The eternal facelift conundrum for almost everyone goes somewhat like this:
“I want to look better, even way better. I want to look in the mirror and see that I look awake and happy instead of tired and sad. I really want that change to happen, but I don’t want people to notice that I’ve had a facelift.”
If this is what you’ve thought, you have a lot of company. If you feel a little embarrassed about saying that, you have a lot of company. The good news is that you can have it both ways – and the reasons are twofold.
First, and most importantly, the facelift must look natural, but the road to natural has to be through the vision and skill of your surgeon, not just doing less. We could do nothing and get natural, but that’s not what you’re signing up for. You’re signing up for skilled surgery, artistic vision and the ethics of someone who will treat your face as if it were their own. Let’s say you’ve found that with your doctor and you get a result that makes you look more as you did in your youth. The vitality, radiance, lift and definition of your face are back, but what will people think????
Here’s the reality. Just to bring it into perspective, let’s look at a situation most of us have experienced. You go to a gathering. You wear a lovely outfit. A couple months later, a similar event is to take place with some of the same people. You agonize because while the outfit you wore to the first event is perfect and you feel fabulous in it, you’re a little embarrassed to wear the same thing again. But think of the people who were at that event. Can you remember what they wore? Chances are that unless something particularly stood out, you can’t.
For better or worse, human nature is engineered to make us a bit more self-absorbed than we’d like to admit.
Now back to the facelift. If it looks natural, most people will just subconsciously register that you look great, or they will consciously register that you look great and will ascribe it to just about anything but surgery on your face. They will think you changed your hair. (If you actually changed your hair around the time of the surgery, all the better.) They will think you lost weight, fell in love, went on a long vacation, retired, began working out, whatever. Of course there are exceptions to this, but mostly these will be people who either have had facial work done themselves and are now primed to notice these things or people who have been thinking about it and want to have some of what you got. And in the latter case they may pull you aside and ask where you had it done. In any event, the bottom line is that if it looks good, if it looks natural and if it looks like the best version of you, your face will cause endorphins to be released in those that look at you – and that’s all good.
One of the facts of life that surprises a lot of my patients (although they invariably say something like, “Oh yeah, that’s right!” when I bring it to their attention) is just another of Mother Nature’s little ironies:
As women age, they tend to become more masculine looking in the face. Features harden and sharpen, and the soft curves of the face of their youth morph into angles.
As men age, they tend to become more feminine looking in the face. The chiseled jaw softens, sometimes into oblivion, and the strong virile features that defined their masculinity in youth seem to melt and sadden.
That is one of the reasons why facelifts, lid surgeries and even BoTox and fillers can go so awry. It’s why women can look “harder” after they’ve had work done and why men can look sort of “weird”. Those of us who treat faces need to understand that you don’t just follow your Doctor Book and approach people like a technician. It is our responsibility to understand the subtle differences that give femininity or masculinity to the face and to be able to translate that into the work we do with our patients.
The aim is to restore softness, sweetness, perhaps even a bit of an angelic look to the woman’s face. On the other hand, the aim with a man is to restore a look of strength and virility to his face. This requires an almost 180 degree turn in our approach to the two genders. And this is one of the ways we make our “work” look natural.
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.
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.
1. Use a self-tanner on your body. Jane Iredale’s Tantasia gives you an immediate bronze with just a touch of glow, and once it dries it won’t come off on your clothes. Its subtle shimmer is especially beautiful on legs and shoulders. Also, it has a lovely grapefruit fragrance for a few minutes, and then it has no odor at all! A great drugstore variety is Jergens Natural Glow. Use this every day and you’ll build up a great tan. Even if you’re fair, you can use the “Medium to Tan” tone to build up your color more efficiently. A “haute” variety is St. Tropez Bronzing Mousse. It will give you immediate color and needs to be applied only about twice a week for a consistent tan. All three give totally believable color.
2. If you use foundation, keep it sheer. Visible foundation looks dated and will accentuate any wrinkles or scars. Use a light dusting of mineral powder, a tinted moisturizer or a tinted primer to warm your natural color. One product we love is TiZO. Branded as a broad-spectrum, SPF 40 sunscreen (made with titanium dioxide and zinc oxide, ergo the name), it has a tint that’s compatible with any skin color and it has that lovely primer quality of making the skin look soft-focused.
3. Use a powder, crème or gel bronzer around the perimeter of your forehead and over your cheeks, nose and the tip of your chin. In short, put the bronzer only where the sun would hit you if you were standing. If you use bronzer all over your face, you run the risk of looking flat and muddy. Again, keep things really sheer; you want the color without the look of spackle.
4. Pinch yourself. That’s the color your blush should be. Place a pop of it right over the apples of the cheeks for a little flush of color. This step will make the face look younger and sweeter.
5. If you’re over 30, don’t try to “create cheekbones” by shadowing in hollows under the cheeks. That will backfire and be aging. What you can do to great effect is take a little shimmer powder or crème and place it on the top of the cheekbones, and even down the center of the forehead and nose.
If you’d like some help, give us a call at 941.951.2220 and set up an appointment for a skin evaluation and a make up lesson. We want you to look like the very best version of yourself and we’re here to make it happen!
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.
Bring us a photo of anything you’ve mothered – a child, a pet, a plant, your own parents – and we’ll honor you with a FREE ($150 value) IPL treatment for your busy hands when you purchase a full face IPL treatment.
IPL (Intense Pulsed Light) is the ideal way to eliminate age spots and small red blood vessels from anywhere on the body and get smoother, silkier skin as a side effect!
Call us today at 941.951.2220 and get your very own Mother’s Day treat, from now until the end of May!
A. The best way to insert soft contact lenses is to place them without stretching the eyelids. The best way to do this is as follows: Place the contact near the tip of your index finger. Make sure it's not too wet - this will allow it to grab onto your eye and not stick on your fingertip when you're trying to insert it. Get in front of a mirror and brace your third or fourth finger on your cheek without pulling down on your eyelid.
Tuck your chin down while looking up into the mirror so you've exposed as much white at the lower part of your eye as possible. Let the contact touch the lower part of the eye and as soon as it "grabs" look up as high as you can (you won't be able to see yourself at this point) and roll your fingertip up slightly to allow the top of the contact to seal onto your eye. It's really easy once you get the hang of it, and it's not that much different than the way people normally insert CL's.
To remove the contact, place the sides of the pads of your fourth fingers together, place them over your contact, and then pinch the pads together a bit to break the seal of the contact with your eye. This way, you can put them in and take them out day after day and year after year without ending up with a saggy lower lid margin down the road.
A. If your eyes seem smaller since you began wearing contact lenses, it may be that the eyes are a little dry. When the eyes are dry we sometimes squint a bit in an unconscious effort to reduce their exposure to the air. If that's the case, you may want to try a contact lens solution that is moisturizing. Opti-Free Replenish is a great solution (no pun intended) for the drying effects of contact lenses. Other than that, contacts should have no effect on the size of your eyes.
The newest Juvederm product, Voluma has been FDA-approved for use in restoring volume in the cheek area. Voluma has been shown to last up to 2 years.
If you loved Juvederm, you will love Juvederm Voluma even more! Voluma is made of hyaluronic acid (HA), a naturally occurring sugar in the body. In large part, the longevity of HA fillers has been determined by the amount of "cross-linking" of the molecules, meaning essentially how densely they're packed together. Voluma is highly cross-linked, to the point where the density of the filler allows it to last up to two years. This added density has not detracted from the smooth, silky way it goes into the face, but (aside from the fact that there is 20% more product in each syringe than there was with Juvederm's former incarnations) Voluma is definitely creating more fullness just from the density alone.
A long lasting filler with immediate results. It works with your body's own collagen to give volume that will last years instead of months.
For people who tend to "burn up" filler, Artefill offers a solution for both needle- and credit card-fatigue. This revolutionary volumizer has been around in its present form since 2006, but I have been watching it all these years to make sure of its safety profile.
Twenty per cent of each syringe-full of Artefill is made up of microspheres -- each one being 40 thousandths of a millimeter in diameter -- of polymethylmethacrylate (known by its acronym, PMMA). PMMA is an inert substance that has been used for decades in medicine, for instance in bone glue and the intraocular lenses that are put in the eyes at the time of cataract extractions.
The other 80% is bovine (cow) collagen, which is what most collagen injections were made of back in the 90's. The reason we don't use bovine collagen anymore as a filler is because it doesn’t last more than a few months.
However it has an ionic charge that suspends the PMMA microspheres the perfect distance from each other while they stimulate the body to form its own collagen around them. PS: For those of us who try to live cruelty-free, I've been assured by the company that the collagen is procured from trimming the hooves of this closed herd of cows - a pedicure, if you will.
For those of you who seem to metabolize away anything, take comfort in knowing that 20% of each Artefill treatment just can't be metabolized, so you get to keep it. Some people ask for multiple sessions over time so that the percentage of filler they retain becomes more and more of the entirety of the volume they want.
Oculofacial Plastic Surgeon, Sarasota, Florida
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