Archive for April, 2010

Sunday, April 4, 2010 @ 12:04 PM
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    The fourth and fifth decades of life are a time when people often begin to become more aware of age and committed to facial plastic surgery procedures.  Accumulated sun damage and prior skin care rejuvenation regimens affect when patients begin to consider blepharoplasty, brow lifts, and facelifts during these decades.  Often, patients will also add staged or simultaneous skin resurfacing rejuvenation procedures to maximize and augment surgical results.  There is often a misconception that surgery and procedures need to be delayed as long as possible to avoid additional surgeries in the future.  The truth is there is no good or bad time to under go surgical and skin rejuvenation procedures; it is only appropriate when a patient becomes bothered enough by the issue to consider surgery and is an intensely personal decision.  The most important consideration to avoid bad outcomes and unnecessary surgeries is to find a practitioner who uses techniques that will provide superior, long lasting results.
 

    Eyelid lift surgery or blepharoplasty offers a long lasting procedure and when performed correctly is often not necessary to have repeated in the future.  Similarly, Brow Lifts usually only need to be performed once if the surgery addresses the laxity issues in the forehead, upper eyelid, and brow complex and adequately releases and re-suspends these tissues.  Minor touch up procedures may be included in future treatments to maintain and maximize results from blepharoplasty and brow lifts.  Revision surgery becomes important when considering revising suboptimal results from poor, inadequate techniques and is more difficult due to scar tissue from the previous surgery and is more expensive.  Having a procedure performed correctly the first time is of paramount importance.
 

    Facelifts are procedures that can be performed multiple times over a patient’s lifetime.  To avoid unnecessary and costly revision surgeries, finding a surgeon who effectively releases and re-suspends the SMAS layer, the primary support layer, of the face is important.  Many surgeons believe they get equally effective results with less aggressive work on the SMAS layer, but there is no short cut to providing superior long lasting results.  When performed properly, a facelift can provide patient satisfaction for ten years, or more.  A facelift addresses an aging jaw and neck line, resetting the clock, but it does not stop the clock from restarting.  Some patients who want to be aggressive about hiding their age may choose to undergo two or three facelifts during their life.  Another popular misconception is that undergoing multiple facelifts will result in a pulled or windswept look.  The truth is that when the skin and deeper SMAS layer are pulled in the correct direction, a facelift can be performed as many times as desired to maintain a more youthful jaw and neck line.  An additional misconception is that a comprehensive and thorough jaw, cheek, and neck lift can’t be performed through an abbreviated mini facelift incision.  This notion is also false; a thorough facelift can be performed through the short scar, abbreviated, mini, s-lift facelift incisions safely with superior outcomes.  Consultation with a knowledgeable facial plastic surgeon will allow for a comprehensive facial rejuvenation plan over the years when a patient is interested and healthy enough for surgical procedures.
 

    Skin resurfacing rejuvenation procedures are important to consider when augmenting and maximizing surgical results.  In addition to noninvasive lasers such as IPL LimeLight and YAG Laser genesis procedures, ablative resurfacing procedures become necessary to maintain youthful looking skin.  Finding a practitioner who offers the state of the art laser rejuvenation procedures is necessary for excellent outcomes with the shortest healing times.  Currently, combining confluent and fractionated laser modalities offers the best treatment for both superficial and deep discolorations and wrinkles as well as stimulating collagen formation. It also avoids complications and prolonged healing times from more traditional chemical peels and lasers.  Laser resurfacing rejuvenation procedures can be performed as often as necessary to restore and maintain youthful, vibrant looking skin.

     Botox, facial fillers, medical skin care products and other preventative and maintenance therapies should be continued in the forties and fifties to maximize the longevity of surgeries and skin rejuvenation procedures. Consultation with a knowledgeable facial plastic surgeon, who applies a global perspective when discussing patient goals and their future considerations, will put the patient at ease and establish trust that the practitioner is making thoughtful recommendations based on his expertise and training.

Posted by: Benjamin C. Stong MD