Mini Facelift for Minimal Signs of Aging

Mini facelifts are best for treating minimal signs of aging. They can treat sagging skin and jowls when these conditions are mild, which is common in younger patients.

For older patients who can benefit from tightening of the jawline and neck area, the doctor needs to augment, tighten and restructure the deep tissues to achieve satisfying results. These techniques aren’t part of a typical mini lift, even though the same surgical incisions are used.

During consultations, we create an individualized plan using one or more of these techniques:

• Mini Lift: the mini lift is a short scar facelift. The procedure tightens the skin, but does not address significant sagging in the jowls, cheeks, and neck.
• Face Lift: the traditional face lift works at the SMAS layer of the tissue, which allows the surgeon to elevate the jowls at a deeper level and provide a lasting and satisfying result.
• Fat Grafting and Liquid Face Lifts: As you age, volume loss in the soft tissues becomes a real problem. The cheeks and lower face will often benefit from soft tissue augmentation, which involves treatments such as autologous fat grafting or dermal filler injection.
• Laser Treatment: A CO2 laser can tighten the skin and remove surface irregularities that have accumulated over the years. While it cannot provide the same results as a face lift, a laser treatment can rejuvenate the skin, and today’s laser treatments require minimal downtime.

Aside from the specific treatment considerations, you should always work with a cosmetic surgeon who is familiar with all techniques and the range of conditions that different patients present.

Face lift surgery has changed from a standard technique to a custom-tailored approach that incorporates several of the latest techniques in facial rejuvenation. Contact our office to set up a personal consultation, in which you can discuss the options available here at our Sacramento cosmetic surgery practice.

“I feel like a don’t have a very feminine profile,” says Erica, on this episode of The Doctors, and “I’d like to see if there’s anything you can do about it.”

“You have a significant accumulation of subcutaneous fat,” says her surgeon. “You also have a significantly weak chin. If we drop a straight line down from the lower lip, we want the chin to hit that line, and you’re significantly behind that line. To make someone more feminine and more elegant, we often perform a chin implant to extend the profile.”

“You did a couple things,” says Dr. Andrew Ordon, during the show’s recap. “You smoothed out that neckline, as the first step. To give more fullness and shape, you added that chin [implant] to her profile through that incision, but people have choices when it comes to chin implants, right?

Different Styles of Chin Implant

Men use square implants, while women use softly rounded chin implants. “It’s only been a couple days since my procedure, but it’s really great an I’m just excited to see the final result,” says Erica. “It’s really remarkable, you can see that difference,” says the host about her before-and-after photos.

While cosmetic surgeons frequently use dermal fillers and fat grafting for cheek augmentation, there are currently no injectables with FDA approved indications for this treatment. Juvederm Voluma XC could change that in the near future, according to yesterday’s news release from Allergan Inc.

According to Allergan (maker of Botox, Juvederm, and Latisse), the FDA’s General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee cast their votes unanimously in favor of Juvederm Voluma XC as a treatment for cheek augmentation, claiming that treatment benefits outweigh the risks.

Already a popular injectable hyaluronic acid dermal filler, Juvederm is typically used for treatment of nasolabial fold wrinkles. If approved, Juvederm Voluma™ XC would be the only dermal filler with an approved indication for cheek augmentation.

“Allergan is committed to working with the FDA as they continue their review of our PMA for Juvederm Voluma XC, with the goal of providing consumers with the first treatment option that has been specifically developed to help restore cheek volume that has been lost over time,” said Dr. Scott Whitcup, Allergan’s Executive VP of Research and Development and Chief Scientific Officer.

The advisory committee’s recommendation will be considered during the FDA review and decision regarding the new indication. FDA approval for the treatment could come later this year.

Photo by LeahLikesLemon

Two Smile Line Solutions Compared

Both Juvederm and Restylane are safe and effective treatments for facial wrinkles or folds. These are the most popular dermal fillers on the market today. Both are made with hyaluronic acid, a natural component of your skin and connective tissues.

Compared to the collagen-based fillers of the past, these products are a major improvement. They not only last longer, but you can receive treatment the same day as the consultation – no allergy test or waiting time is needed.

Let’s discuss a few different aspects of the both products:

Longevity: According to Allergan, Juvederm is the only HA filler FDA approved to last one year with a single treatment. Clinical studies cited on the official website say that Restylane has been shown to last 18 months when patients returned for a touch-up treatment at 4.5 or 9 months.

Cost: the cost of Juvederm and Restylane is about the same. However, Juvederm is sold in a complete syringe, while Restylane is available in two sizes, which can be more economical.

Consistency: Juvederm injectable gel has a smoother consistency than Restylane, which does not necessarily improve the treatment or its results.

FDA approved indications: Both products are approved and primarily used to treat nasolabial folds, or smile lines. Restylane has an additional indication for lip augmentation.

Rewards: Allergan offers the Brilliant Distinctions program that includes Botox, Juvederm, Latisse, and Natrelle breast implants. A less robust offering called “Restylane Rewards” is available through Medicis, the maker of Restylane.

Trust Your Physician to Recommend the Best Filler

Physicians as well as patients tend to have their own personal preferences based on past experience with each product.

When it’s time to decide between them, trust your provider’s recommendation first, because it takes a trained hand to administer Juvederm, Restylane or any other dermal filler. These treatments provide temporary results. So if you don’t like the outcome, you can always try the other filler during your next visit.

Photo by @boetter on Flickr

If neck issues are making you self-conscious, Sacramento Surgical Arts has treatments to consider.

The causes of neck fat are numerous:

• Being overweight is one likely cause, but individuals at a healthy body weight may also have neck fat.
• Weight fluctuations often cause formation of stubborn fat pockets, including in the neck region.
• Genetic factors are also to blame, as the shape of the chin and jaw can make one prone to neck fat.

Neck Contouring with Liposuction

The traditional solution for neck fat, or any stubborn area of body fat, is liposuction. Liposuction techniques include laser-assisted, ultrasound-assisted, and tumescent liposuction. During a consultation, we can recommend the best technique for removing excess neck fat. During liposuction, we use a thin tube called a cannula to suction out the fat from a targeted area.

For Older Adults, Neck lift Surgery is Often Recommended

For patients who are in their 40s, 50s, and 60s, neck fat will often be accompanied by loose skin. In these cases, liposuction alone cannot fully contour the neck area, because the skin may not contract after the fat is removed.

The neck lift tightens the skin, much like a face lift. However, the surgery will also focus on neck muscles, including the platysma muscle, which is often to blame for a sagging neck.

High Tech Non Surgical Alternatives

Although new non-invasive “fat freezing” or “fat melting” treatments are gaining popularity, physicians aren’t using them to treat neck issues.

Laser and radiofrequency treatments can provide a mild improvement. However, most people who are truly bothered by neck issues will benefit from the dramatic and lasting results of a surgical procedure.

Photo by Duane Burdick

This procedure is performed to enhance facial symmetry and profile as it relates to the nasal structure. In some cases, rhinoplasty can also improve nasal function (although another procedure called septoplasty may be more suitable for that purpose).

Why Get Rhinoplasty?

The nose is a major focal point of your face. As such, it has an incredibly powerful effect on your overall facial appearance.

During rhinoplasty, we carefully reshape the underlying bone and cartilage to create a more balanced profile. Even the most subtle changes to the nasal structure can make a dramatic difference.

Rhinoplasty can achieve different goals for different patients.

It’s never a one-size-fits-all procedure. The doctor begins by listening to your concerns about your nose.

Do you think it’s too wide? Too long? Misshapen? During a consultation, share your cosmetic concerns right away and be open about your expectations for nose surgery.

Common concerns about the nose include:

• Too large or wide for the face
• A dorsal hump (bump on the bridge of the nose)
• Flared nostrils
• Nose asymmetry
• Nasal breathing problems

Both men and women can benefit from the procedure, but the technique will vary between genders. Read more about how rhinoplasty works and what to expect during nose surgery at Sacramento Surgical Arts.

Also: read more about my philosophy regarding nose surgery.

Surgeons at the University of Verona evaluated 90 surgical cases performed over a span of 2 years. They assessed the long term stability and aesthetic outcome of simultaneous chin surgery and rhinoplasty. The results varied, depending on the chin surgery technique that was performed.

A Focus on Balance and Proportion

If you visit a cosmetic surgeon and request a rhinoplasty, you may be surprised to hear them recommend chin surgery as well. Remember that they want to give you the best cosmetic outcome, and it’s possible to get rhinoplasty and still have facial proportions that don’t compliment your appearance.

This is largely due to the relationship between your nose and chin. To create a pleasing facial profile, the projections of each element should be balanced. A small chin can make a moderately-sized nose look large, while a large nose might overshadow a normal sized chin.

Relative size, not actual size, is what surgeons measure when it comes to nasal surgery or chin surgery. Each patient needs to be assessed individually, and the surgeon must look at the big picture – not simply the nose or chin alone. For the right patient, a combined chin surgery and rhinoplasty is the best approach.

As Dr. Dario Bertossi and colleagues conclude in their study: “The combined approach in correcting the facial profile is an effective procedure to achieve a more harmonic and consistent clinical outcome,”

Rhinoplasty and Genioplasty: What’s the Difference?

Rhinoplasty can enhance your appearance or improve your nasal function. Because the nose is such a critical focal point in your face, any change will have a powerful effect on your appearance.

Usually an outpatient procedure, rhinoplasty can be done with a general or local anesthetic combined with sedation. Precise incisions are made at the base of the nose and the skin is separated from the soft cartilage and bone. This allows the doctor to reshape the underlying nasal structure.

Genioplasty can augment or reduce your chin size, balancing it with your other facial features. The surgery may involve chin implants (augmentation) or a surgical advancement of the bone (sliding genioplasty). In most cases, a special biocompatible implant is placed in front of the chin bone. In others, the chin bone is separated, advanced and then and reattached.

Photo by Vincent Boiteau

Brow Lift or Botox?

Many people know that brow lines can easily be treated using Botox Cosmetic or Dysport, two injectable neurotoxins that temporarily paralyze tiny muscles that raise the forehead.

Treatment of the “angry 11s” in the central forehead area is one of the most popular cosmetic procedures today. But because Botox gets temporary results, the cost can add up for those patients who want to continue looking young. In these cases, a brow lift is one alternative that can provide results that last longer and, over time, cost less.

Through small incisions behind the hairline, the doctor elevates the forehead tissue and then disrupts the muscles that cause frown lines to appear (the muscles that are so often treated with Botox). Meanwhile, the sagging forehead tissues can be elevated.

Brow Lift or Blepharoplasty?

If a sagging brow is encroaching on your upper eyelids, a brow lift can help. However, if you have loose skin on the upper eyelids, a blepharoplasty procedure (or upper eye lift) is more appropriate. Through tiny incisions, the surgeon removes redundant skin to open up the eyes, which can often improve a patient’s vision at the same time.

A brow lift, Botox, and blepharoplasty can all be used in conjunction to achieve a great cosmetic outcome. A personal consultation is the best way to determine which procedure, or combination of procedures, is ideal in your case.

Photo by Hello Turkey Toe on Flickr

Products like Juvederm, Radiesse, Restylane and the new Belotero have emerged as relatively inexpensive alternatives to facial rejuvenation surgery. They are ideal for people with busy lifestyles.

If you’ve already had treatment with injectable fillers, you may be considering a more long-term solution to the signs of aging. During a consultation, we can help you decide between facelift surgery or a minimally invasive alternative such as Botox or Radiesse.

We’ll consider factors such as:

• Your appearance and how you have aged
• How you feel about cosmetic surgery
• Time you have for post surgical recovery
• What you can afford

In some cases, if a patient has early signs of aging in the jowl area, a facial filler can be used to postpone surgery for several years. With a low treatment cost, this option can be very convenient. With each treatment, you’ll have the opportunity to build a rapport and trusting partnership with the doctor.

The consultation process will also help you set realistic expectations. It’s important to know the limitations of both face lift surgery and injectable fillers, which vary. With fillers, you can usually expect a quick but subtle improvement that lasts 6-12 months. With a face lift, you can look 10 years younger, and the results typically endure for several years.

Photo: “choice” by Jay-dee on Flickr

“The eyes play an essential role in facial attractiveness,” said study author Eser Yuksel, MD. “and beauty and should be surrounded by high walls, similar to the principal of utilizing frames for pictures on a wall.”

“Higher walls allow for greater projection of the eyebrow which we found, correlates to a greater degree of perceived facial attractiveness,” he added.

Studying the Importance of Eyebrow Projection

Doctors studied the surface area of soft facial tissue that resides on the top of the eyelid toward the eyebrow, an area called the “oblique frame.” Ten participants were asked to rate patient photos from 0 – 2 in terms of attractiveness. Zero was considered an “unattractive” rating, while two rating was considered attractive.

First, subjects were shown photos of a group with low oblique frames, while the next group had high oblique frames. Next, the subjects were shown twenty photos of patients who had fat grafting performed to augment their oblique frames.

Those who elected to have fat grafting to enhance their oblique frames, as well as those with naturally higher oblique frames, were judged as more attractive.

“Proper positioning of the eyebrows has long been a major component to facial rejuvenation procedures,” said Dr. Yuksel. “However, this study shows that fat grafting to the oblique frame should also be considered when rejuvenating the face, as it can significantly impact facial aesthetics.”