The Procedure: Mid Facelift and Traditional Facelift

Surgeons use the term “facelift” to describe any procedure on the face that results in a tighter, more youthful appearance. I will discuss the two most recognized approaches: the midfacelift and the “traditional” facelift. The midfacelift is a powerful new way to rejuvenate a person’s appearance who is just starting to show signs of aging. Unlike a traditional facelift, which pulls the entire cheek skin and neck skin in an upward and backward fashion to improve sagging jawlines and necks, the midfacelift pulls the area between the lower eyelid and upper lip in a more vertical direction. This serves to soften the fold between the nostril and the corner of the mouth (naso-labial fold) as well as add more fullness to the cheekbone and shorten the aged, elongated lower eyelid. Because the incision is inconspicuously located within the lower eyelid or within the temple, there is no obvious scar.

The traditional facelift, on the other hand, is a powerful procedure for improving the jawline and neck. With some of the more extensive modifications, naso-labial folds and sagging cheek fat can also be repositioned to produce a more youthful contour. The incisions are hidden in the hairline and around the ear and may or may not include a smaller incision under the chin. This latter incision is useful in approaching the anterior neckbands that may need to be modified through cutting, removal or suture tightening.

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).

Make Your Consultation Today
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.

Hairline

One of the most distressing male features in someone transitioning from male to female is the male pattern of baldness. This usually starts out as temporal recessions but may proceed to a significant loss along the entire frontal hairline. A female hairline is rather straight  across and appears to be positioned approximately one third the height of the frontal face when measured up from the eyebrows. Correction to achieve this goal may involve a scalp advancement, hair transplants or a combination of the two.

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

RHINOPLASTY BEVERLY HILLS

Rhinoplasty is a surgical procedure designed to reshape the nose. Beverly Hills rhinoplasty and facial plastic surgery specialist, Dr. Stephen Pincus, offers rhinoplasty, revision rhinoplasty, facelift, necklift, cheekfold lift, and eylid and eyebrow surgery at his Marina del Rey and Beverly Hills cosmetic surgery clinics.

Thinking of changing the shape of your nose? Read on….. It is said that the nose is the facial feature most noted after initial eye contact with another individual. Being centrally located, it should blend harmoniously with the other facial features and not draw attention to itself. People seeking to change the shape of their nose do so because of several reasons: The nose has been an unattractive feature that may be affecting their career in modeling or acting; it may be crooked or asymmetric (from birth or injury); or it just may not fit in with the rest of their face as the individual feels it should. In this last instance, such preoccupation with the nose may be realistic, unrealistic or misplaced. On profile, a small chin or short upper lip will make a nose look bigger. Also, some individuals seek corrective nasal surgery to establish a more youthful look. With aging and gravity, the cartilage in the tip of the nose starts drooping, producing an apparent lengthening of the nose with a slight hump. Finally, some people have breathing difficulties, headaches or sinus problems due to deformities within the nose. Many times these internal deformities will express themselves externally as well, as with a very deviated septum. In this instance, correcting the deviated septum will help straighten a crooked nose. Form and function should always go hand in hand, and the form of the nose should never be altered at the expense of function. Actually, it is generally found that an aesthetically pleasing nose works well, too.

When discussing nasal surgery, several terms always appear. Rhinoplasty or “nose job” comes from Greek derivatives: “rhino” which means nose and “plasty” means reshaping. If the internal midline structures of the nose, the septum, need to be straightened, we call it septoplasty. Within the nose, on the side walls are several small bones which have a very vascular lining. These bony structures are called turbinates. By swelling up with blood, they can affect airway resistance, humidification and heating. They are responsible for nasal blockage during” colds” or “allergy attacks.” Certain abnormal states can exist which leave these structures abnormally enlarged and then partial removal (SMR or sub mucous resection) may be needed.

WHAT IS DONE

The actual rhinoplasty operation consists of removing excess bone or cartilage and then rearranging and reshaping the remaining nasal structures. In all but a very few cases, the in RHINOPLASTY BEVERLY HILLS
Rhinoplasty is a surgical procedure designed to reshape the nose. Beverly Hills rhinoplasty and facial plastic surgery specialist, Dr. Stephen Pincus, offers rhinoplasty, revision rhinoplasty, facelift, necklift, cheekfold lift, and eylid and eyebrow surgery at his Marina del Rey and Beverly Hills cosmetic surgery clinics.

Thinking of changing the shape of your nose? Read on….. It is said that the nose is the facial feature most noted after initial eye contact with another individual. Being centrally located, it should blend harmoniously with the other facial features and not draw attention to itself. People seeking to change the shape of their nose do so because of several reasons: The nose has been an unattractive feature that may be affecting their career in modeling or acting; it may be crooked or asymmetric (from birth or injury); or it just may not fit in with the rest of their face as the individual feels it should. In this last instance, such preoccupation with the nose may be realistic, unrealistic or misplaced. On profile, a small chin or short upper lip will make a nose look bigger. Also, some individuals seek corrective nasal surgery to establish a more youthful look. With aging and gravity, the cartilage in the tip of the nose starts drooping, producing an apparent lengthening of the nose with a slight hump. Finally, some people have breathing difficulties, headaches or sinus problems due to deformities within the nose. Many times these internal deformities will express themselves externally as well, as with a very deviated septum. In this instance, correcting the deviated septum will help straighten a crooked nose. Form and function should always go hand in hand, and the form of the nose should never be altered at the expense of function. Actually, it is generally found that an aesthetically pleasing nose works well, too.

When discussing nasal surgery, several terms always appear. Rhinoplasty or “nose job” comes from Greek derivatives: “rhino” which means nose and “plasty” means reshaping. If the internal midline structures of the nose, the septum, need to be straightened, we call it septoplasty. Within the nose, on the side wcisions are made entirely within the nose. Generally, bone and cartilage over the upper two-thirds of the nose is reduced in height and is also narrowed. Occasionally, augmentation rather than reduction is necessary if too much has been removed from some prior surgery or if it has been depressed from previous trauma. Augmentation is also used many times for the “Westernization” of certain oriental noses. Finally, the tip cartilages are made more delicate and aesthetic by means of selective resection, rotation and reshaping.

THE PERFECT NOSE

The ideal nose is generally considered to have a well defined tip which projects slightly above the plane of the remainder of the nose when seen in profile. Women usually prefer a slight slope over the remainder of the nose, whereas men generally prefer a strong straight profile. Furthermore, the angle at which the nose is tilted upward also varies. The ideal male nose shows an angle of 90° to 100° between the lip and nasal tip, while the female has an angle of 100° to 120°. Taller people require less rotation to avoid excessive “nostril show.” Additional facial cosmetic procedures such as chin augmentation or reduction and upper lip lengthening or shortening may also be needed to establish facial harmony. While certain ideal aesthetics are always kept in mind, it is most important to have a nose that is natural in appearance and fits the individual. With the advent of video-facial computer analysis, many of these proposed changes can be performed on a frozen picture displayed on a TV screen. This gives the patient an excellent idea of how much reduction, narrowing or rotation the surgeon has in mind. However, the changes displayed should be realistic since the computer can do things which the scalpel cannot.

THE OPERATION

The actual surgery can be performed with the patient under general anesthesia (totally asleep) or under intravenous sedation (twilight sleep). In either instance, it can be done in a hospital, surgicenter or office operating suite. Depending on the complexity, the procedure will take between one and three hours. Following surgery, the patient has a very small intranasal packing and some form of protective external splint.

Usually, the packing is removed the next day and the splint five to seven days later. Surprising to most patients is the fact that pain is either quite minimal or nonexistent. There is usually some swelling and bruising around the eyes which is 90% resolved within the first week. At this time, most people are healed enough to return to work. Most of the usual daily activities can be resumed at this time. However, vigorous exercising or straining is to be avoided for three to six weeks. In some patients, especially those with thicker skin, a certain amount of swelling will persist for several weeks after surgery. Generally, this is more noticeable to the patient than to those around him. Also, it is somewhat worse upon arising each morning and gradually diminishes throughout the day. Head elevation during sleep and avoidance of prolonged sun exposure helps this last bit of swelling to resolve.

In summary, it should be stressed that the goals of rhinoplasty should be realistic and personal. Being an operation that can be either subtle or quite dramatic, it is something that a person should want to do for himself and not merely to please someone else. All questions should be thoroughly answered prior to surgery, and the surgeon should be quite willing to show many examples of his work in this field.

CONSULTATION

To learn more about rhinoplasty, please feel free to view the information provided on this website. Rhinoplasty candidates in Beverly Hills should contact Dr. Pincus to schedule a consultation appointment. Consultation is an important part of the rhinoplasty process as it allows the doctor a chance to examine your nose and facial features and to discuss your options, goals and expectations.
Contact Beverly Hills rhinoplasty specialist Dr. Stephen Pincus today for more information or to make your appointment.

FACIAL AGING

It has been said that facial aging can be summarized by referring to the 3 D’s  Descent, Deflation, Deterioration.

By descent we mean the sagging of the facial tissue caused by gravity. The treatment for this would be pulling back the tissue to where it was many years earlier via a facelift, necklift, browlift or eyelid lift. By deflation we mean the gradual atrophy of the fatty tissue in the face, which had given it the attractive fullness… characteristic of youth. To reverse this, we transfer fat from another part of the body to areas of the face that are deficient. In some cases, we can even use synthetic implants.

By deterioration, we mean the loss of elasticity and collagen in the skin and the general degradation that we see from aging and exposure to the elements. The treatment for this is re­surfacing via laser, dermabrasion or chemical peels, and appropriate maintenance with moisturizers, sunblocks and other topical creams such as retin­A and the alpha hydroxy acids like glycolic acid.

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.

Evaluating a Facelift Result

Though many facelifts are performed in Beverly Hills, the percentage of those that would be considered “excellent” or even “good” is not as high as one would expect. But rather than going into why this is the case, I would like to discuss what constitutes an excellent result. It goes without saying that there should be no serious complications, such as permanent sensory or motor nerve injury or loss of skin with resultant scarring. The result should make you look younger and refreshed. In many instances, colleagues at work will comment that you “look good” or “well rested” and that maybe you should take more “vacations”, like the one they think you just returned from. It should not look like you recently had surgery! The incisions should be imperceptible or well hidden. There should be no distortion of your features, like the corners of the mouth or eyes or the ears. There should be no significant asymmetries between the two sides of the face,  and improvement in the face should be matched by a similar improvement in the neck.

Finally, there should be no “lumps” or “depressions” following the surgery, nor should there be localized discolorations or edema, suggestive of damage to the vascular or lymphatic networks under the skin.