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The Latest Advancements in Facelift Surgery
Dr. Olding discusses the latest advancements in facelift surgery.
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Learn more about Michael Olding, MD
Michael Olding, MD
Michael Olding, MD is the director of the Cosmetic Surgery Center at The GW Medical Faculty Associates and is chief of Plastic Surgery at The George Washington University School of Medicine & Health Sciences and is affiliated with The George Washington University Hospital. He is a board-certified plastic surgeon and a member of the American Society of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, and the American Association of Aesthetic Plastic Surgeons. He completed his surgical training at Cornell Medical Center and McGill University, and has over 20 years of experience. He is one of Washington's premier cosmetic surgeons.Learn more about Michael Olding, MD
Transcription:
Melanie Cole (Host): Millions of people consider facial cosmetic surgeries to be monumental in improving their lives. Welcome to The GW HealthCast. I’m Melanie Cole and today’s topic is the latest advancements in facial cosmetic surgery. My guest today is Dr. Michael Olding. He’s the Chief in the Division of Plastic and Reconstructive Surgery, Chief of the Cosmetic Surgery Center and a Professor of Surgery at the George Washington University School of Medicine and is affiliated with The George Washington University Hospital. Dr. Olding is also ranked in the nations top 1% of cosmetic surgeons by US News and World Report. Dr. Olding, I’m so glad to have you on today. So many people have so many questions about cosmetic surgery. Let’s just jump right in, what are some of the latest really exciting and cool advancements in facial cosmetic surgery?
Dr. Michael Olding (Guest): Good afternoon Melanie, it’s nice to speak with you and I will preface that question by saying that there are many new advancements that occur in plastic surgery and in particular facial plastic surgery all the time. The key thing about them of course is recognizing which ones are relatively problematic and which ones are safe and effective as with any procedure that we do, and that’s really the important thing that people should take away from this podcast. Everyone wants to do something that’s simple with little downtime and that has a beautiful result that lasts a long time. Unfortunately those two things are often at the extreme and that’s why people still require cosmetic surgery. Some of the newest advances in cosmetic surgery have to do with refinement in previously identified techniques which have been utilized now for 20 years. Twenty years ago the idea was, oh I want a facelift and I want to make sure that everybody knows that I got a facelift. Well 20 years ago, everybody did know that they got a facelift and that’s quite different thinking from today. Today whatever we do, or at least whatever I do, is meant to refresh, rejuvenate but not have a neon light showing, oh you just had surgery? Who’s your cosmetic surgeon? So the techniques, although they are refined, they still give the same result and in as the previous techniques where it was a huge change, but they’re minor, smaller sorts of things that together compiled look good and return the clock to what it was years before.
Host: What a great point, and I’m so glad that you made that about what used to be done and what is done now. So along those lines, Dr. Olding, how does a person go about finding a good plastic surgeon?
Dr. Olding: And that’s a great question as well Melanie. The reason that it is such a good question is because today things have changed. Today everybody uses the internet, and that’s a great place to begin. Notice I say begin, not end. You can use the internet to very quickly assess the marketplace, but as you know there are things called fake news and there’s a lot of that, and there’s a lot of fake news as far as cosmetic surgeons and any surgeons as far as that’s concerned that can be a place online. The most important thing then, once you get some reviews, if all the reviews are terrible about somebody, no matter how good they are, I don’t think that’s the type of person you would want to see, but assuming that person gets reasonably good reviews, then you need to start asking in the community. You need to ask your friends have they used this person? Do they know this person? You need to talk to your physician friends, to your doctors, and to have a more concentrated look at the physician that’s not just someone putting out their comments online, and I think that’s probably the best way. As you know, many people these days call themselves plastic surgeons or cosmetic surgeons, and in many times they’re not even surgeons, they’re not board certified surgeons, and many of the times they’re not board certified plastic and reconstructive surgeons. In order to call myself a board certified plastic and reconstructive surgeon, I’ve had to of course finish college, medical school, and then I had to do a required training that’s been approved by the American Board of Medical Specialties, not some weekend board that you can – you as a doctor can pay $500 and get a certificate for the doctor to call themselves, board certified as in certificate. So that’s really key, figuring out if your doctor is certified by the American Board of Medical Specialties and in what. Now there are physicians besides surgeons, that is, besides plastic surgeons who do cosmetic facial surgery, and that’s okay. The ear, nose, and throat people for example can do an extra year, and unfortunately from my perspective they still call themselves plastic surgeons, and they’re not really plastic and reconstructive surgeons. They do cosmetic surgery, but they’re really ear, nose, and throat surgeons who do cosmetic surgery for example, and then there are internists or emergency room physicians who call themselves the same. So you need to be an educated consumer, and I think that’s the first step in not making a major mistake.
Host: That is a great point, and thank you for making that so very clear, and the questions we should ask. So let’s talk about some of the noninvasive procedures that people can consider. Tell us what’s going on in that world, like Botox – we hear about so many of these things doctor, tell us just a little bit about them.
Dr. Olding: Sure, it was with Botox, and – by the way there are many types of Botox out there including some that maybe you’ve heard of and some not. It’s sort of like refrigerator, originally it was a brand and now it’s been much more broadened, things like disport, and they all have their advantages and they’re all pretty safe as long as they’re obtained from a reputable person because just like physicians who talk about themselves being plastic surgeons, there are Botox providers that use Botox that’s actually not made by the company. In fact, there was a death a couple of years ago of someone who was using fake Botox. But the Botox and fillers are really great. They’re wonderful. What they’ve done is postpone the need to have interventional surgery and what happens of course is at some point those things don’t work. They again are being used for refinement and techniques. There is also something that helps get rid of fat in the face, primarily in the area beneath the chin called Kybella. I just mentioned that only to say that we had things like Kybella out there before and they were problematic. They are not so exciting these days. Either patients have had problems, I’ve just seen a couple of them where it’s not really done anything. So there are again many alternatives. It’s why I refer back to saying you have to find a board certified physician and then check them out. As far as facial cosmetic surgery is concerned, the key things have been of late, number one never pulling on the skin. You don’t pull on the skin when you’re doing a facelift, and it is a facelift not a face pull, and the second component of that is that the procedure does have potential risks and complications and the patients just need to be aware of those and they need to be educated about them so they can make their decision about whether or not to proceed.
Host: Then doctor, tell us about some of the more invasive procedures like lower face and neck lifts, what would you like people to know about these?
Dr. Olding: Well most of my patients are looking again for something natural that everyone doesn’t recognize that they’ve had cosmetic surgery. Usually that means not doing a forehead lift because the forehead lift gives you that surprised look – not in everyone, but in many people a forehead lift is the sort of beacon, and by beacon you think of that light and in the same way if you see somebody who’s had an aggressive forehead, their eyes look wide open and starry eyed, so you try to avoid that thing. I’m doing far less than I’ve ever done before primarily because of that. As far as the lower face and neck is concerned, the idea is to lift that in a cranial, that is towards the sky direction so that it doesn’t disort the mouth and so that it tightens up all of the neck tissues including usually the muscles, and the lift is done by pulling up the muscles not by pulling on the skin.
Host: Wow, that’s great advice, certainly something for people to consider and as we wrap up, Dr. Olding what else would you like people to know about some of those latest advancements in facial cosmetic surgery, when to visit a specialist, and really what questions you want them to ask that doctor about outcomes, how they’re going to look when it’s done?
Dr. Olding: Okay, as you’ve already heard, I’m very much about safety. So in order to be safe, you need to find, when you see that doctor you’ve read about and they said, oh well they had good results as far as you can tell, you need to find out, number one especially for facelifts, how many they’re doing. If they’re a plastic surgeon who does breast reconstruction, and who does tissue movement, and skin grafts and all of that, then they’re probably not doing that much of the facial cosmetic surgery, and it’s the one thing that the more you do, the better you get. I can guarantee you I’m 10 times as good now as I was 10 years ago because I do so much of it, and that doesn’t mean that people who do skin grafts are not just as good as I am, it just means that they might be preoccupied with other things, rather than focused on that cosmetic surgery. So I would ask them how many they do, and if they’ve had any major complications. The major complication being a facial nerve palsy – that is not being able to move one side of the mouth after the surgery because that’s our greatest fear.
Host: And your best advice. What do you want us to know about when we’re starting to consider?
Dr. Olding: You will hopefully look more refreshed. You won’t necessarily look 20 years younger, in fact there’s been a study that shows you won’t look 20 years younger no matter how much surgery you have done unless you also look fake. So the best thing to do is to have a good conversation with the person that you choose to have do your surgery. They have to understand what you want so that they can do their best job to deliver what you want, and what you want may be entirely different than what the next person that walks in the door does.
Host: Wow, what great advice. Dr. Olding, thank you so much for joining us and sharing your incredible expertise with so many questions that people have. Thank you again. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Olding or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment. Until next time, this is Melanie Cole.
Melanie Cole (Host): Millions of people consider facial cosmetic surgeries to be monumental in improving their lives. Welcome to The GW HealthCast. I’m Melanie Cole and today’s topic is the latest advancements in facial cosmetic surgery. My guest today is Dr. Michael Olding. He’s the Chief in the Division of Plastic and Reconstructive Surgery, Chief of the Cosmetic Surgery Center and a Professor of Surgery at the George Washington University School of Medicine and is affiliated with The George Washington University Hospital. Dr. Olding is also ranked in the nations top 1% of cosmetic surgeons by US News and World Report. Dr. Olding, I’m so glad to have you on today. So many people have so many questions about cosmetic surgery. Let’s just jump right in, what are some of the latest really exciting and cool advancements in facial cosmetic surgery?
Dr. Michael Olding (Guest): Good afternoon Melanie, it’s nice to speak with you and I will preface that question by saying that there are many new advancements that occur in plastic surgery and in particular facial plastic surgery all the time. The key thing about them of course is recognizing which ones are relatively problematic and which ones are safe and effective as with any procedure that we do, and that’s really the important thing that people should take away from this podcast. Everyone wants to do something that’s simple with little downtime and that has a beautiful result that lasts a long time. Unfortunately those two things are often at the extreme and that’s why people still require cosmetic surgery. Some of the newest advances in cosmetic surgery have to do with refinement in previously identified techniques which have been utilized now for 20 years. Twenty years ago the idea was, oh I want a facelift and I want to make sure that everybody knows that I got a facelift. Well 20 years ago, everybody did know that they got a facelift and that’s quite different thinking from today. Today whatever we do, or at least whatever I do, is meant to refresh, rejuvenate but not have a neon light showing, oh you just had surgery? Who’s your cosmetic surgeon? So the techniques, although they are refined, they still give the same result and in as the previous techniques where it was a huge change, but they’re minor, smaller sorts of things that together compiled look good and return the clock to what it was years before.
Host: What a great point, and I’m so glad that you made that about what used to be done and what is done now. So along those lines, Dr. Olding, how does a person go about finding a good plastic surgeon?
Dr. Olding: And that’s a great question as well Melanie. The reason that it is such a good question is because today things have changed. Today everybody uses the internet, and that’s a great place to begin. Notice I say begin, not end. You can use the internet to very quickly assess the marketplace, but as you know there are things called fake news and there’s a lot of that, and there’s a lot of fake news as far as cosmetic surgeons and any surgeons as far as that’s concerned that can be a place online. The most important thing then, once you get some reviews, if all the reviews are terrible about somebody, no matter how good they are, I don’t think that’s the type of person you would want to see, but assuming that person gets reasonably good reviews, then you need to start asking in the community. You need to ask your friends have they used this person? Do they know this person? You need to talk to your physician friends, to your doctors, and to have a more concentrated look at the physician that’s not just someone putting out their comments online, and I think that’s probably the best way. As you know, many people these days call themselves plastic surgeons or cosmetic surgeons, and in many times they’re not even surgeons, they’re not board certified surgeons, and many of the times they’re not board certified plastic and reconstructive surgeons. In order to call myself a board certified plastic and reconstructive surgeon, I’ve had to of course finish college, medical school, and then I had to do a required training that’s been approved by the American Board of Medical Specialties, not some weekend board that you can – you as a doctor can pay $500 and get a certificate for the doctor to call themselves, board certified as in certificate. So that’s really key, figuring out if your doctor is certified by the American Board of Medical Specialties and in what. Now there are physicians besides surgeons, that is, besides plastic surgeons who do cosmetic facial surgery, and that’s okay. The ear, nose, and throat people for example can do an extra year, and unfortunately from my perspective they still call themselves plastic surgeons, and they’re not really plastic and reconstructive surgeons. They do cosmetic surgery, but they’re really ear, nose, and throat surgeons who do cosmetic surgery for example, and then there are internists or emergency room physicians who call themselves the same. So you need to be an educated consumer, and I think that’s the first step in not making a major mistake.
Host: That is a great point, and thank you for making that so very clear, and the questions we should ask. So let’s talk about some of the noninvasive procedures that people can consider. Tell us what’s going on in that world, like Botox – we hear about so many of these things doctor, tell us just a little bit about them.
Dr. Olding: Sure, it was with Botox, and – by the way there are many types of Botox out there including some that maybe you’ve heard of and some not. It’s sort of like refrigerator, originally it was a brand and now it’s been much more broadened, things like disport, and they all have their advantages and they’re all pretty safe as long as they’re obtained from a reputable person because just like physicians who talk about themselves being plastic surgeons, there are Botox providers that use Botox that’s actually not made by the company. In fact, there was a death a couple of years ago of someone who was using fake Botox. But the Botox and fillers are really great. They’re wonderful. What they’ve done is postpone the need to have interventional surgery and what happens of course is at some point those things don’t work. They again are being used for refinement and techniques. There is also something that helps get rid of fat in the face, primarily in the area beneath the chin called Kybella. I just mentioned that only to say that we had things like Kybella out there before and they were problematic. They are not so exciting these days. Either patients have had problems, I’ve just seen a couple of them where it’s not really done anything. So there are again many alternatives. It’s why I refer back to saying you have to find a board certified physician and then check them out. As far as facial cosmetic surgery is concerned, the key things have been of late, number one never pulling on the skin. You don’t pull on the skin when you’re doing a facelift, and it is a facelift not a face pull, and the second component of that is that the procedure does have potential risks and complications and the patients just need to be aware of those and they need to be educated about them so they can make their decision about whether or not to proceed.
Host: Then doctor, tell us about some of the more invasive procedures like lower face and neck lifts, what would you like people to know about these?
Dr. Olding: Well most of my patients are looking again for something natural that everyone doesn’t recognize that they’ve had cosmetic surgery. Usually that means not doing a forehead lift because the forehead lift gives you that surprised look – not in everyone, but in many people a forehead lift is the sort of beacon, and by beacon you think of that light and in the same way if you see somebody who’s had an aggressive forehead, their eyes look wide open and starry eyed, so you try to avoid that thing. I’m doing far less than I’ve ever done before primarily because of that. As far as the lower face and neck is concerned, the idea is to lift that in a cranial, that is towards the sky direction so that it doesn’t disort the mouth and so that it tightens up all of the neck tissues including usually the muscles, and the lift is done by pulling up the muscles not by pulling on the skin.
Host: Wow, that’s great advice, certainly something for people to consider and as we wrap up, Dr. Olding what else would you like people to know about some of those latest advancements in facial cosmetic surgery, when to visit a specialist, and really what questions you want them to ask that doctor about outcomes, how they’re going to look when it’s done?
Dr. Olding: Okay, as you’ve already heard, I’m very much about safety. So in order to be safe, you need to find, when you see that doctor you’ve read about and they said, oh well they had good results as far as you can tell, you need to find out, number one especially for facelifts, how many they’re doing. If they’re a plastic surgeon who does breast reconstruction, and who does tissue movement, and skin grafts and all of that, then they’re probably not doing that much of the facial cosmetic surgery, and it’s the one thing that the more you do, the better you get. I can guarantee you I’m 10 times as good now as I was 10 years ago because I do so much of it, and that doesn’t mean that people who do skin grafts are not just as good as I am, it just means that they might be preoccupied with other things, rather than focused on that cosmetic surgery. So I would ask them how many they do, and if they’ve had any major complications. The major complication being a facial nerve palsy – that is not being able to move one side of the mouth after the surgery because that’s our greatest fear.
Host: And your best advice. What do you want us to know about when we’re starting to consider?
Dr. Olding: You will hopefully look more refreshed. You won’t necessarily look 20 years younger, in fact there’s been a study that shows you won’t look 20 years younger no matter how much surgery you have done unless you also look fake. So the best thing to do is to have a good conversation with the person that you choose to have do your surgery. They have to understand what you want so that they can do their best job to deliver what you want, and what you want may be entirely different than what the next person that walks in the door does.
Host: Wow, what great advice. Dr. Olding, thank you so much for joining us and sharing your incredible expertise with so many questions that people have. Thank you again. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Olding or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment. Until next time, this is Melanie Cole.