Q. Neck and lower facelift/Various types of procedures: what type my face is really needing? I am set for the above at the end of March. My doctor has been doing this type of work for about 30 years but it seems his main area is tummy tucks and breasts. The face is so important I am wondering if I should wait. He will retire soon and his price is wonderful. I see notes about the Biltmore lift etc., I wonder what type my face is really needing? The S lift, mini etc., and the dangers. I don’t want to lose my smile. Many thanks to all of you, and money is an object, but I could wait and save more.
A. The beginnings of facial skin laxity start when skin repair diminishes and passive skin aging relaxes downward.
The web of fibrous compartments under the skin loses fat, stretches and elongates developing 5 growing “waves” of skin at points of attachment such as the:
- hooding along the eyes,
- lower eyelid / cheek junction or tear trough / nasojugal fold
- nasolabial fold,
- lateral mouth commissure and marionette folds,
- jowls and neck.
The skin itself is not dissimilar to crepe paper held together by collagen, elastin and other structural molecules which also passively diminish with aging.
Facial Aging are created 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.
So, it is important to understand there are 2 layers of the face and neck to rejuvenate; the laxed visible skin AND the sagging soft tissues under the skin.
Since I do not have the advantage to examine you, I hope you will be helped by the information below. My immediate recommendations are to obtain
consultation with a talented, Board Certified Plastic Surgeon with extensive skills in:
- Surgical face and neck lift options. Based on your photos, I would recommend a Face and Neck Lift with micro-lipocontouring of the cheeks, jowls and neck, Neck suspension suture, SMASplasty and fat grafting to the cheeks. It appears that omitting the platysmaplasty may work well for you and be less costly.
- non-surgical skin tightening using Obagi ZO Skin Health Rx regimen and chemical peels
Don’t forget to protect your skin from the elements! UV blockers, anti-oxidants, pigmentation control and acne / oil reduction will maintain your skin rejuvenation efforts. Consult with a Certified ZO Skin Health Specialist!
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 trust this is helpful.
All the best!
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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.
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