I’ve been seeing articles on how Kris Jenner’s facelift has changed. Headlines read, “Kris Jenner hits spa after reports she’s ‘mad as hell’ about $100K facelift” or “Kris Jenner breaks silence on reports her $300k face lift is ‘slipping’.” The gist of these articles? The facelift has relaxed a little bit and doesn’t look as good as it did immediately after surgery.
Yes.
But that is real. Normal. Expected.
YES. The answer is that all surgery “slips” with time. Skin is a dynamic substance. It is not like building bookshelves, or a house. Unlike bricks and steel, tissue is stretchy. It changes over time. We as plastic surgeons know this and anticipate it. It is why we bend people on the table when we do a tummy tuck – we take out a little bit extra skin as we know it will stretch, so we overtighten it a bit. When I do a breast lift, I get you as high and tight and shaped as I can, as I know it will settle. But there are some areas you cannot overtighten- you wouldn’t be able to get the skin closed, or the tension on the skin would cause terrible scars.
Skin takes TIME to relax. Many times this is months later.
What is the quality of your skin? We are all born with different quality. I like to tell my patients some of you are born with great skin quality. Your bathing suit is a Speedo. Great elasticity, thickness, and quality. It will age better. Some of us (sadly I am in this group) got our bathing suit at Target. (Love you Target!). We are cute and stylish, but the quality of our bathing suits and elasticity just aren’t as good. We age faster.
The older you are, the poorer the quality of your skin. Collagen, dermal thickness, elastin content all change. Cell senescence. Wound healing.
Sun damage? Smoker? Are you doing skincare? Wearing sunscreen? This is an exciting area where I think whole body treatments (like hormone replacement, NAD, and peptides) will help us bring regenerative medicine into improving skin health. But even with all of these, I can’t make my 50 something skin into 20 something skin. But I do think that is coming down the road.
Any place where you have fat- face, breast, abdomen- and you lose weight, you are asking your bathing suit to tighten to the smaller size. If your fat yo-yos, when you are larger you are “stretching” the skin again. This is tough on skin retraction.
Also for those who have been obese and have had major weight loss, generally the skin quality and elasticity is poor. I advise those patients to expect more skin relaxation down the road.
Did you do a breast lift? You don’t get to go braless. Gravity is still pulling on that weight and tissue and will stretch it out if you don’t wear a good supportive bra. Are you a runner? That bouncing can be hard on breasts as well. As I mentioned above, try to keep your weight stable. Going up and down in weight will stretch out the skin.
This is key, particularly with a facelift. (Or breast lift, breast reduction, or tummy tuck). Tightening and lifting the deeper layers gives deeper structural change and lift. You CAN put tension on this layer, as that won’t cause visible scarring. So doing a deep plane facelift where you move the deeper tissue and reposition it higher, or doing internal shaping sutures with a breast lift/reduction to lift and shape the breast tissue, takes tension off the skin.
We know skin stretches. Always. How much and when varies from person to person, but it will come. If you restructure and shape the deeper tissue, that is what is giving you lift and shape. You are not asking the stretchy bathing suit of skin to lift you. The deep tissue is doing that. The skin is just a cover.
It is real and expected. Right after a surgery things look tight and snatched. You are a bit swollen. (Swelling does lovely things to fine wrinkling). Your skin has not relaxed yet. Enjoy it. But know it will soften.
This “slipping” or settling will happen with any tightening and lifting procedure: facelift, breast lift, breast reduction, tummy tuck. How much varies from patient to patient. I try to combat this with multiple layers of support.
I had a 68 year old patient who came in for a consultation for a breast lift recently. I show a range of before/after photos in my clinic of different ages, sizes, and skin types. She didn’t like the photos of patients who “settled.” She wants her breasts high, tight, and round. I totally get it! She is 68. Fair thin skin. Postmenopausal. Fatty soft breasts.
I cannot promise that.
I cannot promise that on a young woman. In an older woman, no matter how in shape she is, the skin doesn’t have as much oomph, meaning it will settle. How much varies. I do everything I can to minimize it, and you can help with good support (ie a good bra, keep your weight stable), but in the end we do good surgical technique, you do good postoperative care, and we see what happens. Everyone is different, so results do vary.
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