Facelift – Technique and Experience Is Everything
- Posted on: Oct 18 2017
Natural Facelift Results -Technique Is Everything
There have been many applied techniques used to address facial aging over the years. Some have worked and others have failed miserably to provide natural facelift results such as the techniques that just yank and pull the skin back tightly. It is a well-known principle that skin under tension will ultimately relax. This is beneficial in reconstructive surgery or also in procedures such as breast augmentation. Take an A cup breast and put in a C cup breast implant in place for example. Initially, the breast will look tight and unnatural but within a few months, the skin will relax giving a beautiful result. In a facelift, however, if a skin pull only is done when the skin relaxes in a few months then this will mean that the result will fail as the skin sags again.
Natural Appearing Facelift
The key to a natural appearing facelift is our proprietary technique in the Four-Dimensional Facelift that we have used for over 16 years! The goal is to simply respect how aging affected the face and undo that impact by turning the clock back in time. We work from the inside out or skeleton to skin. For the small percentage of patients who were not blessed with strong cheekbones, a good jawline or a proportional chin, occasionally we have to enhance the skeleton with facial implants or other techniques which balance and support the tissues above the bone. The next layer is the muscle layer and the 30 paired facial muscles which give us natural facial movement and expression. Properly addressing the goal of putting these muscles back where they came from avoids that “joker” look that again screams “I have been altered.” The forehead for example, under the effects of gravity, falls straight down which lowers the brows and closes the sides of the eyes. The vector of pull of the muscles is therefore straight up.
Breaking It Down
The cheeks and jawline, on the contrary, should never be pulled straight up or straight back for that matter. Gravity affects the cheeks by moving things forward and down in a line that is slightly steeper than a line made from the top of the ear to the tip of the chin. So, we simply respect that anatomy and reposition those muscles upward and backward.
The neck is a whole other matter. The Platysma muscle sits just deep to the thin skin of the neck and connects to the jawline and all the way down to the collar bones. When we are 20 years old, those fibers are tight together and attach to a small bone in the front of the neck just above the Adam’s apple known as the Hyoid bone. As we age, the muscle weakens, falls apart into separated bands (which patients hate on photographs taken of them at parties) and the small fat pad underneath lurches downward underneath the chin. This is commonly described as the “turkey neck” and patients for sure only want turkey at Thanksgiving! In all seriousness, repair of the “turkey neck” involves removing the tissue paper like thin muscle at the midline which is causing the bands, removing that unsightly fat pad and repairing the muscle from the base of the neck to just underneath the chin.
The Finishing Touches
Then, after all the muscles of the face are put back we reposition the skin without pulling on it, removing what extra may be there and meticulously closing the skin with sutures that are as thin as your eyelashes. This is how we get incisions to conceal beautifully so female patients can wear their hair up or a male can keep their hair short.
Now, finally we need to address the loss of tone to the skin that has occurred with aging, sun damage, possibly smoking or finally swings in weight gain or weight loss. Trust us when we tell you that pulling harder to make these wrinkles go away will not work! The key is the collagen substructure to the skin which has been damaged over time. The collagen gives the skin elasticity. Like a tube sock that has lost its elastic band, nothing you change about it will keep it up on your leg anymore. Thankfully in cosmetic surgery, we have the answer for the skin and that answer is the proper, simultaneous use of a CO2 laser at the time of the facelift surgery we will actually smoothen the wrinkles and regenerate collagen tone to the skin. We essentially shrink wrap the skin to the underling’s muscles and this is proprietary to our technique in the Four-Dimensional Facelift used for over 16 years!
Posted in: Four Dimensional Facelift