Can All Of These Aesthetic Facial Surgeries Be Done At The Same Time?
Q: Dr. Eppley, I am interested in the following proceduers: Face Lift, Neck Lift, Brow Lift, Temple/Brow and Cheek Fat Grafting or Implants, Lip Lift, Tracheal Shave, Laser Skin Resurfacing.
Can all these procedures be reasonably combined in a single surgery?
My specific questions about these procedures are:
Face Lift- do you perform Deep Plane and or Vertical facelifts?
Brow Lift- I’m interested in having the “tails” or outer corners lifted
Eye area loose and sagging in general
Temple Filler- I’m interested in either Temple/Brow and Cheek Fat Grafting or Implants.
Lip Lift- Can I get a Lip Lift without increasing the size of my upper red lip? When I lift the center of my upper lip (with my finger) it leaves the outer corners of my lower lip sagging downward (frowning) and open. Will the facelift raise my lower lip and mouth area or is there another procedure to address this area? My mouth area is sagging in general.
I’d like to make my cupids bow slightly more narrow and raise/accentuate my vertical philtral ridges and white roll. I’d like to improve the delineation between the red border of my lips and the white of the skin surrounding my lips.
Neck Lift and Tracheal Shave- Does having a Tracheal Shave done simultaneously with a neck lift limit how tight the neck lift can be?
How are the vocal cords located and protected for the tracheal shave? Can you use a burr instead of knife if necessary on older patients with harder thyroid cartilage? What method of scar treatment is recommended if needed for tracheal scar revision?
Can I get wound healing treatments at the time of my surgery.
Laser Skin Resurfacing- I’m interested in the most effective method of skin resurfacing and skin lightening to have done at the same time as my facelift to take advantage of my facelift recovery down time.
A: In answer to your aesthetic facial surgery questions:
1) All of the procedures you have mentioned can be done in a single surgery with one caveat….when laser resurfacing is done with any form of facial lifting it must be done more conservatively than if done alone because of blood supply and potential healing concerns.
2) The facelift technique I use depends on what the patient’s aging tissue optimally needs…not every facelift technique is for every patient.
3) Males are generally better served by tail of the brow lifts and not the whole brow which feminizes the face.
3) For the temples subfascial implants are superior to fat grafting.
4) By definition you can not do a lip lift and not increase the prominence of the cupid’s bow or red part of the central lip.
5) A facelift is not going to raise the sagging corners of the mouth. That requires a direct corner of the mouth lift to change.
6) Without a vertical prolabial scar you can not narrow the distance between the philtral columns.
7) White roll accentuation requires the placement of either filler or some form of a graft underneath it to cause it to become more pronounced.
8) A tracheal shave does not limit the effectiveness of a neck lift.
9) In performing tracheal shaves the key in protecting the vocal cords is to not over do the resection which can destabilize the two halfs of the thyroid cartilage. This has never yet been a problem I have seen.
10) In most older patients it is necessary to use a burring technique due to the partially calcified cartilage.
11) Laser resurfacing is the likely needed technique for tracheal scar revision.
12) When you refer to wound healing treatments you are likely referring to PRP or other wound healing agents. (e.g., BioBlast)
13) I refer you back to answer #1. The most effective laser resurfacing treatment is one done in isolation not where extensive skin undermining has been simultaneously preformed.
Dr. Barry Eppley