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CHAPTER 6 - SURGERY ON YOUR FACE
There are a number of trigger events that plant the seeds and may cause you to seek consultation for facial rejuvenation. There are the subtle signs of aging that begin to set in during the late 30s and early 40s which are hard to ignore:
- looking like you pulled an "all-nighter" when you had a full night of sleep
- needing more makeup and concealer to look your best
- people commenting that you look angry when you are in a perfectly good mood
- wearing more turtlenecks and high collars
- walking past a mirror and seeing your mother’s or father's image out of the corner of your eye
People generally say that they just want their external appearance to match the way they feel on the inside and not surprisingly, most people feel much younger than their age. Rejuvenation surgery will help ensure that you will look as good as you can at any age.
People's faces age in different ways and at different rates depending on variables such as genes, sun exposure and history of smoking. In addition, skin type, ethnic background, and underlying bone structure all play a role in the surgical outcome making it impossible to have a standard formula to predict results. The choice of rejuvenation procedures or surgery to change shapes and contours on the face is made based on a thorough evaluation that takes into account all of the variables.
A facelift tightens loose skin and muscle and repositions excess fat to restore a youthful look. The jowls, lower face, and neck are rejuvenated through a combination of procedures that make the entire face appear balanced. Eyelid surgery can give your eyes a brighter, refreshed and more relaxed look, and your nose can be reshaped to make it shorter, narrower or more defined. You can also have implants placed in your cheeks, along your jawline and in your chin to create better harmony with the rest of your face.
It may be necessary to "relift" your face 10 to 15 years later due to the natural effects of tissue relaxation, gravity and the ongoing aging process. However, it is less common to perform additional eyelid lifting surgery, and repeating a browlift, even decades later is usually unnecessary.
Restoring Your Youthful Face (Facelift or Rhytidectomy)
A facelift is a surgical operation for the purpose of making your face and neck look more youthful. Skin type and tone, degree of skin laxity, and basic bone structure all factor into your choices for facial rejuvenation and contribute to your outcome. We look at each person on an individual basis to customize a surgical plan that meets their needs and desires.
A facelift is not a specific procedure anymore. It has become a more generic term, as newer methods continue to evolve. In years past, large incisions were made and the skin alone was tightened. Nowadays, smaller incisions can be used and the skin and muscle layer (SMAS) are tightened, which results in very little tension on the skin and ultimately, improved scarring. To keep your facelift un-extreme, we reshape the underlying tissues by removing, repositioning, and adding soft tissue rather than just pulling the skin tight. Adding volume back to the face instead of simply removing loose skin, is another very important aspect of a rejuvenated, more youthful look.
Facelifts mainly address the lower two thirds of your face and neck, but do very little to improve the eye and brow area unless the operation is specifically designed to address aging changes on your upper face. Unfortunately, facelifts do not address overall skin texture, skin thickness, or the presence of fine wrinkling and deeper creases near your nose and around your mouth. Consequently, we often do facelifts along with other procedures such as eyelid lifts or browlifts. It is also very common to add non-surgical treatments to a facelift including injections with botulinum toxin (BOTOX®) or soft tissue filler substances, and skin resurfacing techniques to give the best result possible.
Different Facelift Techniques
We are continually devising new facelift techniques, with smaller incisions, and building on older methods. No one technique works for everyone so we have to customize our approach for each person taking into account age, gender, skin type, and bone structure. The universal concept, however, is that loose skin, weakened muscles and drooping fat, like in the cheek or jowl area, must all be corrected to fully rejuvenate the face.
Facelift techniques can be categorized by the tissue level where the work is being done, whether it is a more superficial technique in which we are working with the skin and the underlying muscle layer or whether we are working at a deep level, just above the bone. The different facelift techniques can be performed through access incisions which differ in length and location.
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