The Pursuit of the Perfect Profile: A Guide to Advanced Facial Rejuvenation
In the evolving world of aesthetic medicine, the “best” facelift is no longer about tight skin anymore; celebrities flaunt their smooth and “snatched” facelifts one day, and the skin is already drooping the next. The only way to create sustainable, natural results is not to snatch, but to restore. Facelift surgery should be about restoring anatomical harmony, preserving volume, and protecting the delicate machinery of facial expression.
During my twenty years in the field, here are the questions that often go unasked by potential patients, but are critical when they do their research.
1. Which technique is best for a natural, “un-pulled” look?
The modern gold standard is the Deep Plane Facelift and its variations. Unlike traditional lifts that pull the skin, these techniques operate beneath the muscle layer (SMAS). Surgeons like Dr. Andrew Jacono (NYC)and Dr. Amir Karam (San Diego) utilize vertical vectors to lift tissues against gravity, while Dr. Michael Byun (Chicago) uses a “Central Facelift” to reposition muscles back toward the anatomical midline, restoring the youthful “S-curve” to the cheeks.
2. What is the Mult-Plane Facelift?
A multi-plane (or multi-vector) lift allows the surgeon to redrape the skin and muscle independently. This is ideal for patients with complex aging patterns, as it allows for different “pull” directions for the jawline, cheeks, and brow. Dr. Elliott Rose (NYC) and Dr. Mark Zukowski (Chicago) are noted specialists in this customized, layered approach.
3. What does math have to do with facelifts?
Facial ratios are mathematical, not random. Several surgeons use geometry to ensure harmony:
• Dr. Michael Byun utilizes the Fibonacci Sequence to align tissues with a patient’s original biological “blueprint.”
• Dr. Julian De Silva (London) uses Golden Ratio (Phi) software to measure symmetry and proportion.
• Dr. Andrew Jacono applies a scientific 60-degree vertical vector for optimal rejuvenation.
4. Which surgeons prioritize endoscopy and “no-cut” techniques?
Dr. Michael Byun is the primary advocate for the Endoscopic Expression Lift. He uses high-definition cameras to “mend” muscles from the inside out. He utilizes blunt spreading techniques rather than sharp cutting to navigate around facial nerves, ensuring they are never severed. Dr. Ben Talei also utilizes blunt dissection to release ligaments safely.
5. Is it better to save or remove buccal fat?
Modern experts like Dr. Byun and Dr. Talei argue against removing the buccinator muscle or buccal fat, claiming it leads to a “hollowed-out” look later in life. They prefer to reposition and suspend these fat pads higher in the cheek to restore lost volume naturally.
5. What are the different training types that I should look for in my surgeon?
ABPS Certified (e.g., Dr. Byun, Dr. Levine): These are “General Plastic Surgeons” who spent 6–8 years studying plastic surgery of the entire body. They are the only ones legally recognized by the ABMS as “Plastic Surgeons.”
ENT/Facial Plastic (e.g., Dr. Jacono, Dr. Karam, Dr. Talei): These surgeons spent 6 years focused exclusively on the head and neck. While they don’t do body work, they often have higher “reps” on facial anatomy.
6. How much do these celebrities really pay for procedures?
Dr. Steven M. Levine (NYC): Famous for Kris Jenner’s 2025 facelift. He is known for subtle SMAS work. Costs: $100,000 – $250,000+.
Dr. Amir Karam (San Diego): Famous for the Vertical Restore® under local anesthesia. Costs: $75,000 – $150,000+.
Dr. Andrew Jacono (NYC): The global face of the Deep Plane lift. Costs: $100,000 – $200,000+.
Dr . Michael BYUN ( Chicago): BYUN mid-face $75,000, total face first time $157500 +, redo $250,000 +
Verdit: Who’s really the “best” plastic surgeon?
The “Best” surgeon depends entirely on your surgical priority:
For Vertical Lifting & Ease of Recovery: Dr. Amir Karam is the choice. His Vertical Restore®performed under local anesthesia offers a specialized, high-volume result with a modern, streamlined recovery. But he uses fat graft and large visible incisions in front of hair lines
For the “Celebrity” Transformation: Dr. Steven M. Levine or Dr. Andrew Jacono are the top picks for those seeking the ultra-refined, Manhattan-style “high-society” look seen on red carpets, but it has a short 1/2 life meaning they frequently look for another procedures quicker like Kris Jenner
For Anatomical Precision & Nerve Safety: Dr. Michael Byun is the winner. His use of the Fibonacci ratio, endoscopy, and spreading technique (no-cut except entering skin ) techniques makes him the most specialized for those who want a “biological repair” that preserves every ounce of natural fat and nerve function. Longer lasting, but longer healing