Put Your Best Face Forward

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plastic

A LOOK BEYOND BOTOX AND FILLERS TO THE MODERN STATE OF FACELIFTS

BY DR. MICHAEL C. BRUCK

Botox and fillers have enabled many women and men to maintain a youthful appearance and enhance their looks without having to undergo surgery. How- ever, as aging progresses, Botox (Dysport, Xeomin- more recently introduced in the U.S.) and fillers can no longer sustain a natural youthful appearance.

The aging process is complex. How we age depends on a variety of factors—genetic, environmental, and how we have cared for ourselves. Facial aging results in loss of facial volume deflation from fat atrophy, descent of facial tissues, jowl formation, sunken cheeks, and loss of jawline definition. Over time facial shape gradually changes from heart-shaped to rectangular with loss of the gentle undulating curves of youth replaced by facial hollowing, fat redistribution and facial asymmetry. Facelifts properly, and artistically, performed can restore a soft, natural, youthful appearance that radiates health, vitality and beauty.

Modern facelifts use deeper tissue layers to restore facial shape, enhance symmetry and replace volume. Facial volume is also enhanced by fat injections/fat transfer, which is often performed in conjunction with facelift surgery (fat is usually taken from the hip roll or abdomen with a modified liposuction technique). Several facelift techniques use a variant of the SMAS (supramuscular aponeurotic system)—a tissue layer that is intimately attached to the underlying facial muscles below with connection to the skin above—to restore facial shape. As the SMAS is elevated, jowls are raised, the corner of the mouth is elevated, the nasolabial fold (from nose to corner of mouth) is softened, and descended tissues are repositioned, restoring fullness to the cheeks.

Another technique that uses deeper tissue to rejuvenate the face is a subperiosteal facelift. Facial tissues are separated from their attachment to the underlying cheekbones and lifted. Longer recovery and increased risks have made this a less popular technique among plastic surgeons. Although some excess skin is removed in SMAS and subperiosteal techniques, the skin is not “pulled tight,” and there is no “operated look.” In- conspicuously placed incisions generally heal with imperceptible scars. Facelifts are individualized to meet the needs of each patient. Whether you are a candidate for a facelift can be determined during a consultation with a board-certified plastic surgeon. Continues…

Put Your Best Face Forward is a Beauty article of DOWNTOWN’s Spring 2014 edition. If you would like to continue reading the whole article, you can find it in our latest issue on newsstands now!