Houston, TX plastic surgeon Henry A. Mentz, MD has been practicing for about 30 years. “In the earlier years of my practice, patients who came in for a facelift primarily looked like they were in need of a facelift. They were usually 65 years or older and showed substantial signs of aging. Most showed all four categories of aging: skin quality changes like age spots, fine lines and large pores, skin laxity exhibited by looseness around the eyes, cheek and neck, soft tissue sagging when deep tissues droop like brows, jowls and neck and many had loss of volume with hollowing in the temples, eyes, cheeks and around the mouth. Today, patients’ perspective on aging and appearance has certainly changed and goals of staying youthful are more prominent. Most often women are wanting to stay looking around 35 with minimal signs of aging and this is fantastic.”
Have you seen the average age of a facelift patient get younger?
“When I first started practicing—and you must understand that this is Texas, and Texas sun is strong; and therefore, sun damage in the skin is quite prevalent—many patients who came in interested in facial rejuvenation at that time looked pretty weathered. Some patients had signs of aging accompanied by weight loss and weight gain that affected the face; not to mention the fact that treatments such as Botox Cosmetic and filler were not as common. These patients came in primarily because they appeared 10 years older than their friends who were their same age.
In my experience, these were more challenging patients because a greater detail was required to achieve a satisfying result.
For example, these patients benefited from complex procedures that went beyond just lifting such as repositioning of the eyebrows, soft tissue elevation in the cheeks, muscle suspension in the neck, restoration in volume with fat grafting and skin rejuvenation with lasers to name a few. To achieve a refreshed and more youthful appearance, the procedure used to require layering of different techniques using a single strategy such as the original tightening facelift created an overtightened and windblown appearance because the other issues like weathered skin and hollowness were not addressed.
Today, patients are more invested in their appearance and are diligent about maintaining their youthfulness. Now, it has become a much more satisfying experience for both surgeon and patient because they’re coming in earlier as well as utilizing preventative treatments such as injectables, facials, mini lasers and radiofrequency treatments for maintenance and look to mini-lifts and small surgical adjustments before aging becomes apparent.”
How many would you say, on average?
“I will do about 150 full facelifts and more than 1000 other facial rejuvenation and refinement procedures per year. I am still doing a lot of mommy makeovers as well. I think, in part, COVID has added more demand for facial rejuvenation. There are several parts to that equation. Number one: The spouses and caregivers are at home working virtually, and they can help with recovery which is a great benefit. The second thing is, with a shift to a more virtual society, people are paying more attention to how they look on camera and often times they feel that what they see is not as flattering as they would like.
Younger patients working in the now-virtual office space are saying, “I really don’t like the way I look. In fact, I’m talking to my friend who’s 50 and she looks 10 years younger than I do. What can I do to turn back the signs of aging a bit?”
It is for these reasons that we’re now seeing patients who are just beginning to show their age and that makes it a lot easier to achieve an aesthetically satisfying result. For me personally, this overall evolution has increased patient satisfaction and has been very fun and exciting!”
Are patients coming in for different procedures now?
“Yes, there are great opportunities now in facial aesthetic surgery because it has always been a creative and evolving specialty. I think Instagram and social media, in general, have created a little bit more of a buzz for these name-brand procedures. Patients are more knowledgeable about their options and people are more comfortable sharing their experiences and therefore are more open to trying new things. Most skilled facial surgeons today combine a multitude of different surgical and non-surgical procedures to enhance and/or maintain a patient’s overall result. There are a lot of interesting things out there today that make aesthetic surgery more satisfying! For example, the InMode devices, the Morpheus8, and the FaceTite— all new radiofrequency technology that is safer and more predictable than older versions. These devices are really popular right now because it provides more opportunity for those patients that are in-between. While these additional procedures are beneficial, I think at the end of the day what’s most powerful is an appropriate evaluation and a personalized recommendation.
I predict that in 2021 and 2022 we will see an explosion in facial rejuvenation and aesthetic surgery and I am excited for what’s to come.”
Is there anything that you think people should understand about the “right age” regarding any procedure?
“When we look at patients, it’s not so much the chronological age that defines what they need. It really is the age that they appear. I just finished a patient who is 38 years old going through menopause and experiencing all of the associated changes. She was frustrated that her body and face had changed a great deal making her appear older than she actually was. So many things can affect apparent age such as job stresses, divorce, family illnesses, weight fluctuations and pregnancy. The experience of life can lead to unexpected changes that we have no control over. You’re going to inherit your parents’ genes, and if your parents look 60 and they’re 100, you’re going to be in good shape. However, most people aren’t so fortunate. You can’t sidestep your gene pool or life experiences, and you can’t sidestep that blueprint that God’s given you, so it’s nice to be able to feel good about yourself on the inside and out and have options for improvement. Our motto is ‘The best you is what we do.'”