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Press release from American Society for Aesthetic Plastic Surgery (ASAPS) (February 6,
2003)
New York, NY (February 6, 2003) - Today's skilled cosmetic plastic surgeon
knows that getting the best results from any cosmetic operation requires a
customized surgical plan for each patient. Facelift surgery is particularly
challenging, since patients differ widely in their underlying facial
structure as well as the extent of their visible aging. According to an
article in the American Society for Aesthetic Plastic Surgery (ASAPS)
publication, Aesthetic Surgery Journal, there are at least ten
important considerations in designing a great facelift.
"If patients are aware of the process their plastic surgeon goes through to
develop a surgical plan, they can be more active participants in some of
these decisions," says the article's author, plastic surgeon Robert Bernard,
MD, of White Plains, NY, who is ASAPS' president-elect.
A well-designed facelift will take into account factors including:
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Hairline
Position. A small shift in the position of the hairline is considered
acceptable and usually is not noticed, but patients starting out with an
elevated hairline position may need special techniques to avoid raising it
further.
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Incision
Placement. "Many patients and their friends judge the success of a
facelift on the basis of minimally detectable scars," says Dr. Bernard.
Where to place incisions depends on factors such as the amount of excess
skin and whether the patient has pre-existing creases in front of the
ears.
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Cheek
Volume. "If the cheek area appears flat because of inadequate bony
projection, I sometimes use fat injections to provide better definition,"
says Dr. Bernard. "Implants and other materials are also available for
augmenting the cheeks."
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Fat Pad.
In rare instances, a herniated or prominent buccal fat pad, located in the
cheek area, may need to be removed or sutured at a deep level.
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Cheek Folds.
Cheek, or "nasolabial" folds are difficult to treat, but a facelift that
pulls in a vertical direction will help to restore sagging soft tissue to
its natural position in the cheek area, says Dr. Bernard. Injection with a
soft tissue filler, such as fat, may also be necessary to achieve optimal
results.
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Jaw Line.
Jowls are caused by sagging soft tissue that must be elevated. If excess
fat is present, it may be removed by suction (lipoplasty).
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"Trough."
"There is a region defined by the angle of the jaw where it interfaces
with the neck that I call the 'trough,'" says Dr. Bernard. "A shallow
trough gives the face a rounder look, whereas a deeper trough contributes
to a more chiseled look generally associated with youth and
attractiveness." Dr. Bernard recommends, when necessary, defatting this
area to give it better definition.
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Chin.
The profile of the chin plays an important role in an attractive
appearance. An overly prominent chin, "weak" chin, "double chin" or
"witch's chin" all can be addressed with additional procedures performed
at the same time as a facelift.
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Glands.
Sometimes the glands located in the neck, underneath the chin, appear
prominent and can detract from the neck's appearance. While most patients
find some fullness in this area acceptable, surgical removal or
repositioning of the glands is an option, though not without risks.
-
Neck Cords.
If neck cords appear prominent from the frontal view, correction may
require a small incision underneath the chin, nearly undetectable when
healed.
"These elements of a successful facelift do not include every preoperative
consideration in facial rejuvenation," says Dr. Bernard. "But if similar
evaluations are made regarding the eyes, forehead and skin, the final result
should be very harmonious." |
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