Archive for November 2016

Facelift Disasters – Why They Happen and How to Avoid One


With permission from LookYounger.News        By Dr. Brian Machida with Larry Rondeau

Editor’s Note: Dr. Brian Machida is a double-board certified plastic surgeon practicing in metro Los Angeles. He taught facial plastic surgery for years at the University of Southern California.  He can be reached at Second to Creation Plastic Surgery in Ontario, CA, part of California’s Inland Empire.

Magazines often feature stories about disastrous facelift results.  This really is news, because in a major satisfaction survey, after one year, 97.8% described their results as “very good or beyond expectations.”  Even after 12 years, 61% still felt that way.

All the media attention on “facelift disasters” can give the wrong idea to people who are considering the many advantages of improving their looks.  Still, as we can see, they clearly do happen sometimes.  And some patients, while not experiencing “disaster,” are not completely happy with their results.  We’ll consider the answers to these questions:

  • What’s behind many of these problems?
  • How can you be sure to get the look you want and avoid the kind of results you don’t want?

The basis of many unsatisfactory facelifts

Patient 4 Before & After (Dr. Machida)Problems can occur if your surgeon doesn’t have the level of experience necessary to do a good job with the procedure you need.  Industry statistics show that the average plastic surgeon, who works on the entire body, may perform only 15 to 17 facial plastic surgeries in the average year.  In contrast, a number of my colleagues and I have each performed more than 2,500 facelifts in our careers.  Practice really does make a difference.

For example, the once popular Deep Plane facelift can provide outstanding results.  But it is a very demanding operation with a steep learning curve that requires a highly experienced surgeon.  If the surgeon does not perform it regularly enough, there is higher risk of damage to the facial nerve.  .

Patient 4 RS Before & After (Dr. Machida)The SMAS facelift targets a layer of tissue that covers, surrounds and attaches to the deeper tissues and structures of the face and neck.  It’s attached to the platysma, the superficial muscle covering the lower face and neck.  The SMAS layer underlies the entire cheek area.

Tightening the SMAS and the underlying muscles effectively lifts and rejuvenates the face.  Once the surgeon removes the excess skin, the new look can “turn back the clock” 10 years or even more.  Unlike the “windblown” look that less experienced surgeons or other techniques may produce, the effect can be very natural and attractive.  In the right hands, the SMAS facelift can provide reliable, excellent results.

Promising more and delivering less

Another source of unsatisfactory results (though not the disasters featured in the media) is selecting an inappropriate procedure.  It’s the surgeon’s responsibility to tell the patient exactly what it will take to achieve their (realistic) goals.

But in some areas competition is stiff.  It can be very tempting to allow a patient to believe that a lower-cost Mini Lift will give them the look they want when they really need a full facelift.  True candidates for less expensive Mini Lifts are primarily people whose facial aging is just past the point where non-surgical treatments can help.

Turkey NeckSo, if you have a double chin, a “turkey neck” or excessive neck fullness and your surgeon recommends a Mini Lift, ask:

  • What will you do to correct the laxity (or fullness) in my neck?
  • Will you tighten my platysma?

If your surgery will not address these areas, you would probably be happier with the results a different surgeon would provide.  It’s better for the doctor to under-promise and over-deliver than the other way around.

“Nightmare” Prevention

Effect of cigarettes on face-CUMany “plastic surgery nightmares” publicized in the national media appear to come from two main sources:

  1. Problems in the healing process
  2. Too many procedures

Both of these can often be avoided by better communication with your surgeon.  If you smoke, have diabetes, or are on blood thinners, be sure to tell your doctor.  All of these can get in the way of good healing, which could lead to a “nightmare.”  If the surgeon takes the right precautions regarding healing, you’re already halfway to good results.

Many of the “plastic surgery nightmares” I’ve seen result from too many procedures.  Again, here is where honest communication is crucial.  Patients who expect miraculous results are likely to be disappointed if their procedure results in anything less.  They may visit another surgeon.

Unfortunately they always manage to find someone willing to take their money and perform one more surgery.  But too many procedures can leave a face looking worse than not having needed work performed.  This can result in the “nightmare” photos we often see.

Realistic expectations, and consulting with an experienced, skilled, honest and straightforward plastic surgeon can make the difference between a disappointing result and getting the new look you really want.

Patient 4 Before & After (Dr. Machida)

Feature Photo (at top):  Renowned Italian fashion designer Donatella Versace at TIME 100 – photo by David Shankbone

People First Judge Your Competence by Your Face


Everyone needs to influence someone.   Salespeople, business executives, financial professionals, attorneys, political leaders and parents must sway the opinions of others to succeed in their roles.  And while most concentrate on honing their message and delivery techniques to succeed, research reveals that another factor can play a big role.  Surprisingly, it’s your appearance – especially your face.

Why is appearance so important?  Science has uncovered three underlying reasons:

  1. Loss Aversion: We automatically look for good opportunities and try to avoid people and things that could cause us problems.
  2. Our minds quickly size up and form first impressions of people we meet.
  3. First impressions last.

business people team at a meeting in a light and modern office environment.When most meet others for the first time, their minds automatically try to assess them to determine:

  • Is this a friend or foe?
  • Do I like this person?
  • Can I trust this individual – are they ethical and competent to help me?

Think about it:  When you first meet a doctor, attorney, financial professional, salesperson or repairman, don’t you look for clues as to whether you can rely on them to do the job right?

Mature Male Businessman smiling on phone (portrait)Substantial research has found that in this quick search for clues, appearance – especially facial appearance – has a lot to do with whether we will believe and trust people.  Most don’t realize they’ve been influenced by this unconscious process.

Repeated studies have also proved the truth of the saying:  First impressions last.  Perhaps because most always want to feel that they’re right, what psychologists call confirmation bias takes hold.  It causes your potential clients to tenaciously hold onto their first impression of you, unless you provide overwhelming evidence that they misjudged you.  You may never get the chance.

Proof of the face’s role in assessing competence

In business, it’s crucial to project an air of competence.  Princeton University reports how voters may assess that crucial quality:

Princeton psychologist Alexander Todorov has demonstrated that quick facial judgments can accurately predict real-world election returns.

Todorov and his research partner conducted three experiments asking several dozen study subjects to make snap judgments about people’s competence by looking at their faces – some for just an instant, others longer.

Subjects were show pairs of photos and asked which one appeared more competent.  They didn’t realize they were assessing front-running candidates for upcoming U.S. Senate or gubernatorial races in faraway states.  If a participant recognized either face, their choice was removed from the data.  Princeton University reports:

Percentage of political races won by candidate with more competent-looking face

Percentage of political races won by candidate with more competent-looking face

“Researchers compared the competency judgments with the election results.  They found that the judgments predicted the winners in

  • 72.4% of the senatorial races
  • 68.6% of the gubernatorial races.”

This was no surprise.  Influence expert Dr. Robert Cialdini reports that a 1974 study of Canadian federal elections found that attractive candidates received more than twice as many votes as unattractive ones.  People often equate an attractive face with competence.

The makeup of a successful look

The New York Times reported that researchers from Boston University and the Dana–Farber Cancer Institute measured the effect facial appearance had on judging competence.  This study photographed 25 white, black and Hispanic women aged 20 to 50.  With the help of a Black Models-study cosmetics on competence judgmentprofessional makeup artist, each was shot with four different looks:

  • Barefaced – no makeup
  • Natural – minimal makeup
  • Professional makeup
  • Glamorous makeup

To avoid any model’s confidence level changing because of her look, none was allowed to see herself in the mirror.  Two different groups of more than a hundred subjects viewed the photos – some for a split second and others for as long as they wanted.  Then they rated each woman on competence.

Women wearing makeup – even the glamorous variety – were consistently judged to be more competent than barefaced women with no makeup.  As seen in the Times sample photos (link below), even the glamorously made-up women did not appear out of place in a business setting.  But those with better makeup clearly appeared more attractive.  Again, a better-looking face imparted an air of competence.  FF-White Models-Cosmetic Effect on CompetenceIn fact, Dr. Cialdini stated:

Other experiments have demonstrated that attractive people are more persuasive in changing the opinions of an audience (Chaiken, 1979).

The Halo Effect

For all but models, facial attractiveness has nothing to do with competence.  Why do people upgrade those with better-looking faces and downgrade those with less-attractive or aging ones?  Because of what psychologists call The Halo Effect.  Expert Dr. Cialdini stated:

Research has shown that we automatically assign to good-looking individuals such favorable traits as talent, kindness, honesty and intelligence.

Further, studies cited in “Could an Aging Face Send the Wrong Message About You?” revealed that unattractive or aging faces were judged to belong to people who were less intelligent, friendly, kind and helpful than faces rated average in attractiveness.  Other research found that less attractive salespeople were at a disadvantage in gaining new business.2

Anyone whose role requires them to persuade others would do well to give serious thought to improving their facial appearance.  The Halo Effect unfairly penalizes good, intelligent, competent professionals whose looks have faded.  But it is a fact of human nature that the wise will recognize and act upon.  Highly experienced facial plastic surgeons can recommend affordable ways to get a natural, more attractive look.

Business TeamClick to locate a highly experienced facial plastic surgeon in your area.


  1. The New York Times – “Up the Career Ladder, Lipstick in Hand” (10-21-11)
  2. Improving your Appearance – Could it Improve your Income?”
  3. Etcoff NL, Stock S, Haley LE, Vickery SA, House DM (2011) Cosmetics as a Feature of the Extended Human Phenotype: Modulation of the Perception of Biologically Important Facial Signals. PLoS ONE 6(10): e25656. doi:10.1371/journal.pone.0025656