Frank: You see a lot of these women with some really gaudy plastic surgery. I mean, stretched out to the max. You know, these guys will cut on them and say, "You look beautiful" just to get the money, you know. Do you ever see that? Dr. Michael Salzhauer: Unfortunately, there are some people in some practices that do unnecessary surgeries. Of course, in our practice, we never do that. It abhors me as much as it abhors anybody else when you see women who look like they’ve been through a wind tunnel. There are a few caveats that I need to mention about that look. First of all, it’s very rare to get that super tight, wind-tunnel look after a first facelift. It almost never happens after a first facelift. It’s usually the second or third facelift, where women who have had a facelift let’s say in their 40s or 50s, look great, they look ten years younger than they actually are, come back for a second facelift when they’re in their 50s and 60s, and they look okay after that one, but then they come back in their late 60s or 70s and by the time you’re pulling on the skin on that third facelift, there really isn’t much skin left to pull, and so you end up with that distorted sort of joke, wind-tunnel look I’ll call it. The other thing is as people get older and older, not only does the skin sag down and not only do they get wrinkled, but they also lose volume in their face and they get more thin and gaunt, and when you try to pull back skin tightly against a face that’s lost volume and lost the volume of youth that’s normal contours to the face, it does look very artificial and is not very attractive at all. We avoid that at all costs at our practice, of course. There are some steps we can take to avoid that look, mainly by replacing some of the volume that’s in the cheekbones and in the mid-face that’s lost as people age, and that can be done by fat grafting, taking fat from your stomach or from some other area of your body and putting it in the cheeks. We also have products such as Sculptra and Radius that actually add volume to the cheek area and the mid-face. Again, I hate that wind-tunnel look more than you know. I can honestly say that nobody in my practice leaves with that appearance. Again, if a patient comes in and they’re in their 70s and they’ve had two face lifts, I will be very honest with them and say, âYou won’t look younger. You will just look tighter and I don’t think that’s the look you’re going for. So I urge them to do some other procedure where they add volume to their face and can look younger first before we try to stretch that skin too tight.

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