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Wednesday, Jan. 25, 2023

Surgical Rejuvenation

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Facial procedures have progressed over the years

I get asked to write often on my work; it’s something I enjoy doing, so therefore easy to discuss. Rejuvenation of our appearance is a relatively new phenomenon in our society and has progressed to the point that my patients have the highest expectations. The bottom line, they tell me, is this: “I want real results that appear natural and enhance my look rather than drastically change it.” The three underlined words had been referenced in several studies on what most patients want when it comes to aesthetic treatments, both surgical and non-surgical.

As important to most of these people is the need for minimal downtime, if possible. And trust me, minimal means different things to different people!

OK, I am a surgeon, right? So let’s talk about surgical rejuvenation first. We have all seen them. People that have been “done.” Over-pulled, over-filled and likely undersatisfied.

Surgical rejuvenation does not have to look like this. A well-executed plan of surgery can even include multiple procedures and still look natural. Facial rejuvenation procedures have progressed from stretching only the skin 50 years ago to the latest “deep plane” techniques that I use today. Brows can be lifted and shaped with only a few small incisions hidden in the hairline … that’s right, no visible scars at all. Upper eyelid surgery is done in about half an hour in our office minor procedure suite under only local anesthesia, and you can drive yourself home!

Lower eyelid surgery is a bit more complicated (requiring general anesthesia) but still only takes about 45 minutes to perform and involves repairing the defects in fat, skin and muscle that cause that tired or sad look. Sometimes lower eyelids can be done with a scarless technique – incision on the inside of the lid. Face lifting, meaning the lower face and neck, also requires general anesthesia and takes us a few hours in the operating room. I use the latest deep plane techniques, which offer a more lasting and natural result than older methods. I’m lucky enough to have my own certified operating room in my office complex, so this means no hospital visit or overnight stay. Honestly, a mini-facelift is not very common in my practice, but if indicated, it will only address very early jawline problems when there are no neck problems. A neck lift alone is also relatively rare but possible when only a neck or submental (under the chin) problem exists. It is very common to combine two or more of the above procedures simultaneously and have only one recovery period. Regarding recovery, count on at least one to two weeks, depending on what was done. Sometimes more if you are a significant bruiser or sweller. Women are usually able to hide some swelling and incisions with longer hair. Men usually don’t have this option. Either way, with well-planned incisions and precise closures, most are “almost invisible” eventually.

Only a few years ago, if a patient wanted significant rejuvenation but did not want “surgery,” I had no real options. Fillers and Botox can offer some help but, in general, are not enough for most people wanting to see “big improvement.” However, a couple of years ago, I invested in bipolar radio frequency technology. This now offers these “gap” patients for whom fillers are insufficient, but surgery is not an option for whatever reason. Maybe their job doesn’t allow enough time off, surgery is too expensive, or the patient is just “not ready for surgery.”

I can now offer the next best thing to a facelift. Let me be very clear. It is the next best thing. It is not as powerful, effective or longlasting as a facelift. Still, it can give excellent results with very short periods of downtime using only a needle stick to approach the area in question. We commonly treat the jawline and neck the same as with a facelift. Downtime is two to five days – depending on the areas treated and your skin’s response. Downside? You need three sessions in total. The first session is the most important, with both deep and superficial treatments being done. Over the next three months, there are two more superficial treatments. Most patients only opt for maintenance every six to 12 months with superficial treatment.

In closing, facial rejuvenation is possible for almost everyone, whether surgical or non-surgical. Results can be both impressive and natural, regardless of which method you choose.

Kenneth W. Sanders, MD, is a triple board-certified facial plastic surgeon who has been in practice for 21 years. He loves teaching, as evidenced by his involvement with the Facial Plastic Surgery Fellowship at LSU-Ochsner. He also lectures and trains physicians for Allergan (the makers of Botox and Juvederm) all over Louisiana, Texas and Mississippi. He can be reached at drsanders@drkennethsanders.com or 318.698.8711

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