Third Quarter 2010, Volume 24, Number 2

A two-part rejuvenation strategy… targeting structure and skin for better results


Can surgery buy you happiness?

A two-part rejuvenation strategy…targeting structure and skin for better results

Ask the Surgeon / Health Tip / What’s New

Men want to look good too

Time, gravity, and the elements naturally take a toll on the appearance of your face. As we age, the skin begins to lose its elasticity and wrinkles start to appear. Fatty tissue tends to decrease in volume and in density causing the skin to sag and hang loosely. There are also changes in the bony facial structure that when combined with changes in muscular action and the effects of gravity, leads to more prominent skin folds. These changes are greatest under the chin, in the upper neck, and at the skin folds near the corner of the mouth. Facial plastic surgeons are targeting both the underlying bony structure, as well as the skin, with a two-part rejuvenation combination of implants and a facelift.

Midface implants
One of the strongest characteristics of youth is fullness of the cheeks, indicating an abundance of healthy soft tissues and fat that is present under the skin. Also a sign of vitality, the cheekbones are responsible for defining the face, highlighting the eyes, and adding overall balance to your features. Not everyone can retain contour and fullness with age. Not everyone has prominent cheekbones. When there is depletion of tissue and fat and minimal cheekbones, the skin sags, appears flattened or sunken, and may cause folds and wrinkles around the mouth. The midface implant can hold up the collapsed tissue and restore the youthful appearance of adequately padded skin at healthy levels of distention and elasticity. This improves the contour, creates balance, and bolsters self-esteem.

Midface implants are performed under local anesthesia with sedation. A small incision is made inside of the mouth in the crease above the upper lip. A pocket is created over the bone. Each patient is evaluated for proper sizing and shape of the implant that will provide the desired effect.

The sterile implant is placed into the pocket. The implant is secured and the incision is sutured closed. Supportive tissue forms around the implant after a few weeks; and once healed, it will feel like your normal underlying bone structure.

Chin implants
In a recent study by the University of Rochester Medical Center, researchers found that significant changes in facial bones-particularly the jaw bone—occur as people age. As the jaw bone loses mass, it contributes to sagging skin, decreased chin projection, and loss of jawline definition.

Many people have a chin that is too small for their face. Flat, under-projected chins are usually genetic, although traumatic injury or previous jaw surgery can also result in deformity. Chin augmentation can help restore balance to the lower face and jawline.

Take a look at your profile. A weak or receding chin can sometimes make your nose seem larger or more projected. During consultation, you can discuss if a chin implant will bring your profile back into balance or if a combination of rhinoplasty (nose surgery) and chin augmentation is the solution.

Some patients seek to reduce the appearance of deep grooves from each corner of the lip down to the chin. These marionette lines can be improved by placing small implants along each side of the jaw, just in front of the jowl.

Chin augmentation is performed under local anesthesia with sedation. The face is cleansed and a small incision is made underneath the chin or inside the mouth, where gum and lower lip meet. A pocket is created by gently stretching the tissue. The sterile, custom-fit implant is then inserted in front of the bone. The implant is secured and the incision is sutured. When the incision is inside the mouth, no scarring is visible. If the incision is under the chin, the scar is usually imperceptible.

Nasal surgery or chin implant? Your nose can appear more prominent than it actually is because of other facial features. The noses in these three profiles are identical but look different. The first one shows a normal jaw structure and presents a pleasing appearance. The nose in the second profile appears more prominent because of a receding chin. And the nose in the third profile seems to project even more because of a long sloping forehead and a weak chin.