Patients minimize their downtime and don’t require general anesthesia, says Seattle-based plastic surgeon, Javad Sajan, MD.

By Tonya Johnson

When the American Academy of Facial Plastic and Reconstructive Surgery shared its 2019 survey results in February before the COVID-19 pandemic emerged in the United States, the academy reported that 85% of total procedures performed by its members were minimally invasive non-surgical procedures with skin treatments (up by 39% from the previous year). What’s more, facelifts were on the short list of the most common surgical procedures conducted and were up slightly by 3%.

Now, as shelter-in-place orders begin to lift, and cosmetic and plastic surgeons are preparing to put the new health and safety guidelines into practice, the mini-facelift is a procedure that doctors may want to promote or start offering. It is a less invasive version of the traditional facelift and a good procedure for patients ready to ease their way back into their favorite practitioner’s chair, according to at least one plastic surgeon.

Mini-Facelift vs Traditional Facelift

According to Seattle Plastic Surgery in Washington, patients seeking a mini-facelift generally desire inconspicuous scars, non-invasive surgical methods, and most importantly, a good result. Practice owner Javad Sajan, MD, started performing the the procedure 4 years ago because his patients wanted to maximize results, minimize downtime, and they didn’t want to be put to sleep.

“The procedure will show an effective facelift with a shorter scar and very similar results to a general anesthetic facelift,” he says. “After a mini-facelift, most patients are feeling good and can go out in public in about 2 days, compared to the traditional recovery period after a general anesthesia surgery, which typically last at least 10 [days].” Mini-facelifts require local anesthesia only.

Like a full facelift, the mini version addresses sagging of the jowls and lower face. But a mini-facelift requires a smaller incision than a traditional one and requires less operating time, allowing for that quicker and easier recovery time. This includes reducing the need for postoperative pain medications.

To aid in healing, Sajan uses platelet-rich plasma and placenta stem cells to cover over the incision area. After the first follow-up, which is typically 24 hours postsurgery, patients get ultrasound-guided massages for the face every week for 6 weeks. This therapy method decreases the swelling and helps the skin to smooth out, says Sajan, who has conducted the mini-facelift on more than 1,000 patients so far.

But not everyone is a good fit for this type of elective surgery.

“Mini-facelift candidates are usually younger, with less jowling and less sagging skin on the neck,” Sajan says. The youngest patients that have received his mini-facelift are in their mid-30s, and the oldest are in their 50s. Patients who smoke must also commit to quitting for at least 6 weeks leading up to their surgery and 3 weeks after, to avoid the risk for skin necrosis. Keeping patients on a high-protein diet is another focus. Candidates are also put on a scar protocol system, which helps to minimize tension on the skin.

Virtual Consultation and Software Tools

During the Seattle shutdown – ordered by Gov. Jay Inslee, Sajan and his elective surgery staff have been conducting virtual consultations on a regular basis to stay connected with patients seeking advice on forthcoming surgical treatment availabilities after the plastic surgeons reopen for in-person visits. Until the ban is lifted, he is only seeing emergency cases, as well as postoperative cases that were already in process prior to COVID-19.

“Virtual consultation is a challenge because it’s not as easy as meeting in person. Mimicking what a facelift is going to look like is another big challenge. I always re-drape the patient’s skin with my hand to show them what the results may look like. And one of the hardest parts of conducting a virtual consultation is that I am not able to do that demonstration, so I worry about if the patient is really getting a good understanding of what I’m going to do.”

Javad Sajan, MD, of Seattle Plastic Surgery in Washington

Coronavirus has been a real technology accelerator, Sajan says. For example, his team have implemented a HIPAA-compliant Price Simulator tool. The medical app, which can be customized based on the needs of each practice, is designed to help patients understand what procedures are available, what the costs are, and what will be treated. Sajan says patients like the tool because they can explore on their own and learn more about the procedure before the consultation. Sajan makes this tool available to other plastic surgery practices and, because of the COVID-19 crisis, is waiving the $300 set-up fee and giving the first month free to practices who sign up for the Price Simulator. 

Staying Safe During the COVID-19 Pandemic

As business is eventually restored at full capacity, Seattle Plastic Surgery has taken many precautionary steps, which include the following:

  • Wearing a mask is required to enter the facility
  • Temperatures are taken at check-in
  • Symptom/travel history questionnaires must be completed and passed
  • Additional masks will be provided at the practice
  • All medical providers will wear the approved N95 Mask
  • Minimizing caregiver entrance to accompany patients
  • Social distancing guides will be implemented in patient lobby
  • Ultraviolet light therapy has been newly installed in the operating rooms
  • Wait time of 20 minutes between surgeries implemented to air out room
  • Medical providers will wait 10 minutes before the start of each surgery
  • Virtual consultations, video chat, and texting follow-ups utilized to minimize contact

What Sajan loves most about working as a plastic surgeon is being able to make an enormous impact on people—and changing their lives. “Many patients are OK with a less invasive operation that may not give them the full result of a big operation, as long as they can treat what’s bothering them. And that’s the biggest thing that I’ve learned about doing this operation,” he says. “You have to be driven by what the patients want—not by your own wants.”

Tonya Johnson is associate editor at Plastic Surgery Practice