Facelift
Subj: Re: Face/eye lift
Dr. Bermant,
Hi, I am a 36 yr old male. Over the last few years I have
noticed that my face underneath my eyes has begun to sag, probably
my facial muscles. Also this has resulted in the area beneath
my eyes as becoming whiter than the rest of my face. It is making
me look older than I would like. This has begun to really bother
me.
Is there anything I can do for this condition? Would the new
endoscopic surgery be an alternative? Any advice would be greatly
appreciated.
Thank you.
B
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
The face does show aging. The face is what we and others look
at and shows that aging early. Sagging structures often look
lighter due to illumination and shadows. Without an evaluation
and examination there are just too many possibilities that any
E-mail could ever do justice to. Endoscopic surgery is one method
of operating through smaller incisions and is of use in certain
cases. Set up an office consultation to start the learning process
to see what your options are. It is one of the best methods of
patient education.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Subj: Re: Facial surgery
Dear Dr. Bermant:
I am 34 and no matter how much weight I lose, I seem to have
a double chin, sort of, and I had a really nice jaw line, but
it seems as I'm getting older it's just not as defined as I would
like it to be. so... can you please give me some info regarding
plastic surgery for this problem? Like what can you do for me,
how long the surgery may take, how long will I have to take off
of work, will I have visible scars while it's healing or whatever,
how long does something like that take to heal and last of all
how much can this cost, approx.
I will be so grateful for your help. I live in ..., VA, and
I like what I have seen in your credentials. I hope you can help
me. Also, there are couple of other facial problems I would like
to correct, but this is my first priority. ?
Thank you.
Dr. Bermant responds:
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
There are two different problems that can result in a double
chin.:
The excess skin comes from gravity doing its job and pulling
the skin down the face into the neck region. The extra fat is
from our eating habits. Losing weight sometimes does not affect
certain regions as much as we would like.
Each problem has slightly different solutions, sometimes both problems
coexist. Excess fat alone can be treated by liposuction. Excess or
drooping skin is treated by a combination of neck and or face lift.
Here are photographs
of a case where I used a facelift, neck lift, and liposuction. The
type of surgery for your problem would depend on what your problem
is. There are many types of face lifts with different extents of surgery
depending on the problem treated. Writing a long detailed explanation
of all possibilities is beyond the scope of what is appropriate. Your
best next course for your education process of what might be available
for you is a consultation. That is where we continue our patients'
learning experience of what plastic surgery has to offer.
Typical costs for the more extensive operation (face lift
and neck lift) range from $4500 - $6500 for the surgeon's fee,
$900 for the operating room and about $850 for anesthesia. Costs
can go much lower or higher depending on what the problem we
are treating. We can give a much better idea of the costs after
an in office consultation. For instance a minimal face lift under
local anesthesia would not need an anesthesiologist and have
a lower OR and surgeon's fee.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Subj: Re: facelift
Dear Dr. Bermant,
I am a 23 year old male with a few questions about how plastic
surgery can help me. I am not satisfied with the shape of my
face. When I was in high school I lifted weights and worked out
my neck constantly. The muscles in my neck bulged tremendously
by the end of my senior year. Little did I know that, 5 years
later, these muscles would sag and give me a "doughy"
look. I want a more defined chin and cheeks that are more cut
than they are now. Is this taken care of with a "face-lift"?
Also, I think I have a pigmentation problem with my skin.
Even when my skin is acne-free I have reddish/pinkish discolorations
that look like shadows of acne. I am curious to know if you have
any procedures that can handle this problem or if you can point
me in the right direction.
Finally, I want to ask you about money. How much would a consultation
run me? I am a Marine stationed in Quantico, Va, and I would
be more than happy to make the drive to see you. Also, can you
give me a ball-park figure on what you charge for a face-lift?
I know that the government will not support me on an "elective
surgical procedure," but I have access to money.
Dr. Bermant responds:
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
It is extremely uncommon for a facelift to have value for
a 23 year old face. This operation is usually best to restore
the effects of gravity and aging. Facial features can be accentuated
with surgical implants placed near the boney layers. We generally
do not offer such cosmetic implants because I feel that the risks
outweigh the benefits. I do use such implants for trauma and
tumor reconstruction.
It is hard to comment about the skin condition without seeing
you. The best resource however for such problems is a dermatologist.
I usually refer my patients for such assistance when I am not
certain what would be best for them.
We pride ourselves
in patient education. Learning that surgery is not necessarily
the best option can be a very valuable experience. My surgeons
fee for a facelift $5000. Other charges depend on anesthesia,
where surgery performed, and other issues.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Subj: Re: face lift
I recently had plastic surgery done on the brow, my
eyes and a face lift. It has been 15 days and I seem to be healing
well according to my Dr.. I had all staples in my head but around
the hairline in the back and the sides, where I had stitches
I have a lot of scabbing. The scabbing went all the way out in
to my cheeks. I'm glad I had another week off at work. I talked
to my cousin who had the same done and she had no scabbing. What
caused this on me?
Dr. Bermant responds:
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
Good question for your doctor. Hard to tell which of many
factors could have contributed to such "scabs" as you
describe. Possible causes can include (other causes are possible):
- blood not cleaned from suture lines
- cleaning techniques used
- excessive after surgery bleeding from wounds
- how well the skin was put together (approximated)
- your own healing nature
- healing problems
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Subj: Re: facelift elevating malar pads
Dear Dr Bermant:
I am a 65 year old male considering a facelift. Dr "Smith",
the most recommended in my NJ metropolitan area does a conventional
lift and tell me the nasolabial folds will be improved 50%. Dr
"Jones" (ASPS, PLS, excellent credentials), not as
well known, tells me by raising the malar pads, the nasolabial
folds will be impoved 80%. This is a relatively new procedure.
Dr Jones cannot show me before and after pictures because of
patient confidentiality (understandably). The deep naso folds
are what bothers me most. I am in a quandry. Do you have any
suggestions? Is raising the malar pads a proven superior technique?
Costs are relatively high in my area. If I go out of state
(or out of country) for lower costs, how can I be assured of
the skill of the surgeon? The quality of the faclift is more
important than the cost. Thank you for your reply. Yours truly,
D..
Dr. Bermant responds:
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
Facelift surgery has evolved over the years. New techniques
come, some withstand the test of time. Other methods become fads
and then fade as the results prove not as enduring or newer methods
replace them. Give me a crystal ball that shows what will turn
out best, and I will let you look with me. I too like conventional
SMAS methods for many patients. A malar extension permits nice
nasolabial fold restoration. In other cases malar elevation is
more important. The tissue over that part of the cheek can droop
and cause severe folding. It is best to be flexible and use what
seems best for that particular patient. Deep plane malar dissection
can produce very nice results but also spectacular complications.
Without seeing your case, it is impossible to say which would
be better. Different doctors can use different approaches to
give equally nice results. There is no best way to choose the
doctor. Who did you feel most comfortable with?
Costs are not the best way to choose a surgeon. There are
many horror stories of patients trying to go out of country to
doctors not as well trained as those board certified by the American
Board of Plastic Surgery. In Richmond facelift surgical fees
run from $3000 6,500 depending on what needs to be done. Hospital
OR costs can be under $900.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Thank you very much for your reply Dr. Bermant. It is a help
to me.
Yours truly, D.
Subj: Re: fat chin
Hi Doc,
I know I would look tremedously better if I had my chin tightened
just a bit. I have what appears to be baby fat under my chin.
It is not a pronounced as the patients displayed on the web page;
but it's enough to cause me to write. Approximately, (just a
range) would it cost to have some liposuction and possible muscle
tightening of this area?
Thanks in advance,
c
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
Neck lift and facial liposuction can be for less extensive
problems. Costs depend on too many factors as a small office
localized neck liposuction is much less expensive than a formal
facelift. Let us help you explore your options. Once I know what you
are asking us to do, we can give you a price.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Subj: Re: neck lift
I am interested only in having a neck lift, but when
I went to one surgeon he wants to do a face lift and neck lift.
When I told him I was only interested in the very loose skin
hanging underneath my chin to be removed, he said that you just
didn't get rid of that that you had to do the whole procedure.
Is this correct? My face is just fine, my eyes are good, and
so is the area of my cheeks and mouth. It is just this loose
skin hanging around my neck that I dislike so much. I'm 41 and
have recently lost almost 60 pounds. I still want to loose another
5 to 10 pounds to reach my goal, so he did say I should wait
until I loose the rest of this weight. What is your answer to
this, do I have to have a face lift in order to have a neck lift?
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
Neck lifts are most frequently done through the incisions used for
a face lift to hide the scars. In addition the forces used to correct
the deformity of the sagging neck are the some of the same used to
correct the sagging face. Drawings
and photographs demonstrate these points. Surgical sculpture is
easier to perform after weight loss. Trying to guess what the tissue
will be after the weight loss is harder to do than surgery at your
desired weight. Major weight loss on an operated neck can be unpredictable
leaving loose skin that could have been managed with the surgery.
Patient education is important in MY office for MY patients. These
questions are good for your doctor and are much better managed in
a consultation face to face. We try to design the educational process
that our patients do not have to go looking to the Internet for answers.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
Subj: Re: chin
I visited your web site but could not find any information
about chin lifts. Is there a facility in the Richmond area that
deals with that type of surgery? How can I find out if I am a
good candidate? Thank you, K
This should not be construed as medical advice. I am a Board
Certified Plastic Surgeon.
I perform chin lifts. This is a name for a group of operations to handle
various problems of the drooping chin. Some suffer from tissues sagging
just under the chin.
That is part of a face and neck lift. Others develop laxity of the
supporting tissues of the chin itself. This is less common and is
treated through an incision inside the lower lip. The best way to
understand the problem is for an in office consultation and evaluation.
I can then direct our education towards solutions for THAT SPECIFIC
ANATOMICAL ISSUE.
There are just not enough hours in the day to put all of the
types of surgery that I perform on my website. Plasticsurgery4u
is a representation of what we do, the style we work with our
patients, and details about me. As time permits, it will continue
to expand as it has over the past year.
I hope this information proves of some use. If my office can
be of further assistance, please let us know. We can be reached
at: (804) 748-7737. My staff and I try to ensure the comfort
of our out of town guests during their consultations and procedures.
Michael Bermant, MD
|
Bulletin
Board for Patient's Questions and Answers
Hand 
