Facial aging is caused by atrophy - or thinning - of the tissues that support the face (fat, muscle, and bone) and gravity-induced sagging and wrinkling of the skin itself. Over the course of years, this process results in a thinned, wrinkled appearance. The apparent progression of these two processes varies with every person.

At the Museum Mile Surgical Center, several very safe, effective and proven techniques are used to reverse the effects of these processes. Not only are youthful and natural-looking appearances restored, but aesthetic benefits are maintained over many years. The specific techniques employed are tailored to each patient’s aesthetic needs and anatomical considerations.

If atrophy of the skin’s supporting tissues is identified to be the primary contributor to an aged appearance (especially in areas of the temples, cheeks, jawline, and mouth), then autologous fat grafting or injection is frequently the treatment of choice. A small amount of fat is harvested from another portion of a patient’s body - frequently the abdominal area - and used to sculpt and rebuild natural and symmetrical facial contours. The result of this long-lasting technique is a smooth and pleasing appearance.

 

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When sagging or wrinkled skin tissue is an additional consideration, fat contouring is often combined with a comprehensive facelift procedure: the SMAS technique. SMAS (Superficial Musculo Aponeurotic System) is the fibrofatty layer that supports and separates overlying skin in the face from deeper musculature. This layer continues into the neck and is known as the platysma muscle.

Because the deep SMAS layer is the structural foundation for facial shape and form, repositioning its tissues for aesthetic improvement provides significant advantages in terms of natural appearance and longevity of results. After SMAS repositioning, the overlying skin layer is free of tension, drapes naturally, and incision closures are characterized by rapid healing, minimal scars and normal hairline and earlobe positioning.

Though technically demanding, the SMAS facelift procedure is the only one performed at the Museum Mile Surgical Center. Its benefits and longevity are far superior to the “classic” facelift procedure, where skin is pulled taut and excess tissue removed. This older technique, along with others recently marketed as quick and minimally invasive, represents a temporary stopgap measure that suffers from significant drawbacks. Any surgical technique that relies upon placing tension on skin to eliminate sags and wrinkles is prone to an unnatural “pulled” look. And even if that complication is avoided, positive effects are short-term because skin tissue is too weak to maintain its integrity under stress. The net result is a fast reappearance of drooping areas and lines.

Obviously, facial rejuvenation requires meticulous analysis of each patient’s aesthetic needs and anatomy to assure a pleasing appearance and long-lasting satisfaction. Each patient receives an individualized plan of care that may consist of an optimized blend of facelifting, brow lifting and conventional eyelid surgery, fat injections, Restylane injections, chemical peels, dermabrasion, or other ancillary procedures. But regardless of the rejuvenation therapies employed, the guiding principle behind the care of every patient is long-term satisfaction.


 

Copyright © 1998-2005 Andrew N. Kornstein, M.D.
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