Dr. Wong Thoughts

Surgical vs. Non-Surgical Facelift

posted April 1st, 2013 by waesthetics in Facelift

Facial rejuvenation is an all-encompassing term that includes surgical as well as non-surgical modalities. I am often asked about what modality is the better than the other. The truth is that they both have a complementary role in the plastic surgeons overall strategy in facial rejuvenation and the appropriate technique is selected based on the patient’s extent of aging changes, expectations, willingness to undergo surgery and tolerance for time of work and social engagements.

It is also important to be clear when explaining to the patients that while these treatments do produce ‘results’, the degree of improvement attainable is different. Generally speaking, non-invasive procedures that have no downtime would deliver a very subtle improvement of the aging face, while surgical procedures with some downtime and require time for recovery would give a profound improvement of the aging face.

Non-surgical ‘facelift’ techniques include the use of lasers, radiofrequency and focused ultrasound. These modalities are safe and are able to provide firming and tightening of the skin. They are especially good for patients with very early aging changes and the main advantage of non-surgical facelift technique is that down time is minimal and patients are able to return to work almost immediately. The beneficial effects such as firming and tightening of the skin will gradually be felt over the coming weeks.

The next level up in terms of the results attainable is the minimally invasive surgical lift – and this is the thread lift. With this procedure, sutures with little ‘barbs’ of ‘hooks’ in them are meticulously placed under the skin and secured to the firm tissues of the temple. Lifting and redraping is achieved and these generally last up to 1 to 2 years. The procedure can be repeated at regular intervals as needed and because there are no incisions downtime and swelling are minimal.

Figure: Facial soft tissue spaces are spaces in the face that can be used in facelift that gives safe and atraumatic access to the face. Tightening the facial soft tissue via these spaces gives a profound lifting of the tissues without creating the unnatural appearance of excessive tightening of the face.

Then, for patients who have significant laxity, excess tissues and aging changes who are seeking a significant improvement of the aging face, a properly performed facelift is the best option. Facelift as a technique have also advanced significantly over the past 10 years. Modern COMPOSITE FACELIFT performed via the FACIAL SOFT TISSUE SPACES (Figure 1) have allowed for the procedure to be safely and effectively performed. Bruising and swelling are also minimized with this technique and recovery time as a result is also significantly shortened.


Finally, the range of procedures available are off course not mutually exclusive but complement each other. A patient who has had a facelift performed and after several years would like to ‘freshen’ up, would do well with non-invasive treatments such as radiofrequency or focused ultrasound treatment. To maintain the results obtained by any modality it is important have a good skin care regimen and even regular top up of fillers and botox will also be very beneficial.