Tag Archives: facial rejuvenation

Brow Lift or Eyelid Lift? Maybe Both

Brow lift with or without eyelid lift

 

As in any job, cosmetic plastic surgeons often see the same plastic surgery condition again and again.

I have written about brow lifts or forehead lifts in the past.

https://tavmd.com/2011/12/30/brow-lift-surgery/

 

Brow lift  and eyelid photo

Today I want to tell you about the decision-making process a cosmetic surgeon uses to determine whether a cosmetic surgery patient with excess skin on the upper eyelids needs an eyelid lift, blepharoplasty, a  forehead lift or both.

 

Eyelid surgery

As we age, our eyelids, like other parts of the face, change due to a number of factors, including:

  1. environmental damage—sun exposure
  2. genetics—thinness of the skin
  3. individual factors —what your anatomy is like

 

The skin of the eyelids is the thinnest skin of the body, so the effects of aging are often seen there first, manifesting as drooping of the eyelids and herniation of fat from around eyes.

Cosmetic plastic surgery to correct eyelid droop is called a blepharoplasty. Cosmetic plastic surgeons will remove excess skin and fat from the upper and lower eyelids to give you a more youthful look.

 

Brow/forehead lift

With aging, foreheads will also droop, as brow muscles and skin become lax and allow a downward migration of structures. When the eyebrow is below the bony part of the brow, you have a droopy brow and may be a candidate for a brow lift! Drooping of the brow causes:

  1. lines between eyebrows
  2. horizontal lines across forehead due to over-activity of muscles trying to pull the brows up
  3. appearance of more skin and fullness of upper lids

Brow lifts include:

  • removal of excess skin of the forehead in the center of the brow and in the lateral areas of the brow
  • Elevation and fixation of the forehead muscles in a higher position

 

Evaluation of a patient for upper eyelid surgery or brow lift

When seeing a patient for facial rejuvenation of the upper facial area, I always start with the eyelids.

  1. I look at excess skin in the upper lids and feel the quality of the skin and see how much skin there is for excision. At the time of blepharoplasty, the excess skin is actually measured to the millimeter to be sure that not too much skin is removed and that the cosmetic patient will be able to close his or her eye!
  2.  I look at any extra fat that may be present around the eyelid. The upper lid has fat in two compartments. The first is along the width of the eyelid and the second in the corner close to the nose. Excess fat is removed during surgery.
  3. I lift up the brow and see how much of a difference that makes to the excess skin of the lids.
  • minimal difference to eyelid skin with brow elevation: there is no need for any brow surgery.
  • great deal less eyelid skin with this maneuver: patient may be a candidate for just a brow lift, as long as the brows are droopy.
  • eyelid skin is improved but not totally gone: cosmetic patient may be a candidate for both a brow lift and an upper eyelid lift.

A complete evaluation of the forehead and eyelid area is imperative for patients considering facial rejuvenation of these areas. It is important for patients to know that in some patients there is a significant contribution to droopiness of upper eyelid skin from a droopy brow, and cosmetic patients will not get the results they want if both areas are not addressed.

 

Morad Tavallali, M.D., FACS

Looking Young with Face Lift?

Face lift surgery was first performed by a certain Madame Noel in Paris, France, in the early 1900s. Since then, face lift surgery has become a common cosmetic plastic surgery that has given thousands of men and women a younger and more attractive look. But is it true that people are looking young with face lift surgery?

There are a number of posts here in which I have written about how facelift surgery and facial rejuvenation is performed.

https://tavmd.com/2013/05/10/when-to-have-a-face-lift-surgery/

https://tavmd.com/2013/04/15/face-lift-with-local-anesthesia/

https://tavmd.com/2013/06/30/face-lift-surgery-by-non-plastic-sugeons/

 

A recent study shows that what some cosmetic plastic surgeons have been telling their facelift patients for years may not really be true. For full disclosure, I have always been particularly careful to tell facelift patients that I cannot make them look younger, as I am not privy to fountain of youth secrets. As a plastic surgeon I have told my facelift patients that I am looking for a natural and rested look after the surgery. If a cosmetic patient wants to call that youth, so be it.

 Face lift photo

Face Lift study

A recent study took a number of subjects and showed them before and after photos of cosmetic patients who had undergone facial rejuvenation surgery and facelifts.

They were asked to rate patients on attractiveness and whether they looked younger after the facial surgery and facelifts.

The results of the study showed two interesting facts.

1. Face lift surgery does not make you more attractive

Attractiveness has more to do with basic facial anatomy and proportions than with aging or looseness of the skin. In fact, my plastic surgery professor taught me that some cosmetic patients were “BU”—basically ugly—and frankly beyond hope. One could pull skin tight, fill and remove fat and do all sorts of surgery, but the patient will ultimately remain BU.

 

2. Face lift patients were found on average to look three years younger

Three years is certainly not that much time, yet cosmetic patients who have facelifts do look better if they have been operated on by a skilled, board-certified cosmetic plastic surgeon. So what is going on?

 

After a face lift, patients do not look more attractive and barely look any younger. Yet face lifts continue to be performed at increasing rates, and patients seem to be happy with their surgical results. One answer may be that it is just removal of the signs of facial aging that give a rested look to the patients, who then sees themselves as looking “better” and feeling better and more confident; the idea is that it’s the inner youth and beauty that shines through.

How about that?

 

Morad Tavallali, M.D., FACS

Face lift Surgery by Non-plastic-surgeons

Face lift surgery by non plastic surgeons

Full face lift

 

Your cosmetic plastic surgeon is a human being with all the frailties that brings with it, including a little “schadenfreude.”

A few years ago, I wrote the post below about face lift surgery being performed Face lift Surgery by Non-plastic-surgeons under the trademark name “Lifestyle Lift®” face lift. We have all seen their late-night ads on TV for face lift surgery with amazing results and a seeming ease that baffles the mind of any plastic surgeon who performs face lift surgery. Turns out none of it was true!

https://tavmd.com/2010/10/22/life-style-and-lifts-in-plastic-surgery/

Here is an email I received today from Anne Cohen (whom I do not know, by the way) of a PR firm that is following what has been happening in Florida with the “Lifestyle Lift”  face lift company. I will let you read it, as last time I wrote about it I got another letter from the facelift company’s lawyers threatening to sue me for infringement of their trade name “Lifestyle Lift.” That is the problem. The company became a trade promoting cosmetic facelift with little regard for patients, results, ethics or just being good surgeons. What a shame that these types have now weaseled their way into our health care system.

Dear Dr. Tavallali,For some of my readers, Florida’s settlement with Lifestyle Lift® will be good news. For others, perhaps not.According to numerous articles on the web, Florida’s Attorney General, Pam Bondi, has announced a settlement with Lifestyle Lift® in that state. “Lifestyle Lift has agreed to change its marketing materials and practices to eliminate any possible consumer confusion about its services,” Bondi said.The Florida AG’s office has been investigating the company for several years to evaluate the accuracy and fairness of claims made through its advertising to consumers about its facial rejuvenation services. According to the Florida settlement, Lifestyle Lift® must disclose any compensation made to models used in its advertisements and materials, disclose the services performed on those models and comply with FTC guidelines regarding before and after photos used in endorsements and testimonials. The company can no longer use the term “revolutionary procedure” in its marketing.Further, Florida consumers who experienced unsatisfactory services between 6/1/09 and 6/10/13 may be entitled to a refund by submitting a claim form to Lifestyle Lift® by 9/8/13. You can download a copy of Lifestyle Lift® settlement with Florida via this link. The claim form is the final page of that document.As you may recall, in 2009 the State of New York charged the company with “astroturfing” for posting fake reviews on various websites, alleging they were written by satisfied customers. They settlement required payment of a $300,000 fine and promises not to post fraudulent reviews in the future.That’s the news for today!@
Anne CohenA Cohen Marketing & Public Relations845-901-5885 Cell212-330-8337 Office

 

 

Morad Tavallali, M.D., FACS

When to Have a Face lift Surgery

Age for face lift surgery

 

I often see patients who want to have a facelift surgery. As a cosmetic plastic surgeon, facelift surgery is one of the more common procedures I perform. Here are some articles I have written about facelift surgery:

https://tavmd.com/2010/10/28/what-is-a-full-face-lift/

https://tavmd.com/2012/10/05/face-lift-surgery-a-modern-approach/                                                   Face lift

 

One of the questions patients often ask me is, “When to have a face lift surgery?”

The answer to that question is a little more difficult than one would think!

 

Changes in skin needing facelift

There are a number of changes that make the cosmetic plastic surgery patient see changes in their face that they wish to reverse by facelift surgery. The causes are listed below, but what happens to the face to make the patient see a cosmetic plastic surgeon for a facelift?

  • Brow skin falls, with eyebrow falling under the upper part of the eye socket

  • Eyelid skin droops and fat herniates around the eyelids

  • Cheek skin and fat fall forward, accentuating the lines between the nose and mouth and causing nasolabial lines

  • Jowl skin and fat droop, causing a squaring of the face and marionette lines

  • Neck skin becomes loose and the platysma muscles separate and fall down

  • Skin color changes on the whole face

  • Facial pores become larger

  • Fine wrinkles increase in number and skin becomes rough

 

 

Timing of facial aging

How our faces age and needing a facelift depends on a number of factors, some within our control and others outside.

 

  • Genetics for facelifts

One of the most important factors for determining when to have a facelift surgery is basic genetics. Look at photographs of your mother and father and see when they lost their youthful appearance. You will see that aging occurs in stages. The skin in our faces is like an elastic band that is stretched over the years. Every decade or so, the “elastic band” breaks and we look like we have aged. How often that happens is dictated in part by genetics and hence by how our parents aged.

If by age 45 your mother looked older for her age, it’s a probability that you will, too.

 

  • Environment and facelifts

The insults you have heaped upon your skin also affect your facial aging. Sun exposure will actually destroy elastin proteins in your skin, making it sag. This also leads to abnormal skin cell maturation, which gives us skin cancers and “old”-looking skin. Wind exposure will dry out the skin, and the resulting dehydration leads to a wrinkled look. Hence the term “a weather-beaten face”! Protecting your skin is an important part of delaying the need for a facelift.

 

  • Facial skin protection to delay facelift

How you care for your skin will obviously affect the quality of your skin and delay the timing of a facelift. Creams that moisturize your skin, sunblocks that prevent the effects of the sun and creams that help the natural repair mechanisms of the skin can all help improve facial skin quality and delay facelifts.

 

What age to have a facelift at?

If you have taken the above into consideration, you will see that there is no defined age at which to have a facelift. Everyone is different. The youngest patient I have operated on for a facelift was 38 years old, and the oldest was 80! Still, the majority of the skin changes and drooping of the face skin that requires a facelift seems to occur between the ages of 45 and 60. This is when the greatest changes in our faces seem to occur. When should you have a facelift surgery? When you look in the mirror and are bothered by what you see!

 

Morad Tavallali, M.D., FACS

Lip Lifts – uplifting lips

Lip lifts improve facelifts

 

With any major facial rejuvenation procedure, such as a facelift, there are some ancillary procedures that can significantly help the patient look younger.

Here are some facelift photos to get you in the mood: https://www.tavmd.com/plasticsurgeryphotos/full-face-lift/

A facelift procedure will pull the skin of the face and tighten the underlying muscle and fat. However, other facial structures also show the ravages of time and need the attention of your cosmetic plastic surgeon.

Here is a post on facelifts: https://www.tavmd.com/2013/04/15/face-lift-with-local-anesthesia/

Areas that can be rejuvenated at the time of a facelift include:

  • Brows – A brow lift can elevate the eyebrows and help remove some of the brow lines
  • Eyelids – Blepharoplasty, or eyelid surgery, is the removal of extra fat and skin from the eyelids for a more youthful look
  • Facial lines – dermal lines can be injected with Radiesse or Juvederm or filled with a dermal graft or fat at the time of surgery
  • Rhinoplasty – nose surgery, or rhinoplasty, can frequently help elevate the tip of the nose and give a younger look to the face
  • Lip surgery – making the lip fuller or elevating the lip can improve shape and reduce signs of aging

Surgical lip lift

Although lip enlargement can give the appearance of a lip lift, in reality this surgery is used for patients who have a long lip.

As we age, the maxilla (the bone segment carrying our upper teeth) starts to erode and shrink.  In response, the lip, which used to have a more convex shape, starts to look more concave and longer.
Further, there is also an actual elongation of the lip as skin elasticity and collagen levels diminish.

A surgical lip lift is a procedure used to remove a few millimeters of skin from the upper part of the lip at its junction with the nasal alae (nostrils).
The muscle of the upper lip can also be tightened in this surgery and a contour given to the lip to create a cupid’s bow via differential excision of skin.
This can give a significant improvement to the overall shape of the lips and the face as well.

Before a lip lift; lip is long

 

Before lip lift                                                    

After a lip lift; the lip is shorter and more youthful-looking

OLYMPUS DIGITAL CAMERA

Though some surgeons use an excision on the corners of the mouth to elevate the mouth corners, I do not personally like that surgery due to the visible scarring (patients have to wear lipstick at all times) and unnatural “joker smile” it creates. The lip lift does not have either of these complications.

Surgery can be performed at the time of facelift or at another time under local anesthesia in the plastic surgeon’s office.  Sutures are removed within a week and the scar is hardly noticeable after three weeks. The result is excellent and there is no need to repeat the surgery in the future.

 

Morad Tavallali, M.D., FACS