I've got to do something about my face, but what?

 

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Years ago, it was easy. You chose from a menu of forehead lift, eyelift, midface lift, cheek implants, rhinoplasty, facelift, chin implants and liposuction, which might be coupled with a skin resurfacing treatment. But now, almost each surgical procedure has a noninvasive counterpart to treat the same problem.

The marriage of technology and imagination has spawned a supermarket of noninvasive procedures that claim to iron out wrinkles, lift, chisel, plump and remodel. With a less expensive price tag and less downtime, the issues related to noninvasive procedures boil down to: “What results and how much longevity can I get from noninvasive treatments?”

It’s a good idea to know all your options before you visit us. Your ideal procedure will be based on your facial features, skin quality, ability to tolerate downtime, economic resources and aesthetic sensibility. You can’t make these choices alone. Drs. Dunagan, Yates or Alison will guide you based on a facial assessment supported by years of experience treating patients with similar concerns and facial features.

Though the surgical options are more expensive, the nonsurgical treatments will need to be repeated, so it is up to you to do the math. Here is a sampling of some of the surgical facial procedures and their noninvasive counterparts that are currently available:

Brow Lift or Botox?

Surgical. A brow lift, also called a forehead lift, corrects skin wrinkling and drooping that causes your eyebrows to sag and excess skin to hood your upper eyelids. It can soften the deep creases across your forehead and reduce the horizontal frown lines at the top of your nose and the vertical lines between your brows.

Nonsurgical. Botox, Dysport and Xeomin are neurotoxins that relax the muscles underneath the skin to prevent wrinkle formation. They are FDA-approved to treat the “elevens,” – those lines that form between your brows. They have also been successfully used to treat horizontal forehead lines, crow’s feet, tiny bunny lines on the side of the nose and can give your eyebrows a gentle lift.

Eyelift, Soft Tissue Fillers or Your Own Fat?

Surgical. Upper eyelid blepharoplasty removes the excess fat and sagging skin of the upper eyelids that can make you look tired or sad and corrects a puffy upper eyelid appearance.

Lower eyelid blepharoplasty eliminates under eye bags, excess lower eyelid skin and fine crepe-paper type wrinkles, dark under eye circles and lower eyelid droopiness. The result is a more alert and rested appearance.

Nonsurgical. Injections of Botox, Dysport or Xeomin can minimize Crow’s feet. When injected above the eyebrows, Botox or Dysport can also provide a ten-degree lift to the arch and a slight lift to the tail. To get rid of under eye depressions (bags), your plastic surgeon can inject your own fat or a hyaluronic acid, such as Restylane, into the area. An autologous fat injection (your own fat) usually lasts longer than hyaluronic acid, which will last up to a year.

Cheek Implants, Fillers, or Your Own Fat?

Surgical. Cheek implant surgery can make your cheekbones more pronounced and attractive, replace lost cheek volume (due to aging and weight loss) and fill in hollowed-out cheeks. Cheek implants vary widely in material, size and shape and can be custom made to suit you.

Nonsurgical.  Autologous fat is commonly used to build-up the cheeks. We can take fat from areas such as the belly or thighs and meticulously inject it into the cheek area. This is commonly used as an adjunct to facelift. Filler injections (Restylane, Perlane or Juvederm), or a collagen stimulator (Sculptra or Radiesse) are also great cheek enhancement options. In addition to balancing your face, injectable facial fillers will lift your cheeks to create a youthful appearance.

Rhinoplasty or Injectables?

Surgical. Rhinoplasty can reshape your nose to remove a nasal hump and reduce an enlarged tip. It can also improve the angle between your nose and upper lip. If your nose has drooped with age, rhinoplasty can lift it.

Nonsurgical. A Botox or Dysport injection in the divider between the nostrils can also lift the tip of your nose. Bumps on the nose can be minimized with injections of soft tissue fillers. In some patients, tissue fillers are added to increase nasal volume where desired.

Facelift or Injectables?

Surgical. A facelift can reverse the effects of gravity, tightening deeper tissues, firming up excess loose skin and addressing the volume changes that occur with aging. Liposuction can remove excess fat under the neck.

Nonsurgical. Injectable soft tissue fillers can be used to lift and diminish jowls, lift corners of the mouth, and minimize wrinkles, folds and lines. Injections of Botox or Dysport can be used to make neck cords recede. Necklines can be softened with mini doses of hyaluronic acid fillers in combination with Botox or Dysport.

It is important to know what’s available, so you can get more out of your plastic surgery consultation. But not every option is appropriate for every face. Your next step is to get the benefit of your plastic surgeon’s trained eye. He will identify the procedures that will produce optimal results for you.

 

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