FACIAL REJUVENATION
Facial aging results from both intrinsic changes in the skin
and gravitational changes that affect the skin and deeper tissues
of the face. Intrinsic changes of the skin are largely the result
of the cumulative effect of years of sun exposure, which are
seen as a loss of skin elasticity, irregular or "splotchy" pigmentation,
and a rough texture. Any attempt to improve facial appearance
must address these issues. Treatment focuses on sun avoidance
in addition to a personalized program of skin care that can
help to reverse these changes and improve both the quality and
texture of the skin.
Obagi® skin care products are a proven means to aggressively
improve skin appearance and texture with minimal downtime. Many
patients will then benefit from a deeper treatment using office-based
Obagi® Blue Peels® to more aggressively remove layers
of sun damage and help the skin to regenerate a more youthful
appearance and texture. Personal consultations are available
by appointment for these approaches and products.
Gravitational changes are the result of relaxation of a series
of retaining ligaments that normally suspend our facial soft
tissues and provide a youthful appearance. As these tissues
relax during the aging process, the brow position drops, eyelid
fat and skin acquire multiple folds, and the eyelid area takes
on a "tired" look. In the midface, the fat of the cheek prominence
drops to deepen the fold between the mouth and nose. The lower
face loses the smooth contours of the jawline and the angle
where the neck meets the chin. Surgical correction is directed
at a restoration of these soft tissues to their original anatomic
configuration. The surgical goal is one of restoration, to make
the patient appear "refreshed", free of abnormal distortions
that can sometimes be seen with facial surgery.
The upper face, brow and eyelid areas are best approached as
a unit. Most patients that seek to improve the appearance of
their eyelids can do so only if their brow is in the correct
aesthetic position. These areas can be addressed with a combination
of browlift, often performed using short incision endoscopic
techniques, and traditional eyelid surgery that removes fat
and skin in the combination needed for each individual patient.
Alternatively, botox and soft tissue fillers can provide a less
costly alternative to improve the appearance of these areas
with much less recovery. These less invasive options, however,
do have a shorter duration of benefit and require repeated treatments.
The midface and lower face and neck can be addressed by a facelift
technique. This procedure seeks to resuspend the connective
tissue layer beneath the skin to obtain more youthful midface
contour, a smooth jawline, and increased definition of the angle
where the chin meets the neck. This approach then allows for
the skin to be redraped without tension allowing for a more
natural, less "surgical" look. The goal is to help your face
to return to its previous youthful configuration.
A personal consultation allows for an in-depth evaluation that
results in the combination of approaches that best fits your
specific needs. What follows from the consultation is a personalized
program that most often incorporates the best combination of
the Obagi® skin care program to address intrinsic skin damage,
Botox® and soft tissue fillers to address dynamic lines,
expression lines and some areas of volume loss around the eyes
and face, and surgical procedures to address gravitational changes
and volume loss to the upper face, eyelids/brow, middle and
lower face and neck. Botox and soft tissue fillers have minimal
recovery other than one or two days of reduced strenuous activities.
The surgical procedures are usually performed on an outpatient
basis under general anesthesia or sedation. Recovery usually
involves a one to two week period of activity restriction.