Dr. McMenamin

One such development, says Patrick McMenamin, Sacramento-based cosmetic surgeon and president of American Academy of Cosmetic Surgery, is the laser facelift. He and several of his colleagues from around the country have been using the procedure, refining it, comparing notes and working toward reproducible standardization.

PROCEDURE AT A GLANCE This technique combines use of Smartlipo (Cynosure) laser-assisted lipolysis and liposuction skin-and-tissue tightening associated with subcutaneous application of light and heat energy. After administering tumescent local anesthesia, the surgeon creates three or four small incisions, one behind each earlobe, and one or two under the chin.

(Far and middle left), 57-year-old patient shown pre-facelift (under eye bruising results from a lower lid transconjunctival bleopharoplasty with a skin pinch and a Webster canthopexy performed three days earlier), and (middle and far right) at six weeks post-laser facelift. The area under the chin will improve over time. The patient had the procedure on Monday and attended her photography class on Thursday night. All photos credit: Patrick McMenamin, M.D.

"There are all kinds of theories about what mediates this healing process, whether it's cytokines, leukotrienes, prostaglandins," or some other mechanism, Dr. McMenamin tells Cosmetic Surgery Times. But what he knows for a certainty is that in the hands of skilled surgeons, liposuction — and laser treatments — provide exceptional results.

"In my experience, this represents a different healing process than what I've seen before with my standard facelift techniques. And, on some levels, based on the parameters I use with my patients, it's better. Recovery is easier." Patients have their procedures on Monday or Tuesday, for instance, and go back to work by the end of the week. They also have somewhat normal sensation in the area within the first week, Dr. McMenamin says.