The patient is a 67 year old woman who felt that her cheeks had fallen along with her neck and more wrinkles had recently appeared around her mouth and eyelids. She said that her face looked “sad” and wished facial plastic surgery to correct the drooping and wrinkles and restore a youthful, vibrant appearance to her face and neck. Her procedure was performed safely and comfortably under general anesthesia. The patient was seen the next morning and was also then walking outside. She returned to most of her usual activities after seven days. She was quite elated with the results of her plastic surgery which included a face lift with a neck lift, a hairline brow lift and laser treatment for wrinkles of the lower eyelid and Crow’s foot areas and also around the mouth.
Treatment of the entire face and neck is safe and gives a more harmonious and even result which is therefore more natural appearing. Facial and neck aging affects all of the parts to differing degrees and so when all the parts are addressed with cosmetic surgery, all of the parts “go”.
Facelifts significantly affect the cheek, jowl and neck and also cause change to the area just outside the corner of the mouth. Here, the jowl, marionette line and cheek fold come together and in some patients who have lost facial fullness, have skin looseness and drooping of tissues. Tooth loss in this area can also lead to loosening of tissues and hanging skin just outside the corner of the mouth. The loose skin presents itself as loose or folded skin, wrinkling and a depressed, downward pointing corner of the mouth. Facelifts can direct their lifting to this area to smooth out folds and reduce wrinkles and even slightly to raise but not stretch out the corner of the mouth as can be seen in the facelift surgery before and after photos, especially in the front view where, in the after photo, one can see that the corners of the mouth have been elevated to the neutral, more natural position.
The brow lift has not only served to smooth out the folds, wrinkles and extra skin to make the patient look younger but it has also restored facial proportion by increasing the distance between the eyelash edge and the brow itself and that helps the forehead in its relationship to the rest of the face. The brow has not only been elevated but also has a more natural, curved shape that has some roundness to it and so harmonizes with the round quality of the eye and the eyelid themselves.
Laser treatment for wrinkles was used over the lower eyelid, Crow’s foot area and about the mouth to further smooth the skin which creates a smooth surface that parallels the improvement in skin folding afforded by the face lift. Improvement within all of the parts are working together to create one unified improvement.
