Facial rejuvenation consists of a multimodality, lifelong approach to fight the aging process of your facial skin. Facial rejuvenation includes a combination of surgical procedures and non-invasive cosmetic treatments, including skin care systems, chemical peels, laser therapy, injectable fillers, automated microneedling, and neuromuscular blocking agents such as Botox, and Dysport. Cosmetic treatments can often delay the need for surgery by slowing the anatomical changes that occur when the skin loses its support and elasticity. They are also useful as adjuncts to optimize surgical outcomes and maintain results longer. Surgical therapy is used to address specific anatomic changes that occur below the skin at the level of facial muscles, fat and fascia that cannot be addressed by non-invasive therapies alone. Surgical treatments include facelift, neck lift, upper and lower lid blepharoplasty, rhinoplasty, and forehead lift.
In general younger patients with no wrinkles at rest or on animation require only maintenance skin care and prevention. Skin systems such as ZO medical utilize retinol based regimens aimed at improving skin’s barrier function, and creating smooth, firm, even colored, well hydrated skin. Prevention measures include sun protection, smoking cessation, diet and exercise. For patients with superficial wrinkles, which only appear on animation, toxin injections (Botox), into the forehead, crow’s feet and brow, as well as dermal fillers like Juvederm and Restylane into the nasolabial folds provides patients with improvements with minimal downtime. Light glycolic or retinol peels are also recommended. For patients with deep wrinkles on animation, toxins will soften forehead wrinkles, neck bands, frown lines, and crow’s feet. Additionally, these patient’s often benefit from deep peels (Controlled depth peels), ablative laser therapy, and dermal fillers including Perlane, Restylane, Sculptra and Juvederm. For patients with superficial wrinkles at rest and deep on animation, all of the prior treatments mentioned are recommended, however, deeper peels or ablative laser therapy will be required for improvement, as well as larger volumes of fillers, placed in a deeper tissue plane such as Sculptra and Voluma. Finally, for patients with deep wrinkles at rest, although the aforementioned procedures are often useful adjuncts to surgery, they are rarely sufficient to rejuvenate the face. This is because the skin has lost too much elasticity, and the underlying subcutaneous tissues have also shifted too far to be corrected with cosmetic treatments alone. These patients often benefit greatly from surgical procedures including facelift, forehead lift, blepharoplasty, and necklift in conjunction with cosmetic treatments aimed at optimizing and maintaining results.
Prior to choosing the appropriate surgical, non-surgical or combined treatment approach, you and Dr Capuano will discuss the fundamental decision together. We believe the choice between open surgical procedures and cosmetic treatments should be a well-informed decision. Dr. Capuano will help you to clearly understand what you can expect to achieve from each treatment modality, and will individualize a treatment plan to address your specific goals. In addition, as part of your consultation, the Vectra 3D body imaging system will be used to simulate your post-surgery results, so that you can see your body in before and after photographs rather than someone else’s, making it much easier for you to judge if surgery is right for you.
Contact the office of Northern Center for Plastic Surgery at (201)820-5280 to shcedule an appointment.
You may schedule an appointment with Board Certified Plastic Surgeon Dr. Aaron Capuano, who will address your surgical needs.
Thank you for your question. In my opinion, rejuvenation of the face in a young patient requires addressing skin quality and color as well as underlying soft tissue volume loss. To address your concerns about tired eyes, first improving skin health with a retinol based skin system can address fine lines and color variation that can give you the appearance of shadowing below the eyes. Stimulating and tightening of skin can be accomplished with microneedling, medium depth chemical peels, or through heating of the tissue with laser, ultrasound or radiofrequency technology. Applying these technologies to the cheeks and neck can often tighten the skin throughout these areas and improve the heavy look you are describing. Additionally, filling the areas of subcutaneous fat loss of the lower eyelids and cheeks with soft tissue fillers can soften the transition between the eyelids and cheeks, giving them a more youthful and rested appearance. Specific soft tissue fillers can simultaneously improve your lower lid and cheek contour and lift your cheeks, which may also improve the heavy look you are describing. A thorough consultation with Dr. Capuano is important so a specific plan can be layed out for you to accomplish your individual goals.
Thank you for your question.
The difference between a mini facelift and lower face lift.
A mini facelift is simply a marketing term used to describe a short incision pattern used to do face lifts that stays on the back of the ear and doesn't extend into the hairline. The incision can be used for a face lift or a necklift or both.
Whereas a lower facelift is a procedure where only the lower portion of the face (including the jowl area) and neck are addressed.
My goal is to keep your incision as hidden and minimal as possible, but the mini facelift approach often falls short of allowing correction of a patients concern without creating skin redundancy behind their ears. If your laxity is so mild that you could get away with a mini facelift, you would likely benefit from a combination of minimally invasive procedures and filler rather than surgery, as newer technologies and better techniques have helped bridge this gap and stave off surgery until necessary.
I hope this answer helps