The patient is a 75 year old woman who noted that her jowls (areas just outside the corners of the mouth) were drooping and she wanted to have a smooth jaw line. She also wanted improvement in the skin folding within the jowl area and over the cheek. Her treatment plan included a face lift with a neck lift. Adjunctive treatment included laser treatment for wrinkles around the mouth and cheeks. The patient was very happy with the results of her surgery both in regards to improvement in the folding of her jowl area and in the wrinkles.
Facial Plastic Surgery in Older patients
Healthy older patients are good candidates for facial plastic surgery and older patients report having even less discomfort than younger patients. In general, facial plastic surgery is not painful and well tolerated and a majority don’t take narcotics after their procedure. There can be some stinging and discomfort with laser skin resurfacing but this can be significantly diminished with cool moist gauze.
Some older patients may have developed long term medical issues like high blood pressure (hypertension) or heart issues like coronary artery disease , which can limit blood flow to the heart. Regardless of age, all candidates for facial plastic surgery are thoroughly evaluated to gain a deeper understanding into any existent issues that might affect the safety or the quality of their surgical experience. Plastic surgeons are used to working with other specialists and a patient’s primary care physician and the majority of patients who wish to have facial surgery can be optimized medically for their procedure.
Laser Treatment for Wrinkles
Various lasers have been developed to both tighten and smooth skin but the Carbon Dioxide Laser remains our most successful tool to diminish and even remove stubborn wrinkles. The laser works by ablating (removing ) the surface layers of skin to get to the base of the wrinkles. In other words, the laser works by removing the skin in which the wrinkles reside. This leaves a smooth surface. Our skin protects us from the outside world and also keeps the water within us from evaporating. So when the laser is used to remove the upper layer of skin, the skin becomes weepy and skin care is required to cleanse the skin until it naturally seals itself. The time it takes for the skin to heal to the point where the skin is dry is based on the depth of the laser and generally the deeper the wrinkles, the deeper the laser must go to remove them and the longer it takes to achieve dry skin. As a general rule, laser treatment for wrinkles of the lower eyelid area takes about four days until the skin is dry and six days until makeup may be applied. Wrinkles of the cheeks and around the mouth are often deeper and thus require longer until the skin is dry, which is about six to seven days and then makeup may be applied at eight or nine days postoperatively.
The new skin is soft, vibrant and youthful and really goes with the effects of the face lift and neck lift. In a way, the laser puts the finishing touch on a patient’s facial rejuvenation plan.
