A Y lift is a trademarked name for placing filler in the face to restore a more youthful facial shape and contour. The concept has been around for years, but the term "Y lift" was trademarked by a dentist in New York a few years ago. Basically filler is placed around the midface, eyes, and chin and jaw area to recreate the shape of the face when it was younger. The theory goes that a youthful face is shaped more like the letter Y and as we age we lose the lateral volume of the upper face which makes our faces seem more droopy. The only thing I find problematic about this is that it promotes a cookie cutter approach to facial fillers and volumization. I believe that for patients who naturally have very high cheek bones a Y lift will only make them appear more gaunt and older looking. A personalized approach is needed for every patient.

Patients need to take the time to do their research. The media loves catchy "new" procedures; it is easy for them to report on and it gets good ratings. Remember that just because something is on television does not make it the "best" thing out there, it just might mean someone has the "best" PR person out there. Sometimes a "new" procedure is just rebranding or trademarking a term for something that has been around for years. Plastic surgery is an investment. Just like with any other investment, the more informed you are about the process, options, and expected results, the smarter you will be and hopefully make the best investment decision.

I get many patients coming in for consultation desiring a facelift because they feel it is a permanent fix while fillers or volumization is a waste of money. Some have even gotten upset at me for trying to talk them out of having a facelift and refusing to perform a facelift on them.

On the flip side, I have had patients coming in for non surgical treatments with fillers who I have had to tell them that their issues are best addressed with surgery.

A facelift addresses a completely different issue than volumization with fillers!

I personally believe that a facelift should be reserved for patients with significant neck laxity, jowling, and sagging. It does not address hollowness and volume loss! I feel very strongly about this and will refuse to perform a facelift on someone if it will not address their issues.

The only way to naturally address a face that has lost a lot of volume is by adding volume back! This can be done with fillers, fat injections, or sometimes facial implants. A facelift does not address volume loss.

The reason some people look like they have had plastic surgery is because they were not treated in the best way for their face. Many doctors succumb to patient pressure or desires and will perform surgery that is not right for that patient. Some doctors are also greedy at times and will push patients to have unnecessary surgery.

Please understand that I am a surgeon and would love to operate on someone if it will help them. But I will not succumb to patient pressure when I feel strongly that it will not benefit them. That sometimes makes patients upset.

Neck bands are in reality the medial edges of the platysma muscle--the muscle that is right underneath the neck skin. Some people, especially those with longer necks, can form these bands as the muscle is either tense or starts to droop with age. So does botox help? Depends. In bands that feel firm and tight botox can help. In neck bands that are loose and droopy botox rarely helps and might be a total waste of money. How do you know if it's worth doing? First, start off by going to a person who is experienced in dealing with this issue. He or she can use their best judgement to figure out whether botox is right for you. My rule of thumb is that if the bands are present at rest or with facial animation but the skin seems pretty firm, then botox will generally help. It will also help for people who have had a facelift or necklift in the past and the bands started showing up again.

I get asked about horizontal lines on the neck and the formation of loose thin wrinkly skin on the neck a fair amount. Botox does not help horizontal lines on the neck.

Some people have horizontal neck lines since they were young. It is just a variant that some people possess. As we age, the skin in our neck becomes thinner and looses its support. This tends to exacerbate these lines as well. This issue is a skin issue, not a muscle issue. Botox affects muscular activity and can be used in the neck for neck bands, which are vertical lines on the neck.

So what can help? Well, a neck lift will pull the neck skin tighter and make the skin seem firmer and with more support, but it might not eliminate the horizontal neck lines completely. Using fillers directly into the lines can help improve them as well. Using lasers or creams might help in making the skin a bit more swollen, and hence appear thicker and more supple. This might improve the appearance of the skin, but will need to be made part of your routine and be done on a regular basis.

Neck bands are in reality the medial edges of the platysma muscle--the muscle that is right underneath the neck skin. Some people, especially those with longer necks, can form these bands as the muscle is either tense or starts to droop with age. So does botox help? Depends. In bands that feel firm and tight botox can help. In neck bands that are loose and droopy botox rarely helps and might be a total waste of money. How do you know if it's worth doing? First, start off by going to a person who is experienced in dealing with this issue. He or she can use their best judgement to figure out whether botox is right for you. Any idiot can inject botox. It takes an experienced person to make you look your best and always do the right thing for you.