Question: If I want a procedure that will give me the appearance of having higher cheekbones what would be my best option?

Answer: You have several options to give the appearance of higher cheekbones. The easiest would be simply to place filler high up in the cheek and add volume in this area and this will, therefore, make your cheeks more prominent. A longer lasting possibility would be to place cheek or malar implants so that this volume will last a lifetime. A third option would be a midface lift, which is a surgical procedure that lifts the cheek tissue up into a more aesthetic position, and a final option would be a deep plane facelift where the midface is elevated in conjunction with a very elegant facelift.

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Question: I think I need a midface lift, but I would like to know if it will help with the appearance of nasolabial folds.

Answer: Many years ago there were studies performed analyzing the before and after results of a transtemporal midface lift and this showed that the cheek volume was definitely improved, and this did enhance the overall cheek area, but that it did very little for the nasolabial folds and jowling, and this has been my personal experience as well. The majority of midface lifts that I personally do today are in patients that require facial rejuvenation and are, therefore, part of a deep plane facelift that not only corrects the aging signs of jowling and submental laxity, but can also elevate the cheek complex and give patients an overall refreshed look in a very natural way. This facelift technique also improves the nasolabial folds, so in one single procedure I am not only able to rejuvenate the face, but I am also able to provide midface elevation and improvement in the nasolabial folds.

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Question: What types of mini facelift procedures do you perform?

Answer: I perform a very customized and unique mini facelift procedure, so it really depends on the patient’s anatomy as to which technique I employ, but most patients will benefit from a limited incision or short scar facelift that includes a SMAS imbrication technique where a small amount of the underlying SMAS is actually removed and then the mobile part of the SMAS is elevated and fixed to the remaining SMAS tissue in front of the ear allowing for a very nice lift without significant bunching or fullness. Excess skin is removed and, due to these more advanced and customized techniques, patients can look quite good within a matter of days and sutures removed in a week.

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Question: I am wondering if you can give an estimate on how long the results of an endoscopic browlift should last. I had one almost four years ago (I was 58 at the time) and I am now noticing that my forehead and brows are starting to droop again. Is it normal for this to happen?

Answer: I believe that the majority of browlift results will last a lifetime and I also believe that the majority of patients that require a browlift later in life actually started with low-set brows when they were young. Brows do droop a little bit and they deflate as they lose volume from the aging process and this process will continue throughout their life, so the brows will drop slightly over time, but usually patients get enough improvement from a browlift that later in life, even with the additional aging, they typically will not need another browlift. I have had many patients who have had browlifts earlier in life who then see me for facelift and frequently will go ahead and touch up the browlift along the sides to help improve their overall look. This certainly does not mean that we are performing another browlift, but what is called a lateral browlift does help with the harmony of an extended SMAS deep plane facelift, so I will commonly perform these together.

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Question: I am a 57-year-old woman who recently had a facelift. I am very satisfied with the results right now but how can I expect my face to look over the next ten years?

Answer: The answer to that question really depends on what technique of facelift was performed and whether or not additional work was performed underneath the chin to tighten those muscles. My personal opinion is that an extended SMAS deep plane facelift in combination with muscle work under the chin will be extremely long-lasting, and I typically will tell my patients that they should look better than the appearance they had
prior to surgery for a good ten years; furthermore, they should age with a very natural appearance so that even when they do show signs of early aging later on, this still looks very natural.

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