What can I do to take years off my face?

Dr. Dean Kane Q & A.

Q.  After ten years of a very stressful life, I have decided to invest in me! I lost my only child at age nine to brain cancer medullablastoma then 13 months later lost my husband to a brain aneurysm then my brother passed with liver cancer and last March loss my dad. The toll on me is self evident, it is written on my face, please tell me what can be done to take away the imprint these losses have left me with. Not happy with what I see, I’m ready to write the rest of my story. A.  ​​​I am sooooo sorry for your losses! Congratulations on pulling yourself up and moving on! Thanks for sharing your photos with us. ​ ​Your best initial option will be a face and neck (with platysmaplasty) lift. Depending on the skills of the surgeon, a modified face and neck lift without platysmaplasy will be less expensive and give you a great new start. ​ ​Thereafter, consider extending the outcome of your surgery with minimally and non-invasive options. I have added a long winded discussion…. ​ ​Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below. Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material. Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift. Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed. The most popular of the fillersRestylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting “cousin” Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial (“parentheses”) and marionette folds, the brow (“number 11”) lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic! Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well. Scuptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent. Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles! Dr. Obagi’s new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation. If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin. You may consider: a traditional face and neck lift, short scar face and / or neck lift. The recent resurgence of the S-Lift (created in the early 1900’s), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the “quicker” procedure but not necessarily the quicker recovery or the improvement you desire. Face lift and / or neck lift or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills. ​ I wish you the very best!​
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