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Facelift Adjunctive Procedures

Learn About Additional Procedures Commonly Done Simultaneously With Facelift Surgery

For most patients, undergoing facelift surgery is a decision that they have been contemplating for years.

We respect the commitment these patients have made to themselves and to our practice in thus decision.

Depending on their cosmetic concerns, many patients feel that if they are undergoing surgery, it would make sense to concurrently address additional cosmetic concerns while they are undergoing anesthesia.

Furthermore, many adjunctive procedures are used during facelifts to accentuate the cosmetic outcomes for the correct patient candidate.

Of course, these are procedural options that should be tailored to individual patients depending on their goals, cosmetic concerns, and desires. These decisions should be made during a preoperative consultation and not sporadically on the day of surgery.

The following is not an exhaustive list; however, these are some of the most common procedures that are concurrently performed while a patient is undergoing a facelift operation.

Skin Resurfacing

Chemical peels are a time-tested, effective approach to treating many skin issues associated with aging — sunspots, acne scars, wrinkles (also known as rhytids), etc. There are many chemical peel options available.

Many patients may be familiar with chemical peels that they can receive at an aesthetic spa and even purchase online to perform at home (although this is not recommended). To address deeper skin and wrinkles, medium- and deep-depth chemical peels are often required.

As one can imagine, this is causing destruction of the superficial layers of the skin and can be uncomfortable to a fully awake patient. Therefore, depending on the depth of the peel, we will often perform peels in patients using various forms of sedation and anesthesia.

Laser skin resurfacing serves a similar purpose in addressing the above-mentioned skin concerns. Depending on the type of laser, these can also be associated with a fair amount of discomfort in the fully awake patient.

The decision between utilizing laser resurfacing or chemical peels is often based on surgeon and patient preference as well as the location and depth of the facial rhytids.

While a patient is sedated for a facelift, this could be a convenient time to consider a chemical peel or laser resurfacing procedure. Laser resurfacing and deeper chemical peels will lead to a fair amount of downtime because the skin oftentimes become red and swollen during the healing process.

Therefore, if the patient is already planning on staying out of the public eye, we can kill two birds with one stone.

Autologous Fat Grafting to The Face

The surgical goal of the facelift is to resuspend the soft tissue of the face, neck, and underlying fat pads to a more youthful appearance.

While this has a tremendous effect on resuspending the tissues, aging is also associated with volume loss, typically loss of fat and even recession of some of the underlying bony structures.

One of the most effective ways to restore volume is by transferring fat from the abdomen or the lower extremities to the face.

Many patients are familiar with “fillers” — Juvederm and Restylane, for example. While these are great products, they tend to dissipate within 12 months or less.

The duration is dependent on what type of product is being used and where it is placed. Autologous fat grafting is proven to be a relatively permanent method, although patients will continue to experience volume loss as they continue to age — yes, unfortunately we have not figured out a way to permanently turn back time.

Performing autologous fat grafting as an adjunctive facelift procedure does not add much more time to the facelift procedure.

The patient will typically only have one small additional incision around their umbilicus, or belly button. The fat is harvested using a cannula which suctions the fat away from beneath the skin. It is transferred to the face using tiny puncture sites through the skin.

Common areas in the face that we transfer fat to are the midface/cheeks, around the eyes, arounds the lips, around the chin, and the nasolabial folds. We tend to place more fat than is necessary because not all of it will survive after the transfer. However, the fat that is transferred will remain present for many years after the procedure.

Chin Augmentation

When patients are seeking a facelift consultation, a frequent area of concern is their jawline.

They have often lost definition of their jawline secondary to descent of their soft tissues. This is one component responsible for the “jowls,” an important aesthetic component that can really influence a patient’s final result is the projection of their chin.

When we are looking at a patient’s profile preoperatively, one of our biggest goals is to create an aesthetically appealing cervicomental angle, or the angle created between the neck and the chin.

If patients have a small or recessed chin, an implant can be placed through a small incision underneath the chin which is inconspicuous once it has healed.

Some of the happiest patients are our postoperative chin augmentation patients. This is because we can create such a dramatic result utilizing a simple, quick procedure through a single, small incision.

We typically use an implant that is tapered and looks very natural. One common concern that educated patients have is the risk of infection.

Any time we put a foreign implant into the body, there is a risk for infection. However, excellent blood supply to the head and neck region combined with using sterile technique makes infection and need for implant removal an exceedingly rare event.

Obviously, not all patients will be candidates for this procedure, however if it is a concern of yours, make sure and discuss this with your plastic surgeon.

Blepharoplasty: Eyelid Surgery

When performing  eyelid surgery, or blepharoplasty, our practice tends to divide it into upper and lower eyelid procedures.

For the eyelids, preoperatively, we need to determine if there is an excess skin issue, a muscle issue, or a fat issue. The most common issues are related to excess upper eyelid skin and what we call pseudoherniation of the orbital fat into the lower eyelid region.

Both issues contribute to the appearance of aging.

There are many ways and approaches to perform eyelid surgery dependent on what issues need to be corrected. This is why it is important to seek consultation with an experienced facial plastic surgeon.

Blepharoplasty is an extremely common procedure we perform in patients already undergoing facelift surgery. If you have concerns about your eyes and are considering a facelift as well, please make sure and discuss this with your surgeon preoperatively.

Browlift: ‘Upper Facelift’

We are amazed at how educated our patients are these days before they even walk into our office.

Most patients are now aware that the term “facelift” can be somewhat misleading.

The parts of the face that tend to be most impacted from surgery are actually the neck and the lower face.

The facelift technique that we routinely utilize, the deep-plane facelift, also has a significant impact on the midface, however this technique is not routinely utilized throughout the country because it is more technically demanding and takes time to perfect.

The forehead is not significantly impacted through facelifts.

Many patients complain that their “heavy brows” make them look not only older, but also give the appearance that they are angry and/or fatigued. The normal position for a man’s eyebrow is at the level of the bony rim above the eye. A woman’s eyebrow should rest slightly above this landmark.

If this a concern to a patient, we will offer them a browlift procedure.

There are various approaches and techniques that depend on the gender, brow symmetry, and hairline of the patient. The technique we tend to utilize — the endoscopic approach — hides a few, small incisions behind the hairline. This is a very common procedure that can be performed concurrently with a facelift to address the upper one-third of the face.

Adjunctive Body Procedures

Our clinic is comprised of a team of sub-specialty trained plastic surgeons.

This means we have surgeons who only focus on the face, and surgeons that only focus on the body. This is critical to achieving the best results possible for our patients. We have an excellent working relationship and serve many patients together.

As previously mentioned, surgery is a big decision for our patients. We have many patients that desire cosmetic body surgery to be performed concurrently with their facelift procedure. If a patient wishes, we can coordinate to have them meet both a face specialist and a body specialist surgeon on the same day of their consultation.

We know our patients’ time is valuable and we want to avoid them having to make separate trips to the clinic when it could be coordinated for the same day.

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While this is not an exhaustive list to adjunctive procedures that patients request at the time of their facelift, it does illustrate some of the procedures we commonly concurrently perform with one.

We would be happy to discuss any of these procedures at your facelift consultation depending on your cosmetic goals.

If you have any questions or would like to schedule a consultation, please feel free to give us a ring at 518-786-7000.

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