A 57-year-old patient who was referred by another doctor. She lost 100 pounds and, as a result, has a lot of sagging in her facial tissue. She also has deep creases in her face and brown spots from sun damage. She is not happy with the sagging of her face and neck. The procedures she selected are a rhytidectomy (facelift) plus a 30 percent TCA chemical peel to make a SynergyLift™, a coronal forehead lift, and perioral dermabrasion. The after picture is one year after surgery in the San Francisco area. Pay particular attention to her neck “bands,” which are dramatically better. Also the volume of her face is improved—and NOT from fillers or fat. It is from my technique, Serial VectorLift™.

My facelift technique “puts the tissues back where they came from.” I do not stretch the skin, and that is why my patients do not have that windswept look of some facelift patients. Naturalness comes from using the patient’s own tissues or padding under the skin (we call it fascia) to rebuild their faces without adding fat or fillers, which sometimes can make people look puffy or lumpy. This is why I ask each of my San Francisco area patients to bring me a few pictures of themselves from about 15 to 20 years ago, so I can study the soft tissues of their faces, their cheekbones, jawline, cheek folds, and neck. I study these pictures the night before surgery, then make my own drawings of the patient on a separate piece of paper. I bring those into the OR and create my surgery from those pictures and drawings. (I give the original photographs back to the patients.)