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5 Facelifts Ranked From WORST to BEST! (Plastic Surgeon Explains) · Anti-Aging & Plastic Surgery with Dr. Dan Gould

• 0:00
  SPEAKER_00: There are about five different operations that all get called a facelift, and the price difference between them can be tens of thousands of dollars.
• 0:06
  SPEAKER_00: Nobody explains what actually makes them different.
• 0:08
  SPEAKER_00: You get told the name of the one that the office does, and you're expected to know what it means and how it compares to other procedures.
• 0:14
  SPEAKER_00: I'm ranking these from worst to best based on how much they actually correct and how long that correction tends to hold.
• 0:19
  SPEAKER_00: And when I say worst, I don't mean nobody should ever have it done.
• 0:22
  SPEAKER_00: I mean it's the most superficial and in general the shortest lived.
• 0:25
  SPEAKER_00: Number one is an operation most surgeons don't really do at all.
• 0:28
  SPEAKER_00: Hey, I'm Dr.
• 0:29
  SPEAKER_00: Dan Gould.
• 0:30
  SPEAKER_00: I'm a board certified plastic surgeon at Beverly Hills with a PhD in bioengineering, which gives me a different way of looking at how the face changes over time.
• 0:36
  SPEAKER_00: By the end, you'll know what each one really does, why the one most people think is the best isn't number one, and how to tell which one you're being offered.
• 0:43
  SPEAKER_00: Underneath the skin of your face, there's a layer called the SMAS.
• 0:46
  SPEAKER_00: It's a sheet of tissue that wraps the muscles and connects the ligaments that hold your face up.
• 0:51
  SPEAKER_00: When people say a face is descended, what's descended is that layer and everything attached to it.
• 0:56
  SPEAKER_00: Every one of these operations is a different answer to one question.
• 1:00
  SPEAKER_00: Do you actually move that layer and put it back, or do you just pull the skin over the top of it?
• 1:04
  SPEAKER_00: So the ranking runs from the lift that puts the least back to the one that puts the most back.
• 1:09
  SPEAKER_00: I'll go from the bottom up and I'll tell you who each one is actually right for because every one of these is right for somebody.
• 1:14
  SPEAKER_00: Number five, the skin only lift.
• 1:17
  SPEAKER_00: Sometimes it's marketed as a mini lift.
• 1:19
  SPEAKER_00: The skin gets lifted and trimmed, the layer underneath does not move.
• 1:22
  SPEAKER_00: It's the least invasive and the fastest recovery.
• 1:24
  SPEAKER_00: And for someone in their 40s with good tissue and a small amount of laxity, it can look fine.
• 1:28
  SPEAKER_00: If that's genuinely where you are, it's a reasonable choice.
• 1:31
  SPEAKER_00: The problem is that the deeper tissue that actually drops stays exactly where it is.
• 1:35
  SPEAKER_00: You've tightened the surface over a face that's still sitting low, and an aggressive version of one is where the pold comes from.
• 1:41
  SPEAKER_00: Tension on skin shows, tension on deeper tissues does not.
• 1:44
  SPEAKER_00: Number four, smas plication.
• 1:46
  SPEAKER_00: Now we're touching the right layer.
• 1:48
  SPEAKER_00: The surgeon folds the smash and stitches it, tightening it without cutting into it.
• 1:51
  SPEAKER_00: It's quicker, it's safer and less experienced hands, and for the right face, it does the job.
• 1:55
  SPEAKER_00: Usually someone whose tissue has started to loosen but hasn't really traveled yet.
• 1:59
  SPEAKER_00: What it cannot do is release.
• 2:01
  SPEAKER_00: Folding a sheet makes it tighter, it doesn't let it travel back to where it started.
• 2:04
  SPEAKER_00: If your ligaments have let go and the tissue is genuinely moved, you're tightening it in the wrong position.
• 2:09
  SPEAKER_00: Number three, a smasectomy, their traditional deep lift.
• 2:12
  SPEAKER_00: In this surgery, a strip of the smas is removed and the edges are brought together, which gives real movement rather than just tension.
• 2:18
  SPEAKER_00: This was the standard for a long time and there are beautiful results from it.
• 2:21
  SPEAKER_00: Its limit is that it works on the sheet without fully releasing what's anchoring the sheet down.
• 2:26
  SPEAKER_00: You can move a lot of face this way, you just can't move all of it back.
• 2:29
  SPEAKER_00: For plenty of faces, that was good enough, and for some it still is.
• 2:33
  SPEAKER_00: If you want to know which of these your face actually needs, that's what a consultation is for.
• 2:37
  SPEAKER_00: My practice is in Beverly Hills.
• 2:39
  SPEAKER_00: There's a link at the description to reach out to us.
• 2:40
  SPEAKER_00: Back to it.
• 2:41
  SPEAKER_00: Number two, the deep plane facelift.
• 2:44
  SPEAKER_00: This is the one that everyone's talking about now.
• 2:46
  SPEAKER_00: Instead of working on top of this mask, the surgeon goes underneath it and releases the retaining ligaments, the ones that have been holding the tissue down in its dropped position.
• 2:53
  SPEAKER_00: Once those are released, the whole unit moves this one piece, skin and fat and muscle together.
• 2:58
  SPEAKER_00: Nothing gets pulled against anything, which is why it looks so much more natural.
• 3:01
  SPEAKER_00: The jump from number three to number two is the biggest one on the list, though I should be accurate about what deep plane means because it's become a marketing word.
• 3:08
  SPEAKER_00: Entering the deep plane is a starting point.
• 3:10
  SPEAKER_00: It describes where you're standing, not what you do once you're in there.
• 3:14
  SPEAKER_00: Two surgeons can both say deep plane and be doing very different amounts of work.
• 3:18
  SPEAKER_00: And that's why it's number two and not number one.
• 3:20
  SPEAKER_00: Number one, Vectera.
• 3:22
  SPEAKER_00: That's the approach that I developed.
• 3:23
  SPEAKER_00: Everything in number two, and then two more things.
• 3:25
  SPEAKER_00: I map the exact path your face aged along, and I take the tissue back along it.
• 3:30
  SPEAKER_00: And that path turns out to be different, for instance, for men and women.
• 3:34
  SPEAKER_00: And I treat the layers under the neck muscle as well.
• 3:36
  SPEAKER_00: The fat underneath the platisma, the submandibular glands, where they're contributing, and the muscle repair down in the middle.
• 3:42
  SPEAKER_00: It's at the top because it puts back the most, and that includes the jawline, which is the single biggest indicator of whether a facelift worked.
• 3:48
  SPEAKER_00: The jawline is made by what's underneath the neck, not by what's happening in the cheek.
• 3:52
  SPEAKER_00: If the neck isn't addressed, the face can be beautifully done and the result still looks unfinished.
• 3:56
  SPEAKER_00: Most surgeons don't work in the deep neck.
• 3:59
  SPEAKER_00: That's not a criticism of them.
• 4:00
  SPEAKER_00: It's a genuinely demanding place to operate, and plenty of excellent surgeons make a considered action and decision not to go there.
• 4:06
  SPEAKER_00: All right, the ranking is real, and number one does the most.
• 4:09
  SPEAKER_00: What that doesn't mean is that everybody needs every part of number one.
• 4:12
  SPEAKER_00: A woman in her late 40s whose skin is excellent and whose ligaments haven't let go doesn't need all of number one.
• 4:18
  SPEAKER_00: Doing the deepest operation on a face that hasn't descended that far isn't thorough.
• 4:22
  SPEAKER_00: It's over treatment and it can move things past where they started, which is its own kind of wrong result.
• 4:26
  SPEAKER_00: I've changed my mind about this over the years.
• 4:28
  SPEAKER_00: The best surgery is often about doing less, but doing the right thing at the right layer and the most aggressive operation in the room isn't always the most sophisticated one.
• 4:35
  SPEAKER_00: Somebody with a heavy deep neck and a good mid-face needs the bottom half of number one and not much of the top.
• 4:40
  SPEAKER_00: Anatomy is what decides the technique, not the other way around and not the priceless.
• 4:44
  SPEAKER_00: Using the rank to understand what you're being offered is going to be what allows you to let your own face decide how much of number one you need.
• 4:52
  SPEAKER_00: Let's talk about outcomes too, because this is where people's expectations get set wrong.
• 4:56
  SPEAKER_00: If you had 10 lines on your face before surgery and you have three afterward, that's an excellent result.
• 5:00
  SPEAKER_00: Around 70% correction is an A in facelifting.
• 5:03
  SPEAKER_00: And most surgeons would agree with that.
• 5:04
  SPEAKER_00: I get to 80% maybe two or three times a year.
• 5:07
  SPEAKER_00: And I genuinely can't always tell you why those ones healed the way they did.
• 5:10
  SPEAKER_00: 90% is something a surgeon might see once in a career.
• 5:12
  SPEAKER_00: Nobody puts that on a website, but it matters here because the difference between number three and number one on this list isn't the difference between a bad result and a perfect one.
• 5:20
  SPEAKER_00: It's the difference between tightening a face and actually making it look like it used to.
• 5:24
  SPEAKER_00: And I want to separate two things that get confused constantly.
• 5:27
  SPEAKER_00: Natural and effective are not the same word.
• 5:29
  SPEAKER_00: A lot of surgeons say a result is natural when what they mean is that not much happened.
• 5:33
  SPEAKER_00: I want to draw line that's genuinely different, real improvement around the eyes, and for people to look at you and see no surgery at all.
• 5:39
  SPEAKER_00: Less isn't automatically more natural.
• 5:41
  SPEAKER_00: It's about doing the right amount in the right place at the right time.
• 5:44
  SPEAKER_00: So stop shopping by name and settle two things for yourself before you go anywhere near a price list.
• 5:48
  SPEAKER_00: The first is what an A looks like for you.
• 5:51
  SPEAKER_00: If you're picturing the face you had at 30, no operation on this list will get you there.
• 5:54
  SPEAKER_00: And a surgeon who agrees that it will is telling you what you want to hear.
• 5:58
  SPEAKER_00: 70% is the target.
• 5:59
  SPEAKER_00: Decide now whether 70% is worth it to you because that determines whether you're happy afterwards.
• 6:03
  SPEAKER_00: The second is that the operation should be chosen last, not first, and not by you.
• 6:07
  SPEAKER_00: Work out what's actually dropped, what's deflated, and what's happening under your neck, and the right technique becomes obvious.
• 6:12
  SPEAKER_00: I did a whole video on Vectera and how it maps the way your face aged and why that plan is different for a woman than a man.
• 6:18
  SPEAKER_00: That's the one I'd watch next.
• 6:19
  SPEAKER_00: So five facelifts and they really aren't equal.
• 6:22
  SPEAKER_00: Number one puts back the most and your own face decides how much of it you need.
• 6:26
  SPEAKER_00: Go find out where yours sits and hit subscribe on your way out.