Cheek lift offers new cosmetic option

Betsy Capetta pictured before and after surgery.

The face lift face-off - How procedures compare

Cheek lift offers new cosmetic option
Novel technique avoids tell-tale ‘wind-swept’ face

By Dr. Bob Arnot NBC NEWS CORRESPONDENT

July 20 — There was a time when face lifts were only for the rich and famous. Not anymore. These days many people are getting them — not just millionaires and movie stars. And now there’s a new technique that may make looking younger a little easier and cheaper. But does it really work?


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A PLASTIC SURGEON’S consultation with a patient is akin to an artist’s session with his subject.
Her face is the canvas, and 54-year-old Betsy Capetta wants to see it become a masterpiece.
“My face is aging more than the way I feel inside and I just wanted to have some of the skin around here tightened up and, have that, you know, kind of fresh look,” she says.
So she’s here, entering the operating room, to get one of the latest in a line of surgical techniques that lifts a new area of the aging face from plastic surgeon Dr. Brent Moelleken.
Arnot: “What is it you’d consider really the hottest area right now in plastic surgery?”
Moelleken: “I’d have to say it would be the mid-face.”
The mid-face includes the lower eyes and cheek area. Until recently, plastic surgeons thought the mid-face was too hard to tackle because muscle and tissue in that area are extra delicate.

		Further resources

		•	American Society for Aesthetic Plastic Surgery Referrals: 1-888-272-7711

		•	American Society of Plastic Surgeons Referrals: 1-888-4PLASTIC

		•	For more information on the cheek-lift procedure, visit Dr. Brent Moelleken’s Web site.

But Moelleken of Beverly Hills is one of many cosmetic surgeons now taking on the mid-face with innovative procedures. The new operation he developed is called the “superficial cheek lift.”
“Almost everybody who needs their lower eyes done would benefit more from some degree of superficial cheek lift,” he says.
Whereas a full, traditional face lift involves many incisions, and can sometimes result in a tight, “wind-swept” look when the skin is pulled back, the superficial cheek lift is simpler, less obvious and aims to reverse gravity’s effects by pulling upward.
Arnot: “Is this more of a vertical lift?”
Moelleken: “It’s a purely vertical lift. Because the cheek pad has fallen straight down and it collects on these smile lines. So by lifting directly vertically, we’re able to decompress this fold and rejuvenate the area under the eyes.”

July 20, 2001 — Watch the video of Dr. Bob Arnot’s report on a new surgical option for looking younger.

So how exactly is it done? An incision is made under the lower eyelashes. The doctor goes in just below the muscle, which is cut and tightened, and the cheek pad is then lifted. Permanent sutures anchor the muscle to strong tissue just beside the eye, and the excess skin is removed. After 90 minutes of surgery, which usually includes an upper eye lift as well, the road to recovery begins.

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Capetta will have to keep ice-cold gauze on her eyes for 48 hours, relax and do nothing for four days.
A full face lift takes six weeks to heal and costs $8,000 to $10,000, whereas the superficial cheek lift costs around $6,000 and patients are on their feet, looking pretty good, in just four days and are almost completely recovered in three weeks.
Four days after surgery we get our first peek at Capetta.
Moelleken: “How are you pain-wise?”
Capetta: “Excellent.”
No pain, but at this point her eyes are bruised and bloodshot. Moelleken says Capetta’s surgery was more aggressive — she had bulges under her eyes that had to be smoothed out, which caused redness.
“My healing is not as rapid as I had expected, but I do have confidence that within the week it’s going to be fine,” Capetta says.
“There’s very little chance that this is going to be the new, hot face-lift procedure,” says Dr. Sherrell Aston, a renowned New York City plastic surgeon.
“Surely you can get some change along the lower lid, but you cannot lift the face through the lower eyelid,” Aston says.

But Moelleken notes, “When we tighten the muscle from below, when we lift it up, we’re not using the lower eyelid. That’s very important.”
“This procedure is one attempt by one surgeon to give an improvement to the area that’s traditionally difficult. But its not the answer to correcting the aging of the mid-face,” Aston says.
Moelleken says you need an expert surgeon to do this procedure successfully. “Caution is necessary. The mid-face is a very tough area and the doctor really has to have a lot of experience and confidence in the area underneath the eye before doing this, or you could have real problems,” he says.

Capetta sees a big difference in her mid-face area compared with the sagging, tired look she felt she had before.
“My skin is smoother right here on my cheeks and there’s less of a fold right by my mouth. And what it’s done is it’s just kind of made this whole area very smooth and a little bit less on the eyes,” she says.

	Choosing a surgeon

	Checklist of questions to ask your potential plastic surgeon:
	•	Are you certified by the American Board of Plastic Surgery? When the doctor claims to be board-certified, ask by which board. Only the ABPS is recognized by the American Board of Medical Specialties to certify doctors in the area of plastic surgery.

	•	Do you have hospital privileges to perform this surgery? Some surgical procedures can be performed in the doctor’s office or other outpatient facility but it is important to find out if the doctor has operating privileges in an accredited hospital for the same procedure you are having. Before granting operating privileges, hospital review committees evaluate a surgeon’s training and competency for specific procedures.

	•	Where will you perform my surgery? If it’s in an office-based facility, ask if it’s accredited. Most states don’t require ambulatory or office-based facilities to be accredited, but voluntary application can be made to an accrediting body such as the American Association for Accreditation of Ambulatory Surgery Facilities. Such accreditation means the facility has met strict requirements and denotes a high standard of care.

	•	How many procedures of this type have you performed? Also ask what training has been completed, especially in new techniques. Ask to see certificates of training.

	•	What are the risks involved with the procedure? There are risks with any surgical procedure. Find out what they are, how often they occur, and how they will be handled if they do occur.

	•	What is the expected recovery time? Be sure to discuss postoperative restrictions on activity and typical time periods for resuming work.

	•	What is your policy on surgical revisions? Some cases may require revisions to achieve the desired results. Find out about any costs for which you may be responsible.

	•	How much will the surgery cost? Cosmetic surgery is not covered by insurance, and payment usually is required in advance. Costs include the surgeon's fee and fees for the surgical facility and anesthesia. Other possible costs are the preoperative physical and blood work, medications, surgical garments and private-duty nursing.




Sources: American Society of Aesthetic Plastic Surgery; American Society of Plastic Surgeons