Bridging the Facelifting Gap

Face/Neck lifting, in many surgeons’ hands, can yield dramatic results. These results, however, carry significant recovery, downtime, incisions, cost and risk. Previously available nonsurgical tissue tightening options such as Ultherapy (Merz), Thermage (Solta Medical) and Profound radiofrequency microneedling (Candela) minimized or eliminated many of these downsides, but generally yielded results nowhere close those achievable with facelifting.

There was a big gap between these two approaches, and many patients fell into it.

Percutaneous radiofrequency facial rejuvenation helps fill that gap. While FaceTite isn’t the first percutaneous RF device to be released, it is, in my opinion, the first to really generate dramatic results.

Practical Perspective

Every procedure has a range of possible outcomes depending on surgeon, technique, patient compliance and tissue healing. Some facelift results are dramatic, while others are less than impressive. The same is true of FaceTite. Some of the FaceTite results I’ve seen are amazing; some are just OK.

What differentiates it from other nonsurgical options is that the best FaceTite results can outshine some less-impressive facelift results.

That’s a dramatic statement.

Of course, FaceTite won’t match a really beautiful, advanced facelift, but it can approximate the results of a basic facelift — especially in younger patients. For the first time in the history of treatment of the aging face and neck, the two bell curves — surgical vs nonsurgical outcomes — overlap. We have an attractive option to offer patients with modestly full or loose necks and mild jowls who have more limited finances and recovery time to invest in surgery.

Procedure and Process

Before performing FaceTite, we anesthetize the tissues with tumescent lidocaine. The FaceTite procedure then takes 30 minutes to perform. No sedation is required, so most patients can simply drive themselves home. Most will experience a week or so of meaningful swelling, but they can still function socially during that time.

As with any aesthetic procedure, the quality of the FaceTite result results partially from the experience, judgment and skill of the person doing it.

Outcomes also can be maximized with complementary procedures, such as Giampapa sutures to tighten the platysma. These sutures can even be performed percutaneously with Greg Mueller’s Myellevate device, which makes it easy for less-experienced surgeons. Combining additional complementary procedures, such as cheek or jawline fillers, can even further approximate the kind of results one may achieve with a modest facelift.

One drawback with FaceTite is that the outcomes aren’t totally in the surgeon’s control. FaceTite creates heat to melt fat and contract overlying skin and even the underlying muscle. We hope each patient gets the best contracture and shrinking, but each person’s biology is unique, and responses vary. This leads to more variability with FaceTite than with surgery, even for surgeons with experience, skill and judgment.

No Guarantees

FaceTite really does generate the best minimally invasive results I’ve ever seen. Typical candidates are patients who want meaningful results but can’t have or don’t want traditional surgery. They ask: “What else do you have for me? I’m willing to settle for maybe not the absolute best result you can provide but am not willing to invest in a procedure where I may or may not see any results at all afterwards.”

There are no guarantees in medicine, but with FaceTite, I can tell patients they’ll predictably be able to tell the difference in post-procedure photos.

There’s also a pandemic-related benefit to FaceTite: It requires relatively little in-person follow-up care.

Because of COVID-19, we’re trying to utilize telemedicine as much as possible. My FaceTite consultations can be done virtually, followed by an in-person meeting and treatment. Minimal follow up care is required, and 90% of it can be done virtually. There are no drains or sutures to remove. While some follow up is needed, the entire consult-to-recovery arc might only span one or two in-person visits. Facelift surgery, by contrast, usually requires 4 to 6 visits to the clinic in the year following surgery.

FaceTite isn’t without risk. Patients might get hematomas, seromas or indurated, firm areas. Burns or neuropraxia are possible from the radiofrequency. Permanent internal sutures, if used, can become infected or extrude.

All in all, however, I find FaceTite to be effective and yield high patient satisfaction.

St. Louis, Mo., facial plastic surgeon L. Mike Nayak, M.D., is on the Aesthetic Authority’s Editorial Advisory Board. He reports no relevant disclosures.