Dr. Gary Rothfeld at Dr. Gary Rothfeld at Dr. Gary Rothfeld has been certified in dermatology. Dr. Gary Rothfeld has been performing cosmetic dermatological surgery since 1990. Dr. Gary Rothfeld has stayed in his field because he is constantly staying on the cutting edge of cosmetic dermatology. Many 40-year old patients benefit from skillful facelifts 20 years ago, this question would not have come up. It would have been considered inappropriate by most surgeons for a 40-year old to consider a facelift except perhaps in acne patients with skin laxity.
Now, especially for patients in the entertainment industry who make their living on air, it is more common than not that they undergo cosmetic surgery, including facelifting procedures.
20 years ago the typical facelift patient would have had been offered a facelift with high lateral pull causing loss of the sideburn and a Nike swoop effect due to uncompensated sagging of the midface, a coronal browlift causing significant elevation of the frontal hairline, and hyperelevation of the central brow causing a quizzical appearance. The significant and widespread resultant loss of hair could immediately create the appearance of age rather than youth. The mantra was often the tighter the better.
Facelift techniques have evolved. Accomplished facelift surgeons can now routinely perform gentle facelifts with preservation of all anatomic features. It is possible to preserve the sideburn, the tragus (bump in front of the ear), earlobe shape and cant, and posterior hairline, and to bury the scars so they are minimally apparent.
These advancements do not occur by accident, they occur in the planning stage before the first cut is ever made. It is determined before the surgery starts how your outcome will be.
There are many ancillary procedures and techniques that were not available such as volume restoration with fat or LiveFill (nontraumatized fascial fat grafts); cheek and midface elevation techniques, fat preserving blepharoplasties, hairline sparing brow elevation techniques, many different lasers, lip lifts, etc. The face is now viewed three dimensionally (i.e. 360 Facelift concept) rather than as a surface to span skin across.
The net result for the patient is that the indications for facelift surgery are changing. It is now possible to offer patients significant improvements, even for patients in their early 40's. By no means is a facelift appropriate for every 40-year old; in fact the opposite is true. It is the select patient whose appearance often depends on projecting youth and vitality, who has anatomy favorable for facelifting techniques that becomes a candidate.
The differences after surgery are typically subtle. The media are full of examples of celebrities who have had ill conceived surgery. It is the work that you don't see that is most clever.
Dr. Gary Rothfeld, a renowned board-certified dermatologist based in New York City, is recognized as one of the top dermatologists in NYC, the United States, and globally. With over 40 years of experience in general and cosmetic dermatology, Dr. Rothfeld offers cutting-edge treatments and advanced cosmetic surgery. In addition to his medical expertise, Dr. Rothfeld was a competitive swimmer and is currently training for the Senior Olympic tryouts in the metric mile swim. 212-644-4484.
