Posts Tagged ‘facelift’
Monday, June 20th, 2011
Catching a glance in the mirror or looking at a picture and seeing those sagging jowls and a droopy neck can be a troubling finding. It often seems like it came out of nowhere. I have yet to see a person find this discovery charming. While hope lies in that some magic cream or laser treatment will make it all go away, deep down inside we all know it isn’t true. (but we can dream can’t we?)
When it comes to that loose jowl and neck skin, everyone wants to avoid the dreaded word…facelift. While most people are unaware that a facelift is really just a necklift, everyone would agree that they would like as little surgery as possible. While the fears and recovery surrounding a necklift are largely overstated, one really hopes that they can get by with a ‘minimal’ procedure. This understandable apprehension has led to the nationwide branded selling of facelift surgery.
The best example is that of the Lifestyle Lift. Through their national magazine and television ads, this is a franchise approach to getting a facelift…or some version of it. I have seen many patients who know the name, but don’t really know what it is. Promising to turn the clock back at least ten years and look recovered in just a few days, its catchy name seeks to assure patients that it will fit into their ‘lifestyle’. Interestingly, and perhaps not an oversight, nowhere in their advertising does it even suggest that it is real surgery. Many prospective patients only become aware that it is surgery when they actually visit a company facility.
What is a Lifestyle Lift? While sounding new, it is really quite old and has been practiced by plastic surgeons for decades. It is a scaled-down version of a facelift, a ‘mini-facelift’ if you will. Sometimes called a tuck-up facelift, a secondary facelift, or a jowl lift, it is a limited operation that best improves those sagging jowls with a little tightening of the neck. The operative word here is a ‘little tightening of the neck’. If you have a neck wattle or turkey neck, this is not the right procedure for you.
Because it has an appealing name, the Lifestyle Lift has created a number of name knock-offs, including the Swiftlift and even the Lunchtime Lift to name just a few. Most of these are surgeons who have jumped on the naming and marketing bandwagon and have given their version of a limited facelift its own name. There is no real difference in the procedure or in whom it is or is not most beneficial.
Because it is heavily marketed and the internet exists, the Lifestyle Lift has its share of critics. Much of this has to do with trying to make an individualized custom operation into a factory line retail product. As an operation, however, limited types of facelifts do have a valuable role in facial rejuvenation. Not every patient needs or wants a full facelift.
Facelifting is not an operation that should performed the same on everyone. Nor does having a catchy name mean it leads to better results or a quicker recovery. Many plastic surgeons offer similar limited types of facelifts that just don’t have a branded name, but that doesn’t make them any less effective or useful.
Dr. Barry Eppley
Indianapolis
Tags: dr barry eppley, facelift, indianapolis, lifestyle lift, necklift
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Saturday, May 28th, 2011
Q: I had a SMAS facelift earlier this year in February. I also had my eyelids done as well. I have several problems from this surgery. My eye opening is smaller than before and one of my lower eyelids is hanging down. In addition, you can not tell that I have had a facelift. It doesn’t look different or improved at all. The Dr. said he will not redo it. Will I have to get a complete facelift again? Do you do redos?
A: Anytime there is an outcome that does not meet a patient’s expectations, it is important to determine why. There are only two fundamental reasons; there has been a complication that mars an otherwise acceptable result or there has been a fundamental miscommunication between the doctor and the patient as to what to expect afterwards. Having one lower eyelid than hangs down or is pulled away from the eyeball after surgery is known as ectropion. That is a postoperative complication that can occur after a lower blepharoplasty. If it is a small amount of ectropion and it is not that far out from surgery, then time and patience are acceptable for now. But since it is four months after surgery and there is still some noticeable lower eyelid malposition compared to the other side, revisional lower eyelid surgery may be needed. Why you see no result from your facelift is another matter. That would be an unusual outcome given the nature of how a facelift is performed. I think you need to go back and discuss your results with your original plastic surgeon. Most likely what he said was that he would not revise or redo your surgery at just 4 months after surgery. A different answer may be forthcoming with more time and if your lower eyelid ectropion persists. Only after you have given the original surgeon ample opportunity to come to a mutually acceptable decision should you pursue an outside opinion for revisional surgery.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, ectropion after lower blepharoplasty, facelift, indianapolis
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Saturday, May 21st, 2011
Q: I am 45 years old and have been frustrated with the appearance of my jowl area. I am interested in improving that part of my face. I want to learn more. What is the recovery/healing time? Can anything go wrong during procedure? Thanks
A: Sagging of the jowl area is a natural part of aging and is often the first area of the face to fall. Provided that the neck is not also sagging, and it often isn’t early on, a modified or limited type of facelifting procedure is used. Known by a variety of branded and marketed names, which imply rapid recoveries and minimal interruption in your lifestyle, it is a jowlift or a mini-facelift. Because it is a scaled down version of a facelift, it is a much shorter procedure to undergo and the recovery is likewise much quicker…like in the one week range. Recovery in this limited type of facelift is largely social in how one appears. (bruising, swelling) Other than the typical surgical risks of bleeding, infection and adverse scarring, there is nothing else that can go wrong of any significance. None of these risks have I ever seen in this jowl lift procedure.
The good thing about this jowl lift operation is that it is a solution that is well matched to the size of the problem. Jowling is a relatively minor facial aging issue and therefore it does not need a major operation for its improvement.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, indianapolis, jowl lift
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Thursday, March 31st, 2011
Q: I am interested, I think, in some fillers, Botox and perhaps a partial facelift. What I would like to achieve is a firmer jawline, reduce my crow;t feet and just have a refreshed look. I am attaching some pictures for you to review and give me your recommendations. Thanks!
A: Thank you for sending your pictures. I have done some imaging looking at firming up your jawline. You hve the typical jowling the comnes with aging and this also creates a prejowl indentation as the jowl sags. That is best corrected by a lower facelift (neck-jowl lift) and adding in a small chin-prejowl implant to bring the chin out slightly (yours is a little short) and filling in the prejowl deficiency. The combination of these two makes for a smooth jawline. At the same time, I would place some fat injections in the nasolabial folds (lip-cheek grooves, parentheses) as this is the best ‘filler’ to use when you have are doing a facelift as it is the only filler that potentially can be more permanent. Botox for the crow’s feet can be done either during a facelift or anytime in the office. Just for the sake of one additional suggestion, I have also imaged a rhinoplasty by doing some nose narrowing and lifting the tip a little as this can also have a rejuvenating effect as one gets older.
These computer images will help you think more about what can be done for a refreshed look.
Dr. Barry Eppley
Indianapolis Indiana
Tags: chin-prejowl implant, dr barry eppley, facelift, indianapolis, rhinoplasty
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Sunday, March 27th, 2011
Q: I want to thin out my face and am thinking of having a facelift to initially tighten my skin and then my cheekbones (zygomas) cut and narrowed. The reason I am considering zygomatic reduction and face lift is to first “trim” excess skin for maximum tightening of the jowls, nasolabial region, cheeks and neck. Then narrow my face with zygomatic reduction, perhaps including the arch and the zygomatic body itself. I was hoping to improve skin definition below zygomatic arch and angularity of the jaw first, than schedule second surgery afterwards. Do you think it is a good plan for my case? Thank you kindly.
A: While I don’t have the advantage of looking at your facial pictures, I think your plan is fundamentally fine but it is planned in reverse. You want to do any skeletal or underlying foundational surgery first. The reason being is that such surgery causes a fair amount of external swelling which will stretch any tightened skin, potentially reversing some of the effects of any skin tightening procedure. Maximum tightening of the jowls cheeks and neck (facelift) should, therefore, be done after the bone foundation has been treated.
When considering zygomatic reduction, it is important to know if it will produce much of effect. This can be assessed by locally at plain film x-rays, particularly a submental and/or a water’s view. These simple films give a visual assessment of how significant the curve is on the zygomatic arches. That will have to be ordered through a hospital or any free-standing x-ray facility where the appropriate equipment exists.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheekbone reduction, dr barry eppley, facelift, indianapolis, plastic surgery of the cheeks, zygomatic reduction
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Monday, February 21st, 2011
Q: Hello, I am looking the best procedure for diminishing marionette lines, over lips, and most importantly, droopy skin on the neck. What do you recommend?
A: In reading your question, I am going to assume that you mean marionette lines that start at the corner of the mouth and hangs over the corners. (hence the phrase ‘over lips’) When you combine those aging facial features with droopy neck skin, you are talking about a combined neck-jowl problem. Heavy marionette lines that hang over the mouth corners indicates that there is likely some jowling and skin that is falling forward and down…the reason thaty most marionette lines exist. While I obviously have not seen any pictures of you nor have examined you, all of these aging facial issues point to one and only one effective treatment option…some version of a neck-jowl lift. The key issue is the droopy neck skin. Nothing short of this type of a tuck or lift can change a loose neck skin issue. This is often combined with a corner of the mouth lift to get rid of the overhang, a small little procedure done at the corner of the mouth. This will most effectively get rid of the loose neck skin, ‘over lips’ and decrease the depth of the marionette lines.
It would be helpful to see some facial photographs or come in for an evaluation to confirm this potential recommendation. These are common facial aging problems where patients are often searching for some ‘simple’ or non-surgical approach where such treatments do not really exist. You want to avoid wasting money on any non-surgical treatments that really have no hope of making a substantive difference…and there are lots out there that sound good but don’t work very well.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, facelift, indianapolis, neck-jowl lift, plastic surgery of the neck
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Saturday, February 19th, 2011
Q: I am 52 years old and have myasthenia gravis. I had a thymectomy 23 years ago and currently have very minimal symptoms. I am interested in reducing the appearance of aging, especially in the neck and jowls. Is the IGuide or another minimally invasive procedure recommended for patients who have myasthenis gravis? If not, what are my options to improve my appearance?
A: Having the condition of myasthenis gravis (MG) poses potential issues for anesthesia for surgery but not for the surgery itself. You are likely interested in minimally invasive facial surgery because of its often association with local anesthesia and potential avoidance of general anesthesia. What you want to avoid with any form of anesthesia is a myasthenic crisis. This occurs when the muscles that control breathing weaken to the point that ventilation is inadequate, creating a medical emergency and requiring a respirator for assisted ventilation. This is most likely to occur in those MG individuals whose respiratory muscles are weak. This does not appear to an issue for you whose has minimal symptoms. Nonetheless, it is best to avoid any form of general anesthesia particularly for elective cosmetic surgery.
The IGuide neck procedure, a more limited type of necklift (e.g., Lifestyle Lift) or both done together are procedures which are effective in individuals with early to moderate neck aging issues. Whether any of these are good procedures for your neck and jowl concerns can only be determined by doing an assessment of some photographs. They can be very successfully performed under local anesthesia supplemented by either oral or light intravenous sedation.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, iguide, indianapolis, myasthenis gravis, necklift, plastic surgery of the neck
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Tuesday, February 8th, 2011
The development of a droopy neck and saggy jowls is loved by few…and is the bane of many women and some older men. Much can be found that promises to improve it from creams, exercises, laser and light therapies, and even the occasional clothespin approach. But we all know deep down inside that such hope only benefits the manufacturers and sellers of these products…and the only lifting that gets done is usually from your wallet.
While surgery is the only effective option for that loose neck and jowl skin, everyone would like to have as little surgery as possible and avoid hearing that dreaded word…facelift. While the fears surrounding a facelift are largely unfounded, people would certainly like to avoid that consideration if possible. This facelift phobia has led to the emergence of the concept of the branded selling of facelift surgery.
The most well-known current example is that of the Lifestyle Lift. Through their national magazine and television ads, this is a franchise approach to getting a facelift…or some version of it. Promising to turn the clock back at least ten years and look recovered in just a few days, its snazzy name seeks to assure patients that it will fit into their ‘lifestyle’. Interestingly, nowhere in their advertising does the company suggest it is actual surgery. Somehow the concepts of surgery and lifestyle are incongruous. I have seen numerous patients who have visited their facilities and were surprised to learn that it was actually an operation that requires some recovery and a temporary change in their lifestyle.
In reality, the Lifestyle Lift is an operation that is decades old and is practiced by most plastic surgeons. This ‘mini-facelift’ operation has now cloned many spinoffs including the Swiftlift and Weekend Lift to name just a few. Often touted as being innovative and original by the advertising surgeon, the names suggest that getting a fresh, younger look is really easy…or at least is quick for the surgeon to do.
Like many things that are heavily marketed, the Lifestyle Lift has its share of proponents and critics. An internet search will quickly bare that out. As an operation, however, limited types of facelifts do have a valuable role in facial rejuvenation. Not every patient needs or wants a fuller or more complete type of facelift.
Facelifting is not, nor should be, an operation that is performed the same on everyone. ‘Mini-facelifts’ are best reserved for patients with earlier signs of aging, not advanced problems such as turkey necks. A catchy name does not necessarily make the procedure novel or unique. Many plastic surgeons offer similar type facelift procedures that just don’t have a branded name, but that doesn’t make them any less effective or useful.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, indianaoplis, plastic surgery of the aging face
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Thursday, November 18th, 2010
Turkey and Thanksgiving go together like no other holiday and food combination. While there is no evidence that it was ever actually served at the first pilgrim’s festival, it became a mainstay shortly thereafter. While many will anxiously await for their share of the turkey this holiday, whether it is a leg, breast or stuffing, no one aspires for the turkey neck.
This fleshy fold of hanging skin, known as the neck wattle in the bird, appears in people as well. While in turkeys it occurs mainly in the male, in humans the turkey neck is not gender specific. As we age, the appearance of one’s neck often becomes a bothersome issue. The loss of a once smooth jaw line and a shapely neck shows the effects of gravity and time. Catching one’s profile in a picture can sometimes be disturbing…who is that older person with such a floppy neck?
While creams and other potions do much to alleviate’s one’s pocketbook, the turkeyneck is otherwise a surgical problem. Forget about non-invasive options or ‘lunchtime’ type procedures. These simply will not work for the dangling neck no matter how they are marketed or hopeful one is. For the full neck with good skin, and if one is young enough, good results can be had with liposuction alone. But when the skin is loose and floppy, fat removal alone with only make the neck skin more loose and floppy.
If you can grab a wad of neck skin and fat between your fingers, then some form of a facelift procedure is what is needed. Using the term facelift can be confusing as this procedure often conjures up images of extensive surgery from the forehead down to the neck. In reality, a facelift is really a neck and jowl operation and does not affect the face above the jaw line. It is a poorly named procedure and the term necklift would more accurately describe it than calling it a facelift. It is really less extensive and easier to go through than most people actually think.
When it comes to facelifts (aka necklifts), there are numerous options.Which one is best for any particular person is determined by how much loose neck skin one has. Some jowling and a little loose neck skin may only need a limited facelift. (often called the Lifestyle Lift) If there is a lot of loose neck skin, then the more complete facelift is really needed. This is a powerful neck changer and can produce some really dramatic results. For those that want the least invasive amount of surgery but with a dramatic change, the turkeyneck can be directly cut out in a procedure appropriately called the direct necklift.
The turkeyneck is not a desired culinary item on the bird and many people don’t like it on themselves either. While year round turtlenecks are always an option, a little skillful carving may be a better solution.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, indianapolis, neck wattle, necklift, plastic surgery, turkeyneck
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Thursday, November 18th, 2010
The association of turkey and theThanksgiving holiday goes back for over three hundred years. While there is no real evidence that it was ever served at the first pilgrim’s festival, it became a mainstay shortly thereafter. While many people will anxiously await for their share of the turkey this holiday, albeit a leg, breast or otherwise, nobody aspires to have a turkey neck.
This well recognized fleshy fold of hanging skin, known as a wattle in the bird, appears in people as well. While in turkeys it occurs mainly in the male, in humans the turkey neck is not gender specific. For some, the neck is often one of the biggest areas of concern as one ages. The loss of the once smooth jaw line and a more well-defined neck angle are telltale signs of the effects of gravity and time. The turkey neck is just an advanced stage of neck aging as it eventually flops from side to side in the older patient.
While year round turtlenecks are an option, it is otherwise a surgical problem. Forget about non-invasive options or ‘lunchtime’ type procedures. These simply will not work for the turkey neck no matter how they are marketed. If the neck and jowls are made up mainly of fat with good skin, as usually occurs in the younger patient, then good results can be had with liposuction alone. But when the skin is loose and floppy, fat removal alone with only make the neck skin more loose and floppy
If you can grab a wad of neck skin between your fingers, then some form of a facelift procedure is what is needed. Using the term facelift can be confusing as this procedure often conjures up images of extensive facial surgery throughout the whole face. In reality, a facelift only effects the neck and jowl area and will do nothing for the face above the jaw line. It is a poorly named procedure and a facelift should be called a neck-jowl lift. It is really less extensive and easier to go through than most people actually think.
In actuality, there are only two types of facelifts… limited and full. Which one is best for any particular6 person is determined by the amount of loose neck skin that one has. If the loose neck skin is not extensive, a limited facelift may be enough as this lifts the loose jowl skin a lot and the loose neck skin a little. If there is a lot of loose neck skin, then a full facelift is really needed. This is the most powerful neck procedure and can produce some really dramatic results. The differences between the two are how much of an incision is needed around the ear and the number of days of recovery needed. (even though the recovery is really about how you look or a social issue, there is next to pain at all for either)
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, indianapolis, neck wattle, plastic surgery, turkeyneck
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