Facelift Surgery

The deep plane facelift is a technique that can be used in conjunction with an upper and lower blepharoplasty as well as a coronal brow lift.

While the deep plane facelift affords excellent correction of the nasolabial folds, jowls, and neck, I have found that the aperture of the upper eyelids can yield a significant positive impact on the aesthetic result on the overall youthful appearance of the face.

It is very common for women as they age to have an accumulation of skin on their upper eyelids. This accumulation of skin has been given the medical term, dermatochalasis. Often this accumulation can be asymmetric-meaning greater on one side versus the other and can create differences in the aperture of the eye. It is important when correcting this asymmetry to note the location of the tarsal fold or eyelid crease.

As you can see in the above photograph the patient's right eye has significantly more skin pre-operatively than the left eye. Careful notation of these asymmetries is important so that post-operatively the eyes can have equal apertures and yield an optimal aesthetic result.

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The Impact of Upper Blepharoplasty on Facelift Surgery

Aesthetic and reconstructive facial surgery is particularly enjoyable to me. The deep plane facelift is a technique that I commonly use in my aesthetic practice and which I frequently use in conjunction with an upper and lower blepharoplasty as well as a coronal brow lift.

Analyzing my own results is an important part of my practice so that I can continually improve. While the correction in the nasolabial folds, jowls, and neck are more obvious from the deep plane facelift, I continue to learn more about the impact of the aperture of the upper eyelids as their appropriate placement can yield a significant result on the overall youthful appearance of the face.

It is very common for women as they age to have an accumulation of skin on their upper eyelids. This accumulation of skin has been given the medical term, dermatochalasis. Often this accumulation can be asymmetric-meaning greater on one side versus the other and can create differences in the aperture of the eye. It is important when correcting this asymmetry to note the location of the tarsal fold or eyelid crease. As you can see in the above photograph the patient's right eye has significantly more skin pre-operatively than the left eye. Careful notation of these asymmetries is important so that post-operatively the eyes can have equal apertures and yield an optimal aesthetic result.

I continue to see great improvements in the overall skin texture and quality with the deep plane facelift.

Brian P. Dickinson, M.D.
http://www.drbriandickinson.com/

Facelift, Upper Blepharoplasty, Lower Blepharoplasty

I am a strong proponent of significant attention to the neck and jowls in facelift surgery. While I find it equally important to elevate the cheek and midface, I believe that many patients are immediately satisfied with the appearance of the neck.

I have found that SMAS flaps used to define the angle of the mandible are very effective. I have found that direct excision of fat to give the greatest control to defat the neck. Anterior platysmaplasty is most effective to reduce platysmal banding.

Upper blepharoplasty with excision of periorbital fat is beneficial to rejuvenate the eyes. I am a proponent of transconjunctival removal of fat for lower blepharoplasty and when indicated "skin pinch" lower blepharoplasty to rejuvenate the lower eyelid.

While I have found many positive aspects to all of the different facelift techniques, my preferred technique involves sub-SMAS dissection and wide subcutaneous undermining.

Facial Rejuvenation:The Importance of Upper & Lower Blepharoplasty

While I enjoy all aspects of Plastic & Reconstructive surgery, facelift surgery is particularly enjoyable to me. I am very fortunate to have a successful facelift practice at such an early point in my career. I am very grateful to have learned from such excellent mentors in Beverly Hills and I give the highest thanks to Dr. Giacobazzi, Dr. Moelleken, Dr. Markowitz, Dr. Perlman, Dr. Lesavoy, & Dr. Leaf for giving me the opportunity to watch and learn from them. They provided me with invaluable knowlege, experience, lessons, and insight.

As I review my results, I understand the importance of rejuvenation of the eyes to create a more youthful appearance to the face. As the face ages, the brow descends and skin accumulates around the upper lid and fat begins to herniate through the lower lids creating a tired appearance to the eye. While I do not encourage procedures during consultations, I often point out to patients who present for facelifts that small, subtle changes to the eye can yield a large difference. In this photograph one notices how effectively an upper blepharoplasty, or upper eyelid, procedure in conjunction with removal of fat from the lower eye can restore a youthful appearance to the face when utilized in conjunction with a facelift.

Brian P. Dickinson, M.D.

http://www.drbriandickinson.com/