Facial Procedure

Face Lift

As we age, gravity affects all parts of the body including the face in men and women. The effects of gravity is seen starting in the late 30s but more apparent and prominent in the 40s, 50s, and 60s with more lines, less facial muscle tones and sagging cheeks. A good facelift reverses the signs of aging with a natural appearing look and avoids making the face appear wind blown.

Facelift procedures only deal with the lower 2/3 of the face and neck. The upper 1/3 of the face and eyelids are different regions that also need to be addressed with a facelift. Since aging affects both the skin and muscle, both need to be corrected. Just tightening the skin or suspending the skin with threads or strings is inadequate. Tightening and resuspending the under lying muscle, and removing the excess skin will achieve a natural youthful appearance. The goal of the face lift is to restore the various structures back to its normal anatomical position.

At our certified outptient surgery center, this procedure is performed either with general anesthesia or under iv sedation with local anesthesia. The incision is made starting inside the hair above the ear, and down in front of the ear, and then behind the ear tracing down to the hairline in the neck. The skin is not lifted up much, but a layer of tissue called the SMAS/platysma is elevated extensively. This is used to re-elevate the facial structures and reposition the tissues to it/s more youthful location. This ensures a natural appearance.

After the procedure, you will need to do serial follow ups to receive medications to minimize swelling. You will be given specific instructions to how and when to wash your hair. Sutures will be taken out in 5 days then in 10-12 days and you will need to wear a facial garment to help minimize swelling and help reshaping the neck line. Most of the scars are well hidden and they will fade over time. Temporary swelling and numbness of the face are expected and the patient usually can return to work in 2 weeks.

There are numerous details in performing a maticulus facelift to ensures beautiful result:

Incision has to be precisely perpendicular so that there is good approximation during closure to ensure a scar that will be hardly noticeable.
Near the cartilage portion of the ear, the skin has to be cut thin so that the area appears more natural.
Skin undermining should be minimal to ensure smoothness and less disruption of blood vessels so that there is faster and better healing.
The SMAS/Platysma tissue should be extensively undermined to reposition tissues.
There are tissues called retaining ligament which must be completely released to assure a tension free movement of the soft tissue. These ligaments are located along the malar bone, cheeks, and along the jaw and chin. By releasing these ligaments, we have the freedom to reposition many droopy tissue in more youthful location.
For people with wrinkles along the side of the eyes, the muscle can be transected to weaken the lines.
For people with nasojugal groove-a line beneath the malar bone and the cheeks, the malar fat pad must be separately elevated and suspended.
Patients with heavy nasolabial fold, should undergo careful micro liposuction over the malar fat pad or have fat grafting to the nasolabial fold.
Patients with heavy jowls, should also undergo careful liposuction of the overlying fat. Also, the retaining ligaments of the jawline must all be released to the chin area.
Patients with wide lower third of the face who wishes for a slimmer look can benefit from removal of the buccal fat pad.
For some areas that are depressed, SMAS can be folded upon itself to augment certain areas such as submalar region.
Corner of the mouth can be elevated to give patient a more fresher appearace.
Corner of the mouth can be elevated to give patient a more fresher appearace.
For people with heavy fat neck, the neck must be very aggressively treated. Not only is the Platysma/skin pulled from the sides, but also from the middle. A small incision is made in the natural crease under the chin. Through this area, the fat underneath the skin is removed. Also, there is a fat layer underneath the platysma muscle called the subplatysmal fat pad which should be removed. Then the platysma can be tightened both from the middle and sides.
SMAS that is trimmed during surgery can be used to augment areas that are depressed. Some of the more common areas are submalar region, nasolabial fold, and lips.
All of the pulling tension is placed on the SMAS layers. The skin is allowed to just redrape. This ensures smoothness of the face and good scar healing.
Constant reference to the preoperative photographs to ensure accuracy and symmetry.

These are some of the examples that must be considered on all patients. This kind of approach to all facelift ensures not just better aesthetic results, but also more natural appearance of the face.

There are many new "technology" that claims to rejuvenate the face. There are some benefits and downside to all of these approaches. However, if a patient wishes for a more definitive and dramatic rejuvenate, none can match a beautifully performed facelift.

Endoscopic Brow Lift

The brow and the forehead are often the first region to show signs of aging. Heaviness and drooping of the eyebrows can give us a tired and sometimes angry look. Drooping of the eyebrows also produce heaviness of the upper eyelids and hooding of the upperlid skin if patients have an existing supratarsal fold

As the eyebrows sag and cause hooding of the upper eyelid, patients unconsciously elevate the eyebrow which causes both dynamic and static horizontal lines to appear on the forehead. Repeated frowning can also cause deep vertical creases to form between the eyebrows. Sagging of the skin in the corners of the brow increases the appearance of the crow's feet.

By repositioning the brow to a more natural position, the eyes will appear larger and less tired. The position of the brow is different in men and women so it is important to have a skilled plastic surgeon evaluate each patient and determine the necessary position of the brow. A number of brow lifting techniques exist to improve the appearance of the aging forehead and brow region.

Endoscopic Mid Face Lift

The area between your lower eyelids and your mouth is considered the midface. As you age, the effects of gravity, repeated muscle contraction, and lifestyle causes the skin, fat, and muscle to move downwards. When this occurs, the cheeks begin to look saggy or flat, the lower eyelids to become puffy or hollow, and circles begin to appear under the eyes. Also the lines between the nose and the corner of the mouth deepen.

The ENDOTINE midface lift restores the natural curves and fullness in the cheeks by moving the entire soft tissues back to its normal position. This is achieved by elevating the soft midface tissue from the bone, repositioning it upward towards the eyes, and fixating it in place until it adheres naturally to the bone. This is achieved by usuing the ENDOTYNE midface device. This restores cheek volume and establishes more youthful midface contours. The result will be a natural, revitalized appearance that doesn't appear overdone or "pulled."

When performed skillfully, a cheek lift will deliver a natural but noticeable improvement. It is frequently performed with other surgeries, such as a lower face lift, eyelid surgery, or a browlift. However, for many younger patients, under 45 years old, midface suspension is often a standalone procedure.

During a midface suspension procedure, the surgeon makes small incisions in the area above the ear or the lower eyelid and in some cases, through the underside of the upper lip. A small endoscope and other instruments are introduced through the incisions to lift the delicate midface tissues off the cheekbones. Once lifted, these tissues are repositioned upward (toward the eye) and to the side (toward the ear).

Midface suspension surgery is often performed under IV sedation. Patients typically return home on the same day. Surgical dressings, if used, are removed soon after surgery, and any tissue swelling related to the procedure gradually diminishes.

Jawline Reduction

Rhinoplasty

Eyelid

Cheekbone

Facelift

Fat Transfer

Chin Implant

Lip

Metropolitan Slim & Beauty Medical

Facial Procedure

Face Lift

There are numerous details in performing a maticulus facelift to ensures beautiful result:

Endoscopic Brow Lift

Endoscopic Mid Face Lift

To Facial Procedure