While many studies have already proven the countless benefits of acupuncture, I am quite doubtful with its effectiveness in terms of removing the wrinkles, fine lines, and sagging skin.  First and foremost, these signs of aging are caused by many factors including sun damage, tissue laxity, and pull of gravity.

But despite some critics, one doctor who offers facial acupuncture still insists that by creating a “little scar formation, it would be possible to lift the sagging skin and address other signs of facial aging.”

Some also claim that the acupuncture needles can encourage the body to produce natural collagen, which is a type of protein responsible for making the skin youthful and plump.

The cost of acupuncture for the removal of facial aging is almost the same, if not more expensive, than most traditional non-surgical facial rejuvenation treatments such as laser, soft tissue fillers, and Botox injection.  Also, patients should consider that it requires monthly maintenance that costs around $150.

Meanwhile, the average cost for the first few sessions of facial acupuncture is $1,000.

Whether facial acupuncture really works—or it is just another media hype—patients should remember that facelift surgery is often the most ideal solution to the signs of aging because it provides a longer lasting effect.  By contrast, non-surgical treatments (e.g., laser skin resurfacing, Botox, and soft tissue fillers) must be repeated every six months to two years in order to maintain the youthful appearance.

But regardless if facelift surgery or non-surgical treatment is used, all facial rejuvenation treatments do not stop the aging process.

Traditional facelift surgery can remove 10 to 15 years off from face, with its result lasting a decade or so.  After this period, a patient may need some kind of revisions such as “isolated” facelift including brow lift, eyelid lift, etc.

While the movie has made Dolly’s plastic surgery a butt of joke, with some of the characters’ tacky reference to her “overdone” appearance, not everyone is laughing.  Many people—especially movie critics—believe the actress deserves better than the slapstick, loud film that undermines her talents.

Going back to her acting, some movie bloggers said it was “painful” seeing the actress with overdone plastic surgery especially on the big screen.  This is more of a problem with the emergence of high definition technology that can emphasize any facial flaws.

In fact, one writer at the Chicago Tribune has described Dolly’s plastic surgery “as if she did her last work in a drive-through.”  But despite the harsh comment, he noted the actress’ vocal prowess and her charm.

To digress from the movie and Dolly’s impeded acting skills, facelift surgery is not just about removing the facial aging—e.g., wrinkles and sagging—but more importantly is maintaining the normal appearance and fundamental shape of the face.  This is the rule of thumb followed by board-certified cosmetic surgeons.

“The goal of facial plastic surgery is to create a natural appearance and not a windblown face and squinty eyes,” said Dr. Tarick Smaili, one of the leading Los Angeles plastic surgeons.

To create a natural appearance, Smaili said the most important thing is to remove the right amount of skin.  By contrast, he said that excising too much facial tissue can result to the “dreaded windswept look and squinty eyes.”

Another technique is to go deeper into the facial tissues, the cosmetic surgeon added, so the result of facelift surgery can last 10 to 15 years without the need for revision procedures.

However, Smaili warned that facelift does not stop the aging of the face and so the need for “minor tweaks” after 10 years will be needed in order to maintain the youthful appearance.  Revisions may include “isolated facelift,” Botox injection, eyelid lift, and even nose job (particularly for aging patients whose nasal tip becomes too drooping and elongated).

Citing Dolly’s appearance, Smaili said the actress probably had “too invasive” secondary facial rejuvenation procedures that resulted to her lack of expression.

The findings support a previous study showing that younger patients are more ideal candidates than people aged older than 50 as the latter achieve more unpredictable results, resulting to lower satisfaction rate.

The new study involved patients categorized into three groups: individuals younger than 50, between 50 and 60, and over 60 years old at the time of facelift surgery.

The findings show that patients younger than 50 with minimal signs of facial aging scored higher in terms of satisfaction after short- and long-term follow-ups.  According to the experts’ analysis, these people have “remarkable maintenance of their youthful appearance” years after their facelift.

By contrast, patients aged 60 and above have reported “significant changes caused by facial aging.”  While the report has shown that they looked younger than the “untreated” people of the same age, they manifested more signs of “regression” in the five facial areas that were graded by plastic surgeons.

In general, the patients’ satisfaction ratings were consistent with the analysis of experts when they reviewed the before-and-after photographs.

The experts graded the satisfaction rate of the patients using a 5-point scale (with 5 being the most satisfied).  Most individuals from the 50 and below age group rated all their facial areas with 4 and 5, while the 50-60 rated themselves with scores between 2 and 5.

The patients over 60 rated their facial areas with lower scores of 2 and 3.

While the number of patients in the new survey was relatively small, the researchers believe their findings were consistent with previous studies showing that individuals 50 years and younger are more likely to achieve longer-lasting results with “less noticeable postoperative changes.”

The researchers have discovered that after an “equal number of years elapsed, the facial aging of patients from 40 to 50 age group was less dramatic than the individuals aged 50 to 60 years old.”

According to the findings, younger patients are also ideal to have less invasive facelift techniques in order “to buy time” or postpone an extensive facial rejuvenation surgery.

Less invasive facelift techniques are ideal for younger patients and individuals who need “maintenance procedures” to correct the facial aging.  All forms of facial rejuvenation surgery, while able to remove five to 15 years off from one’s face, do not stop the natural aging process.

For younger patients whose usual problem is the neck “band,” liposuction may be effective as a standalone procedure in neck lift surgery.  This is performed by inserting a cannula, a very thin suctioning probe, to an incision made under the chin to remove the excess fats in the neck and jaw line.

According to plastic surgeons, younger individuals usually have a more elastic skin than older patients, which means that their skin can easily shrink and tighten on its own without any problem after the fatty deposits have been removed.

But for older individuals or those 50 years and above, neck lift is usually performed using an excision technique which may be combined with liposuction.  This is because their main problems are the loose, hanging skin and weakened muscle which can only be corrected with the use of incisions.

In this plastic surgery approach, doctors create two discreet incisions under or behind the ears in order to manipulate and remove the excess skin that is causing the sagginess, and another one that is placed under the chin that will allow them to reduce or reshape the weakened muscles.

But instead of creating three incisions, some plastic surgeons prefer to use internal sutures that can support the neck tissue and tighten the sagging skin.

After the necessary alterations are completed, doctors will close the incision sites using tissue glue or sutures and then wrap a pressure dressing around the top of the head to the chin that will support the new contour during the recovery.

As with any plastic surgery, neck lift is associated with certain risks and complications particularly on patients with serious health issues such poor healing, diabetes, and heart problems.  With this consideration, patients will undergo physical examinations and interviews that will determine their health status and overall candidacy for this procedure.

Aside from being physically fit, plastic surgeons also require their patients to perform certain procedures several weeks before the operation; these may include quitting smoking to promote better healing ability, avoiding herbal supplements and medications that contain ibuprofen and aspirin that can increase bleeding, and preparing all the things needed during their recovery.

Because every person has a varying degree of sagging skin in the forehead, plastic surgeons today are using different types of brow lift surgery which are usually based on the length of the incision used.  But in general, the excision is placed behind or along the hairline in order to hide the scars.

For older patients, perhaps the most popular technique is the temporal brow lift which uses incisions made at the temples behind the hairline that will allow doctors to correct the wrinkles in the forehead, creases in the corners of the eyes or “crow’s feet,” and sagging cheeks.

If needed, this technique is performed with suture suspension in which plastic surgeons uses internal, permanent sutures to support the new, higher position of the muscles and tissues.

Another common technique for patients who need the most correction is the full coronal brow lift which involves making an extensive, temple-to-temple incision that runs across the crown of the head.  With this plastic surgery procedure, doctors can pull the muscle and skin upward and then tighten the forehead area.  If needed, they will also remove the excess skin that is causing the sagging appearance.

While this technique provides a dramatic result, there is a major downside which must be considered: the long incision may become visible for people who have thinning hair or receding hairline.

Because younger patients or those between the age of 35 and 50 usually need a minimal to moderate lift, plastic surgeons have developed a less invasive technique called endoscopic brow lift which uses a slender probe with a tiny camera attached to a screen.  Meanwhile, this instrument is inserted into three to six small incisions that are placed behind the hairline.

With this plastic surgery approach, patients can expect faster recovery, less post-operative pain and discomfort, minimal bleeding, and lower risk of scarring and other complications.

In some cases, the endoscopic brow lift is complemented with permanent sutures to support the muscles and tissues in the forehead in their new, higher position.  These internal sutures hold the tissue in place by suspending the muscles from a barb or just by passing through them.

“Because I am a woman and wants to look young,” she said.

Meanwhile, the journalist claimed that she is practicing healthy lifestyle but despite of this, she said that it did not make any difference with her aging appearance.

As a major cosmetic surgery, facelift usually involves quite a lengthy recovery.  However, Burley was back in front of the camera just three weeks after the procedure probably because she chose a less invasive form of facial rejuvenation surgery and also with her talented make-up artists who can cover up the residual bruises.

During the first few days of her recovery, the mother of one said she has experienced “post-surgical blues” because of the swelling and bruising associated with facelift surgery, symptoms she compared to being in a “car crash.”

Burley said she did not feel intolerable pain during her first few days of recovery although she described her experience as “deeply traumatic.”  Meanwhile, Dr. Tarick Smaili, a Los Angeles plastic surgeon who did not treat the newscaster, said that it is “not uncommon for patients to experience post-surgical blues.”

“Some patients become slightly depress and anxious because of the swelling and bruising.  But because these symptoms drastically subside after a couple of days or weeks, the post-surgical blues disappear.  Such negative feelings may also be triggered by general anesthesia as it wears off, medications, and residual pain,” Smaili added.

But after the swelling and bruising subsided, Burley said she was “thrilled with the result” and even described the cost of her facelift as “money well spent.”  However, she did not reveal the exact amount of her surgery.

Several years ago, Burley had an eyelid surgery to remove the excess skin and fats around her eyes to make the organ appear more rejuvenated and younger.

To achieve the most desired result, the journalist said that doing one’s research and choosing the right surgeon can be very helpful to anyone considering having facelift surgery.

While the newscaster said she did not want to be a “poster girl” for cosmetic surgery, she encouraged people considering the procedure to “go ahead” as long as they have conducted months of research and planning.

Burly said she had spent several months researching about facelift surgery, planning her operation, and selecting the right surgeon.

With her active lifestyle, the actress said she feels “great and rested,” a complete opposite of what she looked like before having facelifts to correct her sagging jaw line, excess skin around her eyes, and “turkey” neck.

The 73-year-old actress said she did not feel pressure to “maintain a certain look,” and in fact claimed that she is happier nowadays compared to her younger years when she suffered bulimia.

Fonda is just one of the growing number of patients aged 65 years and older who are seeking plastic surgery to look young and rejuvenate.  During the previous decade, most people who opted for facelift surgery were in their middle age.

Dr. Tarick Smaili, a well-known Los Angeles plastic surgeon who did not treat Fonda, said he is seeing more and more seniors seeking facelift surgery and non-surgical forms of facial rejuvenation.

“The growing trend is probably caused by the fact that older people are postponing retirement and they are more socially active compared with seniors during the past decades.  And with the oldest baby boomers reaching their 60s, in my personal opinion the number of seniors opting for facelift will double, if not triple, in the next coming years,” Smaili said.

Meanwhile, the cosmetic surgeon believes that Fonda is a great example of a successful facelift surgery as she looks “rejuvenated” and younger than her real age, in addition to the “natural look.”

“She looks naturally beautiful.  First and foremost, patients should remember that facelift is not all about removing the wrinkles and sagging, but more importantly, its aim is to provide you with a natural look by preserving the fundamental shape of the face,” he added.

Smaili said that the “windswept appearance” usually signals that a facelift is not a success, explaining that it is often caused by removing too much skin and pulling too much tissue.

“Because a facelift can make or break your look, one of the most important things a patient should do is to determine if her doctor is board certified.  If not, this is already a red flag,” the cosmetic surgeon said.

But aside from having a skilled surgeon, Smaili also believes that Fonda’s healthy lifestyle and positive outlook make her look younger.

The 56-year-old actor, who was known for his role in the critically acclaimed movie Crouching Tiger, Hidden Dragon, admitted to have an eyelid surgery in a television interview.  He said that his first cosmetic surgery was conducted in 1989 while shooting an action-comedy film.

“As I grew older, my eyelids began to droop,” he was quoted saying.

Eyelid surgery has always been one of the most popular cosmetic surgeries for men in the US.  According to the American Society of Plastic Surgeons (ASPS), about 31,000 male patients had the procedure in 2010 alone.

Meanwhile, Chow said that he had eyelid surgery performed more than once, which is somewhat unusual since the result of the initial surgery typically lasts a lifetime.  In fact, if the sagging recurs, most plastic surgeons would rather recommend a brow lift instead of another eyelid lift.

Dr. Tarick Smaili, one of the leading Los Angeles plastic surgeons, said that eyelid lift typically involves the removal of the sagging, loose skin and tightening the underlying tissue to rejuvenate the eyes.

“Once you remove the drooping skin, it is very unlikely for the problem to recur.  But then again, there is always some exception to the rule”, he said.

While “touch-ups” are possible after an eyelid surgery, Smaili said that repeating the procedure must be carefully done to prevent unnatural result commonly manifested by “fish eyes.”

Meanwhile, Smaili suggests the action star may be getting some Botox injection as an eyelid lift, while it can remove the drooping skin, “is not designed to smooth out the wrinkles, particularly the crow’s feet.”

“It is not uncommon for eyelid lift patients to ask for Botox injection and/or soft tissue fillers to remove the crow’s feet and hollowness especially in the lower eyelids”, Smaili added.

“But during surgical touch-ups, plastic surgeons should make sure that there is enough amount of skin left to allow their patients to close their eyes naturally.  You wouldn’t want to appear like Dinora Rodriguez who is a victim of botched surgery performed by an unlicensed practitioner.”

Rodriquez is the face of a new campaign by ASPS after her traumatic experience with an underground plastic surgery.  According to earlier reports, her surgeon performed eyelid lift even if she was only asking for breast augmentation.  She is now unable to completely close her eyes because too much skin was removed from her upper eyelids.

Because every patient has a varying degree of excess skin and fats, plastic surgeons use different techniques in performing neck lift surgery.  In this way, they can also achieve the most natural result using the least number of incisions as possible.

If the only problem is the excess fats under the chin and along the jawline, liposuction alone is usually enough to create a dramatic change to a person’s appearance.  With this plastic surgery procedure, doctors make a discreet incision under the chin where they can insert the cannula, a slender instrument which can suction out the excess fats.

Some plastic surgeons remove and dislodge the fats by moving the device back and forth while others prefer to use a motorized cannula that is designed to produce accurate, tiny vibrations which are said to collect about 30 percent more fats compared to manual liposuction.  Meanwhile, some doctors collect the fatty cells through laser-assisted liposuction which uses heat energy or ultrasonic-assisted liposuction which uses low ultrasonic waves.

For patients whose only problem is the hanging, excess skin in the area, the neck lift will involve two incisions placed under or behind the ear.  With this plastic surgery approach, doctors can pull the skin tight and trim out the part that is causing the sagging appearance.

In case that the sagging appearance is caused by the weakened, stretched muscles, doctors will reduce and reshape the underlying muscles in the neck and throat area using a small incision placed under the chin.  After the necessary changes are made, they will tighten the skin before closing the incision with sutures or tissue glue.

Meanwhile, some plastic surgeons prefer to use a network of sutures to eliminate the appearance of “turkey” neck or a condition in which there is an excess, loose skin in the area.

Once the neck lift plastic surgery is completed, doctors will suture the incisions and use pressure dressing that is wrapped around the top of the head to the underneath of the chin in order to support the new contour during the recovery period.

Because of the use of incisions, patients should expect permanent scars, although these will fade over time and become almost unnoticeable under the chin and behind the ears.

Perhaps secretary of state Hillary Clinton is the most perfect example of a politician who seems to have had several plastic surgery procedures.  The rumors are hard to ignore as she looks almost 15 years younger today than when she was still the first lady.

Cosmetic surgery expert Dr. Tarick Smaili, who did not treat Clinton, said that she might have undergone eyelid surgery, neck lift, and face lift possibly complemented with Botox injection.  And with her glowing skin, the surgeon added that she had probably resorted to laser skin resurfacing, chemical peel, or dermabrasion.

If you would look Clinton’s previous photos and television appearance, you might notice that she had wrinkles and prominent crow’s feet in the corners of the eyes, and deep creases across her forehead—problems which can be easily treated with soft tissue fillers and Botox injection.

But nowadays, the secretary of state looks more youthful and rejuvenated.  Gone are the sagging skin in her neck and the undefined jaw line, probably due to face and neck lift.

While facial rejuvenation surgeries are enough to erase up to 15 years off your face, skin resurfacing treatments such as laser, chemical peels, and dermabrasion can further make the countenance more youthful by removing or at least minimizing the appearance of sunspots, fine wrinkles, and skin discoloration.  These treatments are also known to correct the leathery, dry skin caused by too much sun exposure and natural aging.

Although good makeup can also do wonders on one’s face, it would be difficult—if not impossible—to achieve the dramatic improvements in Clinton’s appearance.

While some people may think that cosmetic plastic surgery for politicians is superfluous because they are not expected to look just like a celebrity, some may need this “medical enhancement” particularly if their countenance looks haggard or even angry (even if they are not) because of the sagging skin around their eyes and jaw line.

As superficial as it may sound, several studies have proven that our brains judge a person’s traits based on his face—and an angry or tired look caused by sagging skin may not be good to a politician who must appear likeable, competent, and approachable to voters.