Facelift (Rhytidectomy)
Age 68: Facial Rejuvenation
This is a 68 year old woman who presented to me for facial rejuvenation. She wanted to keep it simple. After a thorough examination, and based on her goals, we elected to perform a face lift, dermabrasion of the upper and lower lip lines and a full face TCA (trichloroacetic acid) peel. The facelift was chosen to improve the nasolabial folds and creases around her mouth as well as to improve her jawline and reduces her jowls. The chemical peel is to soften the wrinkles around her face and improve the appearance of her skin. The dermabrasion (skin sanding) around her upper and lower lips is to help reduce her lip lines.
She is seen in these photos about 1 year after her procedures. The only problem she had afterwards was some hard healing from the dermabrasion that resulted in thicker skin that took a few months to soften and look its best. There is an overall dramatic, yet natural improvement. She looks younger, more refreshed. One important element of her transformation is that her skin wrinkling is much less. Providing for the most “natural” results often is a combination of procedures that move and tighten skin, treat the skin itself, and plump areas that are hollowed with fat.
Age: 51 Facelift/Necklift
This is a 51 year old female who desired facial enhancements. She wanted improvements in her neck and jowls as well as her nasolabial folds (the two skin folds that run from each side of the nose to the corners of the mouth). She had a small amount of skin excess on her upper lids. She was an attractive woman in general, so any consideration of enhancements had to keep that in mind.The question for the surgeon is what to do?
So this is where the “art” comes in, not to mention experience and self-limitations. This is what makes one surgeon different from another. What to do also very much depends on what the patient wants–his or her goals. An experienced surgeon will take into consideration that most patients have tremendous anxieties and fears and they often prefer to limit procedures so there is less risk and cost.
To provide them with what they think they want or what the surgeon knows will bring them to where they want to be, this is the educational part of all patient discussions. It is important to develop an understanding of the makeup of the patients personality, goals and fears, not to mention their expectations. There are times to “dabble” with less invasive, non-surgical modalities and then there are times to get it right, with procedures that have withstood the test of time (face lift, blepharoplasty, neck lift, and brow lift for example).
In her case, in my experience, the best way for me to make improvements in her neck, jowls, nasolabial folds, and jawline is to perform a face lift and neck lift with incisions around her ear and under her chin–a whole lot of improvements were accomplished through these very limited incisions. I performed a skin upper lid blepharoplasty and a full face TCA or acid peel to improve the appearance and texture of her skin. She is seen here 12 days after her procedures. She is a good healer, and in general, it would take somewhat longer for most patients to look as good as she does after surgery.
From the patient:
Dr. Caridi…
“I’m not sure I can conjure the perfect words to express how I’m feeling after looking at my before and after pictures. I am so incredibly happy with everything you have done for me…the results are far beyond my expectations! Thank you so much for taking the time to work with me to come up with just the right plan for my procedure and for your artful execution…I am truly touched by the results. Warmest regards to you and your staff…”
Age: 59 Facial Rejuvenation
This is man interested in facial rejuvenation alternatives. He is a smoker. I elected to keep it somewhat conservative because of his smoking and performed a “mini” facelift, an endoscopic brow lift and an upper and lower blepharoplasty. He is seen here at only three months post operation. Note that he looks much more youthful, refreshed, and that his result is quite natural and appropriate looking (we achieved much with minimal incisions).
Age: 55 Facial Rejuvenation
This woman who presented to me for facial rejuvenation. She wanted to know what I thought she should consider. On examination, she has moderate eyebrow ptosis, deep creases of her forehead, significant sun damage throughout her face with areas of hyperpigmentation (dark patches of skin). Her midface was holding up well, but her neck had some anterior fullness and she has lost her youthful angle. She has some deeper skin creases about her eyes and the corners of her mouth.
I like a natural look. I like changes that blend in well and will make you appear more youthful and refreshed. Most of her age is evident in her skin, her eyes, and her neck so these are the areas I will focus upon. She is seen here after an endoscopic brow lift, and upper and lower bleparoplasty, a full face light TCA (acid) peel and an anterior neck lift.
Note the very natural appearance and the improvement. The deep creases of her forehead have been softened, her eyes are open and more attractive, her skin appearance is remarkable with a light peel, and the improvement in her neck is evident particularly on lateral view. I suggested an additional TCA peel now that we know she responds so well without developing areas of post operative hyperpigmentation. This will continue to improve the appearance of her skin and soften the remaining wrinkles around her eyes and cheeks from her sun damage.
Age: 62 Facelift
This is a woman who had a previous face and neck lift elsewhere. She desired further improvements. I suggested that we revise and improve on her previous work as well as enhance her forehead/eyebrow area for the most natural, rewarding outcome.
I performed an endoscopic brow and forehead lift, lower lid blepharoplasty as well as a full face and neck lift. She is seen here about five months after her procedure. Note the overall improvement, good balance and symmetry, and her natural, rejuvenated appearance. The recovery from “secondary” surgery is often much less than the first procedure.
Age: 53 Facial Rejuvenation
This patient had a previous “threadlift” procedure (face lift with the use of long sutures only and minimal surgery) performed elsewhere. She says that she didn’t see any difference with her previous work.
I performed a brow lift, a face and neck lift, a graft to her nose depression and a graft to her nasolabial folds and facial laser resurfacing and dermabrasion of her upper lip. I removed her “threadlift” sutures at the time of her facelift.
Her results are quite revealing and natural. A word of caution about threadlifts is that the results are often disappointing and don’t compare with the results obtained from properly performed face and neck lifts.
