Face Value

To get insight on what’s new in facelift surgery, Medeguide talked to Dr Chartchai Rattanamahattana, Plastic Surgeon, at Samitivej Sukhumvit Hospital in Bangkok, Thailand.

A lot of think we know what as facelift is but what does it really involve?

A facelift is rejuvenation surgery and it is a lot more than just tightening skin. A quality facelift performed today usually extends below the skin to the superficial musculoaponeurotic system (SMAS) and suspending underlying facial muscles as well as reducing excess skin.

Does a facelift cover the forehead, eyes and neck?

No. It primarily focuses on the area below the eyes and above the chin. Those other areas are treated using other procedures like a brow lift, blepharoplasty and neck lift. A facelift may need to be combined several surgeries to get the desired look.

Do you do any special technique in your facelift.

Yes. My approach involves suspending facial muscles below the SMAS so that I not only get tightening effect but a better alignment of the muscles and tissue making the overall effect softer, more natural. My approach also decreases the risk of nerve damage and shortens the procedure time. I also take great care in hiding the scarring around the ears, because that’s where everyone looks. And finally, if I do a brow lift with the facelift, I do that endoscopically so there is no obvious scarring.

Facelifts are appealing to men, not just women, and they are a popular procedure among medical tourists.

What are the do and don’ts to ensure the best possible outcome in a facelift?

The first is be healthy. People who are fit, do not smoke or drink heavily, and have no underlying chronic disease or psychological issues are the best candidates.

The second is be realistic. No doctor can make you into something you are not. Expectation management is key to a successful outcome.

The third is give yourself time to FULLY recover. It takes 2-3 weeks to fully recover from a facelift. This is major surgery and if an infection does arise it will be 5 days AFTER surgery. I have seen many cases, particularly with medical tourists, who put themselves at high risk of infection because they are too much in a hurry to get home.

The fourth is do not compromise quality for price. Again, I have seen too many cases where patients go to a doctor or clinic because it is cheap, and the results have been disastrous. Pick a reputable doctor and a reputable hospital...always. If you doubt this, come see me and I will show you pictures that will change your mind.

Is smoking that big of an issue?

Absolutely. Smoking constricts blood vessels and deprives the tissue of oxygen rich blood it needs to heal wounds, particularly after surgery. I counsel my patients who do smoke to stop smoking, if they can. If they cannot quit, then they must stop at least 2 weeks prior to surgery. I have a very sensitive nose and can tell if someone is cheating.

You treat a lot of international patients. Is there much difference between westerners and Asians?

80% of my practice is westerners. Mostly expatriates living here in Asia. And yes, there are some differences between the two.

When talking about a facelift, caucasians have the ideal skin type for a facelift because it is thinner and less prone to scarring. Asians typically want nose augmentation surgery while westerners want nose reduction surgery.

In terms of attitude or style, my international patients do a lot of homework before they see me. They research extensively on the website, ask for recommendations and normally follow up with me by email after our consultation. Asians, and particularly Thai’s, tend to go more on what their friends say.

Are men a growing part of your practice?

Definitely. They now make up 30% of my patient practice from just 10% five years ago. Men’s attitudes about surgery are definitely changing.

How do patients find you?

Plastic surgery is a word of mouth business, and the vast majority of patients learn about me from other patients. As I said, my patient base is primarily expatriates in Asia, and they use social networks, the internet and social media to talk and share experiences.

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