Face

Face

Surgical & Non-Surgical Techniques to Treat and Prevent Signs of Facial Aging

Trinity Health Of New England offers facial cosmetic surgery to address a variety of issues, including:

  • Reducing the wrinkle lines that develop horizontally across the forehead, as well as those that occur on the bridge of the nose, between the eyes
  • Improve frown lines (The creases that develop between the eyebrows)
  • Raise sagging brows that are hooding the upper eyelids
  • Placing the eyebrows in an alert and youthful position

Facial Rejuvenation with Wess Cohen, MD

Wess Cohen, MD explains the non-surgical options available for those interested in facial rejuvenation.

The cosmetic form of botulinum toxin, sometimes referred to as "Botox" by patients, is a popular injectable that temporarily reduces or eliminates facial fine lines and wrinkles. The most commonly treated areas are frown lines, forehead creases and crow's feet near the eyes. Several other areas have been treated such as thick bands in the neck, thick jaw muscles, lip lines and gummy smiles.

Botulinum toxin is a purified substance that's derived from bacteria. Injections of botulinum toxin block the nerve signals to the muscle in which it was injected. Without a signal, the muscle is not able to contract. The end result is diminished unwanted facial wrinkles or appearance. Commonly known types of botulinum toxin type A injections include Botox®, Dysport®, Xeomin® and Jeuveau®.

Botulinum toxin can be used to:

  • Smooth crow's feet, forehead furrows, frown lines, lip lines and bunny lines
  • Diminish neck bands
  • Improve the appearance of skin dimpling of the chin
  • Lift the corners of the mouth
  • Soften a square jawline
  • Correct a gummy smile

A brow lift, also known as a forehead lift:

  • Reduces the wrinkle lines that develop horizontally across the forehead, as well as those that occur on the bridge of the nose, between the eyes
  • Improves frown lines, the vertical creases that develop between the eyebrows
  • Raises sagging brows that are hooding the upper eyelids
  • Places the eyebrows in an alert and youthful position

The goal of cheek augmentation is to add volume or lift to the cheeks. Some people are bothered by their cheeks losing volume, or even sagging, with age. Others never develop the desired volume in their cheeks and are bothered by cheeks that may be considered flat or thin.

 

Options for cheek augmentation

Valid surgical options for augmenting and enhancing the cheeks are fat grafting/transfer (where a patient's own fat is used) or the use of solid cheek implants. A nonsurgical option is the use of injectable fillers to enhance the cheeks.

The goal of check reduction or buccal fat removal is to thin the cheeks, specifically in the area of the cheek hollows. Although a face that is naturally soft and filled out is considered youthful, some people find that their face feels too full, even chubby.

A buccal fat removal removes the buccal fat pad, a naturally-occurring pad of fat in the cheek hollow area. The size of the buccal fat pad varies with each individual patient, and the buccal fat pad in each cheek may be different sizes. Buccal fat pad extraction surgery is typically not performed in people with thin, narrow faces, as removal of the fat may cause the face to look more gaunt with age.

Chin surgery, also known as genioplasty or mentoplasty, reshapes the chin either by enhancement with an implant or reduction surgery on the bone.

Plastic surgery, and other minor office procedures, can often be performed on the lower jaw line and chin area to improve proportions of the face and to help with one's confidence and self-esteem.

Sometimes bone from the jaw itself can be moved forward in an operation called a mentoplasty or genioplasty. Alternatively, shaped silicone implants can be used to give more projection to the chin. Conversely, bone can be removed to decrease an overly projecting chin. Furthermore, modifications to the upper and/or lower jaw can be advised for improved chewing dynamics and occlusion – or how the teeth fit together. These operations can range from simple to very complex.

Ear surgery, also known as otoplasty, can improve the shape, position or proportion of the ear. A defect in the ear structure that is present at birth or that becomes apparent with development can be corrected by otoplasty. This procedure can also treat misshapen ears caused by injury.

Otoplasty creates a more natural shape while bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to appearance and self-esteem. If protruding or disfigured ears bother you or your child, you may consider plastic surgery.

Ear Surgery Can Treat:

  • Overly large ears – a condition called macrotia
  • Protruding ears occurring on one or both sides in varying degrees – not associated with hearing loss
  • Adult dissatisfaction with previous ear surgery

Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids.

Surgery can be performed on the upper lids, lower lids, or both.

Whether you want to improve your appearance or are experiencing functional problems with your eyelids, eyelid surgery can rejuvenate the area surrounding your eyes.

What Eyelid Surgery Can Treat:

  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
  • Fatty deposits that appear as puffiness in the eyelids
  • Bags under the eyes
  • Drooping lower eyelids that reveal white below the iris
  • Excess skin and fine wrinkles of the lower eyelid

A facelift, or rhytidectomy, is a surgical procedure that improves visible signs of aging in the face and neck, such as:

  • Relaxation of the skin of the face, causing sagging
  • Deepening of the fold lines between the nose and corner of the mouth
  • Fat that has fallen or has disappeared
  • Jowls developing in the cheeks and jaw
  • Loose skin and excess fat of the neck that can appear as a double chin or "turkey neck"

The loss of youthful contours in the face can be due to a variety of factors, including thinning of the skin, loss of facial fat, gravity, sun damage, smoking, as well as heredity and stress.

Other procedures that might be performed in conjunction with a facelift are brow lift and eyelid surgery to rejuvenate aging eyes. Fat transfer or fillers may be suggested to replace the lost fatty volume.

Dermal fillers help to diminish facial lines and restore volume and fullness in the face.

As we age, our faces naturally lose subcutaneous fat. The facial muscles are then working closer to the skin surface, so smile lines and crow's feet become more apparent.

The facial skin also stretches a bit, adding to this loss of facial volume. Other factors that affect the facial skin include sun exposure, heredity and lifestyle.

 

Dermal fillers can:

  • Plump thin lips
  • Enhance shallow contours
  • Soften facial creases and wrinkles
  • Improve the appearance of recessed scars
  • Reconstruct contour deformities in the face
  • Decrease or remove the shadow of the lower lids

Dermal fillers can be very helpful in those with early signs of aging, or as a value-added part of facial rejuvenation surgery.

A neck lift, or lower rhytidectomy, is a surgical procedure that improves visible signs of aging in the jawline and neck.

 

A Neck Lift Can Treat:

  • Excess fat and skin relaxation in the lower face that creates jowls
  • Excess fatty deposits under the chin
  • Loose neck skin
  • Improve the appearance of recessed scars
  • Reconstruct contour deformities in the face
  • Muscle banding in the neck, which created abnormal contours

The loss of youthful contours in the face and neck can be due to a variety of factors, including heredity, gravity, environmental conditions and stress.

Some people feel they are not ready for a full facelift because the upper face is still pleasing. However, many patients will note excess wrinkling of the neck skin, a double chin or "turkey wattle" and jowl lines.

When the neck area doesn't match the upper facial appearance, a neck lift may be a good solution.

Rejuvenation procedures that can be performed in conjunction with a neck lift are: a brow lift, to correct a sagging or deeply furrowed brow or eyelid surgery, to rejuvenate aging eyes.

A chemical peel uses a solution that improves the texture and tone of your skin by removing the damaged outer layers.

Chemical peels can also be used to improve the skin on your neck and hands. Sun exposure, acne or aging can leave your skin tone uneven, wrinkled, spotted or scarred.

A chemical peel can improve:

  • Acne or acne scars
  • Fine lines and wrinkles
  • Irregular skin pigmentation
  • Rough skin and scaly patches
  • Sun-damaged skin

A chemical peel will not:

  • Treat deep facial lines or wrinkles
  • Significantly tighten loose or sagging skin
  • Remove deep scars
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