The Procedure: Lips

The lips should be full and wide with the upper lip slightly rotated, revealing the lower portion of the front teeth. The lower lip should be comparable in size and slightly rolled forward. There are numerous procedures to enhance the appearance of the lips. They can be augmented with the use of fillers like Juvederm, Restylane or fat or they can be enhanced by rolling the mucous membrane from within the mouth to the outside. Additionally, an elongated upper lip can be reduced by excising some of the skin immediately beneath the nose. In this latter instance, the upper lip is considered to consist of “white” and “red” components.

Facial Plastic Surgeon

Dr. Pincus is board certified by the American Board of Otolaryngology (ABOto) and the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). He is also a member of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).

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Since each person’s face is different, the results of a facelift will vary from person to person. Dr. Pincus can explain the details of the various facelift methods along with additional procedures such as rhinoplasty, necklift, eyelid surgery, and forehead lift discuss with you which method will best suit your needs. When combined, these cosmetic surgery procedures can help patients achieve an overall facial rejuvenation to help them regain a more youthful appearance.

If you decide to have a facelift, please contact our office to schedule a consultation appointment. A consultation visit is an important part of every facelift process. Feel free to view our website to learn more about the facelift and other procedures we offer. If there is anything you don’t understand about the facelift procedure, contact Beverly Hills facial plastic surgeon Dr. Pincus for more information or to schedule your consultation visit.

Cheek Augmentation

It has always been my impression that a good looking, balanced face is more square than oval. This necessitates having well developed cheeks and angles to the jaw. For a face to look more feminine, the cheeks are stronger than the angles. And vice versa for a face to be more masculine. To this end, we usually augment the cheeks with either the person’s own fat, injectable fillers or synthetic cheek implants. The implants I use are made of silicone and are screwed to the cheekbone with a tiny titanium steel screw. This ensures that stability and symmetry will be maintained and not change over time. The approach is under the upper lip, and either a malar implant is used to augment the cheekbone area or a combined implant is used to augment both the cheekbone and sub-cheekbone areas.

Cheek augmentation (before & after)

Facial Feminization Services

So many aspects of the face suggest either a masculine or more feminine appearance. Dr. Stephen Pincus understands the importance of creating a natural result with facial feminization surgery, and he has dedicated much of his practice to meeting the needs of his transgender patients. Over the past several years, he has identified the areas of the head and neck that benefit the most from this procedure. Dr. Pincus has a specialized way of achieving the most feminine, natural-looking results while maintaining the patient’s identifiable facial characteristics.

Forehead

Brow bone is reduced and forehead is occasionally made rounder and softer

Hair

More Feminine hairline is achieved

Neck

The Adams apple is reduced

Nose

Nose is made smaller and more refined

Cheeks

Cheeks are augmented to create a youthful, feminine face

Lips

Upper lip is reduced and are made fuller

Chin & Jawline

A prominent chin or jawline is reduced

Eyebrows

Eyebrows are lifted and arched

Browlift in the MtF TS patient

The female eyebrow is arched compared to the flat eyebrow in the male. The ends of the eyebrow (the club and the tail) are at the same level, and the highpoint of the arch is between the outside of the iris and the corner of the eye. Since many MtF TS patients have their supra-orbital ridges reduced, the eyebrows can be elevated at the same time by pulling the forehead skin upward in this open approach. On the other hand, if brow bossing is not an issue, endoscopic (closed) browlifting or even brow elevation through an upper eyelid incision can be performed. This latter technique would be a good approach if upper eyelid surgery were also being performed and most of the elevation that was needed was on the outside or lateral aspect of the eyebrow without significant drooping of the inside or medial aspect of the eyebrow.

Browlift (before & after)

THE VERTICAL FACELIFT IN BEVERLY HILLS

Facelifts go by many names—some technical and some not-so-technical. There is the subcutaneous facelift, the SMAS facelift, the deep-plane facelift, the composite facelift, the MACS facelift, the mini-facelift, the mid-facelift, the endoscopic facelift, the S facelift, the thread facelift, the Lifestyle facelift, the short scar facelift, and, most recently, the vertical facelift. Many of these are just variations or limited versions of the others or just different access approaches to elevate the same tissues.

I would like to discuss the so-called vertical facelift because it has gotten much attention lately as the “best” approach to reversing the downward effects of gravity. Though the actual term may mean different things to different surgeons, the basic idea is to elevate some, if not most, of the tissue straight up. While this may seem to be the obvious approach to reversing facial aging, it is not that simple. Due to the various connective tissue attachments under the skin and the differences in mobility to the various parts of the face, there appears to be a forward as well as a downward descent. This is all too apparent when we look at the oblique fold of tissue going from the nostril to the corner of the mouth. Complicating this picture of facial aging is the atrophy or loss of the subcutaneous fat that also occurs in some areas, leaving a void or depression that looks as though tissue has fallen away. It appears that the best approach to reversing facial aging is a combination of some vertical as well posterior lifting, coupled with augmentation via fat or implants, if atrophy is also present. The vertical component of the lift can be in the deep subperiosteal plane or more superficially in the SMAS plane or even the subcutaneous plane. But it almost always gives a more natural result if there is some element of posterior lifting, as well. To that end, some surgeons are combining a vertical subperiosteal mid-facelift with a posterior-superior vector SMAS or subcutaneous facelift. Alternatively, others combine a posterior-superior vector MACS (minimal access cranial suspension)lift or SMAS facelift with a vertical subcutaneous facelift.