To Lift Or Not to Lift?

Contemplating a facelift or a filler? Celebrated plastic surgeon Haideh Hirmand reveals the most important questions to ask your doctor

Those of you who are Vogue aficionados may have seen Dodie Kazanjian’s comprehensive piece on her journey to have (or not have) a facelift in the magazine’s January 2011 issue. It’s really worth a read — an educational, entertaining real time account of a decision many women consider at one time or another.

Dodie, a multifaceted writer with boundless energy whom I know from previous collaborations, left a message in my office a few months ago. “Can you give me your opinion?” she asked. “I may write about it if I decide to move forward.” A surgeon, no matter how known or accomplished, is of course flattered to be sought out by the celebrated Dodie (who not only knows everything and everyone in beauty, but comes from a long pedigree of medical expertise: her great uncle was a pioneer of plastic surgery).

I was riveted by her piece. First of all, she saw different surgeons and got totally different opinions! When I say different, I mean literally opposite advice. One surgeon recommended his deep plane approach, while I told her there were no studies that prove either technique was superior – and that in fact, there were studies to the contrary, so I recommended a different technique. One surgeon told her to do a browlift, while I banned her from doing one! One was focused on surgery, while I implied that if any surgery were done, it would have to be minimal.

Reading this engaging account made me realize that Dodie’s experience must be typical of what many women experience in their quest to find out the enhancement options that are best for them. So here’s my take on what you should do, should you ever decide to investigate your options for your face (or for the body, for that matter).

  • See more than one doctor — and preferably two or three
  • Make sure that the doctors you consult are experienced in both surgery and new technologies – and that they are honest enough to admit what they can and cannot do.
  • If anyone tells you they developed or invented a technique, ask to see the scientific paper they published on it — and whether it was peer reviewed and Medline referenced.
  • If a doctor tells you that any one technique (especially one they developed) is better than another one for the same purpose, ask why and ask for some proof.
  • Common sense is common sense. If what is being proposed doesn’t make sense to you or is at odds with your vision, don’t do it.
  • If you feel pressured, worry.
  • If the doctor’s ego is so big that there is no room for yours, worry.

As for Dodie, she decided against surgery and went for some volume enhancement – i.e., injections. That was what she felt comfortable with so in fact that is what was right for HER. Which brings me to what I have said many times before:

  • We plastic surgeons are in the business of making people feel better, and not necessarily just look better, by achieving their goals, and not ours and
  • It is our job to educate our patients about their options and what they can benefit from.

I would love to hear about your own experiences, and hope you’ll share them here.

Editor’s Note: Dr. Haideh Hirmand is a noted plastic surgeon, academic and thought leader in the aesthetic and beauty arenas. She completed her doctorate in medicine at Harvard and is clinical assistant professor of surgery at the The New York Hospital/Cornell-Weill Medical Center. She specializes in eyelid and facial rejuvenation, secondary breast surgery, body contouring and is recognized nationally as a pioneer in injection techniques.

2 Responses so far.

  1. avatar Chris Glass` says:

    The decision to go under the knife is a huge one because there is no going back if you decide you don’t like the results. That is the holding point for many of us. I’d love to have my eyes lifted as I haven’t aged well. A friend had hers done and they didn’t come out the way she hoped because her surgery was not done by the doctor but a new associate.
    I can’t agree more about your advice to get multiple opinions and use common sense. In the eagerness to look and feel more youthful it is easy to be beguiled by what we want to hear.

  2. avatar Lizzie R. says:

    I must relate my face lift experience. Some years ago I decided to get a face lift, and went on several consults. One of the plastic surgeons I consulted with had earlier done a non-cosmetic procedure on me, removing a small growth on my eyelid, so i was familiar with him, and liked him. He was recommended to me by both my dermatologist and internist at the time I was seeking a face lift. He had an excedllent record on the state medical board, had been featured in a local magazine, plus had been on the radio discussing plastic surgery at various times. His office was always full, and his staff was very nice. On the basis of this I decided to have my surgery with him. It all went smoothly, but afterwareds I didn’t look much different than before, and he did agree that it hadn’t gone right, so agreeed to do a revision. Now there is where I should have walked out and gone to a different surgeon, but being naive I agreed to have him do it. It was a disaster…I was left with Pixie ears, nerve damage behind my left ear and a permanent neuroma on the left side of my neck, which I still have, but have learned to live with. I had to seek out another surgeon to repair the pixie ears, and the face lift itself was barely acceptable, and a disappointment. I am only thankful that nothing worse happened. The terrible part of this all was that shortly after all of this he temporarily lost his license and had to go into rehab for treatment for substance abuse. He was  then temporarily granted his license after a period of  time, but kept on doing the same thing, and ultimately permanently lost his license to practice due to habitual intemperance ( as they put it) This can happen to anybody and I was stunned as there was never any indication to me that he had a problem, so you have to be doubly careful in who you select, but how can you tell? I have since heard of similar experiences with other plastic surgeons.