The term “liquid facelift” refers to plumping up the face where it has lost volume by the injection of fillers. While fillers can have beautiful results when given expertly and artistically, “liquid facelift” is a term that can be misleading by suggesting surgical results without surgery.
While fillers may be used in the neck area occasionally, in the vast majority of cases the aging of the neck is due more to inelastic skin, gravity, excess fat or skin in the neck and/or the edges of neck muscles forming the “bands” that run vertically down the front of the neck.
In the case of inelastic skin, collagen and elastin in the skin have broken down. This requires rejuvenation of the skin, and neither surgery nor fillers will fix it. For the other aging changes of the neck surgical repair is almost always necessary for an optimal result.
Excess fat can be removed by several techniques and the neck can be surgically tightened so that instead of hanging down, the muscle actually serves as a suspension to hold the neck in a youthful contour. Most often, especially once a person has reached a certain point in the facial aging process, surgical repair of the neck becomes part of an overall facelift. These procedures are done in tandem to achieve harmony and the ideal proportions between the face and neck.
Lastly, with expert surgical technique and a truly artistic eye, a facelift and neck lift will look entirely natural without sacrificing any of the rejuvenation.
If you are interested in this process and want to find out more, please contact us at 941-951-2220.
What to do about those dreaded jowls?? Early on, they’re often caused by volume loss in the face, especially some of that 20% of skull mass that we eventually (and quite normally) lose over our lives. This is how it works: There’s a little ligament, about ½ inch wide, on each side of the chin just where those “marionette lines” form. It’s very tight between the bone and the skin – and it stays tight as our skull starts to become smaller, a process that generally begins after about age 25. This is mostly what creates that first indentation of a marionette line and also the indentation on either side of our chin at the jawline that makes the area just next to it look like a jowl. This is what we call a “pseudo-jowl” and it usually can be smoothed out nicely with a filler. As we proceed to age not only does that process continue, but we also accumulate some fat at the jowl, and other tissues stretch and slide down to form a real, live standard issue, pseudo-no-more jowl. Sometimes people attempt to keep filling the indentation up as the jowl enlarges. That’s when the face can look boxy and distorted – we’ve all seen it – because the actual cause hasn’t been addressed. This is when gravity has superseded the volume loss issue and a facelift is indicated. The volume still needs to be addressed or people can look windblown, but the important thing is for your doctor to know the difference, address the proper condition and do it safely, skillfully and with artistic vision.
If you need help deciding between a facelift or fillers, click here to contact us for an appointment.
1.You have significant vertical “bands’ at your neck.These bands, sometimes called a “turkey wattle”, are the edges of a neck muscle (the platysma muscle). If the bands are very small, sometimes they can be kept at bay with BoTox, Pelleve or Ulthera, daily passive stretching of the neck or a combination of these; however, most of the time they require surgery to fix them definitively.
2. Your general facial shape looks as though it’s shifted from oval or heart-shaped to square over the years.This is gravity at work, and a good facelift will shift that contour change back so the fullness is through the midface and not hanging from your jawbone.3.Your skin is in good shape and it’s the falling of the lower face and neck that’s the problem, not wrinkles.No matter what misleading advertisements you may have seen, a facelift is not going to change your skin texture, at least not after the initial swelling has gone away. That’s what lights and lasers are for – shrinking and resurfacing the skin – and rebuilding collagen and elastin. Wrinkles occur from DNA changes in the skin along with breaking down of the collagen and elastin. Surgery with a scalpel won’t change the skin. A lift is exactly that – it will pick up what has fallen down, but it won’t alter the make-up of your skin.4.When you cup your hands under your chin (so the wrists meet), place your fingers on the sides of you face and then lift up gently, you look much better. Don’t worry about the wrinkles you push into being at the sides of your eyes. You’re pushing; a facelift is shaped from the inside out and nothing is pushed, so unless your skin has lost its elasticity (see above), a well-performed lift won’t leave you with more wrinkles there than you had before the lift (although a bad one certainly can).5.Generally, you’re at least 45 years old, and more likely over 50.Nothing is without exceptions, and genetics and lifestyle choices can always throw off the norms. That said, I’ve seen way too many women in their early 40’s (one was even 36!) who had been advised by plastic surgeons that they needed facelifts when all that was going on was some volume loss. On the other hand, I’ve seen a lot of women long past their forties who really needed facelifts, but they had been pumped up with fillers until they looked stuffed. (See my blog, Jowls: Facelift or Fillers?)If you think you might benefit from a facelift, look at these five indications and then have an evaluation by someone with the skill, the artistic vision and the integrity to advise you properly and make you your most beautiful. Click here to contact us for an evaluation appointment.
What is it exactly that is happening when our skin sags and wrinkles? The answer may be complex, but most of it boils down to loss of collagen and elastin fibers in the skin. We have known for years that if we cause a “micro-injury” to the skin – just enough to stimulate an exuberant healing reaction – we can end up with that healing reaction creating better skin than we had before it was “injured”.
Microneedling is based on that principle and is producing significant results for mild to moderate wrinkling, laxity, coarseness and acne scars. It is a potent collagen stimulator, can be used anywhere on the body and requires no downtime.
In the office, the face is thoroughly cleansed and a numbing cream is applied for 20 to 30 minutes. The procedure uses a “Micropen” that has tiny needles at its tip. The depth to which the needles go is tailored to each individual and to different parts of the area being treated. The procedure is enhanced by use of a gel containing growth factors that are driven into the skin by the needles. For an even more intense treatment, some people prefer to use platelet-rich plasma (PRP), which is rich in your own growth factors. Most treatments take about 30 minutes and you will look a little rosy for a day.
Over the next three days your skin will be a little flakey, but it’s not bad. Amazingly, the tightening, the improvement in texture and the smoothing of wrinkles and scars will be visible quite rapidly. Some of that is due to imperceptible swelling, but over the next few weeks the improvement becomes obvious. While three to four treatments about four weeks apart are recommended, the result is cumulative and you will see improvement after the first time.
Oculofacial Plastic Surgeon, Sarasota, Florida
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