Facial Rejuvenation: Your Choices

Posted Thursday, September 13, 2007 to PROCEDURES > Face

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Botox Injections

Procedure: Diminishes lines and creases in forehead and crow's feet by causing paralyses in select muscles. A simple procedure involving small injections of botulinum toxin into several locations.The needle is very fine and only a small amount of liquid is used so most patients compare the sensation to a bug bite.
Recovery: Some patients experience slight temporary bruising at the injection site, although normal activities can be resumed immediately.
Results: Can be immediate, although may take up to four days. Effects usually last 4-5 months.

Browlift

Procedure: Lifts the forehead, often resulting in a fresher look to the eyes. Through small incisions behind the forehead hairline, a small telescope is inserted and used to guide the surgeon in lifting the tissues of the forehead and brow. At the same time, the small muscles of the forehead responsible for causing frown lines are weakened so these lines are smoothed or disappear.
Recovery: Usually a week recovery, with residual swelling and bruising lasting up to two weeks. Fully recovered by 6 weeks.
Results: Approximately 10 years before normal aging continues.

Cheek and Chin Implants

Procedure: Corrects sunken cheeks or receding chin and improves facial balance. Often combined with a facelift or blepharoplasty, the incisions for cheek implants are made through hairline or lower eyelids. The incision for a chin implant is usually hidden in the mouth.
Recovery: Cheek and chin implant surgery can be followed by swelling and bruising for several days and may also result in difficulty talking and eating for a short time.
Results: Permanent unless the implant is removed.

Cosmetic Dentistry

Procedure: Corrects discolored, crooked or missing teeth. Veneers and bleaching are minor procedures that can improve discolored teeth. Veneers and crowns can be placed on existing teeth to fix badly shaped, chipped or crooked teeth and implants can be used for missing teeth.
Recovery: Usually very little recovery time is needed.
Results: Can be dramatic and are usually permanent.

Dermal Fillers (Mouth)

Procedure: Creates fuller lips with the use of fillers such as collagen and Restylane, or implants such as SoftForm. Fillers are injected into the lips or naso labial folds for added plumpness. Soft implants are inserted through small slits in the skin and can be used in the same areas as dermal fillers with similar results.
Recovery: A small amount of swelling will last the day of injection with dermal fillers. Swelling is likely for a couple of days following an implant and occasionally bruising.
Results: Not permanent and reapplication necessary between 3 and 6 months. Implants produce permanent results unless removed.

Ear Surgery (Otoplasty)

Procedure: Pins back ears. Incisions are made behind the ear to remove a thin strip of skin. The middle cartilage layer of the ear is folded back and secured in position.
Recovery: The ears are wrapped for 1 week and likely to be swollen for a few weeks. Normal activities can be recommenced within 1-2 weeks.
Results: Permanent.

Eyelid Surgery (Blepharoplasty)

Procedure: Corrects drooping eyelids or puffy bags under the eyes. The incision for an upper blepharoplasty is in the lid crease. It is made with either a scalpel or Carbon Dioxide laser (which seals blood vessels as it cuts). Skin, muscle and fat are removed. The eyelids should function normally after surgery. Incision for lower eyelid surgery can be made either inside the eyelid (eliminating external scars) or, if there is a lot of skin excess, incision underneath the eyelashes is required.
Recovery: There is usually some bruising and swelling for about 2 weeks. The final result is apparent about 6 weeks after surgery.
Results: Approximately 7-10 years before normal aging continues.

Facelift (Rhytidectomy)

Procedure: Rejuvenates the face by tightening the skin and sometimes muscles of the face, chin and neck. Incisions are made behind the hairline, and around the ear. Excess facial fat is removed and muscles are tightened.
Recovery: Depending on the extent of surgery, swelling and bruising may last a few weeks. To realize the full result may take 2-3 months.
Results: Approximately 7-10 years before normal aging continues.

Laser Resurfacing

Procedure: Lasers can diminish lines and wrinkles by removing skin in microlayers, until all damaged layers are gone - stimulating the production of new skin. Carbon Dioxide lasers can produce a dramatic reduction in wrinkles, but side effects such as redness are greater. Erbium laser has greater accuracy with less side effects, but can't treat deep wrinkles as successfully. Other lasers can treat spider veins and pigmentation.
Recovery: Usually takes 7-10 days in the case of Erbium laser, and 10-14 days for Carbon Dioxide lasers. With Erbium treatment, redness is usually mild and lasts up to 8 weeks. Carbon Dioxide redness is more severe and can last up to 6 months.
Results: If laser resurfacing is performed to sufficient depth, results may last 10 years or longer.

Liposuction

Procedure: Removes excess fat deposits around the neck. The neck area is infiltrated with tumescent fluid (containing local anesthetic and vasoconstrictor) then fine cannulas are used to remove small amounts of fat. If skin is loose, liposuction may need to be combined with other procedures (such as a facelift) for the best result.
Recovery: Swelling and bruising can last 7-10 days.
Results: Permanent.

Nose Surgery (Rhinoplasty)

Procedure: Reshapes the nose to balance with other facial features. There are two main techniques: open (incision at the base of the nose) and closed (inCisions inside nose) that can change the size of the nose, remove a hump, narrow the nostrils, change the angle and/or refine the tip.
Recovery: Most people take 7-10 days off work to allow swelling and bruising to settle. Pain is minimal and can be treated by over-the-counter pain-killers.
Results: Permanent.

The Aging Face

The specific problems the surgeon faces when performing facial procedures can be divided into two categories: gravitational and intrinsic changes.

Gravitational changes:

Gravitational changes:

• Loss of skin elasticity
• Fine epidermal lines
• Ultraviolet changes
• Hyperkeratosis
• Abnormal pigmentation
• Epitheliomas & other associated lesions
• Fat decumulation

Intrinsic changes:

• Jowls
• Nasolabial folds
• Sagging neck
• Drooping brows
• Ptosis
• Forehead lines
• Blepharochalasis
• Droopy nasal tip

The surgeon needs to formulate a plan to correct those problems capable of improvement and to stress those features that may not be significantly altered or improved by surgery. The proposed operative plan should include surgical and non-surgical approaches.

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