Latest / Scalpel and Skin / Are Facelifts Worth It? Deep Plane vs. SMAS, Recovery, and What Patients Should Know | EP 05

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Are Facelifts Worth It? Deep Plane vs. SMAS, Recovery, and What Patients Should Know | EP 05 · Scalpel and Skin

0:00
SPEAKER_02: What the hell are you talking about?
0:01
SPEAKER_02: I cut people's faces off for a living.
0:03
SPEAKER_00: Do you have any major medical history?
0:06
SPEAKER_00: No.
0:06
SPEAKER_00: Ten minutes later, I had a heart attack five years ago.
0:09
SPEAKER_00: You don't have to disclose everything, but you also don't have to say, I have done nothing at all.
0:15
SPEAKER_00: A lot of people are talking about.
0:18
SPEAKER_00: I don't think that she has had a facelift.
0:20
SPEAKER_00: I think she just had some really good preservation work.
0:23
SPEAKER_02: Celebrities get plastic surgery and people talk about it.
0:26
SPEAKER_02: So, right patient, right procedure, right time, right surgeon.
0:29
SPEAKER_02: That's it.
0:43
SPEAKER_02: Hello, everybody.
0:44
SPEAKER_02: Welcome to episode five of Scalpel and Skin.
0:46
SPEAKER_02: I'm Dr.
0:46
SPEAKER_02: Elja Labraska here with my beautiful baby sister, Mystica Labraska.
0:50
SPEAKER_02: I'm a plastic surgeon board certified 16 years.
0:53
SPEAKER_02: She is 16 years as a dermatology physician assistant.
0:56
SPEAKER_02: She is a master in all things non-invasive.
1:00
SPEAKER_02: And I am a master of plastic surgery.
1:03
SPEAKER_02: So today, this is going to be a fun one, I think, because this today's episode is going to talk about not just plastic surgery, but it we're going to get into celebrity.
1:16
SPEAKER_02: We're going to get into the the culture of Hollywood and the world and everything else.
1:23
SPEAKER_02: And we're just going to have some fun today.
1:25
SPEAKER_02: Okay.
1:25
SPEAKER_02: So every time a celebrity all of a sudden looks younger, looks better, the internet says one of two things.
1:35
SPEAKER_02: They're like, oh, he looked better before.
1:37
SPEAKER_02: She looked better before.
1:38
SPEAKER_02: Or oh my God, this person got a uh got a the best facelift ever.
1:43
SPEAKER_02: AKA uh the Kardashian mom.
1:45
SPEAKER_00: She looks amazing.
1:47
SPEAKER_02: She really did get an incredible facelift.
1:49
SPEAKER_02: This was done by the guy that was in that band, a really good-looking guy.
1:54
SPEAKER_02: He was in a band.
1:56
SPEAKER_02: No, no, no.
1:56
SPEAKER_02: He's got the same name.
1:58
SPEAKER_02: Maroon 5.
1:58
SPEAKER_02: Maroon 5.
1:59
SPEAKER_02: What's that guy's name?
2:00
SPEAKER_00: Adam Levine.
2:00
SPEAKER_02: Levine.
2:01
SPEAKER_02: So this uh Stephen Levine is Chris Jenner's plastic surgeon for this facelift.
2:07
SPEAKER_02: I think she got another facelift 15, 20 years or so ago by Stephen Levine's in New York City, next door to my building, uh my office in New York City.
2:18
SPEAKER_02: Hashtag 60th and Park.
2:20
SPEAKER_00: Is it Park Avenue?
2:22
SPEAKER_02: Yeah, 60th and Park Avenue.
2:24
SPEAKER_00: That's so cool.
2:25
SPEAKER_02: It is pretty cool, right?
2:26
SPEAKER_02: Didn't you?
2:26
SPEAKER_02: You should come visit something.
2:27
SPEAKER_00: Didn't you used to say Shh.
2:30
SPEAKER_00: Hosh.
2:31
SPEAKER_00: Hosh.
2:32
SPEAKER_02: What she's saying is uh so I used to say Park Avenue results or Park Avenue surgery without the Park Avenue prices.
2:39
SPEAKER_00: And now you have Park Avenue prices.
2:41
SPEAKER_02: And now I have a Park Avenue address.
2:43
SPEAKER_02: So I can't say that anymore.
2:45
SPEAKER_02: But in reality, I like I didn't go to New York City to reset the price.
2:51
SPEAKER_02: I went to go to New York City as a challenge, as a fun thing to expand my footprint that social media has allowed me to uh have patients from all over the country and and other countries as well.
3:05
SPEAKER_02: And I just think it's super cool.
3:06
SPEAKER_02: And I'm only four hours from New York City and they have really good food and two of my best friends.
3:10
SPEAKER_02: And my wife and I, we go and and we have a we have a fun time.
3:14
SPEAKER_02: And uh so her birthday was uh just this last weekend.
3:18
SPEAKER_02: On Friday, I operate, I did a mommy makeover, it was beautiful.
3:21
SPEAKER_02: The patient got a great result.
3:23
SPEAKER_02: My wife spent the day, she went for a run in Central Park, then she got a massage, then she had lunch over viewing Central Park, and then and I got done, and then we went and did the golf simulator because it was her birthday, and that's what she wanted to do.
3:37
SPEAKER_02: And then uh the kids were there for that uh as well.
3:40
SPEAKER_02: And then we went and had a drink uh over at a rooftop bar in Manhattan.
3:44
SPEAKER_02: It was just a super good day for her, and I also had a really good day because I got to operate, and that is my favorite thing to do.
3:51
SPEAKER_00: But sounds like the best birthday ever.
3:53
SPEAKER_02: Doesn't someone's birthday.
3:55
SPEAKER_00: Oh, didn't she go to air?
3:56
SPEAKER_02: She went to air, and oh, I forgot to mention she went to Air A-I-R-E.
4:01
SPEAKER_02: Uh it's uh Air Ancient Baths.
4:04
SPEAKER_02: Ancient Baths, yeah.
4:05
SPEAKER_02: And then she went and shopped at Bloomingdale's in between that one and lunch.
4:08
SPEAKER_00: So that's I mean, I mean, that's the the perfect birthday.
4:12
SPEAKER_02: Pretty good day.
4:13
SPEAKER_00: Pretty good day.
4:15
SPEAKER_02: So um anyway, celebrities surprise they get um they get plastic surgery.
4:22
SPEAKER_02: I just had a uh I kind of pseudo celebrity reach out to me today uh about something.
4:28
SPEAKER_02: I I don't we'll see if it goes anywhere, but I I just think it's it's super fun, right?
4:31
SPEAKER_02: Celebrities get plastic surgery and people talk about it.
4:34
SPEAKER_00: So the big the big buzz term right now is deep plane facelift.
4:39
SPEAKER_00: Yeah, what is that?
4:40
SPEAKER_00: What's the difference?
4:41
SPEAKER_02: What is a deep plane facelift?
4:43
SPEAKER_02: So let's go back to the kind of the origin of plastic surgeons doing facelift.
4:47
SPEAKER_02: So what we would do is we'd uh make a cut here, make a cut.
4:50
SPEAKER_02: So we'd make a cut right under the ear uh or in front of the ear or a little bit of both, and then cut out some skin and pull it tight.
4:57
SPEAKER_02: And and that's great.
4:58
SPEAKER_02: So that we call that a skin-only facelift.
5:01
SPEAKER_02: 15 or 20 years ago, we called that a there was a company.
5:05
SPEAKER_02: So the Sonobella 20 years ago was that had commercials all the time.
5:09
SPEAKER_02: Uh, so skin-only facelift, right?
5:11
SPEAKER_02: So skin, it looks good.
5:13
SPEAKER_02: You know, the skin gets pulled for a little bit.
5:14
SPEAKER_02: So, like, ready there.
5:16
SPEAKER_02: There's your skin-only facelift.
5:17
SPEAKER_02: The problem is skin relaxes.
5:20
SPEAKER_02: No matter what procedure you do, skin relaxes.
5:23
SPEAKER_02: And so those skin-only facelifts, they last for six months, maybe, maybe a year, and then you're kind of back to where you are.
5:31
SPEAKER_02: Yeah, right, right.
5:32
SPEAKER_02: With a scar, you know, and then you got a scar and it and it's only been a year, and you know, maybe you look good three months afterwards for your why would anyone do that?
5:41
SPEAKER_02: 40th reunion because TV said so.
5:44
SPEAKER_02: We don't do that, right?
5:45
SPEAKER_02: We we don't do that.
5:46
SPEAKER_02: We we think that's a bad idea.
5:47
SPEAKER_02: And then there are there are other facelifts, but like the the two big ones, the the competing facelifts are the SMAS, superficial muscular apeneurotic system SMAS, facelift, and the deep plane facelift.
6:03
SPEAKER_02: So they're neither one, so deep plane is the hot new facelift, but it's not new at all.
6:08
SPEAKER_02: It's been around since I trained in plastic surgery in the in the 2000 whatever.
6:14
SPEAKER_00: So when you do the deep plane, you're below this mass.
6:17
SPEAKER_00: Is that what you're saying?
6:18
SPEAKER_02: Uh yes, you are below this mass you make a defect in the smash and you lift the the muscle layer and the musculoapineurotic layer with like kind of all together as one.
6:31
SPEAKER_02: It is a little different.
6:32
SPEAKER_02: It is supposedly more evasive.
6:36
SPEAKER_02: However, studies have shown it it doesn't last longer than a SMAS facelift.
6:41
SPEAKER_02: I do them both.
6:43
SPEAKER_02: I I did one, did a deep plane facelift on a doctor just like two weeks ago.
6:48
SPEAKER_02: She looks amazing.
6:50
SPEAKER_00: Why do you decide one person gets a SMAS lift and one gets a deep plane lift?
6:56
SPEAKER_02: Sure.
6:56
SPEAKER_02: You know, it depends on the age of the person.
7:00
SPEAKER_02: It depends on other medical conditions, it depends on a bunch of different factors.
7:06
SPEAKER_02: I try to do a deep plane all the time now, if I can.
7:10
SPEAKER_02: So here's a good one.
7:11
SPEAKER_02: So I've had some difficulty.
7:13
SPEAKER_02: We've all had difficulty with sculpture patients getting facelifts afterwards.
7:19
SPEAKER_02: And sometimes there is some significant scar tissue in there and it makes things a little bit more difficult.
7:26
SPEAKER_02: So there have been times when I've had to do most of a deep plain facelift.
7:30
SPEAKER_02: Nope, not yet.
7:31
SPEAKER_02: I'm still on a roll.
7:32
SPEAKER_02: Uh other parts up higher in the cheek, I've had to just kind of pull the smash, tight do a smash tightening procedure there.
7:40
SPEAKER_02: And it's worked out very, very well.
7:42
SPEAKER_02: It's a little bit of a hybrid.
7:43
SPEAKER_02: You know, it's it's not certainly I the the the way you draw it up in your head, but you take what you can get.
7:49
SPEAKER_02: So go ahead.
7:49
SPEAKER_00: Well, this I get this question all the time.
7:52
SPEAKER_00: If I if I get sculpture, can I get a facelift?
7:55
SPEAKER_00: And I I think I think in general, what we figured out is that it's it's not sculpture that's the problem, it's poorly placed sculpture that is the problem.
8:05
SPEAKER_00: Am I correct?
8:08
SPEAKER_00: Probably to you like you shouldn't be putting sculpture in muscle.
8:13
SPEAKER_02: Right.
8:13
SPEAKER_02: But you have to take the muscle, the muscle layer, the skin off the muscle layer, and you have to get good planes.
8:21
SPEAKER_02: Yeah, you have to find the right plane.
8:24
SPEAKER_02: The uh a a facelift, if you can't get the right plane and you struggle and you get one side's easy and the other side's not easy, that uh uh that you have to account for that in someone who gets different fillers and things like that.
8:37
SPEAKER_02: Just like uh, just like uh a patient who gets some some type of filler in the nose and then wants a rhinoplasty, you can dissolve that.
8:47
SPEAKER_02: Can't really dissolve old fill oh old sculpture.
8:50
SPEAKER_02: So uh the moral of the story is it you can still do it, you just have to be prepared to go to plan B or sometimes even plan C in the middle of the procedure.
9:00
SPEAKER_02: And if you've done a bunch like I have, it's okay.
9:03
SPEAKER_02: And and I I've never had one not look really good regardless of that, right?
9:10
SPEAKER_02: It just takes a little bit longer.
9:11
SPEAKER_02: You have to be more particular and uh stay safe, right?
9:15
SPEAKER_00: So, what I tell patients when they ask me if I get sculpture now, is that going to am I not going to be able to get a facelift down the road?
9:25
SPEAKER_00: I typically say properly placed sculpture and a good, skilled surgeon is usually not going to cause any problems.
9:34
SPEAKER_02: Correct.
9:35
SPEAKER_02: And and I think that I think that's fair almost all of the time, right?
9:39
SPEAKER_02: Well, we all complain about it, but in reality, if we're good enough at our job, it should be fine.
9:45
SPEAKER_02: Right?
9:45
SPEAKER_02: It might take a little bit longer.
9:47
SPEAKER_02: We may grumble a little bit more, the recovery might take another week or two, but it should be fine still.
9:53
SPEAKER_02: So I still like sculpture.
9:55
SPEAKER_02: I have sculpture in my face now.
9:57
SPEAKER_02: Am I gonna get a facelift in the future?
10:00
SPEAKER_02: I don't know, maybe.
10:01
SPEAKER_00: You are absolutely right now.
10:04
SPEAKER_02: You you absolutely are.
10:07
SPEAKER_00: I still got at least 10 years, though.
10:08
SPEAKER_02: Yeah, I mean, you have as many years as you want.
10:10
SPEAKER_02: Like it's fine.
10:11
SPEAKER_02: You just have to have it done before before I retire.
10:14
SPEAKER_00: So do you make patients, if they have hyaluronic acid filler, do you make them dissolve it before you do a facelift on them?
10:20
SPEAKER_02: I need to know where they had it, right?
10:21
SPEAKER_02: Uh-huh.
10:22
SPEAKER_02: I I needed how long it's been, where did they have it?
10:25
SPEAKER_02: Can I feel it?
10:26
SPEAKER_02: Do, you know, do I think that it's still a problem?
10:29
SPEAKER_02: Maybe.
10:30
SPEAKER_02: And and there patients aren't always honest with you anyway.
10:33
SPEAKER_02: So you just have to be ready.
10:35
SPEAKER_02: You just have to be prepared to to to find things that weren't there 10 years ago.
10:40
SPEAKER_00: Yeah.
10:41
SPEAKER_02: Right.
10:41
SPEAKER_02: So uh, you know, that's just that's just how it is.
10:44
SPEAKER_00: One of my favorite things is when I'm I'm doing a new consult and I'll be going through the patient's medical history and I'll say, what cosmetic procedures have you had?
10:54
SPEAKER_00: What what have you done to your face?
10:57
SPEAKER_00: And they say nothing.
10:58
SPEAKER_00: And then 10 minutes later they're like, Well, the the the filler that's in my cheeks and the filler that's in my lips is probably two or three years old.
11:09
SPEAKER_00: And then, you know, they had a blethroplasty and they had submental lipo and all those things.
11:16
SPEAKER_02: Yeah, it's super great.
11:17
SPEAKER_02: I I love that.
11:18
SPEAKER_02: So I was doing, we're ready.
11:21
SPEAKER_02: I was doing an abdominoplasty on a woman earlier this year, so sometime in 2026.
11:26
SPEAKER_02: And I'm doing it and it was, it was, it was tough.
11:29
SPEAKER_02: Like the skin wasn't pulling as much as I needed, as I thought it was going to and expected it to, and um, I'm dissecting through and it just, it just didn't look right.
11:42
SPEAKER_02: Right.
11:42
SPEAKER_02: And then, and it occurred to me then as I got a little bit further along, because you start down low and you elevate the skin flap, and then I realize, oh, she's had lipo in the past.
11:53
SPEAKER_02: So then I go to my medical, to the medical history, no evidence of that, no, no liposuction, right?
11:59
SPEAKER_02: No liposuction.
12:00
SPEAKER_02: Go to the um, I get a clearance from a primary care doctor and everybody.
12:05
SPEAKER_02: It wasn't on there either.
12:07
SPEAKER_02: As far as we were concerned, she had never had it.
12:10
SPEAKER_02: But then uh as she's waking up from surgery, I'm like, have you ever had lipo before?
12:14
SPEAKER_02: She's like, no.
12:15
SPEAKER_02: Are you sure you never had lipo on your on your abdomen?
12:18
SPEAKER_02: Oh yeah, yeah, yeah, I had it.
12:20
SPEAKER_02: And and and what about what about your flanks?
12:23
SPEAKER_02: No, no.
12:23
SPEAKER_02: Well, what about your love handles, which is the same thing.
12:26
SPEAKER_02: Oh, yeah, I had that.
12:27
SPEAKER_02: I was like, okay.
12:30
SPEAKER_00: That's right.
12:31
SPEAKER_00: Do you have do you have any major medical history?
12:34
SPEAKER_00: No.
12:34
SPEAKER_00: Ten minutes later, I had a heart attack five years ago.
12:38
SPEAKER_02: I have a zipper in my sternum, right?
12:40
SPEAKER_02: Yeah.
12:42
SPEAKER_02: So, okay.
12:42
SPEAKER_02: So what is a facelift?
12:44
SPEAKER_02: The like, what what is a facelift gonna fix your brow?
12:47
SPEAKER_02: Is it gonna fix your your eyes?
12:49
SPEAKER_02: Is it gonna does that include a rhinoplasty?
12:52
SPEAKER_02: Like, what's all included in a in a facelift?
12:55
SPEAKER_02: And and so typically when we talk about a facelift, we talk about basically from like the sideburns or uh uh sideburns or so down.
13:05
SPEAKER_02: It's a lower facelift and necklift.
13:07
SPEAKER_02: Okay, so when we say a facelift, we almost always use an include a necklift as well.
13:13
SPEAKER_02: I include a necklift in all of my facelift.
13:16
SPEAKER_02: It's just part of it.
13:17
SPEAKER_02: I can't imagine fixing the just the cheek area, calling it a facelift, and then not including the neck.
13:22
SPEAKER_02: I think that sucks.
13:23
SPEAKER_02: I hate that people would do that.
13:25
SPEAKER_02: I think it's wrong.
13:26
SPEAKER_00: I've seen people, some of my patients that I do things on that have gotten facelifts and their incision is up in their frontal scalp.
13:36
SPEAKER_02: Yeah, so that's that's a brow lift.
13:39
SPEAKER_02: It's it can be good.
13:41
SPEAKER_00: They've called it facelift, though.
13:43
SPEAKER_02: They're wrong.
13:43
SPEAKER_02: Maybe, maybe, you know, there are doctors that call a the total facelift, which would include everything upper, lower eyelids, brow lift, face and neck lift, bullhorn lip lift, all of those things.
13:56
SPEAKER_02: You can call that a facelift if you want.
13:58
SPEAKER_02: If you, you know, but in reality, a brow lift is gonna lift the brows.
14:02
SPEAKER_02: An upper eyelid lift, blefroplasty is gonna lift the upper eyelids.
14:06
SPEAKER_02: A lower blephroplasty is gonna take care of the lower eyelids, remove the fat pads.
14:12
SPEAKER_02: A bullhorn lip lift is another procedure that is super cool.
14:16
SPEAKER_02: And uh basically, in women who so now that the trend for lip filler is people don't put four and five and six syringes of lip filler in anymore.
14:28
SPEAKER_02: So you remove a little bit of skin from right under the nose and and lift that up.
14:33
SPEAKER_02: And it just it kind of turns the uh lip up a little bit.
14:38
SPEAKER_02: It's super, it's a super powerful, really nice procedure.
14:41
SPEAKER_02: Can be done if you only get that done, it takes you know 30 or 45 minutes in the office, numbed up, totally awake and and no.
14:49
SPEAKER_00: How's the scar?
14:50
SPEAKER_02: A well-placed scar.
14:51
SPEAKER_02: You you can't see it.
14:52
SPEAKER_02: Now it's it's under the nose.
14:54
SPEAKER_02: So I, as a guy looking down at you, I would never see it.
14:58
SPEAKER_02: You know, you're five, four, maybe five, five.
15:02
SPEAKER_02: How tall are you?
15:02
SPEAKER_00: Five, I'm like five, three.
15:04
SPEAKER_02: Five, three.
15:05
SPEAKER_02: Yeah.
15:05
SPEAKER_02: So like only people shorter than you might see it, or when you look up and and six months down the road, never.
15:12
SPEAKER_02: It's just you look younger because everything descends.
15:15
SPEAKER_02: I've got everything I always had, except now it's all lower, right?
15:19
SPEAKER_02: That is, I've had that for like almost 15 years here.
15:24
SPEAKER_00: It's it's a plaque on his shelf for people who are just listening.
15:28
SPEAKER_02: Oh, yeah, yeah.
15:28
SPEAKER_02: So the I I have uh a plaque that's been in in multiple of my offices.
15:33
SPEAKER_02: It still has my old office's name.
15:34
SPEAKER_02: It's it's now faded, and and it says, uh, it's Gypsy Rose Lee said, I've got everything I had 20 years ago, except now it's all lower.
15:42
SPEAKER_02: So uh when you get a bullhorn lip lift, you you lip and you remove some of the extra skin from the from the upper lip.
15:50
SPEAKER_02: It's a beautiful, very powerful procedure in the the right surgeon, the right patient, very well hidden scar, uh almost all of the time.
15:59
SPEAKER_02: So let's let's go back.
16:02
SPEAKER_02: We we've discussed that multiple the a facelift includes the lower face and neck, a brow lift includes the brow, upper and lower eyelids are can also be done at the same time.
16:13
SPEAKER_02: I'm doing one next week that's facelift, necklift.
16:16
SPEAKER_02: Uh, just saw her today.
16:17
SPEAKER_02: She's she's gonna do great.
16:19
SPEAKER_02: Multiple processes.
16:19
SPEAKER_02: You know what I think one of the multiple procedures are powerful.
16:22
SPEAKER_02: Go.
16:22
SPEAKER_00: When when we're talking about face and neck treatments, what I think has such a big bang for your buck is submental lipo.
16:33
SPEAKER_00: So many people ask me about what they can do about just this little bit of excess fat under their under their chin.
16:41
SPEAKER_00: Everyone hates that.
16:42
SPEAKER_01: Yeah.
16:43
SPEAKER_00: And the non-invasive things that I have just aren't great.
16:46
SPEAKER_00: They're just not great.
16:47
SPEAKER_00: They I mean, I tell people, I have things in the office that I can offer you.
16:52
SPEAKER_00: I don't want you to do them.
16:54
SPEAKER_02: Yeah.
16:55
SPEAKER_00: They they I don't want to take your money.
16:57
SPEAKER_00: Just go and get submental lipo.
16:59
SPEAKER_00: It's it's a slam dunk.
17:01
SPEAKER_02: I see less of that now than I did five years ago because people are losing weight with GLP ones.
17:08
SPEAKER_02: And yeah, and it's it's now more loose skin than fat.
17:11
SPEAKER_02: I do maybe 20 of them a year now.
17:14
SPEAKER_02: Maybe every couple of weeks, somebody gets a tummy tuck and they they're like, hey, can you take care of this?
17:18
SPEAKER_02: I'm like, yeah, sure.
17:20
SPEAKER_02: And uh, you know, it's a it's just a nice bonus.
17:22
SPEAKER_02: You forget you forget that you had anything done there and and you know, your tummy feels better.
17:27
SPEAKER_02: And you're like, wow, hey, look, my look at this, look at this profile, that looks good.
17:31
SPEAKER_00: If they just want submental lipo, can you just do it in the office?
17:35
SPEAKER_02: Yeah, sometimes yes.
17:37
SPEAKER_02: Yep.
17:38
unknown: Yep.
17:39
SPEAKER_00: No, just local, just know that you just numb them up and do it.
17:42
SPEAKER_02: Yes, you can, yes, you can definitely do that.
17:45
SPEAKER_02: I try to use so the result ends up being a little bit less because it's it's not the same device as you get in the operating room.
17:52
SPEAKER_00: Okay.
17:53
SPEAKER_02: Okay.
17:54
SPEAKER_02: So, you know, so we we try to recommend folks, at least in my practice.
17:58
SPEAKER_02: I I don't have uh I don't have a liposuction machine like in room one down here that that uh that we can do.
18:04
SPEAKER_02: So, but I do, you know, I I have them everywhere else I go, including at the surgery center that we recently just expanded and and opened up and it's been going great, and and that's been a lot of fun.
18:16
SPEAKER_02: So, you know, let's let's talk a little bit about you know different celebrities.
18:20
SPEAKER_02: You know, I think J Lo just got a little facelift.
18:23
SPEAKER_00: J Lo.
18:25
SPEAKER_00: I mean, this could be her second facelift.
18:28
SPEAKER_00: Let's be real, right?
18:29
SPEAKER_02: Right.
18:30
SPEAKER_02: So so she just showed off the new girls.
18:32
SPEAKER_02: Uh this is me holding up.
18:35
SPEAKER_00: This is she how old is she?
18:37
SPEAKER_02: She's 57.
18:38
SPEAKER_02: She just had a birthday uh last week.
18:40
SPEAKER_02: She's July 24th.
18:42
SPEAKER_02: Ask me how I know.
18:42
SPEAKER_02: It's my wife's birthday as well.
18:44
SPEAKER_02: Yeah.
18:44
SPEAKER_02: She's yeah.
18:45
SPEAKER_00: Um it's also Alexis's birthday, our medical assistant at Skin Lab.
18:49
SPEAKER_00: Oh, hi, Alexis.
18:50
SPEAKER_02: Very good.
18:50
SPEAKER_02: So she's not listening.
18:52
SPEAKER_02: Um J Lo just got uh new breast implants, and I also think uh so she showed them off and they look amazing.
18:59
SPEAKER_02: And I we think she got maybe a little facelift too.
19:02
SPEAKER_00: But you know, everybody's looking at the girl, so you can't really what do you think about all these all these celebrities who are getting facelifts younger or allegedly getting facelifts younger, like Lindsay Lohan, for instance.
19:14
SPEAKER_00: Do you think she got a facelift?
19:16
SPEAKER_02: Yeah, allegedly, allegedly she went to the same guy that Chris Jenner uh did.
19:20
SPEAKER_02: Um different type of facelift, most likely incisions just kind of uh in the brow, tunneled down here, maybe in the back, tunneled here, pulled tight.
19:32
SPEAKER_00: Yeah, because she doesn't have any scars, right?
19:34
SPEAKER_02: Not that I mean I you can't, I can't tell.
19:37
SPEAKER_02: I but yeah, you know, I I uh so that's great for someone in their 30s.
19:42
SPEAKER_02: Yeah, so that's that's very good too.
19:44
SPEAKER_02: But you know, now if you five or six years ago, if you ask me, would I ever do a facelift in someone in their 30s, I'd be like, hell no.
19:53
SPEAKER_02: Like, why would I do that?
19:55
SPEAKER_02: Right.
19:55
SPEAKER_02: But, you know, I had I now have patients who lost 225 pounds.
19:59
SPEAKER_01: Yeah.
20:00
SPEAKER_02: 185 pounds.
20:01
SPEAKER_02: Like, laser's not gonna fix that, right?
20:03
SPEAKER_02: Right.
20:04
SPEAKER_02: You know, that so several times a year, each of the last few years, I've done facelifts in uh people in their 30s, guys and girls, actually, uh, in their 30s.
20:14
SPEAKER_02: So, because they just have a ton of loose skin.
20:16
SPEAKER_02: Now, the muscle layer, the smas layer, the deep plane, uh might still be pretty good in them.
20:23
SPEAKER_02: So you tighten it up a little bit and you remove a lot of loose skin.
20:26
SPEAKER_02: So is there a chance that they're gonna get laxity as well?
20:30
SPEAKER_02: Yes, there there is, but like so the skin does relax no matter what facelift you get.
20:36
SPEAKER_02: The skin is gonna relax a little bit.
20:39
SPEAKER_02: And and so just a couple of weeks ago, people were banging on Chris Jenner's facelift and that and that surgeon saying, Oh, it it only lasted a year.
20:48
SPEAKER_02: No, listen, facelifts, they're gonna relax a little bit, and that's normal.
20:52
SPEAKER_02: She still looks great.
20:53
SPEAKER_02: She's like 70, she looks hot as shit, right?
20:56
SPEAKER_02: She's a beautiful, she's beautiful, she's doing great.
20:59
SPEAKER_00: I think in general, you kind of you don't want to look super tight.
21:03
SPEAKER_00: I think that's that's a concern a lot of people have when they're worried about getting a facelift.
21:08
SPEAKER_00: They don't want to look like the cat lady, you know, pulled super tight and look like we think of the facelifts for the the first facelifts from like the 90s.
21:21
SPEAKER_02: Yeah.
21:21
SPEAKER_00: Where people look inhuman.
21:23
SPEAKER_02: And people still do that.
21:25
SPEAKER_02: My my wife is on a Facebook group that's facelift whatever.
21:29
SPEAKER_02: I don't know what it is, but you know, every couple of days or a couple of times a week, she'll show me pictures of like facelift horror stories that I'm just like, oh yeah.
21:39
SPEAKER_00: And and like, what do you do?
21:40
SPEAKER_00: You can't really fix it, right?
21:41
SPEAKER_02: Yeah.
21:42
SPEAKER_02: You can't some of them, some of them you can't fix.
21:44
SPEAKER_02: There are others that I'm like, oh, that that'll go away.
21:47
SPEAKER_02: That that's gonna be fine.
21:48
SPEAKER_02: Uh or that just needs a little revision.
21:50
SPEAKER_02: Then there are others that are like, oh no.
21:53
SPEAKER_02: Like they just, I don't know what people do.
21:56
SPEAKER_02: I know what I do, I know what good plastic surgeons do, and then there's there.
22:00
SPEAKER_02: Other things that I just I don't I I don't know.
22:02
SPEAKER_02: I don't know.
22:03
SPEAKER_02: Right.
22:03
SPEAKER_02: I don't I don't know.
22:04
SPEAKER_02: It looks like it it wasn't done by a surgeon at all.
22:07
SPEAKER_00: I mean, there's bad cosmetic work everywhere.
22:11
SPEAKER_02: Yeah.
22:12
SPEAKER_02: Who else do you want to talk about?
22:13
SPEAKER_02: Maybe had some face work in the last you know few years or whatever.
22:17
SPEAKER_00: Um well Martha Stewart looks right.
22:23
SPEAKER_02: She's like 97 years old.
22:25
SPEAKER_00: Like she's she's she's I I think she's goals.
22:29
SPEAKER_02: She's goals.
22:30
SPEAKER_00: She's hot.
22:31
SPEAKER_02: She is.
22:32
SPEAKER_02: She is hot.
22:34
SPEAKER_00: Hot.
22:35
SPEAKER_00: She looks amazing.
22:36
SPEAKER_00: I mean, who who so a lot of people are talking about Ann Hathaway.
22:43
SPEAKER_00: I actually I don't think that she has had a facelift.
22:45
SPEAKER_00: I think she's I don't either.
22:47
SPEAKER_00: She's I think 42, 43, I'm not sure.
22:50
SPEAKER_00: But I think she just had some really good preservation work.
22:54
SPEAKER_02: Someone like you.
22:54
SPEAKER_02: Yep.
22:55
SPEAKER_02: She's she's been seeing someone like you since she was 23.
22:58
SPEAKER_02: Yes.
22:59
SPEAKER_00: You know, she's she doesn't go in the sun.
23:01
SPEAKER_00: Yeah.
23:01
SPEAKER_00: There was that trending um on social media.
23:04
SPEAKER_00: There's those trending photos of her in, I don't know, it's like the Amalfi Coast or something, and she is covered head to toe in a rash guard, which you make fun of me when I'm wearing my rash guard, but that is how you don't age.
23:22
SPEAKER_00: You stay out of the sun, and that's what Ann Hathaway is doing.
23:25
SPEAKER_00: It is not a facelift.
23:27
SPEAKER_02: You look ridiculous like that.
23:30
SPEAKER_00: I do.
23:30
SPEAKER_00: I know I do.
23:32
SPEAKER_02: Ridiculous.
23:33
SPEAKER_02: You could just be in the shade.
23:34
SPEAKER_02: Can't you just like like me?
23:37
SPEAKER_02: Like, I, you know, when the sun hits my toes, I move my toes, you know, and I'm in an umbrella under an umbrella.
23:43
SPEAKER_02: Can't you like if you're I have two little kids?
23:46
SPEAKER_00: I gotta chase them.
23:47
SPEAKER_00: I gotta chase them.
23:48
SPEAKER_02: They're not toddlers anymore.
23:50
SPEAKER_02: So for those of you that don't know, my sister, when she goes to a pool, to the beach, whatever, she looks she she dresses like Superman, okay?
24:00
SPEAKER_02: Like everything.
24:03
SPEAKER_02: She goes like a little suit.
24:06
SPEAKER_02: And and and then and then like throws a uh a hat that's as big as a uh as big as a table uh on her head.
24:16
SPEAKER_00: The the bathing suit is the S.
24:19
SPEAKER_00: And then I've got all the layers on top.
24:22
SPEAKER_02: It it's ridiculous, you know.
24:24
SPEAKER_02: Uh I I yeah.
24:31
SPEAKER_02: Yeah, since I cut the melanoma off of your neck.
24:34
SPEAKER_00: Oh, way before that.
24:36
SPEAKER_00: That's a flex.
24:37
SPEAKER_02: What?
24:38
SPEAKER_00: Not being tan for 17 years, not the melanoma.
24:40
SPEAKER_02: Right, right.
24:41
SPEAKER_02: Yeah, not not melanoma, right.
24:43
SPEAKER_02: Yeah.
24:43
SPEAKER_02: Uh so uh the other um Kate Beckinsale.
24:48
SPEAKER_02: Oh yeah.
24:49
SPEAKER_02: She's a mutant, she's older than me.
24:52
SPEAKER_00: Yeah.
24:53
SPEAKER_00: She's she but she's, I believe, w uh a celebrity who claims to not do any any cosmetic work.
25:00
SPEAKER_02: Yeah, right.
25:01
SPEAKER_02: Okay, sure.
25:02
SPEAKER_02: Right.
25:02
SPEAKER_02: Cool Kate.
25:03
SPEAKER_02: Right.
25:03
SPEAKER_00: Cool story, but I mean, listen, we don't, we don't, we don't need everybody's medical history.
25:08
SPEAKER_00: Right.
25:08
SPEAKER_00: That that's not it, it's we don't need a celebrity's medical history.
25:12
SPEAKER_00: You don't have to disclose everything, but you also don't have to say, I have done nothing at all.
25:20
SPEAKER_00: Because that sets impossible.
25:23
SPEAKER_02: Unrealistic expectations.
25:24
SPEAKER_02: Guys get it too.
25:25
SPEAKER_02: Brad Pitt, he had a great facelift.
25:27
SPEAKER_00: Oh, yeah, yeah, yeah, yeah.
25:28
SPEAKER_02: Yeah, Brad Pitt had a great facelift.
25:30
SPEAKER_02: I think Tom Cruise had a facelift too, I think.
25:33
SPEAKER_02: Oh, but Brad Pitt definitely had one.
25:35
SPEAKER_02: He looks awesome.
25:36
SPEAKER_00: He looks awesome.
25:38
SPEAKER_00: A lot of people are talking about Bradley Cooper and kind of feeling like he's not looking like himself lately.
25:43
SPEAKER_00: Have you seen that?
25:44
SPEAKER_02: Yeah, so he got a uh a blephroplasty, and and I think maybe they took a little bit too much fat from his uppers.
25:51
SPEAKER_02: So in our upper eyelids, we have two fat pads, one close to the uh to the nose, one in the middle, and then we have a tear duct.
26:00
SPEAKER_02: Um I'm sorry, uh a lacrimal gland, a tear gland where the the tears form.
26:05
SPEAKER_02: And if you take too much of the fat, you can kind of look a little bit sunken in.
26:10
SPEAKER_00: Okay.
26:11
SPEAKER_00: I mean, he's dating Gigi Hadid.
26:13
SPEAKER_00: He's doing just fine.
26:14
SPEAKER_02: I don't know who that is.
26:15
SPEAKER_00: You know, but Gigi, you know who Gigi Hadid is.
26:18
SPEAKER_00: She's like the biggest supermodel in the world.
26:20
SPEAKER_00: How are you all over social media and you don't know who Gigi is?
26:24
SPEAKER_02: My social media feed is plastic surgery and dogs.
26:28
SPEAKER_02: That's it.
26:28
SPEAKER_02: It's just dogs.
26:29
SPEAKER_02: And it was Italy for a few months, and uh, that's about it.
26:33
SPEAKER_00: Gigi is also Taylor Swift's best friend.
26:35
SPEAKER_02: Who's that?
26:39
SPEAKER_02: Okay, so let's let's hit on some, you know, a few things, right?
26:42
SPEAKER_02: I I have some notes here.
26:43
SPEAKER_02: A deep plane facelift is not always best.
26:46
SPEAKER_02: You want to you want to go find the surgeon, not the procedure.
26:49
SPEAKER_02: Just like anything else.
26:50
SPEAKER_02: We are gonna one of the themes for scalpel and skin is find the surgeon, find the physician assistant, find the dermatologist, find, you know, the nurse practitioner, whatever.
27:00
SPEAKER_02: Don't don't find the treatment, like because you don't want to get sold the wrong procedure or the wrong treatment for you and and end up unhappy.
27:10
SPEAKER_02: And everybody's unhappy.
27:11
SPEAKER_02: A deep plane facelift is not always best.
27:13
SPEAKER_02: Sometimes a smash facelift is is the right thing for you.
27:17
SPEAKER_02: Another thing is so what about a mini facelift?
27:20
SPEAKER_02: Uh I that's written down.
27:21
SPEAKER_02: I wrote that down here.
27:23
SPEAKER_02: Is um so the way to get a really good result from a mini facelift is to do a full facelift and call it a mini.
27:32
SPEAKER_00: So no doubt.
27:36
SPEAKER_02: Right?
27:36
SPEAKER_02: You know, everybody wants a mini tummy tuck, and like 1% of the people are candidates for mini tummy tucks.
27:43
SPEAKER_02: So, like, sorry.
27:44
SPEAKER_02: Can filler replace a facelift?
27:46
SPEAKER_02: No, no, it absolutely cannot.
27:48
SPEAKER_02: Is earlier always better?
27:49
SPEAKER_02: No, it's not.
27:50
SPEAKER_02: Some uh, you know, I like I said, some people might need facelifts in their 30s, but certainly not everybody does.
27:57
SPEAKER_02: Yeah, and I wrote down other procedures that we talked about here.
27:59
SPEAKER_02: We hit on just about it.
28:00
SPEAKER_02: We talked about laser and stuff, lip lift, chin augmentation.
28:04
SPEAKER_02: That's a nice one sometimes.
28:05
SPEAKER_02: You put sometimes filler is good for chin augmentation.
28:08
SPEAKER_00: Oh, yeah, we love chin filler.
28:10
SPEAKER_00: That's one of my favorites.
28:10
SPEAKER_02: Did I just do that on you last week?
28:12
SPEAKER_00: You did put a little filler in my chin a few weeks under my supervision.
28:16
SPEAKER_02: Like I haven't done it 20,000 times before.
28:20
SPEAKER_02: So, listeners out here, um, she, my sister, uh, I'm doing her talks and I'm doing her filler a couple of weeks ago.
28:27
SPEAKER_02: And and she goes, Does it make you nervous that that I'm doing that that you're doing my filler?
28:32
SPEAKER_02: I'm like, the hell are you talking about?
28:34
SPEAKER_02: I I cut people's faces off for a living.
28:36
SPEAKER_00: Like, what are you too right about?
28:38
SPEAKER_00: I was like, I wanted you to use a cannula.
28:41
SPEAKER_00: You know, I was telling you what I wanted you to do because I'm type A and that's who I am.
28:47
SPEAKER_01: Yeah.
28:48
SPEAKER_00: And I was like, how do you know, how do you know you're in the right layer with a cannula?
28:53
SPEAKER_00: I was kind of grilling you, and you were like, Because I've seen this layer of skin a million times.
29:00
SPEAKER_00: And I was like, okay, that's a good enough answer for me.
29:03
SPEAKER_02: Yeah, because I I I actually peel back faces and look directly at that layer of skin.
29:08
SPEAKER_02: I know exactly where to be.
29:10
SPEAKER_02: And uh I do liposuction, and liposuction is literally a cannula.
29:15
SPEAKER_02: It's you know, the the one you have is just a little tiny, tiny, you know, it's like, I got it.
29:19
SPEAKER_02: We're we're good.
29:20
SPEAKER_02: Yeah, we're good.
29:21
SPEAKER_02: And by the way, you look lovely.
29:23
SPEAKER_02: Thank me very much.
29:24
SPEAKER_00: I'm really happy.
29:25
SPEAKER_00: We we worked on we worked on my jowl a little bit.
29:27
SPEAKER_00: I feel better about it.
29:29
SPEAKER_00: We did.
29:30
SPEAKER_00: I had it was, I mean, the treatment plan was A plus.
29:34
SPEAKER_02: Oh, your treatment plan for yourself?
29:35
SPEAKER_00: Yeah.
29:36
SPEAKER_02: I see.
29:37
SPEAKER_00: You executed it though.
29:38
SPEAKER_02: So thank you.
29:39
SPEAKER_02: I am the technician.
29:40
SPEAKER_02: Thanks, thanks so much.
29:41
SPEAKER_02: Uh okay.
29:42
SPEAKER_02: Let's talk a little bit about recovery for a facelift.
29:45
SPEAKER_02: Okay, so facelift recovery is not bad.
29:48
SPEAKER_02: The one I did two weeks ago, she already went out to dinner with her husband.
29:53
SPEAKER_02: Uh, you know, she went to a little candlelight dinner 10 days post-op, and I think that's totally fine.
29:58
SPEAKER_02: Whoever you go with is gonna know you had something done.
30:01
SPEAKER_02: Um people, uh the the thing is, not everybody's looking at you.
30:06
SPEAKER_02: Okay.
30:06
SPEAKER_02: That that's the thing that you want to know is unless you look super weird, and you know, if you're out and about, don't wear it.
30:13
SPEAKER_02: How many people listen to that?
30:15
SPEAKER_02: I that's a great question.
30:16
SPEAKER_02: Everybody seems to do very well.
30:19
SPEAKER_02: If if half of the people listen to my instructions, that makes me happy.
30:22
SPEAKER_00: I think the head bra is cool.
30:24
SPEAKER_02: We can it's called a jaw bra.
30:28
SPEAKER_00: I'm calling it a head bra.
30:30
SPEAKER_00: That's great.
30:31
SPEAKER_02: Get the head bra.
30:32
SPEAKER_02: There's a couple of take-home points from this, and and that is, you know, don't shop for a plane, shop for the right surgeon.
30:39
SPEAKER_02: You know, find the right surgeon that's gonna do the right thing for you.
30:42
SPEAKER_02: You know, it's always right patient, right procedure, right time, right surgeon.
30:46
SPEAKER_02: That's it.
30:47
SPEAKER_02: You know, a facelift is gonna be something that's gonna reposition tissue.
30:51
SPEAKER_02: It it's got, it's not gonna treat every sign of aging.
30:54
SPEAKER_02: You may get a facelift and you may still have wrinkles.
30:56
SPEAKER_02: That's because you need laser, right?
30:58
SPEAKER_02: And and that's a reasonable thing to do.
31:00
SPEAKER_00: We said this in the last episode, but you combining laser with facelift is a is a great combo because if you've got a face full of sun damage, but a tight, but tight skin, you're still gonna look older.
31:13
SPEAKER_02: So still gonna look older.
31:15
SPEAKER_02: Treat treat your skin too.
31:16
SPEAKER_02: So, what else do you want to talk about with facelift?
31:18
SPEAKER_02: I'm uh I'm I'm I'm pretty much run its course.
31:21
SPEAKER_00: I think that was good.
31:22
SPEAKER_00: That was good.
31:22
SPEAKER_00: That was that was a good overview.
31:24
SPEAKER_00: I I learned a few things.
31:26
SPEAKER_02: Good.
31:26
SPEAKER_02: So I am uh Dr.
31:27
SPEAKER_02: Elger Labraska, board certified plastic surgeon north of Pittsburgh, and also with a satellite office in New York City.
31:33
SPEAKER_02: Yes, I do facelifts.
31:34
SPEAKER_02: Yes, I do other facial rejuvenation, and I'm here with my sister, Mystica Labrasca.
31:40
SPEAKER_02: She is a cosmetic dermatology physician assistant for 16 years.
31:43
SPEAKER_02: She is the master of skin.
31:45
SPEAKER_02: I am the master of scalpel.
31:46
SPEAKER_02: We are the Lebraskas, we are siblings, we are business partners, and we still get along somehow.
31:52
SPEAKER_02: Thank you very much.
31:53
SPEAKER_02: Let's go.
31:54
SPEAKER_02: That's it for today's episode of Scalpel and Skin.
31:57
SPEAKER_02: Follow the show wherever you listen and come find us on social media.
32:00
SPEAKER_02: Send us the treatments, trends, or questions you want us to break down next.
32:04
SPEAKER_02: This is Scalpel and Skin.
32:06
SPEAKER_02: Let's go.