Twins Facelift study

New, in this month’s issue of the Plastic & Reconstructive Surgery journal, is the 10-year update on the famous twins study, originally devised by Dr. Bernard Alpert at UCSF.

In this study, 2 sets of identical twins underwent facelift procedures, by four master surgeons, all using different facelift techniques. The goal was to see which facelift technique worked better.

For those of you who like the details, the surgeons and their techniques were:
Dr. Jack Owsley — multi-vector SMAS-platysma facelift with neck liposuction,
Dr. Dan Baker — SMAS-ectomy with anterior platysmaplasty,
Dr. Sam Hamra — composite / deep-plane facelift with anterior platysmaplasty,
Dr. Oscar Ramirez — subperisoteal facelift with anterior platysmaplasty.

(N.B. platysmaplasty is a necklift operation, done with an incision beneath the chin area, tightening the neck muscles together in the middle.)

Drs. Baker and Hamra were assigned the first set of twins, while Drs. Owsley and Ramirez worked with the second set of twins.

So, which facelift method was the best?

Well – the answer is not that easy. All four of the twins looked good. All four of the twins, at 10 years out, looked better than they did pre-operatively. So, great surgeons can probably get great results, even if they use somewhat different operative techniques to achieve that result.

Studying the pictures, however, my personal preference was for the results by Dr. Owsley and Dr. Baker. To my eye, these looked the most natural, and the most aesthetically pleasing. This did my heart good – as I use Dr. Owsley’s technique almost exclusively for major facelifts. (Disclosure: I did my facelift Fellowship with Dr. Owsley, learning the technique from him personally, over the course of a year.)

Of interest to me was that the Owsley technique gave a nice result in the neck, without having to open the neck surgically using a platysmaplasty. Also, both Dr. Baker’s and Dr. Owsley’s methods gave excellent correction of jowls and lower facial laxity, and I felt that these methods “aged” better than the other two methods.

Of course, this is a comparison of only 4 patients, not a large, randomized prospective study…nevertheless, it’s fascinating stuff for those of us interested in facelifts!

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