Transcript of the discussion
Interviewer: Facelifting, big part of what you do.
Dr. Chasan: Yeah.
Interviewer: At what point does somebody need a facelift?
Dr. Chasan: Well, I’m gonna put facelift as one of my many tools for facial rejuvenation, okay? And a facelift, people make that mistake of facelift versus a full facelift. A facelift is really a neck and jaw lift, very reliable and reproducible, remove the gel and the turkey neck, okay? So that’s what a facelift does. It does this part of the face, the lower third. And, you know, when I first started practicing, I kind of had one facelift. And now, over all these years, I’ve been in practice 20 years, I have like five different facelifts. So I try to match that facelift with the patient’s anatomy.
So I would say I do a lot of mini-facelifts. We call it “the petite lift.” And the difference between a mini-facelift and, you know, a very aggressive facelift is dissection, how much skin you undermine. In a mini-facelift, it would be less. The less you undermine, the quicker the recovery. There are some people who come with bowl-shaped necks, and they have big submandibular glands and a thick neck. But you can’t do a mini-lift on them. And if you do, you’re really wasting their time and your time. So the spectrum is from mini-lift to actually full-neck contouring with removal of what we call the platysmal fat and, underneath the platysma fat, removal of these glands called submandibular glands. There are these big, thick muscles called digastric muscles.
So, on some people, I’ll actually remove part of the digastric muscle, remove part of the submandibular gland, remove part of that submandibular fat, and then suture this platysmal muscle. And they can go from kind of a bowl-shaped neck where the chin meets their chest to a very contoured, defined neck.
Interviewer: So what are the age ranges of these… like these mini-lifts?
Dr. Chasan: Yeah, most people, I would say in the late 40s is when they start doing mini-lifts. Usually, eyelids and brow lifts are in the late 30s and early 40s and then mini-lifts, in the late 40s, 50s, 60s, even into the 70s.
Interviewer: Okay. And how many years younger can you make somebody look with some of these?
Dr. Chasan: It really depends on…
Interviewer: What do you hear?
Dr. Chasan: It depends on your anatomy.
Interviewer: Like 10 years younger, 15 years younger?
Dr. Chasan: I would say 10 to 15. And it really depends on how fit they are. I always tell patients the best thing for your skin is cardio, avoiding sun, avoiding smoking. So if somebody does that and lives a healthy lifestyle, yeah, they can look 15 years younger. You know, funny you should mention that. I just did a lady. And it surprised me how good she did. She’s actually my age. She was a heavy smoker. She was a patient of mine, I don’t know, 12 years ago. And she came back for a facelift. And she looked pretty bad, a lot of sun damage, a lot of smoking. And I just did her facelift about three weeks ago. And, honest to God, now, this is unusual, but she looks about 20 years younger.
Interviewer: Is that right?
Dr. Chasan: Yeah. It’s actually quite impressive transformation.
Interviewer: Now, what are the fears patients have, because I feel like I could spot a facelift 20 yards away?
Dr. Chasan: That’s their fear. So for brow lifts, every one of them says, “I don’t wanna look like a deer in the headlights,” okay, and that, you know, if I had patients that looked like that, it wouldn’t be very good for business. But we don’t see that. But, you know, you do see it. You see it.
Interviewer: That done look.
Dr. Chasan: That done look.
Interviewer: That tight done look.
Dr. Chasan: And all you have to do is see one of them, and it negates 100. The same thing with the facelift is “I don’t wanna look windblown,” right? “I don’t wanna look like that tight, windblown look.” And I usually tell people that that windblown, tight look is either one of two things, an expert surgery…so if you’re a pro at it and you are detail-oriented on how the earlobe insets, where the sideburn is, how you treat the posterior hairline so they can wear their hair up, that you’re not pulling on the skin, because skin will stretch. You’re pulling on what we call the SMAS layer, which is the superficial covering in the muscle. It’s very fibrous. It doesn’t stretch like the skin. If you do the right things, you won’t get that look. The other way is some people, you know, they’ve had five, six facelifts.
Dr. Chasan: After five, six facelifts, you’ll have that look. So I try to caution my patients to have a life plan on how many they’re gonna have, how long facelifts last. And if it’s done expertly, you should not be able to tell that they had a facelift.
Interviewer: Are there women out there in San Diego, they’re 60, 55, that look years younger, nobody knows they had a facelift, not even their friends, that you’ve done?
Dr. Chasan: Most of my patients. Yeah.
Dr. Chasan: Most of my patients.
Interviewer: So if I saw one of your patients walking down the street…
Dr. Chasan: You wouldn’t know. You shouldn’t be able to know. I’d be embarrassed if you knew. You shouldn’t.
Interviewer: So when I see somebody that looks fantastic at 55, I’m gonna think maybe that’s Dr. Chasan’s patient.
Dr. Chasan: I hope so, yeah, and pride myself on that.