How Facelift Results can be Improved by Also Addressing Volume Loss, and Eye Appearance

How Facelift Results can be Improved by Also Addressing Volume Loss, and Eye Appearance

how can I improve the results of a
facelift a facelift is one of the biggest investments you can make to
enhance your appearance typically performed by specialty trained doctors
facelifts are performed in operating rooms with the team of people in
addition to the surgeon over the course of several hours with so much time
resources and money spent on a facelift why are there people who are
disappointed with how they look after facelift surgery I’ll discuss what kind
of results should be expected from a facelift as well as the facial aging
issues that a facelift alone does not address I’m Dr. Amiya Prasad I’m a
Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic
and reconstructive surgeon I’ve been in practice in New York City and Long
Island for over 25 years I routinely perform all types of facelifts from
short scar mini lifts to more extensive deep plane or subs mass facelifts I
often perform a combination of face and neck lifts for people who are more
advanced facial aging since facial aging also affects the appearance of your eyes
I often perform eye rejuvenation such as upper and lower eyelid surgery at the
same time in many of my face lift surgeries I make it a point to address
the volume loss of aging seen in the lips and facial support structures
through strategic placement of selected hyaluronic acid fillers to enhance the
lips and vertical lines in addition to the cheekbones chin and jaw angles
one of the core principles in my practice is to first define the problem
before determining the optimal strategy to reach a solution it’s therefore
important to first identify what specific problems can be addressed by a
facelift a facelift involves a surgical restoration of the cheeks and jawline
soft tissue which has become loose and descended downward due to facial aging
these anatomic features are not just skin but they exist in layers which
include the skin soft tissue and the connections to the deeper facial muscles
the connection to the deeper facial muscles is often referred to as the
muscle and is referred to in our profession as thus mass which stands for
the superficial muscular aponeurotic system thus mass serves as a critically
important foundation for the skin to be supported by skin only lifts and
procedures such as thread lifts do not have the level of support of a properly
performed facelift and consequently don’t work very well as I mentioned
earlier aging changes are not limited to the cheeks and jawline but also affects
the eyes for example aging can cause the upper eyelids to appear hooded or
sagging as the skin above the eyes stretch and become redundant with age
the lower eyelids can also have a puffy appearance which is often referred to as
eye bags puffy eye bags are due to fat that is normally around the eyes
prolapsing forward combining eyelid surgery with face of surgery is
something I recommend to help you look your best as a combination when
appropriate the recovery time overlaps the face of surgery and you get the most
value out of the cost of the operating room
facility and staff in our office there are two important factors in facial
aging one is the descent of the skin and soft-tissue which is addressed by
facelift surgery the other is volume loss at the bone and soft tissue level
youthful facial volume can be appreciated by the fullness and
projection of the cheeks the jaw line definition and the overall facial
harmony seen in a younger person many facelift patients often report that they
really liked their results during the first few months after surgery and then
they feel that their facelift doesn’t look as good after one year this is a
misconception since during the early recovery period the swelling which is
temporary can create an appearance of having more youthful volume as the
healing process progresses this temporary fullness caused by swelling
disappears so how do I address your facial volume deficiency if I’m
performing your facelift as a surgeon I have used two strategies in the past to
help my patients one was to place facial implants made of silicone such as cheek
and chin implants at the bone level the other was to harvest fat and perform fat
grafting patients often resisted having facial implants and fear of looking
overdone they were generally willing to have a small chin implant but often
objected to having cheek implants I found myself concerned about two things
with the placement of cheek implants one was whether the patient would be
satisfied with the outcome or would they feel that the shape wasn’t what they
wanted or if the implant was either too small or too large the other concern for
me was whether the patient then skin would eventually or at the
same time reveal an outline of part of the implant particularly as aging
continued and bone loss and skin thinning could make the implant appear
more visible further if the patient wanted the implant to be removed it
means they have to undergo another surgery I also try to enhance the facial
soft tissue loss with fat grafting this involved my performing liposuction and
taking the fatty tissue and placing the fatty tissue into the areas of facial
volume deficiency unfortunately the fat survival rate was too unpredictable and
patients needed more surgery in order to try and restore the lost volume from the
first surgery in addition aged skin is intrinsically thinner and weaker than
younger skin this means that whether it’s fat or filler the skin has a
limited weight bearing capacity I made a significant paradigm shift in my
approach to facial volume deficiency several years ago this was the result of
a synergy from combining the principles of facial implant surgery with the
technological advances of recently introduced thicker and longer lasting
hyaluronic acid fillers such as Juvederm Ultra Plus and Juvederm Voluma I place
these fillers without surgery using blunt cannulas at the bone level of the
cheeks jawline and chin I cannot overstate the importance of technique
many doctors and so-called injectors believe that if their needle contacts
the bone that there at the bone level the needle may be touching the bone but
the filler is generally not going where they intend the material to be placed
while facial fillers have a reputation for appearing doughy and unnatural I use
my knowledge and experience as a facelift and facial implants urgent to
precisely place filler at the bone level below the facial muscle layer which
results in a more defined and sculpted appearance I call this technique
Structural Volumizing because it adds structure and definition to the face as
I mentioned earlier about technique I use very few entry points to place the
hyaluronic acid filler so bruising is rarely an issue many of the so-called
master injectors do demonstrations on social media platforms with needles
piercing the skin multiple times in just one small area only to be repeated
several times more for the other areas to be addressed that’s a lot of poking
which means more swelling and more bruising by performing Structural
Volumizing I’m able to be much more precise with volume and shape allowing
me to make micro adjustments for asymmetric features unlike a facial
implant which would require additional surgery should there be a need to
reverse the filler all I have to do is use an enzyme called hyaluronidase in my
exam room and the filler is completely dissolved I routinely use structural
volumizing for people who’ve had facelift surgery performed by other
surgeons who want to look better these patients are often delighted to learn
that they don’t need another facelift and are very impressed by how good they
look in less than 30 minutes in my exam room
if you’re considering a facelift you clearly care about your appearance and
you expect to look significantly better afterwards while faceless
surgery is effective for lifting sagging cheeks and jowls I counsel my patients
about facial volume loss and the appearance of their eyes and lips when
planning a comprehensive treatment strategy for them my patients appreciate
this integrated approach by me as they are a beauty doctor rather than having
to go to multiple people for different services whether I address volume at the
same time as a facelift or afterwards restoring structure improves the balance
and definition of your face in a way that completes the intended outcome of a
beautifully performed facelift I hope you found this information helpful thank
you for your question you

About the Author: Earl Hamill


  1. Just another of your incredible well articulated video's! I get so much out of every video of yours that I watch! Thank you. How I wish you practiced here in SoCal!!

  2. Your videos are really great, thank you for providing such valuable information in a world full of bells and whistles!

    Do you know which lasers are good, but also do not compromise the fat in the face?

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