Treatment of Photoaging

To the Editor: In a section entitled “Procedures for Facial Rejuvenation” in his article on the treatment of photoaging, Stern (April 8 issue) 1 briefly mentions blepharoplasty and face-lifts, and he characterizes them as expensive, highly profitable, and poorly studied in a scientific manner. The rest of the discussion focuses on nonsurgical procedures that are temporary, as he notes in his concluding paragraph. We believe that this characterization is both incomplete and biased. Surgical procedures are the gold standard for facial rejuvenation and are significantly more permanent than dermatological procedures. Done well, they are safe and effective and can be life-altering. . . .