Premiere Facelift Specialist David Santos, MD, FACS
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Category: Aging

Plastic surgery patient demographics are changing

Plastic surgery patient demographics are changing – Related Stories – Plastic Surgery SmartBrief.


It would be smart to discuss this issue with the cosmetic company prior to the procedure and come to an agreement. This would have avoided the problem. Perhaps she could have gotten it done without the reality tv cameras, and avoid potentially loosing her endorements.

Article from below here


Kris Jenner says the cosmetics company she endorses has NO RIGHT to sue her for getting plastic surgery back in June … because the procedure didn’t affect her face … it just tightened up some loose neck skin.

The company in question — called B&P — sued Jenner earlier this week, claiming she breached a contract to endorse a line of their anti-aging skin care products … when the famous mother publicly admitted to getting a facelift.

By doing so, B&P alleges, Jenner violated her agreement not to harm the reputation of the company and the product she’s endorsing — an eye care line called “Beautiful Eyes in a Bag.”

But sources close to the Kardashian Klan tell TMZ, Kris is adamant … the lawsuit is BOGUS — because Kris’ facelift didn’t affect her eyes in any way whatsoever … JUST HER NECK.

Kris’ alleged agreement with B&P went into effect in March 2011 and was to be effective until March 2012 — but Kris admitted … she got the facelift in June.

Vertical Scar on Neck to Remove Loose Skin

Blanchard asks:

I am a 58 year old female with history of weight loss of 135 pounds. I had a very successful abdominoplasty (removal of 10 pounds of skin) and breast reduction with lift. I am scheduled for an arm lift soon and would like to have my loose skin removed from under my neck. My PS tells me there is so much skin there that I would end up with big wrinkles behind my ears so he suggests an incision down the front of my neck. I will be a long incision. Is this normal? I am concerned.

It is quite common to have moderate turkey gobbler deformity or significant loose skin in the neck area after losing weight.  Today frequently, patients who have undergone lap band surgery or gastric bypass surgery and have lost a good deal of weight, 50 to 100 pounds, have resultant moderate laxity to the neck skin area.

Remedy for this particular problem is somewhat complex.  Some surgeons will approach the solution differently.  One good answer is to simply perform a standard neck lift/facelift to significantly improve the neck issues.  This can be performed at the same time as a platysmaplasty which requires an incision in the submental crease which is just behind the chin area and minimally visible.  A large percentage of patients who undergo this procedure in an expert fashion will have resolution of concerns to the neck area, but there is always a possibility of persistent laxity in the neck area.  Staging of the procedure is also a consideration.  Many patients undergo standard facelift/neck lift with submental approach platysmaplasty will not require further treatment of the neck area, but some do and when they do a vertical scar in the neck area, also known as a t-neck, can be utilized and decided upon at that time which is essentially at a later time.  So in essence, a vertical scar is not essentially required or necessary but indeed might be depending on the particular anatomy and circumstance.

David Q. Santos, MD

Seattle Facial Plastic Surgeon

I Had a Facelift 4 Years Ago and Don’t Want Another One What Can I Do to Help Sagging?

Photo from here

Sharla DeCelle in Las Vegas, NV asks:

I had a facelift approximately 4 years ago and have started to get the deep fowls around my mouth. I’m 60 years old and want to look vibrant for my age but do not want a another facelift. Are there other alternatives that will help the wrinkles and jowls?

Several options for nonsurgical facial rejuvenation:

If your areas of concern are the “deep frowns” around your mouth; so often the nasolabial folds and marionette lines around the mouth contribute to the sagging and contribute to the aged appearance.  Without doing “surgery”, injections into these areas, particularly with fat transfer or other materials can provide good resolution/good improvement, without undergoing a repeat facelift.  Specifically for wrinkles on the other hand; wrinkles are nicely treated with expert fractionated laser treatment.  If you are concerned about the sagging jowl; in some instances laser lipolysis can provide some tightening in this area although this has to be done with great expertise and care.

Nonetheless there are options to help rejuvenate the face that don’t entail or require facelift surgery.  But there is not a single procedure that will provide resolution for the areas you are concerned about, but a combination of these treatments can remedy the problem.

David Q. Santos, MD

Seattle Facial Plastic Surgeon


How Long Do the Effects of a Lifestyle Lift Last?


A regular facelift or separate procedures cost so much more, but I’ve been told that the effects last 5-10 years if you don’t smoke, or experience weight changes. How long can I expect the effects of a Lifestyle Lift  to last under similar conditions?

Image via here

The important component of a Lifestyle Lift is tightening of the deeper structures of the face, the SMAS/fascia and muscle structures. This tightening provides a real improvement in the overall appearance, particularly in the neck and jowl area. It is impossible to attribute an exact time period to which you turn back the clock, however as a general rule Lifestyle Lift and/or facelift provide around eight to ten years loss of appearance of aging. It is true that standard facelift procedures do cost more, but Lifestyle Lift provides an efficiency that translates into saved dollars for the individual who desires real aesthetic improvement. Essentially when undergoing a Lifestyle Lift or a facelift by an experienced surgeon, one will expect to achieve a good  improvement in appearance and aesthetic youthfulness and decrease in the overall appearance of aging changes. This is a turning back of the clock. We can’t stop the clock, we can’t stop aging, but we can back it up several notches with a lift procedure. As time goes on, ongoing aging will occur.

David Q. Santos, MD

Seattle Facial Plastic Surgeon

TLC for Skin Below the Chin

Article from The American Society for Aesthetic Plastic Surgery

If you’re a woman of a certain age, a glance at your exposed chest may show that you need more than a pushup bra. Women in their fifties begin to show wear in exposed areas. According to the June 2011 issue of More magazine, “Your skin below the chin needs TLC.”

Nora Ephron, author of “I Feel Bad About My Neck” is not alone. Necks are frequently left unprotected with moisturizer and sunscreen. But, if you’re starting to look jowly, there’s a surprising and effective treatment for loose skin under the jawline. A plastic surgeon or dermatologist can skillfully inject Botox into the vertical muscles under your jaw, relaxing them so that they loosen their downward pull on the skin. Cost is $250 and up.

You may also have loose neck skin, sadly but aptly referred to as “turkey neck.” Tighten up before Thanksgiving with Thermage, a skin tightening treatment that uses radio-frequency energy to heat the skin’s deepest layers and stimulate collagenproduction. Cost is about $1,200. You can also boost Thermage effects with Fraxel, a resurfacing laser. If your knees are also sagging, the same skin tighteners used on the neck are also used to lift and tighten this hard-to-fix area.

Your chest, which is so evident in today’s scooped out styles, may be striated with lines and discolored with mottling. Mottling can be treated with glycolic peel laced with retinoic acid for about $100 to $200 a session. Pigment-targeting lasers will take care of your brown spots in about 3 sessions at $350 each. A hyaluronic acidfiller, such as Restylane, could even be used to plump up the lines in your chest for about $500 a treatment.

To prevent further damage, slather your chest with sunscreen, especially in the frequently-exposed clavicle area.


Celebrity Plastic Surgery:  Lynne Curtin from the Real Housewives

Lynne Curtin from The Real Housewives

Is It Safe to Have a Facelift After Sculptra?

Eimel in Gold Coast asks:

“I had a Sculptra injection and am supposed to have 1 more in 6 weeks, the doctor’s idea was to make my skin stronger so he can do a threadlift. After doing some research I think this is not for me and I’d like to go back to my original idea of having a traditional facelift – but I am now worried that if I get a facelift when my skin is a bit tighter from the Sculptra treatment it will sag again in 1-2 years once the Sculptra wears off. Can this be a problem after just 1 Sculptra injection?”

It is safe to have a facelift after Sculptra.

Sculptra is a quite successful filling agent that provides fullness to the face and lasts for a prolonged period of time.  Some feel two years and some researchers and physicians feel that it lasts even longer.  It is actually difficult to absolutely state the time that an individual Sculptra might dissipate, if at all.  It does not simply go away completely at two years.

The best time to choose to do a facelift should not be influenced by when fillers such as Sculptra might wear off.  When there are significant sagging components to the face, particularly jowls and neck area, the best remedy is for a facelift.  Indeed many individuals undergo a facelift and also have concomitant filling, whether fat grafting, Sculptra or other fillers such as Restylane.  This provides additional rejuvenation.  If you have a facelift now, there will be changes over time that are for the most part unpredictable.

The best answer is to have a facelift now and as time goes along consider supplemental rejuvenation treatments as needed and as recommended by your physician, such as additional Sculptra or additional other fillers.  On the other hand, if you wait for the Sculptra end point, when all the Sculptra is dissipated, the time period of this waiting period could be two years, could be several years and is unpredictable.

By David Q. Santos, MD -Real Plastic Surgery

The New Face of Suzanne Somers


We see another transformation from one of the loveable people in whom we have watched so much over the years.  Suzanne Somers is a beautiful woman and has been the likeable star of Three’s Company, and the leader of ThighMaster.  She wants  to keep her youth and beauty, she wants to look better.

When making this decision it is imperative to make sure that the plastic surgeon is board certified and has performed a good deal of the particular rejuvenation procedure. We do not know exactly what was done, but, these pictures suggest fillers of some nature.  Fat grafting is the present day most popular rejuvenation filler  although temporary fillers such as juvederm(R) or Restylane (R) are common as well.  Her new look is very unnatural, grainy, doughy, sponge like.   The best guess, as to what was placed, would be that of fat grafting.

With fat grafting the fat is harvested from the abdomen or thighs, and injected expertly into the face.  Great care must be taken to place the fat in deeper tissues and to apply the right amount in the right places.  Also expert techniques are required again, which further qualifies the importance of having a surgeon who has doe this a lot provide the service.

Generally, a good deal more of fat is placed in areas than ultimately desired, so that increased overdone bulkiness of areas treated is common and normal.  Some studies suggest 30% of fat ultimately takes to provide the desired effect.  We do not know how long it has been since Ms. Somers procedure and so there is real hope that the plumpness will recede over time.  In fact if this was soon after the procedure she could actually have a good result, but this may be overly optimistic.  Time will tell.

Nonetheless, if there was too much fat placed then it certainly will certainly ultimately look unnatural down the road.

We care about Suzanne and hope her the best.

David Santos MD

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