With the advancements of medicine and surgery there are now numerous facial procedures and treatments that can combat the progressive effects of facial aging. There are many factors that affect the appearance of the face including age, sun exposure, weight fluctuations, previous surgery or treatments, smoking, or simply hereditary. Fortunately, today’s plastic surgeon has many tools to help treat some of these problems. In general, facial treatments are either non-surgical or surgical. Non-surgical treatments include a wide range of light acid peels, skin care products, non-ablative lasers , neurotoxins such as Botox®, and dermal fillers such as Restylane®, Juvederm®, and Radiesse®. Surgical procedures include facelifts, browlifts, eyelid surgery, fat grafting, implants, and liposuction. Non-surgical treatments mainly focus on the superficial surface of the skin, fine lines, or deep folds, while surgical procedures remove and tighten excess skin, resuspend muscles or droopy structures, and eliminate excess fatty deposits such as bags under the eyes.
The goal of all facial treatments and procedures is to obtain results that are NICE. NICE is an acronym that I use to help patients understand the goals of facial rejuvenation. A successful facial procedure must be Natural in appearance, preserve the patient’s Identity, have Concealed and imperceptible scars, and be in Equilibrium with the remainder of the face. We are all too familiar with public figures or movie stars who have unnatural and scary looks after plastic surgery. Those procedures lack balance, have unsightly scars and facial expressions, or change the patient’s identity. The goal of all facial procedures is to look more “refreshed” or to look “wonderful for your age” not to look “odd or overdone”. The greatest praise I get from my patients is when they tell me that all their friends comment how good they look, but don’t realize they had surgery
A Facelift is a procedure performed to reverse the effects of age, gravity, sun exposure, and daily stresses. By removing excess fat, tightening facial muscles, and readjusting the facial skin, a patient can look like a younger, rested, more beautiful version of themselves without a change in identity.
A Facelift is a highly individualized procedure that takes into account each person’s unique bone structure, skin texture, skin elasticity, and underlying muscle tone prior to developing a surgical plan. Most facelifts involve a combination of re-suspending the neck and facial muscles, contouring the fatty layers, and re-draping the neck and facial skin. Most patients start inquiring about facelift procedures in their late 40’s and early 50’s. When correctly performed, a facelift can result in a more energetic and rejuvenated appearance. Facelifts can be performed either under local sedation or general anesthesia and recovery is usually between 7 – 10 days.
A forehead lift, or Brow Lift will correct or improve forehead wrinkles, crow’s feet, frown lines, droopy brows, and excess skin of the upper lids. The procedure is performed with an endoscope through very small imperceptible incisions in the hair bearing scalp. The procedure takes approximately one hour to complete and can be performed under local sedation or general anesthesia. It is often combined with other facial procedures to help balance the face. The recovery is usually a few days and most patients are back to work in 5 to 7 days.
Eyelid Surgery or Blepharoplasty is a procedure that targets the area aroungd the eyes. As one of the first signs of aging, eyelid surgery helps correct excessive and loose skin as well as the fatty bags that form above and below the eyes. Eyelid surgery can erase years of aging, giving eyes a smoother and more youthful appearance. Lower eyelid procedures can be combined with laser resurfacing of the skin to help tighten the skin and eliminate any visible incisions. The upper lids usually requre excision of excess skin as well as the fat bags. These procedures can be performed under local sedation. The recovery is usually a few days and most patients can comfortably return to work in one week.
Liposuction of the Neck by itself can be a rewarding procedure for well selected patients. It is important that the neck skin have good elasticity and therefore the patient should be relativley young. The amount of fat to be removed should also be moderate. Liposuction of the neck can give very nice contours with minimal surgery and scars and is performed as an outpatient procedure usually with light sedation. The recovery is very quick and most patients are ready to return to a normal lifestyle in a few days. For those patients with very heavy necks, poor skin quality or excessivley loose skin, or for the older patient population that has loose muscle tone as well as loose skin, the proper treatment of the neck should include a necklfit and/or facelift.