Blepharoplasty in Facial Rejuvenation

Blepharoplasty is one of the more effective aesthetic procedures for facial rejuvenation in the right surgical candidate. Patients who present for upper blepharoplasty often complain of excessive skin or fullness in the upper outer quadrant of their eyes. Occasionally, this excess skin can obstruct their visual field or can simply cause a heavy feeling in the eyes giving the patient a tired appearance or tired outlook. Typically patients who undergo upper blepharoplasty report not only do they begin to look younger, but also feel younger.

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Laser Facelift:Fractional CO2 Laser for Young Women

The fractional CO2 laser is becoming a very effecitve tool for managing early signs of aging in the younger population. Early signs of aging such as crow's feet, lower eyelid skin laxity, and irregular pigmentation or dyschromias may be effectively managed by the CO2 laser. Many women who are in their early thirties and who present with early signs of aging often choose to undergo facial rejuvenation with the CO2 laser and then undergo facelift surgery years after CO2 laser resurfacing.

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Adjustment of the Platysma Position and Chin Augmentation to Improve the Neck

The relative position of the inferior portion of the chin to the neckline can have a significant appearance on how youthful a neck can appear. For example, to the untrained eye it may appear in the before picture that the neck would need to be tightened. In reality the chin needs to be lowered to the position of the neckline. The addition of a chin implant, mild submental liposuction, a platysmal repositioning can have a significant impact on the youthful appearance of the neck.

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The Laser Facelift: The Mixto Fractional CO2 Laser Facelift

The Laser Facelift can be very effective in patients with Fitzpatrick Skin Types I-III. The fractional CO2 laser can effectively tighten the skin around the upper and lower eyelids, the nasolabial folds, and the pre-jowl area. The CO2 laser is also very effective at reducing dyschromias or pigment irregularities on the face due to sun exposure.
The fractional CO2 Laser works by producing a controlled burn to the surface of the skin as well as stimulating collagen formation in the dermal layer of the skin. It is therefore quite common for the appearance of the face to improve up to one year or more after the procedure.
It is becoming more common for many women with Fitzpatrick Skin Types I-III to undergo fraction CO2 Laser skin resurfacing to improve the skin texture and then returning to undergo a formal facelift 2 to 3 years following the laser treatment.


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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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Facelift. Male Necklift

Traditionally as male individuals age, the greatest signs of aging occur in the neck. Males often do not have deepening of the nasolabial fold as seen in females. Therefore, I often find the best way to rejuvenate the face in males is to address the neck.

This can be done with the same incision as seen in female patients to address the lower face and neck or it can, in some males, be performed with the z-plasty on the anterior aspect of the neck. The incision is limited to the area beneath the chin and above the thyroid cartilage.

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Facelift. Deep Plane Facelift.

I enjoy all of the different types of facelift techniques that I have learned.

My preferred facelift technique is the deep plane technique. Which technique I perform depends upon the presence of jowling, the heaviness of the neck, and the depth of the nasolabial fold. I find that a significant amount of youth can be restored to the face with effective treatment of the neck in facelift surgery.

Appropriately addressing the neck requires a small incision beneath the chin to adequately correct the presence of platysmal bands or deposits of fat beneath the chin.

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