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Category: Facelift

Facial Rejuvenation Surgeries

Facelift Before and After PhotosThere are a variety of types of facial rejuvenation treatments and procedures. While non-surgical methods can be incredibly effective, in many cases, surgical methods prove to be the better approach and may produce better results. If your face has begun to show signs of aging such as sagging skin, fine lines, wrinkles, and folds, the following facial rejuvenation surgeries can help you achieve a more refreshed and youthful appearance.

Facelift Surgery

Facelift surgery can improve many signs of facial aging in the mid face, lower face, and even the neck. Various techniques including the mini-facelift, mid-face lift, deep plane facelift, neck liposuction, and Ultherapy® can correct the following issues:

  • Jowls
  • Sagging facial tissue
  • Turkey neck
  • Descending cheeks
  • Nasolabial folds
  • Wrinkles and lines in the mid and lower face

Dr. Pearlman can help you determine which facelift approach you need and whether you should combine your facelift with other procedures for more complete facial rejuvenation.

Silhouette InstaLift™

The Silhouette InstaLift™ is a minimally invasive surgical procedure that can lift the deeper layers of the facial skin to rejuvenate your appearance. The surgeon uses sutures with bidirectional cones to elevate and reposition the skin on your face. Over time, your body naturally absorbs the sutures and stimulates more collagen to improve skin quality.

Brow Lift Surgery

Brow lift surgery can lift and tighten the tissues of the upper face. This surgical approach corrects horizontal forehead lines, drooping brows, and brow furrows, and it may also improve upper eyelid hooding in some cases. Certain techniques can also elevate sagging cheeks. Patients who need a brow lift may feel that they look continually angry, sad, or tired. After the procedure, your forehead and brow area will appear lifted and smooth, erasing the negative expression that previously marred your appearance.

Blepharoplasty

Another facial rejuvenation surgery is blepharoplasty, more commonly called eyelid surgery. This procedure can correct sagging eyelids and displaced fat in the areas around the eyes. Patients can receive upper blepharoplasty, lower blepharoplasty, or both to fully rejuvenate the tissues around the eyes. The surgeon will adjust the muscle tissue, eliminate excess skin and upper eyelid hooding that may impair vision, soften fine lines, redistribute fat tissue, and reduce puffiness and bags around the eyes.

Each of these surgical procedures can be performed alone or may be combined with other procedures for complete facial rejuvenation. During your confidential, personal consultation, Dr. Pearlman can recommend which procedures will best help you achieve your aesthetic goals and desires.
Dr. Pearlman offers facial rejuvenation surgeries and many other plastic surgery procedures to enhance the appearance and rejuvenate the face and body. If you would like to learn more, please call (212) 223-8300 or fill out our online contact form to request your consultation today.

The 6 Types of Facelifts

Before and After FaceliftIf your face is noticeably aging, it may be time to consider getting a facelift. As individuals age in different ways and at different rates, Dr. Pearlman offers six types of facelift procedures, including surgical and non-surgical options. Depending on your needs for facial rejuvenation, one of the below facelift procedures could help you achieve a more youthful and rested appearance.

1. The Mini-Facelift

The mini-facelift targets aging in the lower face, including minimal skin sagging, early jowls, and excess skin. This procedure is not designed to address heavy jowls or severe signs of facial aging, but it can create a more uplifted, smoother facial contour. The best candidates for this procedure are younger patients with the aforementioned characteristics of aging who desire a more youthful and well-defined lower face and neck.

2. The Mid-Facelift

The mid-facelift targets cheek sagging to rejuvenate the midface region. This procedure elevates the tissues of the cheeks to eliminate sagging and reduce deep creases. Best for patients who do not have jowls or excess skin sagging in the neck, the mid-facelift can enhance facial definition, create more attractive cheek contours, eliminate nasolabial folds, and even improve the lower eyelids. It can also be incorporated with other facial procedures if needed.

3. The Deep Plane Facelift

The deep plane facelift targets severe cheek and neck aging. This procedure lifts the muscle tissue and skin to correct heavy cheeks, neck sagging, and skin laxity. Long recognized for its ability to produce the most natural-looking and longest-lasting facelift results, the deep plane facelift can yield a refined and rejuvenated appearance. Research has shown that patients look at least five years younger after a deep plane facelift and still look better five and a half years after their surgery than they did before. This gives the best and longest-lasting result in facelift surgery.

4. The Silhouette InstaLift

The Silhouette InstaLift uses dissolvable sutures and cones to anchor the cheeks and re-suspend sagging facial structures such as jowls, cheeks, nasolabial folds, and excess neck skin. The Silhouette InstaLift procedure mitigates many signs of aging with very little downtime, ultimately encouraging the body’s natural process of producing collagen around the threads. The procedure is typically used around the cheeks, brows, jawline, and neck in order to restore structure and youthful orientation to the face. Patients often wish to correct sagging facial tissue, such as jowls along the jawline, mild drooping skin under the chin (“turkey neck”), descending cheeks, and deep creases from the outer nostrils to the corners of the mouth (nasolabial folds). The best candidates for this procedure are younger patients who aren’t quite ready for a full surgical facelift.

5. Neck Liposuction

Neck liposuction targets excess fat in the neck and even the jowls.This procedure is often combined with facelift surgery to eliminate surplus fat that accumulates beneath the chin. This procedure may be appropriate for individuals who would like to eliminate a double chin and flatten prominent jowls. The best candidates have minimal laxity of the neck skin.

6. Ultherapy®

Ultherapy® is a non-surgical treatment that can lift and tone sagging, loose skin along the jawline and under the chin, and it can even raise your brows. Using ultrasound energy, Ultherapy® stimulates the foundational tissues and support layers of the skin to help tighten early jowls and early skin laxity. This procedure is best for younger patients, those who would like to preempt the need for surgery, patients who may not be ready for surgery, or patients who wish to prolong the effects of a previous facelift procedure.

Steven J. Pearlman, M.D., F.A.C.S. is dual board certified in facial plastic surgery and would be pleased to help you achieve your aesthetic goals with facial rejuvenation. To schedule your confidential, in-depth personal consultation with Dr. Pearlman, please call 212-223-8300 or fill out our online contact form today.

Lifting Your Appearance With The PearLift

During this past month we held a media event announcing the release of a brand new non-surgical procedure that starts with Ultherapy  which tightening the underlying facial structures including the SMAS and Platysma. After that we continue with the Dot™ fractionated CO2 laser. That way the skin is rejuvenated inside and out. 

We were fortunate enough to have Carol Ruth Weber attend our event this past month and go through the motions of the Pearl Lift. Like any patient she had concerns, which we were able to address. 

You can read her account of our event by clicking here

10 Questions about Facelifts

Closeup of Woman's FaceFacelifts are still growing in popularity, and for good reason—facelift results can be powerful and last far longer than those achieved with minimally invasive procedures.

If you are contemplating a facelift, here are answers to questions I hear most often.

1. Who is a good candidate for a facelift?
There is no set age or profile. Factors to consider include age, body type and size.

2. What type of facelift is best?
It is more important to find the right surgeon rather than choose your own preferred technique.

If you like the results of facelifts done by a certain surgeon, then you are on the road to obtaining the results you want.

3. How long does the surgery take and what is the recovery time?
Standard facelifts usually take 3-4 hours. Recovery times differ, but in general, noticeable swelling will go down within 10 to 14 days. Try to schedule surgery about a month before any special events.

4. How will I look different?
My patients often report feeling that they look refreshed rather than “different” or “operated on”, which I achieve by shifting more of the facial tissue than just superficial layers (which can create the “pulled” or obviously “lifted” look).

5. What should I look for in a plastic surgeon?
Look carefully at patient examples from the surgeon you are considering, so that you and your surgeon have the same understanding of how much will really change. Always ensure that your surgeon specializes in the face and, is certified by an accredited medical board such as the American Board of  Facial Plastic and Reconstructive Surgery.

6. What are the risks?
Like any surgery, facelift procedures carry some risks, including infection and hematoma. The incidence of these risks relates closely to the surgeon’s skills, though there are small but real risks even in the best surgeon’s operating room.

7. I want to lose a few pounds; should I wait to have my facelift?
Ideally, a patient should be in the best possible health and shape possible before any surgery. A few pounds will not make much of a difference but for more than a few, wait until you feel comfortable with your weight before planning your surgery.

8. How long will the effects of a facelift last vs. fillers?
Facelift results will last for years, though the longevity depends on several factors including skin quality, significant weight changes, and environmental factors (e.g. excessive sun exposure).

Fillers are temporary solutions for adding volume to deflated tissues, and typically last for months rather than years—but they can be complementary to facelifts.

9. Should I consider another procedure in conjunction with my facelift?
Eyelid surgeries are most frequently performed with facelifts. Be advised that the additional procedure will add a bit more discomfort and can lengthen recovery time.

10. What is the difference between facelifts, neck lifts and mini-lifts?
Plastic surgeons say “facelift” to refer to a procedure that impacts the cheeks, jowl and neck.

A neck lift addresses neck skin redundancy or deformity. Mini-lifts are usually done for patients who have more minor concerns about their cheeks and jowl, or to refresh a previous facelift.

Adventures in Amsterdam Part 2

The second of the course included a live televised rhinoplasty that I performed. This was a stressful, yet exhilarating experience. The patient was recruited by one of the faculty members. She had a deviated septum and was given the option for a cosmetic rhinoplasty by a visiting Professor from the U.S., namely me. I treated her just like one of my own patients. I received the photos by email a few weeks prior. I uploaded the photos into my computer and performed computer imaging on the photos. I then saw the patient the afternoon before for a personal examination and to discuss our plan. Most importantly, to make sure that the patient was comfortable with me and the surgical plan. When the consultation was complete, she was quite excited at the prospect of a new nose. She had a crooked nose and a very wide twisted nasal tip that was over-projected (stuck out too far from her face).

I maintained my routine of doing what Dr. Robert Simons and my mentors always taught: a rhinoplasty is performed 5 times. The first time is when you meet the patient, discuss their desires and perform a thorough nasal examination. The surgery is already being planned in the surgeon’s mind. The second time is reviewing the photos and imaging, often with the patient at a second consult. The third time is the morning of surgery. I review the photos, the written surgical plan and the imaging. The fourth time is actually performing the surgery. For a primary rhinoplasty, surgery rarely deviates from the plan given a careful evaluation and intimate knowledge of nasal anatomy. The fifth time is a year later, comparing the before and after photos to see how the nose actually came out. We critique our own results to help affirm or look to further refine our personal technique. For this young lady, the first two steps were reversed, but the rest adhered to. I had gone over this plan many times in my head before her surgery.

 Back to the surgery, I went to the operating room on Thursday morning, a beautiful newly renovated facility. I was even given bright yellow surgical O.R. clogs to wear. They have them in every size, and are cleaned after every surgery just like the surgical scrubs. I was then wired for sound and off to the surgery. There were three video cameras, one above the patient, a second from the side and a third with a close up view from below the nose. I was quite comfortable narrating my rhinoplasty since I am usually accompanied in surgery by ether a fellow in Facial Plastic Surgery or a resident from the New York Presbyterian, Columbia, Cornell program.  The moderator back in the lecture hall was Prof. Gilbert Nolst-Trenite, a recognized international leader in rhinoplasty education and author of numerous textbooks and hundreds of articles on rhinoplasty.  He asked questions throughout the surgery and related questions from the audience. By the time I started surgery, my butterflies were gone. With a scalpel in my hand, I felt quite at home. Surgery went very well. The feedback during surgery from the other faculty in the lecture hall and attendees was quite positive. 

Thursday afternoon was a relief. Despite having performed thousands of rhinoplasies, this was an exception; the pressure of a live rhinoplasty in front of the symposium as well as a dozen faculty of established rhinoplasty surgeons was now over. I had one more lecture that afternoon.  But first there was a cadaver dissection lab. This is quite routine for me since I have participated in and taught in many of these lab sessions. There is a room with fresh frozen cadaver heads on trays. These are from people who have donated their bodies for medical study. The cadaver heads are always treated with respect and will be used by a number of specialties in pursuit of medical educations. The faculty members helped the attendees perform dissections and surgical techniques on these specimens according to a planned lab manual.

My afternoon lecture was,  “Intra-nasal Rhinoplasty, a dying art?” Another name for intra-nasal rhinoplasty is closed rhinoplasty. This is a topic for another series of blogs. In a nutshell, most young surgeons only taught the open rhinoplasty approach. There are a number of contributing factors for this. However, for most patients, I feel that a skilled, experienced surgeon can get equal results with closed intra-nasal rhinoplasty without an external incision across the bottom of the nose. A better view of the tip cartilages doesn’t automatically make for a better surgeon or better results. It’s as stated prior: precise analysis, understanding nasal anatomy and an armamentarium of sufficient rhinoplasty techniques is what it takes to obtain quality results. This is with or without an incision across the bottom of the nose. 

That night was a banquet dinner for the entire meeting, including faculty and attendees. There were a few speeches and I was honored and surprised with a crystal cut glass wine decanter. At dinner, another faculty member had just arrived for his talks the next day, Prof. Tony Bull from Great Britain. Dr. Bull is recognized as one of the most well respected rhinoplasty surgeons in the world. He also has a tremendous sense of humor that comes out in conversation at dinner plus throughout his lectures.

 

What is a Non-Surgical Facelift?

03Your face often is the first to tell your story. It shows if your life has been one of happiness or sadness, stress or relaxation. It tells how old you are, if you’ve spent your time outdoors or indoors and a slew of other stories about your life. While we all agree that telling our stories can be enjoyable, not all of us want it written all over our faces.

As you age, you may notice these changes to your face that you’d rather not have:

  • Fat loss in the face

Body fat is the substance that gives your face a youthful appearance. Adults that have lost facial volume will have a hollow appearance under the eyes, on the cheeks and through the lips. This will make you look much older than you are — or want to — look.

  • Facial sun damage

Repeated exposure to sun over the years causes less elasticity in the skin fibers. Fine wrinkles often appear as you age, and your skin is often referred to as leathery. If you’ve spent a lot of time in the sun, went tanning a lot when you were younger, or just forgot to wear your sunscreen, you may begin noticing this unsightly change to your skin’s appearance.

  • Extra hanging skin

The loss of elasticity due to less collagen production in the aging body often affects your eyebrows and neck. It can also cause the phenomenon commonly referred to as jowls along the jawline.

Although you may wish to ease these effects of aging, you may also be reluctant to go through surgery. Fortunately, there are newer technologies available which provide a facelift while eliminating the need for surgery.

Fat Injections and Fillers
Though you may have joked about it, a fat transplant really is possible! Plastic surgeons are able to inject fat from your abodomen below the facial skin and plump up the areas that have become hollowed out. However, with all the fabulous new facial fillers we now have, Dr. Pearlman is finding less and less of a need for fat transfer. Why not take something off the shelf that lasts close to a year instead of an invasive fat transfer that requires time off and healing?

A liquid facelift product called Sculptra is also used as an injection to fill in sagging areas. It helps the body create its own collagen with no scarring or negative lasting effects.

Although not technically a filler, Botox relaxes facial muscles. It is best if you have fine wrinkle lines such as those caused by sun damage.

Facial Rejuvenation
The popular product available to stimulate your own body’s collagen production is Thermage. This is a helpful procedure if you have lost elasticity in the face. It applies heat therapy, and the procedure typically only takes an hour. The results are very minor. 

Laser Skin Tightening
The use of lasers has proven successful in everything from correcting vision to removing offending gallbladders. It can also be used for general skin tightening. This is the alternative to the traditional facelift which required cutting and anesthesia and often produced scarring. Again, this is skin tightening and can work great for your skin but won’t lift jowls or saggy neck skin.

Ulthera

Ultherapy is the only non-invasive FDA approved treatment that can specifically target the deep foundation below the skin that is addressed in cosmetic surgery without cutting or disrupting the surface of the skin. It is also the only procedure to use ultrasound imaging, which allows us to actually see the layers of tissue we target during treatment and ensure the energy is deposited precisely to where it will be most effective. Generally patients see about  30% to 50% of the result of a surgical facelift for a quarter of the price.

 Improving your appearance as you age has never been easier.  Remember, in truth there is no such thing as a “non-surgical facelift.” However, marked improvements can be made in skin color, texture, wrinkles and volume loss. Plastic surgery may be just the option for you, except there might not be a need for a scalpel, should you choose to avoid that route.

 

Copyright 2013. As licensed to Pearlman Aesthetic Surgery. All rights reserved

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