Correcting the unfavorable outcomes following facelift surgery.

Although many deformities formerly observed after rhinoplasties are seen less because of more sophisticated techniques, the deformities that may occur after conventional facelifts seem to be growing by epidemic numbers because of the widespread and almost universal use of conventional facelift and blepharoplasty techniques. The unfortunate appearance of these patients is the fault neither of the surgeon nor of the patient, but frequently both get blamed. Throughout every step of the history of medicine there have been improvements made that cause the physician to abandon a technique or medications that clearly are shown to be suboptimal. Unfortunately, this has not happened with rejuvenative surgery. More sophisticated techniques like composite rhytidectomy have a steeper learning curve, take more time to perform, and require longer periods of convalescence for the patient. Many experts in aesthetic surgery continue to teach conventional techniques because the public does not seem to know the difference. Fashion magazine articles on aesthetic surgery promote simple and easy techniques without bothering to explain the unfortunate and minimal results that are obtained. The obligation of any surgeon doing aesthetic surgery is the same as any physician must have in any medical field. If any operation would give a patient a suboptimal or negative result, then attempts must be made to improve these techniques. Although traditional techniques will continue to be used, there are certain conclusions that can be made: 1. More people who have undergone plastic surgery are showing eventual signs of surgery that are neither attractive nor youthful. It is clear that results of conventional facelift techniques are not predictable and are often unfavorable. 2. Facelift deformities are not the fault of the surgeon but are natural byproducts of the techniques that are used. These techniques must be improved. 3. Composite rhytidectomy with orbital fat preservation as a primary procedure will create a harmonious facial rejuvenation that will disallow the appearance of unwanted deformities such as hollow eyes and the lateral sweep. 4. Composite rhytidectomy as a secondary procedure produces the most effective correction of the unintentional but unfavorable results that follow traditional rejuvenative surgery.