IT used to be that a cosmetic surgery patient who was tired of sagging
jowls would discreetly ask for names of reputable doctors who did
face-lifts. A surgeon, building a practice as word of mouth about his
skills spread, became, in effect, his own brand.
But now face-lifts themselves are being branded. Certain minimally
invasive procedures are marketed directly to patients in a
one-size-fits-most approach. Patients pick an operation — usually after
seeing it touted online, on TV or in magazines — and are referred by a
national organization to a doctor.
Two procedures sold this way are the Lifestyle Lift, which an ad in
Family Circle describes as “revolutionary” and a way to “remove
wrinkles, frown lines and sagging skin” in about an hour; and the
QuickLift, which also benefits from nationwide marketing that promotes
a short recovery and only local anesthesia.
Because these procedures, priced at $4,000 and $5,900, contrast with
more extensive face-lifts requiring general anesthesia and usually
costing more, they have become popular: More than 100,000 patients have
received the Lifestyle Lift alone since 2001, according to the company.
But some surgeons think branded face-lifts are problematic. It is not
the procedures themselves that disturb critics — many plastic surgeons
and otolaryngologists (head and neck surgeons) offer their own
quick-recovery face-lifts. But some doctors are concerned that patients
may be so persuaded by advertising that they don’t seek a second
opinion or investigate the full range of options. Consumers may pick a
minimally invasive procedure when the results they seek may require
more complex — and expensive — intervention.
“What’s new is this is plastic surgery being marketed to the public as
a widget,” said Dr. Brian Reagan, a plastic surgeon in San Diego.
“People are buying, so buyer beware.”
In this new landscape, patients are encouraged to seek an advertised
procedure rather than work with a surgeon to select from a menu of
options. What’s more, some patients are now “looking not for the best
doctor, but the one who has the magic wand,” said Dr. Reagan, who has
given a lecture titled “Invasion of the Mini-Lifts ... Coming to a
Clinic Near You.”
Dr. David M. Kent, an osteopath and facial
plastic surgeon who founded Lifestyle Lift, said he employs nearly 100
doctors in 31 offices who are trained to do Lifestyle Lifts. (The
company also has 10 doctors in private practice who license its brand.)
“Every single patient gets the same basic face-lift,” he said,
explaining that it consists of lifting underlying layers of muscle and
connective tissue, and trimming skin. Patients also receive custom nips
and tucks as needed.
The QuickLift, which roughly 10,000
patients have had since 2003, is sold differently. Doctors who offer it
maintain their own practices and might also offer traditional
face-lifts. A company, MDCommunications, helps those physicians market
the QuickLift by placing television spots and optimizing how fast a
doctor is found online.
Dr. Dominic A. Brandy, the developer of
the QuickLift, coined the term to describe his adaptation of an S-lift,
an operation that uses teardrop-shaped sutures to suspend sagging
features. Dr. Brandy said he improved on the S-lift by pulling the face
vertically instead of toward the ears.
Currently, 25 to 30
doctors receive patients through QuickLiftMd.com. The doctors attended
a one-day workshop priced at $1,950 (and sometimes a few other days of
training) taught by Dr. Brandy, a cosmetic surgeon with a background in
emergency medicine.
Teresa Bradley, 47, found her QuickLift
surgeon on the company’s site. Even before meeting him, she had decided
QuickLift was for her. “I researched the procedure,” she said. “It was
excellent.” But she has agonized over the results. “He lifted one side
very high and left the other side hanging,” she said.
Now Ms. Bradley said she realizes the QuickLift is only as good as the surgeon doing it.
In
response, Dr. Brandy said, “When you teach somebody a procedure, even
if they use the basic same procedure, skill levels are so different.”
The
American Society of Plastic Surgeons hasn’t taken a stand on branded
procedures. But its president, Dr. John W. Canady, advised, “Go get a
second opinion from someone who doesn’t have a big ad.”
Patients
should be presented with a range of options, said Dr. David S. Kung, a
board-certified plastic surgeon in the Washington, D.C., area. He
considers deeper-plane face-lifts “the gold standard,” because they
“last the longest and they can effect the maximal change,” he said. But
he sees a place for middle-of-the-spectrum face-lifts, which in his
opinion, include the QuickLift, Lifestyle Lift and another (nonbranded)
lift, the minimal access cranial suspension.
Dr. Kent said that
before patients meet a Lifestyle Lift surgeon, they see a consultant
and watch a video in which the company’s medical director explains its
philosophy. Then they meet with a surgeon before deciding whether to
proceed.
But three Lifestyle Lift patients and Dr. Mario S. Yco,
a board-certified otolaryngologist who was an employee of the company
for about a year, said that patients were urged to put down a deposit
before they met with a surgeon.
“The consultant sold the
surgery,” said Dr. Yco, who practices in Encinitas, Calif. Often by the
time he saw patients, the surgery was booked. “There were many patients
I had to cancel,” he said, explaining that he didn’t deem them
appropriate candidates.
In response, Dr. Kent said, “It’s never
a consultant that decides whether or not a patient should have
surgery.” He described the company’s consultants as “people-friendly
people.” They make sure patients “understand what they are getting
into, explain the things we offer, talk about the doctor,” he said.
Dr.
Yco said he was amazed at the power that advertising had over Lifestyle
Lift patients. “They are sold by the concept, they are not sold by the
surgeon’s credentials,” he said. “Unfortunately if they are not
satisfied, it’s a big drop for them.” He added, “It’s like lemmings
going down a cliff.”
In May, on the job site Monster.com, the
Manhattan branch of Lifestyle Lift ran an ad seeking applicants to be
plastic surgery consultants. “No medical experience needed,” it said,
adding that the right candidate would have an “ability to match the
offerings of Lifestyle Lift with the desires of Clients.”
Sharron
Bryant, a manager for Lindt Chocolates in Dallas, who got a Lifestyle
Lift in 2007, said she had a “high pressure” consultation and put down
a deposit before meeting a surgeon. Ms. Bryant, then 59, paid $6,100
for a Lifestyle Lift and chin liposuction. She never needed pain
medication during her weeklong recovery, she said.
But she
disliked the loose skin that remained on her jowls and neck. “I got
nothing for the money,” she said. She later paid $8,200 for a
traditional face-lift from a different surgeon.
With “every
plastic surgery procedure, there’s a certain number of people
afterwards that are unhappy,” Dr. Kent said. “There’s nothing wrong
with them medically. They are just dissatisfied.”
On
Realself.com, a Web site where patients discuss cosmetic surgery, 37
percent of the 170 people who reviewed the Lifestyle Lift said the
procedure was “worth it,” while 63 percent didn’t think so.
Leigh
Floyd, 46, a technical writer in Houston, is an “extremely satisfied”
customer of Lifestyle Lift, which she partly attributed to her
realistic expectations. “You won’t look 20” afterward, she said,
“because it’s still your 40-year-old skin.”
But she was most
impressed by the skill of her surgeon, Dr. Kevin R. Smith, a Houston
otolaryngologist. “His sutures were so tiny,” she said. “I just know I
picked the right doctor.”
Here’s some advice for those considering face-lifts.
Check
whether your surgeon is certified by one of the boards of the American
Board of Medical Specialties at abms.org. They require physicians to
complete residency training in a specialty and to pass rigorous oral
and written exams.
Before you schedule an operation, meet the
surgeon to make sure you’re on the same page. “The best surgeons will
give you their honest opinion whether they can achieve what you’re
looking for,” said Dr. John W. Canady, the president of the American
Society of Plastic Surgeons.
Don’t settle for a hasty
consultation. The downside as well as the upside of an operation should
be covered, said Dr. Robert Singer, a plastic surgeon in La Jolla,
Calif.
You should never feel as if you’re being sold a
procedure. “If you’re getting a high-pressure sales pitch for a
procedure, personally that would worry me,” Dr. Canady said.
