The aesthetically most important region in the face is what Ramirez termed the “central oval” encompassing an elliptic area around the eyes, cheeks, forehead, lips and chin. It is what we see when we look directly from in front at a person. Facial aging in this region comprises loss of skeletal substance, loss of volume of the soft tissues, downward migration of the of the soft tissues secondary to relaxation of their anchorings and intrinsic aging of the skin.
Classic face lifting procedures (a misnomer, as these procedures had most effect on the neck and lower third of the face overlying the lower jaw) always had a hard time addressing these changes, even in their more modern and more extensive adaptations.
From the incision in front around the ear one can not pull the tissues of the face upward, the pull is mostly backward. This obviously does not counteract the downward migration of the important midface tissues, which have to be moved upward and not backward.
The harder one pulls backward in fact during a classic facelift, the more unfavorable the result in the midface actually becomes, until one arrives at the infamous “windswept face” a comic book rendering of a face meeting the strong gusts of a storm head on.
Midface lifting represents a more powerful technique to address the changes brought about by aging. It addresses the lower eyelid, cheeks and nasolabial folds as a unit. The direction of the lift is vertically upwards, which repositions the soft tissues over the cheek bones recreating a youthful fullness. At the same time the junction between the lower eyelids and cheeks is softened and the nasolabial fold becomes smoother. Additionally, changes in the lower eyelid are addressed as the descended muscle around the eye is tightened and anchored higher. In keeping with the concept of creating structure first and the just redraping the skin over it, removal of skin is minimal, avoiding the frequent stigmata of eyelid procedures such as shrinking of the eyelids and loss of natural eye shape.
At Trinidad Institute of Plastic Surgery we create structure first and foremost. Structure is beauty. Skin just drapes over it.
The tightening of the eyelids alone is most of the time sufficient to reduce bulging of intraorbital fat. The procedure is extremely versatile and can be combined freely with implants to address skeletal volume loss or “volumetric” techniques such as fat redraping or grafting to restore soft tissue volume. Light peeling to address intrinsic skin changes is possible.
Recovery time is shortened compared with extensive classic face lifting techniques while the risk of damage to important motor nerves of the face is markedly reduced. Operating time is roughly half of a deep plane face lift and the time until the patient can resume social life is not much longer than a lower eyelid procedure.
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Posts (63)
1. A Cleft Pastiche
2. A Cure for Migraine Headaches: Botox, Nerve Decompression, Brow Lifting and Septoplasty
3. Abdominoplasty (Tummy Tuck)
4. Aesthetic Craniomaxillofacial Surgery of the Midface
5. Applied Aesthetics of the Female Breast
6. Autologous Breast Augmentation with Fat Grafting
7. Autologous Breast Augmentation with Micro Fat Grafting and External Expansion
8. Blepharoplasty – Eyelid Reshaping and Eyelid Tightening
9. Botox in Aesthetic Medicine
10. Breast Augmentation and Enhancement – Breast Implants
11. Breast Implants for Breast Augmentation and Enhancement: Teardrops, Gummy Bears, Furry Brazilians and the Baywatch
12. Breast Lift (Mastopexy)
13. Breast Reconstruction
14. Breast Reduction – Before and After
15. Breast Reduction – Reduction Mammaplasty
16. Breast Reduction – Techniques and Indications
17. Candidate Selection for Abdominal Wall Contouring
18. CEO Announcement: Aesthetic Medicine and Skin Therapy
19. CEO Announcement: New Plastic Surgery and Cosmetic Surgery Forum at Trinidad Institute of Plastic Surgery
20. CEO Announcement: Telemedicine and Virtual Consultations at Trinidad Institute of Plastic Surgery
21. Cleft Lip and Palate – Yardsticks for Perfection
22. Correcting Crooked Noses and Faces
23. Cosmetic and Plastic Surgery Abroad for the Medical Tourist
24. Craniofacial Surgery
25. Denise’s (Bridgetown/Barbados) Experience at Trinidad Institute of Plastic Surgery
26. Electrical Injuries – The “Great Masquerader” in Burn Surgery
27. Face Lift – Rhytidectomy – Rhytidoplasty
28. Fronto-orbital advancement for correction of craniosynostosis
29. Gunshot Injuries of the Hand
30. Healthgrades
31. Incisions for Breast Augmentation
32. Kayla’s (Georgetown/Guyana) Experience at Trinidad Institute of Plastic Surgery
33. Laser skin rejuvenation in dark skin types
34. Laser Tattoo Removal in Dark Skin Types
35. Lip Enhancement
36. Liposuction – Lipoplasty – Liposculpture
37. Malar Bags and Festoons
38. Maria’s (Port-of-Spain, Trinidad) Experience at Trinidad Institute of Plastic Surgery
39. Midface Lift
40. Mini Abdominoplasty
41. Optimal Implant Size for Breast Augmentations and Enhancements
42. Options in Breast Reconstruction
43. PIP Implants – Removal or Exchange after Breast Augmentation
44. Plastic Surgery – A Plastic Surgeon’s Perspective
45. Rhinoplasty – Nose Reshaping
46. Simone’s (Bridgetown, Barbados) Experience at Trinidad Institute of Plastic Surgery
47. Six Packs and the Male Abdominal Wall
48. Skin therapist Areana Emmanuel featured
49. Skin Therapy and Aesthetic Medicine Service Menu September 2010
50. Smoothing the Wrinkles
51. Specialist Treatment of Burn Injuries
52. Structural Abdominoplasty – Tummy Tuck
53. Tendon Problems in the Fingers and Hand – Trigger Finger, Trigger Thumb and de Quervain’s Disease
54. The Art of Reducing Excessive Sweating
55. The Culture of Aesthetic Surgery
56. Trinidad Institute of Plastic Surgery Featured in Caribbean Belle Magazine
57. Trinidad Institute of Plastic Surgery in Caribbean Beat Magazine
58. Verdine’s (Miami/FL) Experience at Trinidad Institute of Plastic Surgery
59. Vertical Breast Reduction and Breast Lifting with Short Scars
60. What is cosmetic surgery, what is reconstructive surgery, what is everything in between ?
61. What is the cost of … ? And why are there consultations ?
62. Worst Wrists
63. Writing for the gallery
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