Facelift? Or face grafting?
Dr. Dean Kane Q & A
Q. Hello, I’m 27 and I want to know if I’m a good candidate for a facelift o fat grafting? I want to look better but I don’t want be very obvious at first view. I lost a lot weight during breastfeeding and my face look practically has a skull first my nasolabial folds and then my cheeks are flat. What kind of treatment would you recommend and how much would you charge me? I know it’s only an estimate. It can be more or less but I want to be ready economically speaking
A. I’m sorry for your post pregnancy changes. So sorry to welcome you to the “aging” club.
Your facial skin appears tight with no skin laxity. You may have lost some mild volume in the upper cheek / lid region or maybe some slight shifting of the fat compartments called cheek ptosis. Fat replacement replacement is only one option. Face lift is not.
Facial Aging develops from the 5 different layers of the skin, fat, muscle and bone.
During the first 20 years or so of life, the body genetically determines how to develop and repair a constantly changing “face” including all these layers (as it does elsewhere in the body). Thereafter it remains robust in repairing itself from injury but the accumulation of environmental, health and nutritional exposure will add to the passive inability for the body to care for itself after 30. This is when physical changes such as skin laxity, irregular pigmentation, lines and wrinkles and skin diseases occur. We now have many options to rejuvenate the layer or layers of the face which need care or stimulation to reverse the aging trend.
1. The top layer or stratum corneum of the epidermis is the rough, pigmented layer of the skin; creating most of the depth of the wrinkle.
· Exfoliation is best for this using:
· Retin-A (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper epidermis,
· Some lasers and chemical peels.
2. The second layer is the dermis which thins with aging. The natural collagen, elastin and hyaluronic acid (which hydrate and toughen the skin) are thickened by the use of:
· fillers (Restylane and Juvederm), or
· Retinoids (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper dermal skin cells.
· Sculptra properly managed is the latest sensation in stimulating firming and thickening of the dermis
. ClearLift, a laser option and now ThermiRF will continue to stimulate collagen production under the skin BUT when combined with Sculptra and Retinoids
Is a terrific trifecta for sinergistic dermal thickening, exfolliation, collagen and dermal structural molecule production with skin tightening.
3.The next layer or fat also thins or droops with age and maybe:
· filled (Restylane and Juvederm), fat grafting or
· redraped (threadlift, short-scar, traditional, endoscopic face / neck / brow lifts / cheek)
4. The muscle which creases the skin into wrinkles and folds is weakened and rebalanced with
· Botox or similar injectable muscle relaxers like Dysport or Xeomin.
5. Bone also undergoes a dynamic process of resorption, thinning and descent. Options for cosmetic enhancements include:
· structural fillers, particularly like Radiesse (bone mineral)
· volumizing gel fillers like Juvederm and Restylane
Facelift, necklift and forehead lift are surgical procedures which include:
a. an incision along the periphery of the tissues
b. a suspension or re-positioning of the underlying soft tissues, and
c. a redraping of the skin with removal of skin excess.
A sub-group to the facelift is the mid-face lift. This is used to detach the soft-tissues of the cheek which have descended, separated and lost volume and suspend them to the lower orbital rim. Generally, the fat pockets under the eyes are trimmed or added to the volume of the cheek and the eyelid skin is redraped.
Everyone needs one or more layered improvement and in personalized combinations to achieve their optimal result.
· All surgical, minimally invasive and non-invasive procedures and their combinations should be discussed following a proper examination with a well versed, Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he limited in his skills.
I hope this is helpful. All the best!
This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.