The Refresher Process

Pictures First Consultation

The first consultation with a Refresher Lift plastic surgeon begins with an evaluation of your motivation for surgery. We want to make sure that you have realistic expectations and valid motives. For example, whereas it’s okay to be motivated to look younger and more attractive or increase your confidence professionally or socially, desiring plastic surgery because of low self esteem or a desire to look like Angelina Jolie are perhaps not the best motives.

Is the Refresher Lift right for you?

On your first consultation, we also want to make sure that your physical characteristics are conducive to obtaining good results. We want to rule out other areas that may need treatment rather than those specific to the Refresher Lift. It’s a fact that most Refresher Lift prospects do not understand why they need such a lift. Is it the eyes, the saggy skin, the fine wrinkles, or the nasal-labial folds? Besides the Refresher Lift, there are at least a dozen features that can be improved with facial procedures. To name just a few: brow lift (forehead wrinkles and angry look), lower eyelids (tired look), upper eyelids (impaired eye sight or old look), neck plication (hanging neck skin or "turkey neck"), TCA Peel (fine wrinkles on upper lip), Fractional Erbium or Nd:YAG 1540 Lasers (age spots, acne scars, fine lines), etc.

With so many options for facial rejuvenation, a consultation with a board-certified plastic surgeon is very important!  Other medical specialties are not trained in all the areas of the face, or the procedures best suited for those areas, so they cannot give you an unbiased opinion of what is best for you.  Imagine that you have a problem with your car that you cannot diagnose. Would you take your car to a brake shop, a body shop, an AC specialist, an exhaust specialist, an engine mechanic, or a transmission shop? If you choose the wrong specialist, you may end up fixing something that needs no fixing. Facial plastic surgery works in the same way.

Erasing the clues of aging

How can you tell someone's age? The human brain can analyze millions of pieces of information in an instant to determine age — the face being what we look at first. Your brain quickly analyzes tell-tale hints on the face like skin tone, fullness of lips, eyelid smoothness, cheek fullness, and wrinkles. As Board- Certified Plastic Surgeons, we focus on removing these tell-tale hints so that others see the younger, fresher you of yesteryear.

Let’s have a look at how these signs of aging are removed with a Refresher Lift.

Computer Simulations

During the initial consultation, our sophisticated computer simulation will show you approximately what you will look like after surgery.  Note however, that such simulations cannot be predictive of the actual results but are highly indicative (and many times even better than what was simulated!). Why can’t the computer show actual results? In some ways the computer is one-dimensional. For example, a brow lift can take away frown lines to create a more relaxed, happier look. The computer can simulate raising the eyebrows up in one direction to illustrate this procedure. In actuality, however, what happens during a brow lift is that the forehead (and therefore the eyebrows) is raised in several directions in order to raise the eyes. So while the computer can simulate the results of the procedure, in cannot take into account many of the extra intricacies our trusted surgeons have refined over the years. Skin tone may also not appear exact in computer simulations, but in some cases may actually be far superior after the Refresher Lift compared to before.

Likewise with before and after photos. The reason is that following surgery, skin tone typically improves for several reasons:

• First, wrinkles will tend to disappear because the skin surface is stretched slightly so as to do away with loose/hanging skin.
• Second, since the skin is displaced slightly relative to the underlying muscles, the old wrinkles will no longer reappear where they once were, giving the old wrinkles time to "heal" and fade away.
• Third, the skin after surgery will look fresher and rosier because of the increased blood flow to the face — something that is not simulated by the computer.

Compare the computer simulations below with the actual surgical results and you will easily understand this concept.

Computer Simulation Side View

Notice how the surgeon via the computer has removed the slightly hanging neck line, raised the eyebrow, and diminished the nasal-labial fold.

Computer Simulation Front View

Notice how the right picture has the nasal-mouth folds removed, a straighter jaw line, and slightly raised and smoother forehead.

Computer Simulation 3/4 View

The simulation shown on this view is a straighter jaw line, and an almost imperceptible lifting of the cheek. However, the angry look is still slightly there because the brow has not been lifted, just the eyebrows!

On the day of surgery, we take more pictures without makeup so that we have pictures that we can compare, also without makeup, a week to two weeks after surgery.

These preoperative pictures are actually more important than the consultation pictures because without makeup, all the small wrinkles, folds, and skin blemishes are visible. These clinical pictures are the ones we use to determine the actual changes pre- and post-operatively.

Pre-operative Pictures

Post-operative Pictures

A week following surgery, we take another set of pictures. These photos are also taken without makeup and compared with the pre-operative pictures. As you can see from these pictures, there is still slight bruising around the eyes, and the scars are still visible on the brow, hairline, and around the ears (which all can be camouflaged with makeup).

What’s more noticeable is the skin tone, which looks more like the skin of an 18 year old rather than a 48 year old woman. This effect is created by stem cells that we inject in the face (along with the adipose tissue) which creates new capillaries that increase the blood supply to the skin and creates this skin glow.

In fact, when this particular patient went out to dinner with her 20-something year old son, her son’s friends thought she was his date!

Finally, one to two months following surgery, we take our last pictures and these are with makeup and compared to the ones taken during the consultation.

As you can see, the final results can be stunning. Although we cannot turn back the clock, the Refresher Lift can indeed fool the brain into believing that you are up to 20 years younger than you really are. The actual results are better than what the computer predicted because the computer cannot show changes that happen on a three dimensional object.  Nor can the computer show the skin tone enhancement. When we say that computer simulations are not meant to represent the final outcome, we mean it! The Refresher Lift is not a gimmick like so many of these “lunch time procedures” that do nothing more than make you look unnatural, feel dissatisfied, and end up poorer. Moreover, the Refresher Lift can only be performed by Board-Certified Plastic Surgeons who have shown competence in facial cosmetic surgery. That is your guarantee that the surgeons who perform the Refresher Lift are not depending upon a weekend course to make you look better. They are all Board-Certified Plastic Surgeons with experience in hundreds to thousands of plastic surgery procedures. They are the best of the best.