The patient is a 68 year old man who noted that he felt that he looked old and wanted to look younger He thought his skin was loose and drooping, especially in the jowl and neck areas and he thought he had folding extra skin of the upper eyelids with fat bags of the lower eyelids. At his procedure a face lift with neck lift was performed with upper eyelid surgery and removal of fat from the lower eyelids and this was performed through an incision inside the eyelid. The patient also had a support procedure for the lower eyelid to create a youthful crisp lower eyelid and to give functional support to improve lid health. He was very happy with the results of his surgery.
Probably the most important concepts when doing face lifts in men is to achieve significant improvement without changing the character of the male face. Facial cosmetic surgery is inherently feminizing as the lift smoothes and softens the contours of the facial form. It is therefore important to preserve some of the natural landmarks of the face in men while at the same time moving tissues into their normal anatomical position. The locations of incisions about the ears is also modified in men so as to avoid moving bearded skin into areas where men don’t shave and preserving the natural hairline of the sideburns, temple and frontal hairline. When male patients have upper eyelid hooding (skin excess), it’s often better to directly and conservatively remove this tissue rather than perform a brow lift, even when the brow is low and is causing the hooding. Men have a naturally low brow and raising the brow level can be very feminizing and even change the character of the male face.
Lifting of the skin and soft tissue (fat) of the cheek and jowl can be done in men just the same as in a female facelift but care must be taken to avoid overly exposing the hard tissues (bone) of the face by removing too much fat because this can create a harsh appearance.
Preservation and potential improvement in lower eyelid position is a very important component when cosmetic eyelid surgery is performed. Having a cosmetic procedure for the lids gives us the opportunity to determine whether there exists dryness of the eyes that may be secondary to lid weakness and decreased adherence of the lid to the globe (eyeball). It is this close relationship of the lid to the globe that help keep the globe moist between blinks. By adding a small adjustment to the position and shape of the lower lid, it is possible to improve on patient’s dry eyes. Regarding the shape of the lower eyelid, as the lid becomes loose with the aging process, the center of the lower lid can droop at its mid portion and take on a “bowed” appearance and this especially occurs in men and when there are fat bags supporting the lids in men. Lower eyelid support surgery can both improve the bowing shape that can be associated with dryness and can also improve the shape of the lid by making the lid less bowed and shaped to lie more across the lower lid and so he patient can also look better.
