Total Face

Posted Wednesday, September 12, 2007 to PROCEDURES > Face

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Andrew Frost describes some of the approaches to fixing problems of the aging face.

Wrinkly and Saggy Brows

People of all ages can have problems with the brow, starting with a few forehead lines. If eyebrows are sitting in a good position, nothing particularly invasive is recommended. Botox injections and laser resurfacing can hold a forehead and keep it looking reasonably smooth before the effects of gravity set in.

When people notice the outer aspect of their eyelids becoming a little heavy, a brow lift can be worth while. An endoscopic brow lift or limited open brow lift are good approaches to this problem.

The standard for brow lifts is the open brow lift, which is an incision across the scalp or at the hairline. A deep brow lift can have some side effects, such as numbness of the scalp or a scar that the hairdresser can see. With an endoscopic brow lift or a limited open brow lift, the surgeon uses a slightly smaller incision and keeps it to the side of the scalp. People with minimum drooping of the brow, or people with tissues that aren't heavy, will find these operations work well.

People who have found that their brows have dropped to a significant degree, and for men in general, an endoscopic brow lift is not sufficient, so it's worth considering an open procedure.

The surgeon will also look at the muscles that hold the eyebrows down. They need to be released effectively with an endoscopic approach. The incisions in the scalp are small and recovery is relatively quick. If the brows are particularly heavy, it's worth considering an open brow lift to elevate the tissues and gain access to those muscles that depress the eyebrow region.

The Eyes & Crow's Feet

There are a number of procedures available for the eyes and crow's feet area. Crow's feet can be treated effectively with botox injections.

It is possible to surgically release or weaken the muscle that contracts to cause crow's feet. This is a similar operation to the upper part of a facelift or brow lift, because the muscle at the side of the eye needs to be exposed - and can be divided at the edges and separated, which very effectively and permanently eliminates crow's feet.

With the upper eyelids, removal of excess skin is an appropriate method that leaves a very fine scar on the upper eyelid. Any bulging of fat pads can be dealt with as well. This procedure can get rid of that tired or aged appearance, provided there is an excess of skin and the fat pads are bulging forwards.

For the lower eyelids, surgeons use a 'trans-conjunctival' approach. This involves removal of fat that is bulging forwards into the lower eyelids. Sometimes a reinforcement procedure can be performed on the lower eyelid tissue that helps hold the remaining fat pads back in the eye socket. Recovery takes a little longer following this kind of procedure, but in the long term can have advantages especially for people who have a reoccurrence of fat pads after surgery.

It's uncommon to find an excess of fat in the lower eyelids. Surgeons will consider using laser resurfacing to tighten lower eyelids. If the lower eyelid margin is lax or loose, tightening with a canthopexy helps support the lower eyelid margin and elevates the skin, returning the shape and appearance of the younger eye.

The Cheeks

Nasolabial folds (between nose and corner of mouth) occur because the cheek's fat (that normally sits above the cheek-bones) drops down. In the past, it's been a difficult area to effectively correct. But some of the newer techniques that involve lifting the tissues of the cheek appear to work well. To really make a difference to the nasolabial folds and the lines that run down at the corner of the mouth (known as the 'marionette lines'), they tend to be treated with a deep mid-face lift. This is an effective procedure for the cheek area.

The Jowls

For young people in their mid to late-30s, who are beginning to show a little jowling at the border of the jaw, there is not uncommonly some excess fatty tissue. A little liposuction may be all that is needed to improve that area. If there isn't much fatty tissue and there is jowling present, a mini facelift may be needed.

Often the aging face is not treated by one cosmetic surgery technique alone. A combination approach ensures facial balance and harmony and a natural result.

Add Comment