The patient is a 66 year old woman who was very active in her community and felt that her facial appearance did not match her energy level or her feeling that she was young “on the inside.” She simply wanted to have a face lift to restore her youthful appearance. She also noticed that she had difficulty applying eyelid make up and that it quickly smudged after application.
Her procedure was done safely and comfortably under general anesthesia and she was walking outside the following morning. Recovery was rapid and the patient was back to her usual daily activities after five days. She was very happy with her cosmetic results and especially her new “look”.
Face lifts make patients look younger by returning the skin and soft tissue to its location in youth. Loose skin and fat around the jaw line can be smoothed and lifted so that the squareness and sharpness of the jaw line can be appreciated. This defines the edge of the face and defines the neck as well and gives these two areas both definition and a relationship to each other.
In general, facial plastic surgery doesn’t change the character of the face, and this patient still looks the same but the curviness and roundness of her facial features have changed and become sharper and more angular and go better now with her angular cheeks and nose. The patient reported after her surgery that her face was more angular in her youth and the drooping of her skin and soft tissues that occurred with the aging process had obscured the angularity of her youth.
The patient also had upper eyelid surgery, or upper blepharoplasty, where excess upper eyelid skin was removed. This procedure, though small, is very powerful in terms of the gain that can be achieved. Not only does this improve on aesthetics by removing skin excess but it also defines the lid by giving it a sharp crease which appears even and beautiful . After the skin is removed, patients find it much easier to both apply and to retain make up without having to reapply make up frequently.
Patients that have upper eyelid surgery often notice that there are subtle effects on their brow position and some functional improvement too. Patients with skin excess of the upper lid often, and not consciously sense that extra skin fold pressing on their lid and the globe (eyeball) and may be, though they are not aware, reflexly raising their eyebrow in an attempt to pull the skin excess away from their eye. As the excess skin is removed with upper eyelid surgery, the patient no longer must raise the brow and the brow descends naturally to its normal position, as can be seen in this patient. This lowering of the brow helps to restore normal brow/eyelid relationship aesthetics by decreasing the large space between the brow and eyelashes that exists preoperatively. The new smaller space between brow and the lashes looks fresher and more youthful and the sharpness of the new lid crease goes with the beautiful angularity of the rest of the face.
Strain in the areas of the brow and forehead is also diminished because the patient no longer must keep the brow elevated to keep the excess upper eyelid out of the eye. A decrease in strain in the muscles keeping the brow up results in fewer headaches and less discomfort. So upper lid surgery can have not only cosmetic effects but also give functional improvement. The procedure gives both a look of calm and may increase a feeling of calm in the patient.
