Facelift Surgery. Deep Plane Facelift & Fractional CO2 Laser

While the neck is often a significant area of concern for many patients who present for facial rejuvenation, I find that the deep plane facelift is very effective at restoring the position of the cheek.

In the youthful face, the cheek is positioned beneath the lower eyelid so that a smooth contour exists between the lower eyelid and the cheek. As we age, the cheek begins to descend, causing a gap to be created between the lower eyelid and the cheek.

When performing facelift surgery, the surgeon repositions the cheek back to beneath the lower eyelid to restore this contour. Often after patients have a facelift they remark about the improvement in the appearance of their eyes. This is because the volume of the cheek is now repositioned into the proper location.

The patient in the above photograph underwent deep plane facelift, and CO2 laser to her lower lids and peri-oral rhytids or “wrinkles”. In the before photograph she is 89 years old, in the after photograph she is 89 years and 10 months.

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Necklift. Male Facial Rejuvenation.

More male patients are seeking consultation regarding facial rejuvenation. Male patients often present to the office wanting to improve the appearance of their face and neck.

Prior to performing any procedures, I first determine if the jowls or nasolabial folds need to be addressed to create a more youthfull appearance. If a male patient has significant jowling or a deep nasolabial fold then we can proceed with a lower face and neck lift.

If there is no jowling and a nasolabial fold which is not deep then we can proceed with a necklift. The necklift can be performed with an incision in the neck itself, with an incision beneath the chin, or with standard facelift incisions. Another very effective means to address the aging neck in the male is with a platysmalplasty and neck z-plasty.

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Facelift Surgery. Deep Plane Facelift

The deep plane facelift is a technique that can be used in conjunction with an upper and lower blepharoplasty as well as a coronal brow lift.While the deep plane facelift affords excellent correction of the nasolabial folds, jowls, and neck, I have found that the aperture of the upper eyelids can yield a significant positive impact on the aesthetic result on the overall youthful appearance of the face.

It is very common for women as they age to have an accumulation of skin on their upper eyelids. This accumulation of skin has been given the medical term, dermatochalasis. Often this accumulation can be asymmetric-meaning greater on one side versus the other and can create differences in the aperture of the eye.

It is important when correcting this asymmetry to note the location of the tarsal fold or eyelid crease.As you can see in the above photograph the patient's right eye has significantly more skin pre-operatively than the left eye. Careful notation of these asymmetries is important so that post-operatively the eyes can have equal apertures and yield an optimal aesthetic result.

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