The quality of the faclift is more important than the cost. Thank you for your reply. Yours truly, D..

Dr. Bermant responds:
This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Facelift surgery has evolved over the years. New techniques come, some withstand the test of time. Other methods become fads and then fade as the results prove not as enduring or newer methods replace them. Give me a crystal ball that shows what will turn out best, and I will let you look with me. I too like conventional SMAS methods for many patients. A malar extension permits nice nasolabial fold restoration. In other cases malar elevation is more important. The tissue over that part of the cheek can droop and cause severe folding. It is best to be flexible and use what seems best for that particular patient. Deep plane malar dissection can produce very nice results but also spectacular complications. Without seeing your case, it is impossible to say which would be better. Different doctors can use different approaches to give equally nice results. There is no best way to choose the doctor. Who did you feel most comfortable with?

Costs are not the best way to choose a surgeon. There are many horror stories of patients trying to go out of country to doctors not as well trained as those board certified by the American Board of Plastic Surgery. In Richmond facelift surgical fees run from $3000 6,500 depending on what needs to be done. Hospital OR costs can be under $900.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Thank you very much for your reply Dr. Bermant. It is a help to me.

Yours truly, D.


Subj: Re: fat chin

Hi Doc,
I know I would look tremedously better if I had my chin tightened just a bit. I have what appears to be baby fat under my chin. It is not a pronounced as the patients displayed on the web page; but it's enough to cause me to write. Approximately, (just a range) would it cost to have some liposuction and possible muscle tightening of this area?
Thanks in advance,
c

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Neck lift and facial liposuction can be for less extensive problems. Costs depend on too many factors as a small office localized neck liposuction is much less expensive than a formal facelift. Let us help you explore your options. Once I know what you are asking us to do, we can give you a price.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Subj: Re: neck lift

I am interested only in having a neck lift, but when I went to one surgeon he wants to do a face lift and neck lift. When I told him I was only interested in the very loose skin hanging underneath my chin to be removed, he said that you just didn't get rid of that that you had to do the whole procedure. Is this correct? My face is just fine, my eyes are good, and so is the area of my cheeks and mouth. It is just this loose skin hanging around my neck that I dislike so much. I'm 41 and have recently lost almost 60 pounds. I still want to loose another 5 to 10 pounds to reach my goal, so he did say I should wait until I loose the rest of this weight. What is your answer to this, do I have to have a face lift in order to have a neck lift?

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Neck lifts are most frequently done through the incisions used for a face lift to hide the scars. In addition the forces used to correct the deformity of the sagging neck are the some of the same used to correct the sagging face. Drawings and photographs demonstrate these points. Surgical sculpture is easier to perform after weight loss. Trying to guess what the tissue will be after the weight loss is harder to do than surgery at your desired weight. Major weight loss on an operated neck can be unpredictable leaving loose skin that could have been managed with the surgery. Patient education is important in MY office for MY patients. These questions are good for your doctor and are much better managed in a consultation face to face. We try to design the educational process that our patients do not have to go looking to the Internet for answers.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Subj: Re: chin

I visited your web site but could not find any information about chin lifts. Is there a facility in the Richmond area that deals with that type of surgery? How can I find out if I am a good candidate? Thank you, K

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

I perform chin lifts. This is a name for a group of operations to handle various problems of the drooping chin. Some suffer from tissues sagging just under the chin. That is part of a face and neck lift. Others develop laxity of the supporting tissues of the chin itself. This is less common and is treated through an incision inside the lower lip. The best way to understand the problem is for an in office consultation and evaluation. I can then direct our education towards solutions for THAT SPECIFIC ANATOMICAL ISSUE.

There are just not enough hours in the day to put all of the types of surgery that I perform on my website. Plasticsurgery4u is a representation of what we do, the style we work with our patients, and details about me. As time permits, it will continue to expand as it has over the past year.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

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