Face Lift Plastic Surgery Information Resource for Southern California including Los Angeles, Orange County, Newport Beach, Beverly Hills, and San Diego.
Face Lift
Overview of Customized Face Lift
The concept of face lifting has undergone dramatic improvement over the last last decade. In my hands of experienced plastic surgeons, it has become less focused on skin-tightening and more focused on the resuspension and addition of fat with gentle redraping of the skin. This eliminates the over-done "surgical look" and creates a more natural, youthful appearance. The difference between "surgical-look" of the traditional face lift and the natural look of the new CustomLift® is apparent in the pictures. With the Custom Lift® it is not appearent that they had anything done, aside from the fact that they look more refreshed. There is no reason to have an "operated on" look.
Custom Lift®
Facial aging is a very complex process. It primarily involves the descent and loss of facial fat and muscles and secondarily the sagging of the skin. This is why it is essential to address each patient's specific problem areas instead of performing a one-size-fits-all lift. The CustomLift® is a methodical way of identifying the individual causes of each patients facial aging and applying the most appropriate correction method possible. This creates predictable results with minimal down time. It addresses the underlying problem instead of creating a "pulled" look.
Youthful Face
Aging Face
The real value of the Custom Lift® is in the experience and methodical thought process of the board certified plastic surgeon. Rather than a "one size fits all" procedure created by a cosmetic surgery marketing team, the Custom Lift® is unique for each individual and performed by highly experienced Board Certified Plastic Surgeons. These Plastic Surgeons have their own practices based on great results and patient referrals as opposed to being managed by a marketing group.
What exactly is CustomLift®?
There are three fundamental processes that make the CustomLift® exceptionally predictable and successful:
- Clearly Define the Priary Concers
- Identify the Contributing Factors
- Prioritize
The fundamental concept of the CustomLift® is to educate each patient in an easy to understand fashion outlining the causes of their facial aging. Then, to prioritize their treatment plan so that the patients can achieve their desired result in the least invasive manner possible.
1. Clearly Define the Primary Concerns.
A consultation with a board certified plastic surgeon will accomplish this task.
The most common concerns include:
- a tired appearance of the eyes
- a gaunt, hollow look of the cheeks
- sagging jowls
- hanging neck
It is essential to understand the patient's primery concern to make sure that, at a minimum, this concern is corrected.
2. Identify the Contributing Factors.
CustomLift® categorizes this via a "Regional Approach" to facial rejuvenation. Facial aging is not an isolated process; it usually involves an entire region, if not the entire face. This can be a difficult concept to understand but it makes sense. A great example is the tired, sagging upper eyelid. Patients routinely believe that simple removal of the upper eyelid skin will take care of their problem. Usually, this is not the case; especially in people over 40 years of age. Often, there is a sad look to the outer corner of the eye caused by descent of the temple region. In order to treat the problem completely a regional approach is necessary; otherwise you will get an unnatural appearance as one part is rejuvenated and the other stays lax. Typically this is best addressed by an upper blepharoplasty and temple lift. Together they correct all the contributing problems to this region. Conveniently, adding the temple lift does not significantly increase the recovery or cost of the procedure.
Eyelid Rejuvenation
A more complex example is what occurs with aging with the face and neck. There are always multiple contributing factors. It is the plastic surgeon's responsibility to determine what they are based on his/her extensive experience and training. Later in this section we will break down each area into components. This is the methodology that is used by plastic surgeons who perform the CustomLift®. Breaking down each area will allow you to easily understand what is causing your area of concern.
3. Prioritize. Simply telling telling the patient what needs to be corrected is not enough. It is critical for the surgeon to accurately assess what is the relative importance of each contributing factor and to prioritize them. This enables you to make an educated decision as to what is necessary to achieve the results you are looking for. You can make an educated decision regarding how much or how little you wish to have done. A "one-size-fits-all" face lift is never appropriate.
Obtaining the Best Result Possible is Paramount.
Other heavily marketed face lifts concentrate on a "one-size-fits-all" factory-type face lift. CustomLift®, on the other hand, represents the best that plastic surgery has to offer.
To enhance the results certain ancillary procedures such as a chemical peel, fat transfer or BOTOX® can be added. This allows for a more complete facial rejuvenation.
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Face lift enhanced by Chemical Peel and conservative Lip Augmentation. |
CustomLift® Components
The CustomLift® evaluates facial aging by separating the face into three anatomically linked regions; the upper face, the mid face, the lower face and the neck. This regional approach allows the patient to understand all the components of aging within that area.
Typically, it is critical to address multiple components within the problem area in order to obtain an optimal natural rejuvenation. In keeping with the CustomLift® philosophy, it is essential for you to understand the relative importance of each component. This allows you to obtain the optimal result with the least invasive approach. Let's go through each region.
Upper Face Rejuvenation
Approach to the problem areas of the Upper Face.
The six most common concerns regarding the upper face are listed below. Remember, the entire concept of CustomLift® is to identify which of these problems are of concern to you AND the relative importance of each concern. With this information you can intelligently outline which procedures are best suited for you. Unfortunately, with time everyone will experience aging to ALL six areas but this does not mean that each area must be addressed at the same time.
1. Upper Eyelid.
The most common concern with the upper eyelid is excess skin. Fat excess is rarely a problem except in the Asian population. In fact, the upper eyelid region LOSSES fat with age and becomes hollow and gaunt. Sometimes, there is a little bulging fat pad right next to the nose. Aside from this all fat in the eyelids is precious and should be preserved. If this fat pad is present, it is located just above the corner of the eye near the bridge of the nose. This should be removed at the time of upper blepharoplasty surgery.
Animated Upper Eyelid Surgery
Scroll over the image to see the effects
of a skin removal from the upper eyelid.
Notice how the crease is more defined
and the eyes look more rested.
What does the Upper Blepharoplasty do?
CustomLift®'s approach to upper blepharoplasty is to remove the redundant skin to define the upper eyelid and give it a youthful appearance. In women, this creates an elegant, defined upper eyelid, which allows makeup to go on easily without smudging. The size of the upper eyelid is decided by the patient. Men, on the other hand, are usually looking for a less dramatic result. They do not tolerate an "operated-on" appearance.
How do I know if an Upper Blepharoplasty is right for me?
If your upper eyelid skin is loose and sagging you would most likely benefit from an upper blepharoplasty. Typically, this redundant skin can be easily pinched and feels "paper" thin.
Patient with significant excess skin and hollowing of the upper eyelid. Notice how rejuvenated the post-operative picture looks, without an "operated" appearance. |
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2. Temple Region, Outside Corner of the Eye and Crow's Feet
This is the area of the upper face that typically ages the quickest. Yet, it is often not addressed by the majority of plastic surgeons. The temple region is the outer part of the eyebrow and the outer corner of the eye. Elevating this area with a Temple Lift creates dramatic improvement in appearance. The nice thing about this procedure is that it can easily be done under local anesthesia with or without a blepharoplasty.
Animated Temple Lift
Scroll over the image to see the effects of
a temple lift. Notice rejuventaion of outer brow,
outer corner of the eye and crow's feet.
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Notice tired and hooded appearance of outer part of the eye and eyebrow. Notice the bright and elegant appearance after temple lift and upper blepharoplasty. |
What does the Temple Lift do?
The temple lift does several key things in terms of rejuvenating the upper face. It lifts the outer corner of the eye. This dramatically improves the lateral hooding of the eye that often makes you look sad even when you are not. It raises the outside part of the eye brow creating a very elegant look. In fact, it usually replaces a brow lift completely. It's effect is not to raise the central eyebrow, which can oftern can make you look older and surprised, but rather improve the shape.
| Correction of crow's feet with upper eyelid surgery and temple lift. |  |
How do I know if a Temple Lift is right for me?
In keeping with the CustomLift® approach, Dr. Cruise routinely performs both an upper blepharoplasty and a temple lift at the same time. This rejuvenates the entire upper facial region. Best of all, both can be easily done under local anesthesia without discomfort.
3. Brow
With aging and loss of facial volume, the brow routinely deflates and drops down. Sagging of the eyebrows is never uniform. The outer part of the brow almost always drops more than the inner part. Look in the mirror and see if this applies to you. If only the outer part of the eye brow has fallen then a temple lift is the best choice for correction.
If the entire brow has dropped, then a brow lift may be necessary. The word "may" is used because the CustomLift® approach prefers to correct the problem at its cause. Often the brow falls because the upper eyelid/brow area has lost significant fat.
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Example of one sided brow sag. Right brow corrected with brow lift. |
The loss of fat volume causes the brow to descend not because there is an excess of skin. It also causes the upper eye to look hollow. The best way to correct these problems is to perform a temple lift to raise the outer brow. Then, to replenish the lost volume with either fat or a soft tissue filler.
By correcting the cause of the problem, facial rejuvenation looks much more natural.
What does a Brow Lift do?
A traditional brow lift elevates both the inner and outer part of the brow. The temple lift, however, elevates only the outer part of the brow.
How do I know if a Brow Lift is right for me?
It is far more likely that you will need a temple lift before you need a brow lift. Remember, the goal is to make the brow look more youthful not just higher. The real question in the CustomLift® approach is whether or not you need a brow lift in addition to the temple lift. You can check this by first imitating a temple lift as described in the picture above. If the central part of the brow still seems low than a brow lift may be necessary.
Caution: A traditonal brow lift without a temple lift will create an older, hollow, surprised look.
Surprised Look.
As you can tell, I am much more enthusiastic about the temple lift than I am about the brow lift. This goes back to the CustomLift® principles which demand that the cause of the problem needs to be corrected. The temple area and outer brow fall much earlier and more significantly than the central and nasal part of the brow. Therefore, this is the area that should be addressed primarily. There are too many people walking around with an unnatural "surprised" look to their brow because their problem was not addressed at its root.
By correcting the cause of the problem, facial rejuvenation looks much more natural.
4. Hollow, Sunken Appearance of the Upper Eyelid
This topic is a perfect continuation of the brow area. As mentioned above, the brow often falls because the brow region and upper eyelid losses fat with age. Not only does this cause the brow to drop but it causes the upper eyelid to appear sunken and hollow.
Animated Fat Transfer to Upper Eyelid
Scroll over the image to see the effects of a fat
transfer
to upper eyelid.
Notice how the fat
replenishes
lost volume necessary for a
youthful appearance.
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Soft Tissue Filler correcting hollow upper eyelid. Notice the dramatic natural rejuvenation. |
Traditional cosmetic surgery principles would treat this problem with a tight upper blepharoplasty and a brow lift. This often leads to a hollow, surprised appearance that actually looks older. The CustomLift® approach treats this problem by replacing the lost volume with a soft tissue filler or fat which, after all, is the root cause. Excess skin is removed as necessary.
Young hollow looking eyelids that would benefit from extra volume.
The same eyes as above but filled in with soft tissue filler to give it more youthful, fuller look.
What are soft tissue fillers?
Soft tissue fillers are a myriad of injectable products that add volume. 
There are two distinctly different types to choose from. One type comes packaged and ready to inject. You most likely have heard of them by name, i.e. Restylane®, Juvéderm™ , Radiesse, etc. These last anywhere from 6 to 24 months. The other type is your own fat. Obviously, this fat needs to be removed from other parts of your body, purified, and then re-injected. The clear advantage of the packaged soft tissue filler is that it does not require a donor site and, therefore, is much simpler with less down time. The advantage of fat is that it lasts forever.
How do I know if I need a soft tissue filler for the upper eyelid?
This can be done by first simulating a temple lift with your index, middle and ring fingers. Now, look at your upper eye lid. Is it hollow? Does it look sunken? If so, a soft tissue filler will help tremendously. The good news is that it is relatively quick with minimal to no down time. A huge advantage of the packaged soft tissue fillers for the upper eye lid is that they last much longer here than they do in the lips or naso-labial folds. They can often last up to two years.
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Soft Tissue Filler to the Upper Eyelid Region. |
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5. Crow's Feet and Forehead Wrinkles
Wrinkles that are caused by facial animation are best corrected with Botox®. As mentioned earlier, crow's feet that are caused by excess skin can be removed by performing a temple lift. Crow's feet that only occur during smiling require Botox®.
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Static Crow's Feet corrected with Temple Lift |
Animated Wrinkles
Example of face at rest and dynamic wrinkles.
Those can be best addressed with BOTOX®
The results from Botox® often are amazing. It has essentially no down time. The obvious draw back is that it lasts only 4 to 5 months.
6. Poor Skin Quality and Sun Damage
With age and sun exposure many unfavorable things happen to facial skin. The surgical procedures above address how to manage skin excess, skin sag and volume loss. The most difficult problem to correct, however, is poor skin quality.
Aging causes the dermis to become thin. This, along with sun damage, causes the skin to loose its elasticity. Therefore, neck and facial skin that is tight and smooth in a 30 year old becomes loose and saggy in a 50 year old.
How can skin quality be improved?
The CustomLift® addresses poor skin quality primarily using two modalities. One is a chemical peel. This penetrates the dermis causing it to heal with thicker, more elastic dermis. It has anywhere between a 3 day to a 2 week recovery period depending on how strong of a peel is desired. The most impressive result of a chemical peel is its ability to get rid of the aged spots and caused by sun damage.
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Sun damage corrected with chemical peel. Notice the dramatic improvement of skin quality. |
The second modality is daily exfoliation and dermal thickening. This is typically done with a glycolic acid moisturizer in the morning and retinoic acid (Retin A) at night. Both of these agents are excellent exfoliators. They effectively get rid of the top layer of dead skin and leave a healthier, radiant appearance to the skin. They are effective and inexpensive, unlike many highly marketed products which really do not work. Other products can also be incorporated but these two are essential.
Putting it all together: How to decide which procedures are best for you.
Remember, the entire concept of the CustomLift® is to clearly define the problem areas and to prioritize what needs to be done. This is where your plastic surgeon's experience is absolutely critical.
The most common surgical combination I do for the upper face is the upper blepharoplasty combined with temple lift. These two go hand in hand especially for people in their forties and above. The nice thing about this combination is that it can easily be done under local anesthesia with minimal down time and predictable results.
Mid Face Rejuvenation
CustomLift's® approach to the problem areas of the Mid Face.
1. Lower Eyelid
The lower eye lid is the most complex region of the face when it comes to the aging process. Only recently has plastic surgery begun to comprehend what really is causing the aging appearance here and even more recently have we figured out how to treat it.
The biggest culprits of lower eye lid aging process include:
- excess skin
- sagging of the outer corner of the eye lid (crow's feet)
- bulging eye lid fat (bags)
- circles under the eyes
Each one of these problems is caused by different aspects of the aging process. The key is to identify which ones are your primary concerns, prioritize them, and address them in methodical fashion.
Before we go into the individual aspects of the lower lid, one needs to consider the profound effect fat loss has on the cheeks and lower eyelid. It is most likely the single biggest contributor to the aged look of the lower lid and mid face, yet, only recently have we begun to understand this. Because of its attention to detail, CustomLift® has been at the forefront of recognizing this extremely common problem and addressing it on a routine basis.
Fat transfer to the cheeks and lower lids has become one of the most common procedures Dr. Cruise performs on the face. Replenishing volume is treating the problem at its root cause.
2. Excess Skin of the Lower Lid
Excess skin of the upper eyelid occurs relatively early in the aging process. The lower lid, however, is somewhat different. Skin laxity becomes a problem typically later in the aging process. Fat loss routinely precedes skin laxity. Excess skin shows itself as redundant, wrinkly skin over the lower lid. This skin can often be pinched and pulled away from the lid once it becomes significant.
Animated Lower Eyelid Skin Removal
Scroll over the image to see the effects of
lower eyelid skin removal.
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Correction of wrinkly lower eyelid skin with skin removal and temple lift. |
3. Excess skin of the upper cheek and crow's feet; tired appearance
Traditional plastic surgery techniques typically treat this problem with skin and muscle removal. The CustomLift® addresses this by performing a temple lift with, or without, skin removal of the lower eyelid. This tightens the saggy skin all the way down to the upper cheeks and crow's feet area. This accomplishes many positive things. It gets rid of the crow's feet as well as the excess skin of the lateral part of the lower lid. In addition, it creates a youthful, bright, elegant appearance.
As you may have noticed, the temple lift is a very effective treatment for both the upper and lower eye lid. This is because the temple lift has a powerful rejuvenating effect on entire lateral eye region. Aging of the temple region is responsible for a significant portion of what we recognize as upper facial aging.
The temple lift is perhaps the most powerful rejuvenating procedure related to the upper face and eyes.
Animated Temple Lift
Scroll over the image to see the effects
of a temple lift. Notice rejuventaion
of
outer brow, outer corner of the eye
and
crow's
feet and excess skin of the lower lid.
4. Bags under the eyes
Bags of the lower eye lid are caused by two completely different processes involving fat. The first process is the most obvious. It is caused by bulging fat of the lower lid. This fat swells more in the morning and when you are tired.
Animated Removal of Bags under the Eyes
Scroll over the image to see the
effects
of removal of bags.
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Example of removing lower eyelid fat, otherwise known as "bags." |
The other process is less obvious. It is caused by LOSS of fat within the upper cheeks. You can confirm this by pushing down on the circles under your eyes with your index finger. Most likely you will immediately feel skull bone. This is because the fat that once covered this bone has melted away.
Hollowing of lower eyelid corrected with fat transfer to the lower eyelid crease. Notice how well this corrects the "circles under the eyes." |
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The CustomLift® evaluates each of these two processes and determines which needs to be corrected. It is not uncommon to remove the fat that is causing the bags and then to transfer fat into the circles under the eyes. This directly treats both issues and, thus, is the most effective treatment for lower lid rejuvenation.
5. Hollow Cheeks and Circles Under the Eyes
All humans begin losing fat in their cheeks starting from the day they are born. Losing fat before the age of 16 is considered "losing baby fat." Losing this same facial fat after the age of 30 is considered "aging." At 20, this aging is attractive as it sculpts and defines the face; especially the lower cheeks and jaw line. Once we get over the age of 30 our fat reserves are gone and aging sets in.
Animated Fat Transfer to Cheeks and Lower Lids
Scroll over the image to see Fat Transfer to
Cheeks and Lower Lids
Representation of loss and descent of facial fat with age
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| Youthful Face. Cheek fat is just below the eyes. | Aging Face. Cheek fat has descended and diminished in volume. |
This fat loss becomes a problem in women around the age of 30 and with men around the age of 40. This is because a more defined look is desirable in men whereas, in women, it is considered an early sign of aging. This is why most female models are in their teens and early 20's, whereas, men tend to look more attractive somewhat later in life.
The significance of loss of cheek fat has only recently come to our attention. This is perhaps the most significant cause of what we perceive as facial aging.
Youthful cheeks with a lot of facial fat.
By the age of 50 most of the cheek fat has gone away leaving behind a hollow, gaunt appearance. Loss of fat over the upper cheek bone leaves the characteristic circles under the eyes. The only way to treat this problem is to replace the fat with fat transfer.
What does Fat Transfer do?
There are several aspects of fat transfer that make it exceptionally appealing.
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First and foremost, it replaces the precious fat of the cheeks creating a youthful appearance that can not be obtained by any other method.
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It takes fat from an area that usually has an excess, i.e. the abdomen creating a win-win situation. Unfortunately, with age we accumulate fat in the areas we don't want it and lose it in the areas where we need it most.
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It can easily be done under local anesthesia, thus, making it cost effective and convenient.
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Finally, the amount of fat transferred is controllable as the procedure can be repeated until the desired result and shape is obtained. Adding fat not only replaces the fat you have already lost, it gives you a buffer so that when you lose fat in the future it is not noticeable.
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Fat transfer to cheeks. Notice how effectively it rejuvenates the hollow, gaunt appearance of the face and how natural it looks. |
6. Naso-labial Folds
CustomLift's® approach to the naso-labial folds, aka "parenthesis deformity," is dramatically different than the current standard treatment. The mainstay of the current treatment is injecting a soft tissue filler to plump up the crease. This does not treat the root cause of the problem; it is a short term cammouflage.
These folds are not actually caused by the crease getting deeper. It is caused by the fold above the crease hanging down making it appear deeper. Therefore, just filling in the crease does not make sense. In addition, soft tissue fillers rarely improve the look for more than two months.
The fold above the crease begins to hang because of loss of cheek fat. Once the volume of the cheek has diminished the skin begins to hang exagerating the crease. Therefore, CustomLift's® long term treatment to the problem is to replenish the lost fat. This will significantly improve the hanging folds by inflating the cheeks.
By correcting the cause of the problem, facial rejuvenation looks much more natural.
Lower Face Rejuvenation
CustomLift's® approach to the problem areas of the Lower Face.
1. Jowls, Jaw line, and Marionette lines
Marionette lines, jowls and poor jaw line definition are routinely treated by a face lift. It is important to go over the causes of these problems so we can better understand the treatment.
Animated Correction of Lower Face
Scroll over the image to see the effects of
face lift on the jaw line, marionette lines and
down turned corners of the mouth.
Marionette lines are the lines that form at the corner of the mouth and go downward (they are named after the moving mouth portion of a marionette).
They may look like an extension of the naso-labial folds but they are different and must be treated differently. The root cause of jowling, marionette lines, and poor jaw line definition is the similar. It is a combination of saggy facial skin, droopy facial fat, and loss of facial fat volume.
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Correction of jowls, marionette lines and poor jaw line definition with face lift. Notice the youthful triangular appearance of the lower face. |
Optimal correction of these three issues requires correcting each of the three underlying problems. Having said that, you may choose to obtain partial correction by choosing a more conservative procedure. This is what the Lifestyle Lift™ offers.
Lifestyle Lift™ performs a basic face lift under local anesthesia correcting primarily skin excess. CustomLift® offers this one dimensional procedure as well to specific patients who do not need much fat elevation and fat replacement. This is rare. In addition, Lifestyle Lift™ does not routinely directly address the neck problems which is often a primary concern of the patient interested in face lifting. Still, in the right patient, the Lifestyle Lift™ can obtain good results but it is limited.
If all that is necessary is skin tightening than a mini face lift under local anesthesia may be a good option. This one of the least invasive options offered by CustomLift®. As mentioned above, facial aging is rarely just a skin problem.
The CustomLift® is not a procedure; it is a plan to identify all the aspects of facial aging and choose which procedure(s) is/are necessary to obtain the result you are looking for.
Fat elevation and fat transfer is an integral part of the CustomLift® when jowling and hollow cheeks are present. Fat suspension elevates the jowl fat so that it is repositioned back into the cheek where it belongs. Then additional fat is added to fill in for the fat that has melted away with aging. This provides the optimal rejuvenation as it defines the jaw line, eliminates the marionette lines and recreates fuller, youthful cheeks.
An important component of the CustomLift® is the addition of the temple lift which Dr. Cruise includes in all of his face lifts. The temple adds such a dramatic improvement over conventional face lifts. The temple lift is explained above.
Facial Aging in Men
Anatomically, there is very little difference in facial aging between men and women. There is, however, a significant difference in treatment and expectations. Men are much less tolerant of an "operated-on," surgical appearance. Therefore, it is critical to make sure that their result is completely natural.
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They key to male face lift is to maintain a natural appearance. |
In summary, the Custom Face Lift, at a minimum, is a conventional face lift performed by an experienced plastic surgeon. Routinely, however, it also includes fat elevation, fat transfer, and a temple lift.
2. Weak Chin
The primery goal of facial rejuvenation is to create a more attractive, rejuvenated facial shape. If it is needed, adding a chin implant greatly enhances the result. In fact, it is common for the chin to sag and recess with age.
Animated Chin Augmentation
Scroll over the image to see the effects of
chin implant on recessed chin.
A chin implant will plump the chin out and fill in the area in front of the jowls, creating a more triangular, defined look.
Improvement of facial aesthetics with chin implant in conjunction with neck lift (no face lift was performed). |
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As with any component of the Custom Lift® it requires evaluation to determine if a chin augmentation would be helpful. The surgeon will assess not only if it is needed but the relative importance of adding a chin implant. This will allow you to make an educated decision.
What does a chin implant do?
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In women, a chin implant will create a more defined jaw line as well as a more triangular face.
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With men, it will not only define the jaw line but will create a more powerful, masculine appearance to the entire face. |
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3. Upper Lip Wrinkles
Wrinkles around the lips are caused by a combination of factors. The most significant are
- loss of collagen,
- loss of fat, and
- the constant motion of the underlying muscles.
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Correction of fine wrinkles around the lips with dermabrasion and soft tissue filler.
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The most effective way to improve these wrinkles is dermabrasion along with a tiny bit of Botox®. The dermabrasion will smooth out and thicken the underlying dermis. Then, a very small amount of Botox® can be injected just under the skin to flatten the muscle. This will not affect lip motion but will do a great job of decreasing or even eliminating the wrinkles. The overall result may be enhanced with the addition of a conservative amounth of soft tissue filler to plump the lips.
Thin Lips and Upper Lip Wrinkles
Scroll over the image to see the correction
of Thin Lips with Soft Tissue Fillers and
Upper Lip Wrinkles with Dermabrasion
4. Thin Lips
The gold standard for obtaining predictably fuller lips with very little down time is Hyaluronic Acid. Soft tissue fillers made of hyaluronic acid are marketed as Juvéderm™ , Restylane®, Perlane, etc. These are a dramatic improvement over the previous gold standard - collagen. They are advertised to last anywhere between 6 to 18 months. In reality, however, predictable enlargement lasts 6-12 months in the lips.
Injection techniques have improved significantly. Routinely, Dr. Cruise will numb up both lips before he performs the augmentation. This ensures that the procedure is pain free. In addition, Dr. Cruise uses needles that are half the size routinely used. This allows for more precise placement. In addition, bruising is rare and swelling is minimal. Returning to work the next day is not a problem.
Correction of thin lips with Juvéderm™
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5. Down Turned Corners of the Mouth
Often, patients complain that they appear sad or upset because they have a permanent frown. This is because the corners of their mouth have become down turned with age. The most effective treatment for this is a face lift. There is, however, a much simpler answer - Botox®.
By selectively relaxing the muscles that cause frowning with Botox®, the corners of the mouth will elevate about 3-4 mm. This simple maneuver, when performed properly, can eliminate the frown and give a happier, more pleasant facial expression. The lips will continue to move normally and no one will ever know.
Neck Rejuvenation
When is a neck lift necessary in addition to the face lift?
There are three primary indications for making a chin incision and operating directly on the neck as part of the CustomLift.
1. Prominent Neck Bands
These are the cords often referred to as a "Turkey Gobbler." They represent the inner border of the Platysma muscle. The best way to predictably correct these bands is to remove and suture the neck muscles together in the midline. This removes the cords and creates a more youthful, smooth contour with a defined neck angle.
Correction of neck bands (turkey gobbler) is best achieved with direct excision of cords and muscle tightening |
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2. Poor Definition of the Neck Angle.
People with poor definition of their neck angle have a neck that essentially goes from their chin to their upper chest. Many jokingly say that they have "no neck."
Animated Neck Lift
Scroll over the image to see the correction
of Neck Bands and Loose Skin on the Neck.
The key to the CustomLift® is to define and treat what is causing the heavy, undefined neck. Routinely, it is a combination of excess fat and hanging platysma muscle. The best way to address this problem is to begin with liposuction of the midline neck and jaw line. Then the remaining excess fat and hanging muscle in the midline must be directly removed via small incision under the chin. The muscle is then tightened in the midline and suspended in an lifted position. This will create the desired, defined neck angle that did not exist preoperatively.
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Example of poor definition of neck angle; corrected by neck lift only. |
The purpose of the CustomLift neck lift is to re-create a youthful neck angle. |
3. Heavy Neck
The heavy neck will always have poor definition as well. This is because the increased mass completely covers the neck angle and gives an undesirable heavy appearance.
A word of caution: Face and neck lifting is best done on people within 30 lbs of their ideal body weight. Heavier people will have considerable improvement with facial rejuvenation but the result will not be as good no matter what technique is used.
The advantage of the CustomLift is that it directly addresses even the heavy necks and will provide the best result possible. This is especially true when compared to face lifts claiming to be quick with a "one-size-fits-all" technique. The procedure is similar to that performed for the undefined neck angle but there is considerably more fat removed.
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Example of heavy neck with poor neck angle definition corrected by CustomLift (Neck Lift with Chin Implant). |
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Face Lift incisions |
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Traditional face lift incision. |
CustomLift incision. Notice there is no incision behind the ear. |
Glossary of CustomLift® procedures for facial rejuvenation
Upper Face
1) Upper Blepharoplasty
2) Temple Lift
3) Brow Lift
4) Soft Tissue Filler of the Upper Eyelid
5) Botox®
6) Chemical Peel/Skin Care
Mid and Lower Face
1) Lower Blepharoplasty
2) Temple Lift
2) Fat Transfer
3) Face Lift
4) Chin Implant
5) Dermabrasion
6) Lip Augmentation
7) Botox®
8) Chemical Peel/Skin Care
Neck
1) Face Lift
2) Neck Lift
3) Neck Lift Midline
4) Platysma Plication (Neck Muscle Tightening)
5) Liposuction Neck and Jaw Line
6) Platysma Muscle Transection
7) Muscle Suspension
8) Chin Implant
Testimonial
Dear Dr. Cruise,
I just had to let you know about my recent good fortune since my face lift. Everyone who sees me is losing it, they all think I look at least 15 years younger and at age 74, I'll take it. When you released me after a quick recovery, I went bowling on my league, my average was 135, I bowled a 181 & 189! Then the next morning I was up reading my morning paper and noticed I didn't have on my glasses that I've needed for the last 30 years and my vision was great!! So you get the credit for making me look 15 years younger, improving my bowling scores and my eyesight!! What a star you are!! You are now a true friend for life. Thanks to you and your crew for the professionalism, kindness and consideration shown to me and my daughter.
Sincerely,
Betty
Face Lift Cosmetic Surgery Information Resource for Southern California including Newport Beach, Orange County, Los Angeles, San Diego, and Beverly Hills.