There's No Right Age for a Facelift

Dr. DeBusk (00:12):
So facelifts are a procedure surgery that addresses typically the face from the cheek down to the low neck or all the way to the collarbone. We generally lump in facelifts with face rejuvenation. Now, facial rejuvenation is kind of a myriad of different procedures depending on what patients may benefit from or what concerns they have that we want to address. But in general, when we talk about facelifts, we're talking about lifting the cheek under the eye, lifting the jowl or the soft tissue along the jaw, and then tightening the neck basically from under the chin, again, all the way down to the collarbone. In facelifts, again, it's a very broad term. There's a lot of different techniques and they've really evolved over the years. I strictly do what's called an extended release deep plane facelift, or more specifically a preservation extended release deep plane face and neck lift.

(01:09):
So the most common reason people honestly want facelifts is the jowling or the excess tissue along the jaw, the laxity or the banding or excess tissue under the neck. And then oftentimes people feel like they have a deeper nasolabial fold. So those are the three most common reasons people want facelifts. And that's what a facelift will address is actually all three of these things. But I would say the number one reason people come in wanting a facelift is for the jowls and then the fullness or the laxity of skin under the neck, under the chin. Anytime we do a consultation, I look at the face from top down, typically divided into three different parts where the upper third is the brows, forehead upper eye, the middle third is the cheek, lower eye, upper lip, and then the lower third is the jaw. When we look at the brow, a lot of times what I always ask patients is, "Do you do Botox?

(02:01):
And if you do Botox, do you feel like you have to limit the amount you use over the outside of the brow?" And oftentimes people say, "Yes, because I feel heavy, it drops, it feels too full." Well, that's typically a sign that you start to get age related changes to the brow, then you would benefit from repositioning or elevating the brow through a brow lift procedure. Now the lower eye, we all start to get this tear trough. Some people start to get bags or puffiness. Some people just get a hollow or a combination of both. A facelift will help improve that to a degree, but an isolated lower eyelid surgery, lower blepharoplasty with or without potentially fat grafting or revolumization, those things are procedures I often do in combination because the face, the whole thing ages together. So it's not like most people don't just have jowls or just have laxity under the neck.

(02:55):
Usually it's a combination of things. So I like to go over all the procedures patients would benefit from because a facelift is great, but in isolation, it doesn't address all the age related changes that we see in the face. So always when people come in and they do this, if they lift the face and they like what they see, then you're talking a facelift. Now there's a lot of different modalities out there, different non-surgical, minimally invasive treatments that help reduce the amount of fat under the skin that can help tighten the skin to a degree. And I think they're all great, but I think the reality is once you're looking in the mirror and you start lifting and say, okay, this is what I want, this is what I need, then we're looking at facelift because if you're looking for something to lift or to alleviate the jowls, the heaviness, the fullness along the jaw or that laxity under the neck, the best bet is going to be a surgical procedure such as the facelift.

(03:54):
What is the right age? And that comes up every single day. There's no age limit. So it's not like you don't qualify for a facelift until you're 55, 65 or whatever it is. It really just depends on the degree of age related changes you see in your face because some people, it's genetics. I tell everybody 50% of aging is genetics, the other 50% is environmental exposure, sun, all those types of things. Some people just age faster than others. I've done facelifts in patients in their late 30s because they do have jowls, they do have laxity under the neck that wouldn't really improve as well with non-invasive treatments. They have some patients that were in their late 60s, early 70s that really had minimal jowl changes and just a little laxity under the chin. So everybody's different. It really just depends on what you see in the mirror and whether or not I think it's something that we can improve surgically.

(04:48):
And I think that now with the facelift techniques that we do now, everything looks natural. We're repositioning all the deep structures. There's no tension, no tightness of the skin. So people aren't as afraid of having that stigma, that crazy fish mouth wide, crazy look associated with facelifts in the past. So we're seeing younger patients with earlier changes that are interested in facial rejuvenation for two reasons. One, if you have less age related changes, so you have early jowls but not super heavy jowls. You have early laxity, but it's not hanging down to your collarbone or to your chest. Well, it's a lot easier to get you a much crisper jaw, a much improved mid-face all the way down to the neck because those changes aren't as severe. And two, the tissue quality is better when you're younger. So the muscle's stronger, the tissue's thicker, which overall leads to a better outcome.

(05:49):
And data shows that the earlier you do it, the longer it lasts. Again, because that tissue quality is so much better than if you wait until you're in your 70s, you got more severe age related changes, your tissue's a lot thinner and weaker, and you can't guarantee that you're going to get the same degree of improvement as somebody who's younger. In every single consultation, I do a comprehensive overview of the face. Again, I'd say 70% of people come in and they're like, "I just don't like my neck or I just don't like my jowls," which I respect that. But again, I still go over the entire face because the whole thing ages is one unit. So again, the upper third is the brows, forehead, upper eyes. The middle third is the cheeks, lower eyes, upper lip, and then the lower third is going to be kind of the jaw, neck.

(06:34):
And then I talk about the typical age related changes we see with each third. So with the brow and women, we usually see that outside of the brow starts to fall. The fat pad of the brow starts to crowd or create a little heaviness of the outside of the upper eye. The upper eye, usually we start to see excess skin, maybe some fat, maybe some of the gland has started to fall and become more visible, creating fullness. Lower eyelids, we usually start to see that tear trough or that hollow, start to see some bags or some of the fat of the lower eye, and sometimes we get excess skin of the lower eye. With the cheeks, we have these superficial and deep fat pads of our cheekbones. So with time they resorb, separate, but mostly they fall. And when they fall, yes, they worsen our tear trough and they also worsen our nasolabial fold.

(07:21):
Our upper lip starts to elongate. We start to see less red lip. We have less dental show, meaning when you passively open your mouth, you start to see less and less of your upper teeth. And then we start to see less and less of that outside or lateral upper lip. So the white lip of the skin of the lip becomes longer, the red lip becomes less and less visible. In the lower third of the face, again, as this tissue in the middle of our face is mobile, well, so is this tissue in the lower portion of our face? We have these dense ligaments, we call them, on either side of the chin. And that tissue that's mobile will fall. It's more affected by gravity than those dense ligaments. So that's what the jowl is. As this falls, pushes on this ligament, creates that heaviness or fullness along the jawline.

(08:10):
And specifically in women, you go from a more heart-shaped face to a more square shaped face as time goes on. And then the neck, the platysma muscle or the muscle that creates the bands starts to become loose, skin becomes loose, then we lose that sharpness underneath our chin. So those are the things I talk about with everybody and I talk about specific procedures that can address each one of those things. And just rejuvenating the lower two thirds of the face, meaning from the cheek all the way down to the collarbone, does make an improvement, but a lot of times it doesn't really match if you don't do the brows or definitely if you don't do the lower eyes. And I want to be transparent and let people know there are limitations with what facelifts can achieve in isolation. And as long as they're aware and have no desire to address the brows, the eyes, then I respect that, but I want patients to be aware there are limitations with facelifts in isolation.

(09:07):
I more so manipulate the face to show them the types of changes that they can get because every face is different. Some have more mobility, some have less. I've used the 2D and 3D imaging modalities in the past. And to be honest, I'm just not super impressed using them as a predictor of what we can or cannot achieve because a lot of times it can be underwhelming or it can create changes that aren't necessarily achievable. What I think is more accurate is by showing them the type of movement that they get in the face. And that has been much more successful for me and for the patient to get a better idea of what the outcome will be. So the difference between men and women is basically our bone structure and then the thickness of the skin and then the types of changes that we see.

(09:55):
Most men don't really get big, heavy jowls. Typically what we see is a lot of laxity in the neck. And then with the brows, men just have heavier brows that sit lower and we have a more prominent ridge of bone above the brow. A lot of times when you do a endoscopic brow lift in men, it's not as significant of an improvement as it is in women. Sometimes we have to employ different techniques like direct brow lifts where you're moving skin on the forehead or if men are bald or have a severe receding hairline, it can limit the potential options that we have to lift the brow. Men's skin doesn't really stretch, is it not as elastic as women, specifically in the lower two thirds of the face because of all the hair follicles for beard hair and then the associated blood vessels with those hair follicles.

(10:46):
It doesn't stretch pull typically in the same way as women. The overall technique is the same with the lift or the release, the lift. Sometimes the vector or the degree or angle of lift may be a little bit different to maximize the improvement of the fullness under the chin. But overall it's relatively the same. You just have to approach it, your fine tune details a little bit different specifically, how you lift position lifting, potential fat grafting certain areas, things like that. Two things men are afraid of specifically with facelifts is one, they don't want to look feminine and that is not the case. Because you get a facelift does not mean it's going to make you look like a woman. I bring up Kenny Rogers daily. With men, again, it's all about lifting. It's not about over volumizing the cheek, giving you really feminine cheeks or doing things to make you look like a woman.

(11:43):
All it is is taking the tissue that you have and lifting it up, maybe adding a little bit of volume in areas that you've lost it. Men, typically, they start to see a lot of loss of the mid-face volume, soft tissue. As that deflates, then that skin becomes a little bit redundant in the nasolabial fold area or around the mouth. So volumizing that to a degree, lifting it to help soften or improve that area, it will not make men look less masculine. So there's a lot of different things that maximize patients' recovery. One specific thing I'm very strict on is diet. So diet is crucial and from what I've seen over the last several years with respect to swelling. So I put everybody in a high protein, low carb, low sugar, and even gluten-free diet, ideally for the first four weeks after surgery. All these things, sugar, carbs, gluten, regardless if you have a gluten insensitivity, they make you swell.

(12:41):
They make you hold onto fluid. So you will retain a lot of that post-inflammatory fluid in your face. And I've seen it with patients. All surgeries are the same. I mean, for the most part, facelifts are not a bloody procedure. There's not a lot of trauma to the tissue. Specifically with deep plane facelifts, you're in what we call a glide plane. So that plane opens up easy. There's not a lot of trauma. Some patients, day one, very minimal swelling. And some patients, day one, I mean, significant big puffy cheeks. Bruising is not typically something that we have to really worry about, but the puffiness and the swelling is one thing that is harder to control because it's really, from what I've found, specific to the patient's diet. So number one is diet. Two is actually the procedure itself. So I do, again, what's called a preservation extended release deep plane face and neck lift.

(13:39):
What preservation means is we're leaving the skin attached to the muscle pretty much everywhere in the face except for a little area behind the ear. What that allows is minimal area for swelling under the skin. It's safer for the patient for many reasons, specifically with blood supply to the skin, and it really reduces the areas of the face that can swell. And there are other things to add. So red light therapy is a big one. It's been around for a while. People have asked me for the last several years about it, but really over the last 18 months, I think I've seen a lot more data with respect to wound healing, mitochondrial health, all these different things that it can help with. And I'm a big believer, so I advocate for red light therapy, even pre-treatment and post-treatment. And the last thing that I've become a huge fan of is postoperative hyperbaric oxygen therapy.

(14:31):
With our data, I always quote that we found that it can improve recovery by decreasing swelling and bruising by 35% within the first two weeks. So those four things, diet, the surgical technique itself, the red light therapy, and then the hyperbaric oxygen therapy, all those things together can make a huge improvement in the postoperative recovery, specifically within the first two to four weeks. I tell every patient, if you stick to the diet, you do the hyperbaric and you stick to our postoperative instructions recommendations. Typically by two weeks, you're what we call restaurant ready. You could go out to eat, wear your hair down. You don't look like you're super swollen. You don't look like you had a big surgery. Now that's not everybody. That's just a general kind of outline or general timeframe in the postoperative setting for patients because some people don't swell at all and some people do hold onto fluid more so.

(15:30):
But with respect to the more traditional older techniques, patients are recovering a lot faster. Specifically with hyperbaric, there's all kinds of chambers. There's soft chambers, hard chambers. The things that I always tell patients you have to look at is the atmospheres or the pressure of the chamber and then the percentage of oxygen. So data supports two atmospheres or twice the pressure of normal air and then at 100% oxygen. And as long as you're getting exposure to those two things, then you see that clinical improvement. If you're getting less, because there's some that are 1.5 at 40, 50% oxygen, it's not going to hurt, but I don't know to what degree it's going to help. So I typically recommend specific areas or specific chambers or people that have chambers with those parameters because you're going to get the best benefit. I'll see them postoperative day one.

(16:21):
So the next day I'll see them postoperative day three, postoperative day six or seven, week two, week four. So we keep a really close eye on you through those first two to four weeks because for me, the reason I like everybody postoperative day one is just to obviously see how you did overnight, check the skin to help the skin and make sure there's no fluid collections because 96% of fluid collections or hematomas occur within the first 24 hours and then the other 4% can occur within the first 10 to 14 days. So that's why I tell everybody the most important time period of recovery is the first two weeks after surgery. So you're up and moving the next day, but I don't want you lifting anything. I don't want you getting your blood pressure up. I don't want you exercising. I want you getting out, a little walk, getting some sunshine to keep you mentally sane is great, but I really stress the importance of those first two weeks.

(17:20):
The most common question is more of a concern and it's, "I don't want to be pulled too tight. I don't want my mouth super wide. I don't want to look like a freak." And I mean, I tell them with the deep plane, it's impossible. I've never made anybody look like anybody else. And I know a very well known facial plastic surgeon in Beverly Hills, I've seen him say, "This is facial rejuvenation. It's not witness protection. The whole goal is not to make you look like somebody else. It's just to turn back the clock." About 100% of my patients, because I always ask at the two week and the one month, what has the response been from your friends and family, regardless if they tell them they've had any sort of surgery or not. And they always say, they look at them and they're like, "You look good.

(18:11):
I don't know what it is, but you look good." And that's always the goal because I don't want you to look different. I just want people to look at you and be like, "Wow, you get a haircut, you get a tan, what's going on?" So facelifts, very natural, very safe, and it's probably my favorite procedure to do. Again, a lot of questions depend on the amount of swelling that people get. It varies patient to patient. Typically, if they have a little bit of swelling of the muscle on the side of the neck or if they've got swelling in the cheek, under the eye area or a lot of tightness, the tightness is what bothers people early because I always tell them, look, we're making that muscle tight. The skin is not tight, but the muscle under the neck is tight and we want it to be that way those first several weeks.

(18:59):
So it's always a little stiff moving the neck side to side and kind of extending or moving the head back, and that's always a concern. And then if they have a little bit of swelling to the side of the eyes, those are usually something that people are always a little bit concerned by early, but those things always go away. And you know that as a surgeon intraoperatively because everything's nice, smooth, contours look good. But one thing I do tell every single patient is that recovery is a lot. It's an emotional. Physically, people aren't in much pain, to be honest. Tylenol, ibuprofen is all people really need, especially after the first 24 hours, but it's an emotional week. And I don't think people talk about that enough. One thing I tell every patient is I am your surgeon up until the point you wake up and go home, then I become your therapist, especially that first week because it's a lot.

(19:56):
And it doesn't matter how much I prepare you, patients are always, it's emotional. And what happens is people look at themselves postoperatively, they're swollen, they've had surgery, they don't look like themselves. And they always say, "Oh my gosh, why did I do this? I didn't look that bad before." And that is a very common thing to experience for patients in the first seven days. Once you get to day 14, huge sigh of relief, you're like, "Okay, I'm looking better. I'm looking good." At a month, you're pumped. You did it. You're looking great. Maybe still a little puffiness and swelling, but you're really happy you did it. But it is like clockwork. I become your therapist day one to day seven for sure. Icing the first three days will help significantly with any swelling that you have at the lower eyelids, but I don't like a lot of ice on the rest of the face.

(20:53):
But with the eyes specifically, first three days, 20 minutes on, 20 minutes off while you're awake, and it can make a dramatic improvement with the amount of puffiness that we get under the eyes. I like just the soft elastic, it's a white strap that goes around the head. Kind of looks like the old timey dentist head wrap that they used to give, they used to see in cartoons where people would wear the little white ribbon or the white scarf looking thing. I like that. I like a soft compression for the first two weeks because what I've found is that throughout the day, people get a little deep edema or some of the swelling kind of sits under the chin. Then if you wear that head wrap, it just kind of forces it out. And to be honest, a lot of people just like the support or the feeling of support by wearing it for those first two weeks, but I don't get fancy.

(21:42):
I don't like things too tight because you're going to be numb in certain areas of the face and I don't want you to potentially cause any sort of issues with the skin. People always look like themselves after surgery. Now, if you come in and you've got a turkey neck that's hanging down to your collarbone and then you come back and it's flat, yes, people will be able to tell that you had surgery. But for the most part, the responses my patients have gotten is not that, "Oh, you had a facelift." It's, "Oh, what have you done? Why do you look good?" And a lot of times it's not what people are saying, it's how people are looking at them and they can tell that they're trying to analyze and try and figure out why they look different or what it is. And that's always, for me, the biggest compliment.

(22:29):
If you look at somebody without knowing them or even knowing them and say, "Oh, they've had a facelift," that is not a good thing. Because if you can tell somebody had a facelift, then something didn't go the way it was intended. So anesthesia is one thing that you see a lot out there or certain providers say they do it all under local, you're wide awake, twilight. And twilight's not a real definition of anesthesia, so there's a little bit of grit and people don't really understand what that means. What we use is general anesthesia, you're asleep, you have a breathing tube in, you're completely comfortable, safe during the whole procedure. Dr. Firat is our anesthesiologist. She is amazing. So we only use MD anesthesiologists in our practice and she has a lot of experience and she's honestly one of the best providers I've worked with ever.

(23:24):
There's a lot of things as a facelift surgeon that you have to be very aware of and pretty picky about, and that's blood pressure, intraoperative and postoperative, and then when patients wake up, nausea. So I want patients to be comfortable and don't want them to be nauseous, but mainly it's because I don't want them trying to feel like they vomit or do vomit, makes their blood pressure go up. It increases risk for postoperative issues. So we've actually played with some of the different type of general anesthesia over the last several years. And the type that we use now, it requires very minimal narcotics for the patient's intraop and post-op. Narcotics typically cause a lot of nausea in patients. So by reducing or completely eliminating the amount of narcotics patients need and then dealing with hydration, certain things intraoperatively, it's dramatically improved patients' postoperative recovery, almost completely wiped out any sort of nausea that patients get and has really had a good ability to control patient's blood pressure.

(24:24):
And the main thing is patients being comfortable intraoperatively, but then it allowing me to give patients the best result while patients are under general anesthesia. I think there may be limitations with the results people can get, at least for me, if a patient's awake the whole time during surgery, because I'm not trying to rush through these things. I do one big surgery a day and that's it. One patient gets my undivided attention. I take my time because we're in the face, there's nerves in the face, there's muscles in the face, there's vessels. It's not a race for me. It is, I'm going to do the best I can possibly do to give the patient the best outcome and I'm not going to let me trying to rush through it affect that whatsoever. I think what makes me different than a lot of facelift surgeons out there is I'm a head and neck surgeon, board certified head and neck surgeon, and then facial plastic surgeon.

(25:20):
So I did five years of head and neck surgery training. And as a part of that, we did a lot of facial plastics, but we did a lot of, the vast majority was head and neck cancer. So it was cancer resection, so removing jaws, removing cheeks, removing cancer in the head and neck, and then reconstructing it. So with microvascular reconstruction, so taking tissue from the arm, the back, the leg, the thigh to reconstruct the face. So there's no anatomy, I haven't surgically manipulated or seen in the face and neck from the skin all the way down to the skull base. And then during my fellowship, it was a high volume reconstruction practice as well as cosmetic practice. So we did three to five head and neck reconstructions a week. And again, that's rebuilding a face, whether it's a whole half of the face, the whole jaw, airway, everything.

(26:14):
So my comfort level within the head and neck is extremely high because that's all I've ever known, that's all I've ever done. Now, when you translate that to facelifts, what that allows me to do is be as aggressively possible safely. So I see all the vessels, I see all the muscles, and more specifically, more importantly, I see all the nerves. So because I can visualize these things, see them every single time I do a facelift, I know they're safe and I know I have released as much as possible to give patients the best outcome. So the incisions on the side of the face go right in the sideburn, so kind of parallel the area where we have these little thin baby hairs and our more dense sideburn hair all the way up to the top of the ear, kind of at that transition zone where we all have a natural crease where our ear and our side of our face meet.

(27:04):
Then behind the tragus, so that little triangular shaped piece of cartilage on the ear, so behind it, and then down under the earlobe crease, back up into the hair and then down into the hair. So as you heal, you'll never see it and you can wear your hair back and there's no big visible scar. The big thing about the scar is not only the position, but the lack of tension. And that's the whole goal, the whole premise of deep plane facelifts is there's no tension on the skin. When you see really wide visible scars pulled down ear lobes, those are where surgeons relied upon tension in the skin to create that lift. Well, the result of that is wide, visible, ugly scars. So with the scars with facelifts, at three months they look great. Six months, hard to see at a year, can't even find them.

(27:50):
I just saw one of my one years yesterday and we can't even see. And I know where to look and I still can't even find the incision. Everybody heals a little bit differently, but for the most part, specific in front of the ear, I've never had a problem whatsoever. Behind the ear, sometimes at a year they can kind of feel it in the hair, but you can't see it. And obviously visibility is the most important. You don't want anybody to see it, but it doesn't cause any discomfort, pain, anything like that. So again, diet, and this is, I emphasize diet. And before surgery, try to maximize that diet, high protein, low carb, low sugar. Two weeks before, if you can do it, will really help your postoperative swelling. A lot of times we start people on Arnica or Bromolin, so kind of over-the-counter type medications to help reduce bruising and swelling, usually about a week, five to seven days before surgery.

(28:43):
Now, if you're taking things like vitamin E, fish oils, aspirin, those need to be held at least a week, if not 10 days before surgery. Now, if you're taking aspirin for medical reasons, you have to get clearance from your cardiologist and we look at all those things. And then another big thing that we're seeing is nicotine, not only smoking, but just nicotine consumption. So you want to hold off and completely be off of nicotine for at least two weeks before. If you're an active smoker, you need to be off of no cigarettes whatsoever for at least four weeks before surgery. And then in those two scenarios, then you're going to definitely. Hyperbaric oxygen therapy postoperatively is non-negotiable. You have to do it just to avoid any issues, complications. I mean, obviously if you're on GLP and you lose a lot of weight and you have a lot of laxity, you may have more skin, all these things, but surgically you're still doing releasing the same.

(29:40):
You may have to pull in a different degree, vector, whatnot to maximize the improvement, but overall it's the same. But we do typically want people to be off the GLPs at least two weeks before surgery, and that's mainly to keep you safe with anesthesia. And then for me, I always get the question, when can I restart post-op? I like to hold it for four weeks post-op. I want you to have an appetite. I want you to eat protein. I want you to consume good calories to help maximize your recovery. I don't want people jumping right back on and then fasting and not eating and having no appetite because when you're recovering, your appetite is suppressed. And then if you add on your GLPs, then it's going to even further suppress an appetite. And if you're not getting good nutrition, it can have negative implication on your recovery.

(30:29):
I typically say stop your retinoid and your retinol two weeks before and then don't start until the one month after, just because I don't want to, again, to affect any sort of wound healing issues around the incision. And definitely if you get laser, because a lot of people get laser at the time of surgery, so you want to hold your retinols or retinoids, your prescription strength stuff two weeks before, and then we'll restart at the four week mark. So I love lasers. I think that they play a key role in facial rejuvenation. When we talk about facelifts, I always talk about the three pillars. So surgery is one and that's what I do. Skin management is another. And regardless if you're doing surgery or not, you need to be managing the skin. Two things everybody needs to be on is a retinoid at night, vitamin C during the day.

(31:17):
Put those things together as they thicken all three layers of skin so they combat or prevent the loss of collagen in our skin that we typically see as we age. And then the last pillar is Botox and filler because our muscles will always move. We'll always potentially develop wrinkles and we always lose volume. But laser is one of the things that we can do intraoperatively to help address the skin itself. So the laser that I love is the erbium. Erbium and CO2 are the big ones, ablative lasers that a lot of patients are aware of. Erbium is not as hot, not as deep typically depending on your settings. What it does is it resurfaces the top layer of skin so that epidermis will grow back thicker and tighter. And erbium is a really great one because it is lower risk for a lot of patients with different skin tones.

(32:04):
Because we're in South Texas, we have a lot of patients with darker skin tones. And if you use a more aggressive laser, there's higher risks with those patients. But you can use the erbium and you can get very similar, if not the same result as the CO2 with a lower risk profile. Now when you do it during surgery, the one caveat is you can't do the neck at the time, but you can do the full face. So if you're asleep under general anesthesia during the facelift, I think always adding a laser because typically in the face where patients are concerned about the skin is the wrinkles around the mouth and the wrinkles and the thinness of the skin of the lower eye, and those respond very well to laser treatment. So cost is always a question, and especially now in the media, they talk about these crazy high prices, West Coast, East Coast, all over the country.

(32:52):
But the reality is cost varies because when you're doing facelifts or facial rejuvenation, it may be a facelift with the brows and your eyes, your fat grafting, your lip, laser on all these things. So you can't put a single number on the cost of a facial rejuvenation surgery or facelift, but usually around the 20 plus thousand get you started. But our patient care coordinators are phenomenal. They're great at itemizing these things, full transparency, you get to see what the cost of surgery is, what the cost of anesthesia is, what the cost of the facility fees are. So there's no hidden fees. What you get is it. You're not stuck with some hidden bill. There's nothing coming, no invoices coming after surgery. We're completely transparent. So you get to see pricing of everything. But price is always a question and it's not a black and white thing because every patient's different.

(33:46):
What they want surgically is different. What they need surgically is different, but our patient care coordinators are great to talk people and help walk them through it. And then we have a lot of financing options that are available to patients so you can pay these things off monthly or just a limitless amount of financial options out there for patients. Call our office, talk with our patient care coordinators. They give you a good kind of price range that is very realistic. And then once we do the consultation, we talk about all the things that you would benefit from, address the things that concern you, and then you get more specifics. But the call to the patient care coordinators give you a lot of information.

Announcer (34:37):
Basu Plastic Surgery and Aesthetics is located in Northwest Houston in the Towne Lake area of Cypress. To learn more about the practice or ask a question, go to basuplasticsurgery.com/podcast. On Instagram, follow Dr. Basu and the team at Basu Plastic Surgery. That's B-A-S-U Plastic Surgery. Behind the Double Doors is a production of The Axis, T-H-E-A-X-I-S.io.