In-Office Facelifts

First, Demetri and Gopi begin with discussion of the clinic intake visit. During a first visit, Demetri takes time to understand each patient’s goals and priorities as they relate to their appearances. Using this knowledge, he walks each patient through all possible treatment choices, then helps the patient decide the best path forward. He takes a detailed procedural/surgical history and performs a top-down examination of the patient’s face.

Then, Demetri describes different surgical and non-surgical options to improve facial aesthetics. He divides these options into non-invasive (micro-needling, fillers, Botox), minimally invasive (radiofrequency-assisted lipolysis), and surgical (facelift). Demetri explains multiple approaches to facelift, noting that he tends to prefer a deep-plane approach that mobilizes the superficial musculoaponeurotic system (SMAS). Demetri then shares pearls from his practice about optimal incision sites, the importance of acquiring the right instruments, and the addition of tranexamic acid to tumescent anesthesia to reduce risk of hematoma.

Finally, Demetri outlines his post-operative management. In addition to standard post-operative protocols, his patients undergo hyperbaric oxygen treatment to increase oxygen delivery to tissues and lymphatic massage to aid lymph drainage. The episode wraps up with Demetri’s advice to listeners wanting to improve their cosmetic surgical skills.