Looking to make a change, but don’t want a major overhaul? Consider smaller surgeries, which are gaining traction and becoming the way to go for certain patients.
Small Change, Big Impact
Nonsurgical treatments serve a purpose, but they have limitations. “They are great, but they don’t give the same results as surgery,” says Salt Lake City facial plastic surgeon P. Daniel Ward, MD. While many people accept nonsurgical options for what they’re worth, others want more “oomph” and permanence. Advances in science and technology and a better understanding of aging have allowed doctors to develop quick procedures that can be done under local anesthesia. The results are impressive, and the recovery processes are brief.
A paradigm shift from corrective to preventive surgery drives younger patients to choose these youth-maintaining “tweakments.” Beverly Hills, CA facial plastic surgeon Kimberly J. Lee, MD says, “Some patients get their feet wet with more minor procedures before larger ones.” Every face is unique, and each patient has goals to achieve. Kirkland, WA facial plastic surgeon Daniel J. Liebertz, MD adds that younger patients who opt for these surgeries do not usually display signs of significant global aging. “These procedures are appealing because they target a single region and get people back on their feet in a week or two.”
01: Buccal Fat Removal
What it is:
Plastic surgeons have been removing the deep buccal fat pads in the cheeks long before young Hollywood made it the procedure du jour. Stanford, CA facial plastic surgeon Sam P. Most, MD calls the surgery easy with minimal downtime. “A small incision is made inside the mouth at the cheek to access the fat pad, and some fat is removed.”
Palo Alto, CA facial plastic surgeon Jill L. Hessler, MD says, “The goal isn’t to create a hollow-looking face, but rather to reduce the excess fullness in the cheeks.” The buccal fat pads can obscure the cheekbones and jawline in naturally full faces, so removing them creates a more chiseled look.
How long it lasts:
Forever, but weight gain and aging affect the results.
What else you need to know:
The face can appear older and gaunt with less fat, especially in thinner faces. “You want to be careful and think about future facial volume loss and skin laxity,” adds Dr. Hessler.
02: Preservation Rhinoplasty
What it is:
A typical rhinoplasty removes parts of the nose that cause imperfections. But preservation rhinoplasty, which has become mainstream in the last few years, retains much of the natural cartilage, tissue and bone in parts of the nose where they are typically surgically removed or altered. “It keeps a natural nasal contour, providing a beautiful result in the right patient,” Dr. Most says.
New York facial plastic surgeon Lee Ann M. Klausner, MD explains that the procedure can utilize an ultrasonic device to reshape the bone, which is thought to be more precise than traditional rhinoplasty instruments. “It’s less traumatic to the surrounding tissues, which results in less postoperative swelling.”
How long it lasts:
Indefinitely
What else you need to know:
The technique works best for noses with minimal flaws from the front and small humps that aren’t crooked.
03: Chin + Jawline Liposuction
What it is:
The ultimate fix for a “snatched” profile. It removes fat and a double chin through incisions hidden under the chin and behind the ears, which allow the bony structure to stand out.
How long it lasts:
Forever
What else you need to know:
The surgery uses local anesthesia, takes less than one hour and offers minimal post-procedure pain, bruising and swelling. “Most patients are back to work in a few days,” says Dr. Liebertz. In some cases, fat removal can cause the skin to appear loose. Dr. Klausner likes to tighten the skin with treatments such as FaceTite and Morpheus8.
04: Reunion + MyEllevate
What it is:
Rivaling the effects of a mini-necklift comes the one-two punch of Renuvion and MyEllevate. Renuvion, an FDA-cleared device, improves skin laxity under the chin and on the neck using helium plasma and radio-frequency energy delivered via a probe under the skin. Renuvion is often coupled with MyEllevate, a minimally invasive, light-guided procedure that uses semipermanent sutures to re-elevate facial and neck muscles. Together, the treatments improve skin, tissue and muscle laxity, as well as lines and wrinkles on the face and neck.
How long it lasts:
Between three and five years
What else you need to know:
Dr. Lee says the combination is less invasive than surgery because there’s no cutting. However, there is bruising, swelling and discomfort.
05: Lip Lift
What it is:
Lip lifts are in demand and beloved by those experiencing filler fatigue. “Once people realized the downsides of lip filler, they discovered that removing some skin between the upper lip and the base of the nose enhances the lip’s shape and allows more of the pink lip to show,” Dr. Ward says.
The straightforward procedure takes about one hour under local anesthesia and requires a few days of downtime. First, a small incision is made under the nose. Then, the skin above the upper lip is pulled up and sutured to raise the height of the lip.
How long it lasts:
Forever
What else you need to know:
Lip lifts offer almost immediate results, but scarring is a trade-off. With good scar management, the scar should fade and become barely visible. Some patients may still need a bit of filler for added volume. Those with a prominent gummy smile should avoid the procedure, says Dr. Hessler, as it can make it appear worse.
06: Mini-Necklift
What it is:
The mini version of a traditional necklift, which tightens the platysma muscle and saggy skin in the neck through incision points under the chin and behind the ears, leaving inconspicuous scars. Dr. Liebertz says these lifts improve the neck contour and skin tightness in those with very early facial aging.
How long it lasts:
Five to 10 years
What else you need to know:
A mini-necklift has far less swelling and bruising than the full version. However, Dr. Liebertz adds that patients with significant skin laxity, double chins or vertical bands won’t see a major improvement.
