Patient Concerns and Expectations
When meeting for an aging face consultation, it is important to discuss with your surgeon the concerns you are having about your face. These may be in terms of exact concerns such as “My eyes look heavy,” or “I do not like the sagging skin under my chin and neck.” Other times, patients may not be able to exactly pinpoint what they think is making them look older than they feel. They may seek the advice of their surgeon. It is important when meeting with your surgeon to convey what it is about your face that is making you look older or at least what is displeasing you. The aging face consultation should be an open discussion between you and your surgeon, whereby you can both enter a dialogue about the potential options. Most importantly, when Dr. Bard is evaluating patients for their aging facial concerns, it is of utmost importance that they have realistic expectations of what can be accomplished. Patients who have the unrealistic expectation of looking like they did when they were 25 years old are not candidates for aging facial procedures. The goal of an aging facial procedure is to address certain aspects of the face which help to give a natural and more youthful appearance—it will not accomplish turning back the clock 20 years.
Procedures which enhance a Facelift—Laser Resurfacing
Oftentimes when patients are seeking facial rejuvenation they are concerned about the more obvious findings such as sagging neck skin but are overlooking the skin itself. The integrity of the skin needs to be assessed with every evaluation. What good is less skin sagging when the skin itself has fine lines and sun spots? Laser resurfacing is a procedure that can nicely complement the outcomes of a facial rejuvenation procedure. Dr. Bared utilizes a fractionated laser which helps to give the benefits of the traditional, aggressive laser without the lengthy recovery time. In fact, he often performs these procedures concurrently because the recovery from the laser resurfacing can proceed at the same time as the recovery from the facelift. Typically patients can expect an average of 5 days of the appearance of a sunburn appearance followed by pinkness of the skin. The degree and length of the pinkness of the skin varies between individuals; however, Dr. Bared has patients use a skin-toned sunblock which needs to be used to protect the new skin. After about 10 days makeup can be applied to the face. Sun protection is, of course, of supreme importance after a laser resurfacing procedure. Sun avoidance and protection help to prevent issues which can be exacerbated by the sun such as prolonged pinkness and slight darkening of the skin.
Procedures which enhance a Facelift—Fat Transfer
Facial volume loss is a phenomenon that is becoming more and more understood and appreciated in facial rejuvenation. As we age, our skin not only begins to hang but it also deflates over certain areas of the face. You may notice that your temples have become slightly more concave with time or that your cheeks may appear flatter. This is due to two factors—facial fat and bone loss. Studies have demonstrated the skeletal changes which transpire with age. The bone in our mid face and cheeks becomes less prominent. We also lose facial fat in this area both lending to a loss of facial volume. Today patients have options when replacing volume to the face. These include either (and in most cases both) the use of fillers and fat. Fat transfer is a procedure which Dr. Bared at times performs concurrently with aging facial surgery. Fat is removed from the abdomen and hips and replaced in the face. The fat cells are transplanted in to the face and survive there as they did in the other parts of the body. The use of fat allows for the restoration of volume which can be lost with aging. Dr. Bared performs a very conservative degree of fat transfer which provides for subtle augmentation to certain parts of the face without an unnatural appearance.
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