HEAD & NECK

Face Lift

The aging face reflects the tired, drawn-out appearance of aging. Gravitational changes and the effects of deflation are accentuated, producing significant bulges and irregularities from the lid-cheek junction down to the jawline. During your extensive consultation Dr. Sasaki will not only demonstrate these findings, but also explain the various reasons for their occurrence. He will then provide you with realistic surgical options to address each of these areas. The end-result is a natural age-appropriate appearance that you will appreciate for many years to come.

A face lift technique in a younger patient is different from that for a more aged face. Although younger patients present with tighter and firmer skin, they frequently exhibit increased laxity of structures below the skin. In this case, Dr. Sasaki may suggest an endoscopic surgical approach through small hidden incisions behind the hair line for facial rejuvenation. On the other hand, if there exists a small, but still significant amount of skin excess, Dr. Sasaki may recommend a hidden short scar incision in front of the ear to elevate the drooping deeper structures and adjust the skin for your new, natural and age-appropriate refreshed look.

A face lift procedure in an older patient, who presents with laxity to the skin and deeper structures, including the cheek fat pad and muscle, will require more extensive surgery to individualize the elevation and fixation of the lax skin, as well as the repositioning and tightening of the cheek fat pad and adjacent muscle. This type of facelift requires an incision in front of the ear. In the more advanced aged face, a lower lid blepharoplasty and other selected volumetric procedures may be indicated to restore a natural, fuller and age-appropriate refreshed look. Some patients prefer more stable foreign materials to augment their faical features such as silicone anatomical implants for the flattened nasal profile, low profiled cheeks, and poorly projected chins. These implants may be safely and quickly inserted under local or general anesthesia.

An endoscopic face lift procedure may be recommended for younger patients whose skin is still firm and tight. Through two small incisions behind the temporal hairline and another short incision inside the mouth just above your canine tooth, an endoscopic camera and long narrow instruments free all facial tissues away from the cheek bone in a safe manner. A number of absorbing sutures and/or an absorbing device elevates and anchors the tissues for your natural and rejuvenated appearance.

An endoscopic face lift takes about two hours to perform under general anesthesia at the hospital. Since there is no facial dressing or drains, you may shower and wash your face daily after surgery. You should eat softer foods for about a week. You are advised to rinse your mouth frequently with salt water and brush your teeth after each meal to reduce the normal bacterial levels in your mouth. You can expect a slight amount of facial swelling for about a week. The sutures inside the mouth are absorbed on their own. The skin incision sutures are removed within ten days after surgery.

Dr. Sasaki may recommend a complete face lift procedure for more mature patients who reveal drooping skin, cheek fat pad and platysma muscle. The incision begins with a short horizontal incision within the hair of the sideburn, follows the crease line in front of the upper ear, goes inside the well of the ear, and exits out along the crease line of the ear lobe. The deeper stable layer, named the superficial muscular aponeurotic system, is elevated and tightened to address the prominent marionette fold, extending from the corner of the mouth down to the mandible and the jowl. A single suture suspension system, developed by Dr. Sasaki, is passed from a dot incision within the nasolabial line, capturing and elevating the cheek fat pad back to its normal location over the cheek bone. Liposuction may be recommended above and below the jawline to provide a more contoured and sculptured look. Lastly, the freed skin is gently tailored and approximated to its opposite side in front of the ear to give you a natural and rejuvenated appearance.

The complete face lift procedure takes about two to three hours to perform safely under general anesthesia in the hospital (especially with additional scheduled procedures) or under local anesthesia in the office suite. A minimal amount of swelling can be expected that resolves within three weeks. Since there are no dressings or drains, you may shower and wash your face daily after surgery. The few sutures in front of the ear are taken out within ten days. One can resume normal activities within six weeks.

In selected patients, Dr. Sasaki may suggest a non-surgical tightening and elevation of the face by Ulthera treatment. This FDA-cleared device precisely focuses thermal coagulation points at the muscle and skin level to promote collagen and elastin fibers to shorten and elevate mild-to-moderate sagging tissue by 3 months. This procedure may also be indicated for patients not yet ready for a surgical procedure or in post-facelift patients who desire further tightening without another surgical intervention. Please click on Ulthera for more information.

Methods of fat harvesting, processing and injection are critical to obtaining a higher percentage of living fatcells. Current research continues in optimizing these factors to increase the chances of fat survival and retention within grafted sites. The American Society of Plastic Surgery cautions our members that further research is needed before “stem-cell” preparations can claim any benefits over traditional approaches for fat grafting.

Sculptra® Aesthetic obtained FDA-clearance for facial volume enhancement in 2009. This biodegradable product consists of Poly L-Lactic Acid (PLLA), which is mixed in water for at least days in its sterile vial. The prepared lidocaine containing solution may be injected into temporal, face and perioral hollows in a series of three to six sessions about six weeks apart. As the PLLA material is metabolize by the patient to water and carbon dioxide, PLLA stimulates replacement-collagen that slowly rejuvenates facial contours in a very predictable manner. European experience indicate that collagen augmentation can last up to 2 ½ years after the last injection. Sculptra® Aesthetic is contraindicated in individuals with known hypersensitivity to any of its components or in patients with a known history of keloid formation. Sculptra® Aesthetic is injected only by Dr. Sasaki. Please click on Sculpltra Aesthetic for more information.