Facial Plastic Surgery – Missoula, Montana

DR. STEPHEN HARDY: The facelift in general is reserved for the patient who is starting to develop a little bit of the jowl in this area and the loose neck. I mean, really, anybody over 35 would look better with a facelift. Everybody looks better when they do this. Is it really appropriate to be doing facelifts on those patients? No. I think that when you take, say, a 45 to 50-year-old patient, some of them are aging more than others, and they are very good candidates. Some patients aren't good candidates until they're 55, 60, 65 type of thing. But it's a wonderful procedure. I mean, I think we do a wonderful facelift in this office. I love looking at the pre- and postoperative photographs. It's incredibly gratifying to see how good the patients look and to see how good they feel about themselves. They come back and say, I can't believe how good my neck looks and how good my cheeks look. So I love doing that operation because the patients look and feel so good. It's a pretty straight-forward operation. It works very, very well. It usually takes about two-and-a-half to three hours, always done as an outpatient. Especially here in Montana, one of the first things they say is, I don't want anybody to know I had this. And I said, you know what, in two weeks, nobody will. You're going to look great, but nobody's going to say you had work because it's not the kind of procedure I want to perform. I don't want to see the corners of their mouths widened. I don't want to see their brows, you know, halfway up their forehead type of thing. I think that that's a very unnatural look. It's kind of almost become a natural look on the Coast, so to speak, and I don't want to say anything bad about it, but I just think that maybe it's being a little bit overdone, and people here in Montana don't want that kind of thing. They just want to look refreshed. And we can deliver on that type of thing. You can make somebody look very, very good and have a nice long-lasting effect on a facelift or a brow list or on one of those types of procedures without it looking the least bit unnatural. In terms of the eyelids, I usually separate the eyelids from the facelift. I usually like to, I mean, you can combine procedures, but one of the things I'm not a big fan of is trying to get as much done on the patient as possible. I think that that's sort of a way of trying to extract as much as you can out of the patient at once, and I really don't think that's sometimes the greatest idea. I think the best thing to do is to do the right operation on the patient. They come, and they're complaining about this, do that. Don't worry about their eyes. I mean, if they have incredibly large bags, and we say, well, we might be able to make that look better, that's fine. The eyelid operation, again, pretty straight forward operation. Incisions are very well hidden right underneath the lash line here, or you could perform it from inside the eyelid, just to remove the fatty tissue. Then the upper eyelid crease incision is hidden so well that when you open your eyes, you just can't see it at all. The only time you can see the line is when you close the eye, and even then, the eyelid skin is very thin and heals with minimal scarring. The incision is very, very hard to see. Those are operations that take a very short amount of time, an hour or less, to perform those, and almost always under local anesthesia, which is the slightest big of oral sedation. They walk right out. You know, they just have to go put ice packs on their eyes for a couple days, and they're generally doing well.