This is a 62 year old white female. She is 5’5” and 155lbs with no history of previous surgery. She is a non-smoker. Her greatest area of concern was her lower face related to her significant jowl development and marked submental and lateral neck fullness. This was compounded by her slightly retrusive chin. She had also begun to develop some hooding of the upper eyelid skin. Having discussed all of the risks and benefits of facial rejuvenation she decided to proceed and underwent a full lower facelift with a SMAS plication and significant liposuction of the submental area and neck. At the same time she had a small chin implant placed as well as a conservative upper lid blepharoplasty. Her postoperative course was unremarkable and within a month the scars had begun to heal nicely and she was back to all normal activities. Photos obtained at four months show that she has achieved a significant improvement. The face is elevated, the jowls are less conspicuous, there is more definition to the submental area and neck and the eyes appear more open and bright. She appears significantly refreshed without some of the distortion seen in overdone facelifts. She is quite pleased with her new appearance.

This is a 65 year old white female whose only previous surgery included a partial thyroidectomy twenty years ago and a ruptured Achilles tendon. She is a non-smoker and a retired nurse. She is 5’6” and 134lbs. She had two areas of concern. First were her eyelids. She had significant hooding of the upper lids, while her brow was in a reasonable position. She did not have a great deal of excess fat. Upon examining her lower eyelids she had a little bit of puffiness and her snap test was acceptable. As far as her face was concerned she had significant jowl formation, loss of mid face volume, prominence of the nasolabial fold and laxity of the neck particularly with the development of long platisma bands. In order to correct her aging process she would need a standard four lid blepharoplasty with only a small amount of skin excision from the lower eyelids. As far as her face was concerned she would need an open corset platismaplasty for the vertical bands as well as a full facelift. Having discussed the risks and benefits of surgery at length she decided to proceed. She underwent the full facelift with a corset platismaplasty and SMAS plication as well as a four lid blepharoplasty and small amount of fat excision without any difficulty. Her postoperative course was uneventful and she was back to normal activities within two weeks. Photos obtained at three months show that she has achieved her desired result. Her face looks refreshed without an over operated appearance. Her eyes are more open in appearance with less redundant skin. The cheeks are in better position, the jowls are diminished and her vertical bands have been removed. She is quite pleased with her surgical outcome.

This set of before and after photos features a 54 year old white female in good health who has had previous plastic surgical procedures including a brow lift and upper blepharoplasty. She was a nonsmoker. Her present concern was the appearance of her lower face. She had gradually developed crepiness, laxity in the neck area, and some jowl formation. In order to achieve her desired goal she underwent a lower face and neck lift with mild liposuction of the sub mental and neck area. She had a completely unremarkable course. Two months postoperatively she is completely healed. There is better balanced between the previously operated upper face and lower portion. The skin is smooth and tight without appearing overdrawn. She has a nice natural neck line and her jowl has been eliminated. She appears refreshed but not over operated.

This is a 61 year old white female non-smoker who for several years has been concerned with facial aging. Her daughter was getting married and she wished to look refreshed and more youthful prior to the happy occasion. Examination showed hooding of the upper eyelids without a great deal of excess fat, but on the lower she had significant puffiness. She also demonstrated classic signs of facial aging with loss of mid face fullness, jowl formation and submental fat deposits without platisma banding. In order to correct this she underwent an upper lid blepharoplasty with skin excision and a small strip of orbicularis muscle and a transconjuctival lower blepharoplasty for the herniated fat. She also underwent a full facelift with SMAS plication as well as submental and neck liposuction. Her postoperative course was uneventful and she was back to normal activities within a few weeks. Photos obtained at 3 months show significant improvement in her facial appearance. She now has a rested and more youthful presentation without looking over operated upon. She is very happy with the results and is all set for the upcoming wedding.

This set of before and after photos features a 60 year old woman who presented with wished to do something proactive about the gradual res of facial aging. This resulted in laxity to her neck, early jowl formation and loss of cheek fullness. Her upper eyelid skin was also beginning to droop which caused her eyes to appear tired, heavy and less open. After thoroughly discussing her aesthetic goals we determined that a 3 pronged approach would provide the greatest rejuvenation and correct each of the issues noted above. Specifically, the patient underwent a 4 lid blepharoplasty (eyelid lift) and standard facelift where the deeper fascia were placated and liposuction of the neck was performed. Photos taken only two months later show the patient to be completely healed. Her face appears natural, soft, vibrant and refreshed. Instead of an over-operated (or 'pulled too tight') appearance, she looks just like she did 10 or so years ago - which is the sign of a first rate facelift. Suffice to say, the patient is very pleased with the result and so am I.
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