Want the Best Facelift? Small Innovations Can Improve Your Results

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Before and After SMAS facelift by Dr. Brian Machida

If you’ve decided on a surgical solution to improve your appearance, you want the best facelift you can afford.  It’s important to realize that there are two parts to a great facelift.  The first is getting the right type of facelift performed by a highly skilled, experienced facial plastic or plastic surgeon.  The second is healing from your procedure as well as possible.

Your surgeon can perform a truly outstanding procedure.  But if you don’t heal well, even excellent surgical technique will not result in the best facelift possible for you.  You won’t get the results you want.  Choosing the best techniques are something I might want to discuss with an audience of surgeons.  I’d like to talk to you here about some things your surgeon can do to help you heal as well as possible.  And don’t worry – a board-certified specialist can add these healing innovations and still give you outstanding results you can afford.  Please note:  “How to Make a $16,000 Beverly Hills-Quality Facelift Cost Much Less.”

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Facelift by Dr. Brian Machida, Inland Empire, CA

Best Facelift Healing Innovation 1:  Reduce bleeding and hematomas with Artiss

The most common facelift complication is hematoma.  Nationwide, about 9% of all facelift patients experience them.  A hematoma is a collection of blood under the skin.  If you’re going to get one, it usually occurs within 24 hours of your procedure.  Hematomas often require prompt treatment.  This is often done in your surgeon’s office.  But a large hematoma could send you back into surgery.  If not treated promptly, hematomas can damage your skin and underlying tissues.

A new, FDA-approved treatment can substantially reduce your risk of getting a hematoma.  It’s called Artiss.  Artiss works by using the same system your body uses to stop bleeding.  It’s quite a remarkable system.  Key components are fibrinogen, and thrombin.  Here’s how a noted author, Dr. Michael Behe, Professor of Biochemistry at Lehigh University describes the process:

Normally fibrinogen is dissolved in plasma, like salt is dissolved in ocean water.  It floats around…until a cut or injury causes bleeding.  Then another protein, called thrombin, slices off several pieces from two of the three pairs of protein chains in fibrinogen.  The trimmed protein – now called fibrin – has sticky patches exposed on its surface that had been covered by the pieces that were cut off…

Because of the shape of the fibrin molecule, long threads form, cross over each other and (much as a fisherman’s net traps fish) make a pretty protein meshwork that entraps blood cells.  This is the initial clot.

So, fibrinogen forms a fibrin patch to seal a wound and stop bleeding.  This naturally occurs to prevent a simple cut from becoming a major emergency.  Artiss allows your surgeon to put a fibrin patch exactly where it’s needed to completely seal your facelift flaps.

Normally, the surgical flaps opened in a facelift are closed with sutures.  When I also spray Artiss along those flaps a fibrin web forms to seal them tight.  Studies have found that facelift patients whose surgeons used fibrin sealants like Artiss reduced their hematoma risk by 75% or more.

Additionally, Artiss reduces the risk of oozing while your facelift flaps heal.  In fact, fibrin sealers like Artiss are even successfully used in performing orthopedic surgery on patients with hemophilia.  A growing number of facial plastic surgeons use Artiss to reduce the risks of facial irregularities that occur when patients temporarily take off their surgical dressings.  I use it regularly when performing facelifts at my in Inland Empire, California practice.

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Facelift by Dr. Brian Machida, STC Plastic Surgery, Inland Empire, CA

Best Facelift Healing Innovation 2:  Further reducing bleeding risk with TXA

Tranexamic Acid (TXA) is a medication many gynecologists use to reduce bleeding in women with heavy menstrual cycles.  It prevents the key blood clotting protein mentioned above, fibrin from being broken down too soon.  To prevent blood clots from breaking free and causing damage, your body naturally dispatches special anti-clotting agents to cut them up.  However, if it happens before you’ve fully healed, you can start bleeding again.

To avoid this, I add Tranexamic Acid to the fluid I inject during your procedure.  It’s enough to discourage bleeding, but not enough to promote unwanted blood clots.  Research, including a recent study published in Facial Plastic Surgery & Aesthetic Medicine, found that TXA substantially reduced bleeding during surgery.  Fluid draining after surgery was also notably less.  Post-surgical drains could be removed sooner.  TXA is one more innovation highly experienced facial plastic surgeons may use to improve your healing and provide better results.

Best Facelift Healing Innovation 3:  Safely reduce pain with Exparel

Facelifts do not produce as much discomfort as many surgical procedures.  But this is an issue worth considering.  In America, managing pain after surgery is a big deal.  Many take opiates prescribed by their doctor after surgery.  Some become addicted and a suffer host of serious problems.

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Reducing use of opioid medication after surgery is worth thinking about

The answer is not forcing patients to experience more discomfort by overly reducing pain medication.  Nor is it to prescribe high dose NSAIDS, which come with their own significant risks.  I believe the best pain management after surgery begins during the procedure.  That’s why I administer Exparel before the end of surgery.

Exparel is a time-release shot of bupivacaine, a painkiller on the World Health Organization’s List of Essential Medicines.  It’s not an opioid.  In fact, it outperforms opioids without the risk of addiction.  Why doesn’t every surgeon use Exparel?  In my opinion, most should.

Exparel will substantially reduce pain for the first 72 hours after your procedure – just when you need it most.  Studies have found that it reduces the need for opioids after surgery.

To avoid opioids after Exparel wears off, I prescribe a short course of Celebrex to reduce discomfort.  There’s good reason for this.  Many painkillers work by reducing the COX-2 enzyme, a key player in the process of feeling pain.  Unfortunately, NSAIDS like aspirin and ibuprofen also inhibit the COX-1 enzyme.  Inhibiting COX-1 makes it easier to bleed, which you want to avoid while recovering from surgery.  Celebrex only affects COX-2, which significantly reduces pain without increasing your bleeding risk.

For some patients, after the Exparel wears off a brief, controlled regimen of opiates like Norco or Percocet may be more appropriate.  In any event, a safer pain management program starts with a shot of Exparel as your procedure concludes.  For many patients, this can substantially reduce or completely eliminate the risk of post-surgical opioid dependence.  A surgical procedure that makes you look younger and more attractive while helping you avoid the opioid crisis really is the best facelift.

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Before and just one week After Deep Plane Facelift by Dr. Brian Machida, MD, FACS –

Find the best facelift in your area          CONTACT Dr. Machida Inland Empire, CA 

I’m sure I am not the only experienced facial plastic surgeon who uses these methods to aid their patients’ healing and recovery.  If you would like a surgeon who will give you the best facelift available to you, start by looking for a board-certified facial plastic surgeon or a plastic surgeon who specializes in the face and neck.  Check facelift Before and After photos on their websites.

Ask the surgeon about the kind of facelift they’d recommend for you:  deep plane or SMAS.  Then ask to see photos of that specific procedure.  Ask what kind of anesthesia they use (general, IV sedation, or local plus oral sedation).  The latter has been called “the safest method available.”

Finally, ask whether they use special methods like those described here to reduce bleeding, hematoma risk, and to safely manage pain.  Then, you’ll have all the facts you need to determine the best facelift for you.  If you’re in Inland Empire, California, come see me for a free consultation at STC Plastic Surgery in Ontario.

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About Dr. Brian Machida, MD, FACS

Dr. Brian K. Machida, MD, FACS is a double board certified facial plastic surgeon. He has an exceptional level of experience, having performed ( read more )

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