Lifestyle Lift: Making sense of the controversy

The controversy

Since its advent, Lifestyle Lift has been heavily promoted in TV infomercials and online with the emphasis on the advantages mentioned above. Some advertising even described it as a "one-hour facelift," although the company has retracted these claims. At one point, the promotional campaign apparently got to the point of posting misleading online reviews, which resulted in a court case and a settlement (as per the The New York Times article). There seems to have been no posting of fake LSL reviews since then.

On the other hand, Lifestyle Lift received a lot of negative reviews on some independent plastic surgery discussion sites. In particular, the LSL's "yes-it-was-worth-it" rating on realself.com (a popular plastic surgery rating website) tends to fluctuate between 30 and 40%, which is not exactly stellar. Still, this means that at least a third of the patients appear to be happy with their LSL experience. Of course, online reviews statistics is not a scientific measure of effectiveness. Unfortunately, there seem to be no clinical trials published in peer-reviewed journals evaluating the benefits and risks of Lifestyle Life and/or comparing it to alternatives. This is understandable: the Lifestyle Lift company probably wishes to keep proprietary "know-how" confidential. However, the lack of comprehensive scientific studies makes is difficult to evaluate the merits of LSL in an unbiased manner.

Another concern voiced about Lifestyle Lift is the experience and skill level of some surgeons performing it. The company states that only board-certified or board-eligible surgeons perform the LSL. In particular, the LSL website says:

"Lifestyle Lift offices recognize only three Boards as qualified to certify plastic surgeons specializing in the facial area: The American Board of Plastic Surgery, the American Board of Facial Plastic Surgery, and the American Board of Otolaryngology Facial Plastic Surgery. A plastic surgeon or facial plastic surgeon certified by one of these Boards has graduated from an accredited medical school and has completed at least five years of additional training as a resident surgeon. Additionally, the doctor has successfully completed comprehensive written and oral examinations to become Board certified or Board eligible. Only these physicians can call themselves plastic or facial plastic surgeons. Be aware of surgeons calling themselves 'cosmetic surgeons'".

Recognizing only the surgeons certified by the boards directly relevant to the LSL procedure is a commendable approach. However, the term board eligible raises potential concerns. According to the Merriam-Webster dictionary, board eligible means "being a physician who has graduated from medical school, completed residency, trained under supervision in a specialty, and is eligible to take a qualifying exam given by a medical specialty board." In other words, a board eligible surgeon has not taken or passed the qualifying exam given by a medical specialty board and, therefore, is potentially more likely to have knowledge gaps than the equivalent board certified surgeon. Furthermore, board certified surgeons typically have more years of experience than board eligible ones. Some critics have alleged that Lifestyle Lift's lower costs are partly due to the lower fees commanded by board eligible (as opposed to board certified) surgeons. That said, many of the Lifestyle Lift surgeons are highly skilled, have many years of experience and are fully certified by the relevant boards.

In the light of the above and considering a seemingly wide range of patient outcomes, it appears that the skill level of a particular LSL surgeon may affect the outcome at least as much as any other factor.

Another concern commonly raised by the critics is that Lifestyle Lift tends to be less durable that traditional facelift. This may be a necessary trade-off made for the sake of the Lifestyle Lift's purported advantages, such as faster recovery, cost savings and somewhat lower risks. Indeed, the traditional facelift tends to be rather durable because it involves not only lifting the skin but also revising and tightening the underlying muscle and connective tissue. It is far more than "skin deep" so to speak - it is a major intervention requiring general anesthesia and associated with longer recovery and higher risks. Conversely, the Lifestyle Lift typically involves less intervention and primarily focuses on the skin. Not surprisingly, it would tend to be less durable.

In that light, some people would be better candidates for Lifestyle Lift than others. In particular, some people in their 40s and 50s have significant skin sag and yet largely retain youthful facial musculature, bone structure, and fat distribution. In such cases, Lifestyle Lift may provide just the right amount of intervention and sufficient durability at lower cost, arguably offering an attractive alternative to a traditional facelift.

Bottom line

Lifestyle Lift is a "lighter" variant of traditional facelift surgery. The specific technical details of LSL haven't been fully disclosed due to its proprietary nature. Compared to traditional facelift, LSL is claimed to be less invasive, produce less scarring, have shorted recovery time, require only local anesthesia and be cheaper and less risky. On the other hand, the results of Lifestyle Lift tend to be less durable and dramatic compared to traditional facelift, especially when facial aging has affected deeper tissues (muscle, fat, ligaments, bone, etc.). Therefore, Lifestyle Lift appears to be a better fit for people in their 40s and 50s. Some older individuals may still benefit, e.g. those with unusually youthful facial structure and/or those for whom general anesthesia is contraindicated.

Lifestyle Lift has been criticized on a number of grounds including insufficient disclosure, lack of published clinical trials, seemingly high percentage of unsatisfied customers, and lack of full board certification of some LSL surgeons. On the other hand, it appears that between a third and a half of the LSL patients are satisfied with the results. The main factors affecting the outcome appear to be proper patient selection and the skill & experience of the surgeon.

Lifestyle Lift may be a viable option if you are a good candidate for it, especially if your budget is limited. However, it would be wise to get a second, independent opinion from a plastic surgeon unaffiliated with the Lifestyle Lift company. Do not let yourself get pressured into going through with it, maintain control over the situation until you are sure that LSL is your best option considering all the facts. Research the doctor assigned to perform your surgery to see if he/she is highly experienced, board certified and there is no action against him/her in your state or other states. Make sure you are in good shape and are not likely to develop a severe reaction to the local anaesthetic and other medication to be administered. But most of all, have realistic expectations - for less money you are likely to get a facelift that may not be as effective or last as long as a conventional facelift.

Lifestyle Lift (Wikipedia)
Lifestyle Lift ratings/reviews on realself.com
New York Times: Company Settles Case of Reviews It Faked