The Ultra Lift

Posted Thursday, September 13, 2007 to PROCEDURES > Face

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

When rejuvenating an aging face, Los Angeles plastic surgeon Dr Grant Stevens combines several lifting procedures in the one surgery. Jodi Thiessen reports.

Cosmetic surgery techniques continue to advance, allowing for more successful results, shorter surgical and recovery times and fewer complications.

Due to the numerous advances, combination surgery is more feasible and is in fact giving results that are more natural and harder to detect than ever before.

In the past the trauma of surgery may have limited the amount of procedures performed in one session but now getting more done at once is not only possible but helps patients get back to their daily life faster.

Los Angeles plastic surgeon Dr Grant Stevens has combined several facial lifting procedures and coined this new combination approach the Ultra Lift. "It's a comprehensive rejuvenation of the entire face and neck," says Dr Stevens. "It eliminates the contradictory signs of the traditional segmented lift."

Previous lifts have addressed isolated areas around the face but haven't considered the face and neck as a single unit.

The Ultra Lift still addresses areas of the face individually in terms of customized treatment for each patient - only treating areas in need - but treats all of these areas at once. The components are then finally tied together with a C02 laser resurfacing. "The resurfacing tightens and smoothes the face and gives it a look that is much more uniform and consistent than the traditional segmented lifts."

The Ultra Lift divides the face and neck into the upper third of the face (brow), middle third (cheeks), lower third jowls)and the neck. The 5th area to be addressed is the skin.

Brows

For aging of the brow and temple areas an endoscopic browlift is utilized. "Using endoscopic surgery, I do a vertical lift of the temple as well as any brow repositioning that is necessary." Endoscopic surgery uses a tiny telescope that is inserted through small incisions made in the scalp. The telescope projects the anatomy onto a television screen allowing the surgeon to see exactly what they are doing.

Three small incisions are made about an inch behind the hairline. Each is about 1/2 inch long. Through these incisions two problems can be addressed: wrinkles and drooping of the brow. The forehead is elevated and any muscle muscle tightening to minimize wrinkles between the eyes is performed. "If the brow is low then I elevate it, if it isn't then I just fix the wrinkles," explains Dr Stevens.

Sagging of the temples can also create an aged look. "This is called temple hooding which crowds the lateral portion of the eyelid," says Dr Stevens. Through the endoscopic incisions the temple area can also be lifted vertically. This area is also reached through the facelift incisions (see under 'Jowls').

Cheeks

The same endoscopic incisions (and facelift incisions) are used for the vertical cheek lift. As the cheeks fall vertically, by elevating them vertically they can be repositioned to a more youthful position. The skin is elevated and the muscle and fat pads repositioned and anchored to where they used to be.

Jowls

The jowls are accessed through traditional facelift incisions. This runs in the scalp starting from the temple, retrotragel (in the ear) around behind the ear and back into the hair. Each facelift is individualized but they are all deep plane facelifts. "If the patient's problem is deep naso-labial folds (creases from nose to corner of mouth) I do a deep plane facelift all the way to the folds," explains Dr Stevens. "If the problem is primarily jowls then I address that area."

The Ultra Lift is a multiple plane facelift. The jowls are reattached horizontally as opposed to vertically as with the cheek and brow areas.

Neck

The necklift is performed through the incision running from the ear back into the hair. After removing any excess fat from the neck with liposuction if there is still the need for muscle repair and skin tightening it is done at this stage.

Laser-Resurfucing

"Using the Feathertouch C02 Laser can now safely resurface the entire face at the same time as the surgery," says Dr Stevens. The central portion of the face around the eyes, nose, mouth and chin are where most of the wrinkles and rough skin texture exist. The laser is used more aggressively in this area after the surgery.

Recovery

Patients are usually monitored overnight in a care facility. The face is dressed with i soft cotton gauze bandages for the incision sites and a Flexan ® semi permeable membrane over the lasered areas.

By day three all the dressings have been removed. By day five all the sutures are removed. "1 recommend the patient takes off between 7-10 days work. If they are able to, 14 days is even better," says Dr Stevens.

The bruising and swelling is variable from patient to patient but usually within a couple of weeks it has resolved to a socially acceptable point. Dr Stevens says: "After four weeks the patient will have a glimpse of their result but the laser provides subsequent lifting and smoothing which can take up to three months to see the final result."

Proactive Patients

Dr Stevens places all patients on a pre operative skin care regime in preparation for the surgery and a different post operative regime along with vitamins to minimize bruising and swelling. This allows patients to not only gain the maximum result because their skin is prepared and healthy, it also allows them to be involved every step of the way. One week after surgery a makeup artist analyses the skin tones as well as hair and eye color and custom blends a camouflage makeup for the patient. The second week after surgery this is adjusted as the redness produced by the laser has faded.

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