The patient is a 54 year old woman who reported that her face had just recently “fallen” and she also didn’t like the fold at the corner of her mouth which reminded her of her grandmother. She wanted to have improvement in these areas but she wanted to have a natural appearance and didn’t want anyone to notice that she had had a face lift. At her procedure she had a neck lift with her face lift and also laser treatment of wrinkles over her lower eyelid and Crow’s foot areas.
She was very elated with her cosmetic results after her procedure and was especially gratified by the change in her jowl and neck and that her marionette line was significantly improved. The greatest improvement from most facelift techniques is that in the jowl area, the skin and fat that seems to hang down over the jaw line past the edge of the corner of the mouth. The marionette line goes from the edge of the corner of the mouth to the jawline and is at the front of the jowl and so when the jowl is lifted, the marionette line is lifted also and the marionette line is softened and in some cases completely removed. In this patient, the marionette line has progressed from a line to a fold and with lifting of the jowl, the fold has been flattened with a resultant youthful and natural appearance.
Her chin appears to have more prominence (sticks out more) but she didn’t have a chin implant. Why? Because moving the soft tissue of the jowl and marionette line backwards and pushing the neck back makes the chin appear to be more prominent and so no chin implant is necessary. Defining the chin in this natural fashion helps to not only define and emphasize the jaw line but also makes the face more prominent. And defining the neck by moving soft tissue and skin backwards makes the neck appear longer and narrower, which in turn, makes the face appear larger.
But is an apparently larger face better? The answer to this question is another question: Why do movies use close ups where they show an actor’s face across the entire screen? The answer can only be that we see the face as being a thing of beauty, something that not only is beautiful but defines us. And so anything we can do to naturally place emphasis on the face by making it appear slightly more prominent with face lifting creates beauty. And by defining the face and separating it from the neck we also create beauty and harmony.
This also explains why many working patients want to have a face lift and neck lift. It helps to define the beauty of our faces, creating calm and unity of the features when others look at us but also gives us the calm and confidence to move through our day.
Smoothing the skin with laser treatment creates harmony because the rest of the face is smooth and so now the eyelids “go” with the rest of the face. So smaller procedures can be added to a face lift that not only improve on beauty in those small areas but lend harmony to the entire face.
