Patient Question:
I am contemplating having facial rejuvenation surgery. What are the differences between a “mini-facelift”, a “lower facelift or neck lift”, and a “full facelift”?
Dr. Kenkel answers:
One of the many things that can be challenging for a patient exploring plastic surgery is understanding what the various names of the procedures mean. Additionally, they are all not used consistently, so each physician may mean something totally different when referring to a particular procedure. “Mini facelift” is certainly one of those terms. This has implied several things and often infers that this a short procedure that can result in “facelift-like” outcomes. It plays off the fact that most of us have apprehension about surgery, particularly when it is elective and would prefer a smaller or shorter operation that achieves our goals.
My experience has been these procedures are truly short lived and often mini facelifts yield mini and temporary results. Those performing the procedures often use the same incisions that we use for more traditional results without the benefit.
A lower facelift procedure targets the jawline and neck of the patient. It will help strengthen the jawline, helping eliminate the “jowl” or excessive skin and fat resulting in distortion. It will help address loose skin and fat underneath the chin and tighten up the muscles, reducing the muscular bands of the neck. This procedure will not address the central face or “cheek fat” and will not help the nasolabial folds or laugh lines. A lower facelift takes about 3 hours and can be performed as a day surgery or overnight stay depending on the magnitude of the procedure.
This differs from a neck lift which focuses solely on the neck and has less of an impact on the jawline and jowl. A neck lift may be done for patients who are early in the aging process.
A facelift addresses the neck and jawline as well as the cheek fat pads and nasolabial folds, creating more harmony among the areas of the face. It is a bit more complex procedure and takes us closer to 4 hours to perform. I ask my patients to spend the night when undergoing a facelift.
Which procedure is right for you depends on your goals and priorities. When we see you in the office we will listen to your needs and then examine and analyze you. It is often helpful to view photos of you 10-15 years ago. This often sets up our expectations for the procedure. Based on all of the above, we can come up with the proper options to achieve your goals.
Patient Question:
My brows are low but I am afraid to have a brow lift. Where are the incisions, what is my recovery, and will I look like myself?
Dr. Kenkel answers:
These are excellent questions and ones I hear commonly from patients seeking rejuvenation around the eyes. The traditional brow lift uses an incision from ear to ear giving us a great opportunity to shape the brow area. Unfortunately, it also puts patients at risk for numbness of their forehead and scalp and in some cases hair loss. Brows are unique to everyone. There is no normal position or shape for the brows. In fact, if you look in fashion magazines you will see pleasing brows in all different shapes and positions. For that reason, it is very helpful to not only understand your goals but also view old photographs to see what your brows looked like when you were 15-20 years younger. These photos serve as a template for us as we plan what may work best to open your eyes. The worst thing we could do would be to change the shape of one’s brow or overly elevate a brow in a person whose norm is on the lower side.
For this reason, I have migrated to a more limited brow lift concealed within the hair. This procedure is close to the brow itself and does not require us to overly release the forehead area. This results in less swelling and an easier recovery not to mention a more predictable outcome. The exact position in the hair will very among patients depending on what the goal is for that individual.
Patient Question:
Can Botox or Dysport help the corners of my mouth and decrease my sad appearance?
Dr. Kenkel answers:
The short answer is yes! There is muscle that spans from your jawline to the corner of your mouth called the depressor anguli oris (DAO). When we weaken it with a neurotoxin, we eliminate the force of that muscle which causes the corners to turn up. Its impact lasts around 3 months.
Many patients have lost volume in this area termed the marionette line or fold, accentuating the above. These patients benefit from filler injected in the area to help restore the volume and eliminate the down turning of the mouth. This restores the balance of the mouth and helps create a more natural balance between the upper and lower lips.
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