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Browlift
 As the face ages, the brow usually descends with the rest of the face. Although the nose is relatively fixed, the central eyebrow usually does descend some. This produces some transverse creases at the base of the nose. The lateral eyebrow is less fixed, and usually descends more than the medial part. This causes two problems. First, all the tissues that were above the bony orbital rim are now in the upper eyelid. Secondly, the lateral eye muscle (the orbicularis) bunches and you develop “crow’s feet.” Generally, you do not even notice most of this. Instead, what you see is the formation of transverse forehead lines as the forehead muscle (the frontalis) tries to hold the eyelid up. Though an excellent drug elsewhere, reversing this with Botox ® only risks having the eye brows fall to their lowest point.
A browlift:
- Elevates the brow back to its normal position,
- Pulls the brow tissue out of the upper eyelid,
- Flattens the “crow’s feet,”
- Eliminates the need for the forehead muscle to contract, improving the forehead.
- Frequently eliminates the need for an upper blepharoplasty.
We generally, therefore, recommend a browlift at the time of a primary Today’s Facelift, and one is almost always needed for a secondary facelift if it was not done at the time of the original procedure.
The procedure is done endoscopically through small
incisions in the scalp in line with the nerves. This eliminates the numbness of the older type of browlift. The incisions are also much smaller, heal faster, and have much less hair loss. Like Today’s Facelift, we fix the tissues to solid deep structures to prevent relapse and improve longevity. Usually you can hardly find the incisions by a week. There is minimal bruising and the browlift adds no recovery time to a Today’s Facelift procedure. Additionally, we remove most of the muscles between the eyebrows to eliminate those little parentheses that tend to form as we age.
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Blepharoplasty
Lower eyelid rejuvenation is frequently done with Today’s Facelift, especially when the central face also needs rejuvenation. This procedure elevates and supports the cheek and lower eyelid and anchors them deep lateral to the eye. Only the small amount of bunched skin and muscle under the eye is removed. Because of this and the support the lateral sutures provide, there is less chance of postoperative droop of the eyelid. Protruding fat is rarely removed, but rolled over the bony orbital rim to fill the area where fat is missing. This and the lateral support also makes this procedure ideal if you have already had a lower blepharoplasty and now have a hollow or elongated lid.
A browlift is frequently all that is needed to rejuvenate the upper eyelid. This is especially true if you have already had an upper blepharoplasty. In fact, we rarely do anything to an already operated upper lid other than a browlift, since the skin is usually tight enough once the brow is elevated to its normal position. In Today’s Facelifts done primarily, however, there is frequently some excess skin that needs to be removed. Occasionally there is also some fat that needs sculpting, but removal of too much fat causes the eye to look sunken. In fact, for secondary procedures, fat injection is frequently necessary to truly rejuvenate the eyelid area.
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Lip and Mouth Rejuvenation
 With time several things happen to our mouths
- The upper lip elongates,
- Fat is lost causing:
- Loss of the pout
- Loss of Philtral & Cupid’s Bow definition
- Wrinkles to form
- The red lip appears smaller
- The mouth corner descends causing a “sad” appearance.
Today’s Facelift will generally correct the turned down
corner, and help us look our happy self again.
Several techniques are available to correct the other problems. Injection of a filler or fat can smooth the lip and/or plump it. Fat has the ability to also reverse some of the aging effects on the skin itself. If this does not smooth the area enough, then laser resurfacing or a peel can help. The lip can be plumped with an implantable collagen sheet. This fills the lower part of the lip and makes the red portion more prominent. Excision of the skin just above the vermillion border or just under the nose can shorten the lip and also make the red lip more prominent. This is generally more reliable.
Earlobe Rejuvenation
As we age, the ear lobe stretches and enlarges. Today's Facelift corrects some of the sag. However, on occasion, the lobe is just too large. This is easily corrected with an inconspicuous scar along the edge of the ear.
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Volumizing the Face
 Several things happen as we age. The most talked about is droop of the tissues. Skin aging, mainly from sun damage and muscle action, is also readily recognized. The least recognized problem is volume loss. This actually happens to multiple tissues. We lose fat, muscle and bone. By relocating the descended fat and support structures, Today’s Facelift corrects some or most of the appearance of the loss. When this is not adequate, the tissue can be further filled, lifted and rounded with a product off the shelf (Radiesse®) or your own fat. Fat is the ideal since there is increasing evidence that it contains multi-potent stem cells that can further rejuvenate the overlying skin. We usually harvest the fat from your neck or wherever you have too much anyway. The injection of either can be done at the time of Today’s Facelift or under local anesthesia later.
Skin Rejuvenation
Even if we correct all the effects of gravity, you may still look old if your skin looks old. Fortunately, the skin is easily corrected to an equally younger appearance.
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Buccal Fat Pad Removal
There is a natural fat pad overlying the lateral teeth in the cheek. In most people, this simply provides a natural roundness to the cheek. It blends with the surrounding fat and cannot usually be distinguished from it. However, in some people, with absorption of the surrounding fat or thinning of the nearby fat from a conventional facelift, the Buccal Fat Pad becomes prominent. This produces a bulge on the cheek. Fortunately, this is easily corrected. The fat pad can be removed, or, frequently better, repositioned to provide bulk in the upper cheek, where it is needed.
Lifestyle Enhancement
What good is looking young and wonderful if you do not feel the same? We offer counseling on diet, exercise, smoking cessation, and general wellness. We also can provide advice and have available products to help protect you from the harmful effects of the sun.
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