Facial Plastic Surgery Procedures
A brow lift (forehead lift), and sometimes combined with an eyelid lift can be a simple yet dramatic change to your overall appearance.
The problem: People tell you that you looked tired and ask if you had enough sleep. They ask you if you are upset or angry. You look in the mirror and you look tired or angry even though you are not. There are horizontal wrinkles on your forehead and vertical wrinkles between your eyebrows. Your eyes seem smaller. There is extra skin hanging down over your upper lid, maybe even as far as the eyelashes. You don’t look like yourself anymore. Your external image does not communicate the internal YOU.
The anatomy: The forehead has several layers: the skin, the fat, the muscle, the fascia, and the bone. As people age, or due to their genetics, there can be a loss of elasticity. Either from aging or sun damage the forehead begins to drop this means that the skin has down over the bone. When this happens, the upper eyelids are crowded and the extra skin pushes down. It also causes hooding and skin excess laterally between the brow and the airline. Because we are programmed to not allow our vision to be obscured, there is a subconscious reaction to lift up the forehead to compensate. This causes multiple horizontal wrinkles. It also causes the brows to drop later in the day as the forehead lifting muscles get fatigued. This is why some people feel that their eyelids are more droopy or closed late in the day. They may also feel this as a pressure. This laxity may be brought on by age and sun damage or it can be simply genetic. Sacramento plastic surgeon Dr. Andrew Kaczynski has performed brow lifts in Sacramento for over 25 years, even on young people in their twenties with great improvement.
The solution: When something falls, the solution is to lift it. When the brow falls the solution is a brow lift. This can be done in several ways. The original traditional brow lift was called a coronal brow lift. This involved an incision across the top of the head from ear to ear and was more surgery than most people wanted. In my practice, this has been largely replaced by the endoscopic brow lift. With this procedure, several small incisions are made behind hairline. An endoscopic television camera is placed inside these incisions and the rest of the surgery is done by releasing the forehead from the bone pulling it up and reattaching it at the proper level. Occasionally in people with very high foreheads a hairline brow lift is performed so as to not raise the hairline excessively and make people look like they’re bald. The brow lift is an outpatient procedure performed at our state-of-the-art surgery center at Advanced Concepts in Plastic Surgery in Sacramento and has minimal discomfort with the occasional headache the first day postoperative. Downtime is one week because there may be some swelling and bruising. Sutures are removed at one week and at that point, people can get back to work. It is usually two weeks until light exercise and four weeks until the full recovery for exercise.
Eye Lid Surgery (Blepharoplasty)
What is Blepharoplasty?
Eyelid surgery or Blepharoplasty has been performed by Dr. Kaczynski at Advanced Concepts in Plastic Surgery in Sacramento for over 25 years.
The problem: You look in the mirror and your eyes look different. They look smaller. They may look puffier and swollen. There may be extra skin hanging down or bunching up under your eyes when you smile. You may look tired or drowsy, just not like your usual self. Maybe eyelid surgery can help.
The anatomy: The eyelid skin is the thinnest skin in the body. Because of this it is more susceptible to age and sun damage, loss of elasticity and stretching. In the upper eyelids, it is mainly the skin that gets stretched out, sometimes the muscle and rarely does the internal fat hold out. If there is fat bulging this is usually at the side closest to the bridge of the nose. Often upper eyelid excess is complicated by sagging and dropping down over the brow (see brow lift). When the sagging of the brow is severe enough this has to be addressed along with the extra skin in the eyelid. In the lower lids the most common problem is sagging or herniation of the fat pads. This causes the “bags”. The skull is very hard and the eye is very soft. There are small fat pads around the eyeball in side the sockets that protected and act as shock absorbers. And as people age these fat pads can bulge out. This process is made worse by allergies, sinus disease, thyroid or kidney problems. Because the eyelids skin is so thin and susceptible, damage and stretching can occur at any age. Eyelid surgery is often the first cosmetic surgery done on a person, well before any kind of face lifting but perhaps after non-invasive skin tightening Thermage. Some people may even benefit from eyelid surgery as early as their twenties.
The solution: Blepharoplasty
Blepharoplasty is plastic surgery to remove extra skin muscle and fat from the eyelids when these structures have stretched out or bulge out changing normal contours. As mentioned above this can be associated with medical problems or eventually just be a sign of general wear and tear. In the upper eyelid a crescent, or half Moon of skin is removed right in the crease of the eyelid. This creates a defined crease and opens up the eye. Sometimes some muscle is removed as well. Occasionally fat is removed near the bridge of the Nose. In the lower lid an incision is made in the crease underneath the eyelashes. The skin is lifted up. The muscle layer is opened. The extra fat is removed. The skin is tightened by removing the excess. Sometimes a suture is placed from the lower eyelid to tighten the lower lid if it is extremely loose. This is called a canthopexy. This procedure can be done alone or with a brow lifts or a facelift. When done alone it is usually done with local anesthesia and sedation. When it is done with several other operations, is often done under a general anesthetic for comfort and safety. The blepharoplasty usually takes one to two hours and is an outpatient procedure. There is minimal pain and discomfort involved. Sometimes there is bruising and swelling. A week at home to recover is sufficient. Patients can then go back to work after the sutures are removed at one week. The sutures placed are dissolving sutures and they usually dissolve by seven days. The ones that have not dissolved are then removed.
Restore Youth and Fullness with a Sacramento Facelift
The Facelift has been around for about 100 years and everyone has a fairly clear idea what a it is. In a facelift, you make an incision, separate the skin from the muscle layer, pull it as hard as you can and remove this extra skin and then stretch it tight. Right? Actually there are still some plastic surgeons and other types of doctors who do this type of surgery. Most plastic surgeons do what could be called a two-dimensional procedure: lifting up the muscle layer in a variety of fashions with many variations on the same.
But is a young face a tight face? If you pinch the cheeks of an 18-year-old the skin isn’t tight. As a matter of fact it’s rather loose. It isn’t tight at all. The difference is young faces are full of fat. Note in the picture below how round and full Angelina Jolie’s face was as a teenager and then how much less fat she has in her face over the following 20 years. She is still beautiful but in 20 more years, she may be thinking she wants some of that youthful fullness back.
The Modern Lift
As most people age, unless they gain a lot of weight, their faces lose fat. It’s like a balloon that starts to deflate. When faces deflate, skin starts to sag and settle. This contributes to the aging look.
When a Sacramento facelift is done, skin and muscles are tightened and lifted. But this face lift alone doesn’t replicate a youthful full face in everyone. There is a third dimension missing: volume.
At Advanced Concepts in Plastic Surgery, we perform what is essentially a modern Sacramento facelift where volume is added as needed. The missing volume is fat, so usually the best fat replacement is fat. This is removed from a donor site like the tummy with a blunt needle and then re-injected into the cheeks chin or lips as facial filler. Combined with a lift this volume brings back a youthful look. If you think back to high school and college everyone had a full face and a skinny body. Then over the years the face tissues start to disappear and the body gets fatter. It’s unfair but that’s the way many people age. By reversing the process, filling what has been deflated, the plastic surgeon restores a youthful look. This also re-creates a more natural look without excessive pulling.
As a certified plastic surgeon, Dr. Andrew Kaczynski has been performing Sacramento facelift surgery at Advanced Concepts in Plastic Surgery for over 25 years. His patients travel from Folsom, Roseville, Auburn, Stockton and San Francisco to seek his surgical artistry.
Dr. Andrew Kaczynski is a Board Certified Plastic Surgeon serving Roseville, Folsom, Granite Bay, Sacramento and San Francisco.