“The best way to ensure a good outcome is to choose a surgeon who is qualified (board certified) and has extensive surgical experience in both number of cases and years of experience.” Leo Lapuerta, MD, FACS, offered that sentence as the main point he wants prospective patients to hear, and it shapes how he thinks a facelift consultation ought to run.
Dr. Lapuerta is a triple board-certified plastic surgeon in the Houston area with more than 30 years of experience and more than 30,000 surgical and non-surgical procedures behind him. His practice publishes a detailed guide to facelift candidacy, technique and recovery, and much of the material below comes from it.
For readers in their fifties and sixties weighing a lift, his view turns the consultation into an interview. These are the questions worth bringing, grouped by topic.
About the surgeon
Which board certified you?
One certification worth asking about by name is the American Board of Plastic Surgery. Dr. Lapuerta holds that certification along with certification from the American Board of Surgery and in Surgery of the Hand.
Can you give me your facelift numbers?
Ask for a case count and the number of years behind it. In Dr. Lapuerta’s view, experience with the specific procedure, measured both ways, is the best determinant of an outcome patients judge as good. That is his view, and this question tests it against the surgeon sitting across from you.
May I see results on faces like mine?
His practice keeps more than 3,000 before-and-after images for patients to review. A gallery is most useful when you can find patients whose starting point resembles yours in age, skin quality and degree of sagging.
About your face
Does my aging call for a mini, SMAS or deep plane lift?
The practice offers several facelift types, from a mini facelift for earlier changes to deep plane and extended deep plane lifts for more advanced descent. A good answer explains why one technique fits your anatomy and another does not.
Is there anything on my list a facelift will not fix?
The practice is direct on this point. A facelift does not replace skincare or erase sun-related pigment changes, and on its own it may not correct etched lines, poor skin quality or volume loss. Those concerns may call for fat transfer or skin resurfacing alongside the lift.
Should my neck be part of the plan?
Patients with neck laxity often need a neck lift at the same time, according to the practice, so the face and neck match after healing.
Am I too old for this?
The practice says there is no ideal age for a facelift. Timing depends on visible signs of aging, skin elasticity, facial structure, and the degree of correction needed. Your medical history also has to support elective surgery.
About the day of surgery
Is the facility accredited, and who gives the anesthesia?
Many facelifts are performed under general anesthesia. Dr. Lapuerta owns and operates a QuadA (AAAASF) accredited surgical facility and works only with physician anesthesiologists, never nurse anesthetists or anesthesia assistants. He also holds privileges in the Memorial Hermann network, at HCA hospitals including The Woman’s Hospital of Texas, and at St. Luke’s Houston Medical Center.
Am I ready for the recovery?
The practice lists realistic expectations about scars, downtime and recovery as part of candidacy. Swelling and bruising peak in the first few days, and you will need to limit lifting and strenuous exercise until cleared. Like any operation, a facelift carries risks, and the consultation should cover yours.
About the years after
Will I keep aging?
Yes. The practice states that a facelift resets the aging process without stopping it, and that longevity depends on skin elasticity, weight stability, sun exposure and technique.
Dr. Lapuerta reports a pattern he sees at follow-up visits. Partners who came to the first consultation unsure why the patient wanted surgery often return describing changes beyond the face, such as more energy and new interest in exercise and healthy eating. Some, he says, tell him they would have encouraged the surgery sooner had they known.
This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.
