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Doctor's Picks 2012: Elective and Cosmetic Procedures

As recently as five years ago, facelifts were often associated with a tight, pulled look. Then, in seeking more natural results, there was a focus on less manipulation of the deeper tissues—but this meant the lifts didn't last as long. None of this is true anymore, says Dr. Marcus. After several years seeking the perfect combination of technique and equipment, Marcus's deep plane facelift has allowed him "to give dramatic results to patients but to have a very, very natural appearance," he says, delivering "what I really think are superior results with a single operation in the neck, along the jawline and along the cheek."

With Marcus's deep plane face-lift, dissection is focused on the SMAS (submuscular aponeurotic system), the deepest muscular layer beneath the skin. The procedure takes longer but the results are more natural, less painful and longer lasting.

"This has completely changed the way I think about providing a full facelift for a patient," says Marcus.

Length of procedure: 4 hours Recovery time: 2 weeks Cost: $6,000–9,000 More at uwhealth.org/plasticsurgery

One of the first places we notice aging and fatigue is in the eyes, whether it's dark circles and puffiness below, wrinkles or drooping and sagging upper lids. Eyelid surgery, known as blepharoplasty, is especially popular with men because they don't have many of the tools utilized by women through makeup and grooming at their disposal. For both genders, however, blepharoplasty is a relatively low-risk, mildly invasive procedure that yields dramatic, natural-looking results.

The procedure is performed on either the lower or upper eyelids (or both) and consists of a combination of tightening lax skin and removing fat that bulges around the socket creating bags. Parfitt's barely noticeable incision is right next to the eyelash line, and he is careful to avoid downward tugging to better preserve the integrity of the eyelid shape. His patients have little discomfort and no pain following blepharoplasty, which is done with IV sedation.

Length of procedure: 45 minutes for upper or lower, 90 minutes for both Recovery time: 1 week Cost: $3,500–4,500 for upper or lower, $7,000–9,000 for both More at facialplastics.com

For those who don't yet need maximum neck or cheek work and are seeking a less invasive procedure with shorter downtime, Robertson says his mini-lift is a value-packed surgery. Not to be confused with other so-called "mini-lifts" that may  involve only minor suturing and tightening to the skin layer, Robertson's mini-lift manipulates the SMAS layer so it's "the same degree of work that I do in a deep plane facelift."  The lift is still performed at the SMAS layer, but less of the neck and cheek is exposed than with the full lift.

"The key with any facelift, whether it's effect or longevity, is driven by what you're doing to the SMAS," he says. Another benefit is that it's safe to add on procedures simultaneously, such as fillers, lipo or skin resurfacing. One downside is that result lasts only about two—thirds of the lifespan of a full—facelift. However, "if you can promise two—thirds the result with half the downtime, that suits many patients," he says.

Length of procedure: 2 hours Recovery time: 1 week Cost: Under $5,000 More at robertsonplasticsurgery.com

It's one of the longest-standing elective eye procedures around, and yet it's constantly evolving and benefiting from technological advancements. Even as recently as last year, the doctors at Anderson & Shapiro—who were the first in the state of Wisconsin to perform LASIK seventeen years ago—have instituted the new, highly precise Active Tracking System. Today's LASIK at Anderson & Shapiro is all bladeless, all laser and completely customized to the fingerprint-like uniqueness of each person's eyes.

"We're taking thousands of different measurements and we're using that information to get the most exact correction we can for each eye," says Shapiro. Technology has widened the spectrum of eligible patients as well, so if you've ever been told you're not a candidate for LASIK, it's worth a new visit to the doctor. The biggest surprise for most patients, according to Shapiro, is their ability to see 20/20 the day after surgery. "The combination of the new tracking technology, using all lasers and better customization is just giving us outstanding results."

Length of procedure: 25 minutes (but plan on 90 minutes on-site) Recovery time: 24 hours Cost: $1,950 per eye More at be2020.com


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