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At the Spalding Drive Plastic Surgery center in Beverly Hills, our doctors and staff are committed to providing the best possible experience for their clients. Our high standards and our physicians’ dedication to the needs of their patients have gained them the respect of our peers. Our diverse staff specializes in a wide range of cosmetic surgery techniques. Many [...]
Archive for the ‘Facelift’ Category
The Effect of Facial Fat
Thursday, May 24th, 2012Will fatty tissue in my face affect my facelift?
Sunday, December 18th, 2011Question:I hold some weight in my face. Will a skin-only facelift be sufficient or should my muscles also be manipulated? Answer:Elevating only the skin will provide a very temporary correction. Appropriate elevation of the layer underlying and supporting the skin, called the SMAS (superficial musculoaponeurotic system) is necessary for long-term correction.
Will my facelift scars stop growing hair?
Friday, December 16th, 2011Question:Is there a chance that I will experience hair loss at the site of the incisions for my facelift? Answer:Hair loss following facelift surgery may result on occasion due to a poor scar. I design my incisions to be nearly invisible when healed, and hidden within the hairlines without hairloss.
Local vs General Anesthesia for facial surgery
Wednesday, December 14th, 2011Question:What anesthesia is used for a facelift? Do I have a choice in what is used? Answer:A facelift can be performed under local or general anesthesia. Local is a great option and works very well for many patients. During the consultation, we will determine the best option that will have you as comfortable as possible [...]
Will my sideburn placement change after a facial procedure?
Monday, December 12th, 2011Question:I’m a 56-year-old male looking to have a facelift. Is there a chance that after the surgery my sideburns could be relocated to an unnatural position? Answer:Hello, this is unlikely. When performing a male facelift, we do our best to ensure everything appears natural and we take this into consideration when incisions are made during [...]
Can a facelift fix my marionette lines?
Saturday, December 10th, 2011Question:I’m a 45-year-old female looking to get rid of my marionette lines. Is a facelift the right answer for me? Answer:It depends on your individual circumstances. The depth of the lines and the presence of any other issues you would like to correct will dictate the necessity of having a full facelift performed as opposed [...]
How to avoid looking pulled too tightly after a facelift
Friday, December 9th, 2011Question:I’m a 60-year-old woman who wants to get a facelift but I’m scared of stories I’ve heard where the procedure can cause a windswept and very unnatural look. How do you avoid this? Answer:Lifting the face vertically is ideal and will result in the most natural look. Performing a sideways lift may result in a [...]
Can I have blepharoplasty and a facelift at the same time?
Tuesday, August 2nd, 2011Question:I’m a 50-year-old woman who would like to have a facelift before I retire, which will be in about 5 years. I also have puffiness and bags around and under my eyes. I’d like to have it all taken care of at the same time but I’m concerned about the safely of that, especially because [...]
What facial plastic surgery will help enhance my jawline?
Monday, July 25th, 2011Question:My cheeks seem to travel right down into my neck. I have lost the definition of a jawline. What type of surgery would you recommend for this problem? A facelift or a neck lift? Answer:Based on your description, a facelift sounds most appropriate. A necklift is often performed with a facelift to yield the best [...]
How can I fix a facelift gone wrong?
Tuesday, July 19th, 2011Question:I had a facelift 2 years ago. I’m not happy with the results. It looks like I’m surprised all the time. Can you repair this type of problem using corrective surgery procedures? Answer:It is possible to correct a poorly performed facelift with a revision. The most common cause for revision procedures however is under-correction, not [...]
Blepharoplasty Table
FAT REPOSITIONING
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| Figure 1 Frontal of a female patient following traditional transconjunctival removal of lower eyelid herniated orbital fat with resultant tear-trough deformity (nasojugal fold). | Figure 2a Frontal of a patient with midface decent and a double-convexity contour deformity (lower eyelid herniated orbital fat convexity followed by the cheek/malar mound convexity). |
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| Figure 2b One year post operative photograph demonstrating improvement in lower eyelid contour following lower eyelid transconjunctival fat repositioning and an endoscopic sub-periosteal midface lift. An endoscopic brow lift and upper blepharoplasty were also performed. | Figure 3 Transconjunctival incision at the inferior edge of the tarsus using a Colorado needle – right eye. |
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| Figure 4 A preseptal dissection is performed bluntly keeping the septum intact – right eye. | Figure 5 Sharp dissection between the medial fat pad and the inferior oblique muscle using scissors – right eye. |
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| Figure 6 The medial and central fat pads are grasped with forceps and a “see-saw” movement is made allowing free movement of the fat pads from the inferior oblique muscle – left eye. | Figure 7 A retractor is used to retract the lower eyelid and the orbicularis oculi muscle exposing the inferior orbital rim and arcus marginalis – left eye. |
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| Figure 8 A suture and needle is passed through the skin and orbicularis oculi muscle medial to the nasojugal groove and retrieved in the subperiosteal pocket – right eye. | Figure 9 The medial fat pad pedicle is splayed-out prior to placement of suture – left eye. |
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| Figure 10 The central fat pad is repositioned inferolateral to the medial fat pad – left eye. | Figure 11 Fat granuloma of the right lower eyelid following fat repositioning. |
| RESULTS | |
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| Figure 12a Before | Figure 12a After |
| A, Frontal of before (left) and after (right). | |
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| Figure 12b Before | Figure 12b After |
| B, Right (oblique), before (left) and after (right). A 55-year-old-woman with dermatochalasis and herniated lower eyelid fat. Before (left) and 1 year post-operatively (right) following lower eyelid transconjunctival fat repositioning, endoscopic brow lift and bilateral upper blepharoplasty. Notice the improvement of the lower eyelid contour and tear-trough deformity. | |
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| Figure 13a Before | Figure 13a After |
| A, Frontal of before (left) and after (right). | |
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| Figure 13b Before | Figure 13b After |
| B, Left (oblique), before (left) and after (right). A middle-aged woman with brow and midface ptosis, dermatochalasis and herniated lower eyelid fat. Before (left) and 20 months post-operatively (right) following lower eyelid transconjunctival fat repositioning, endoscopic brow and midface lift and bilateral upper blepharoplasty. | |
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| Figure 14 Before | Figure 14 After |
| Frontal of before (left) and after (right). A 38-year-old female complaining of “a deep groove under her eyes and heavy upper eyelids.” The before photo on the left reveals minimal herniated lower eyelid fat with a moderate tear-trough deformity. Following lower eyelid transconjunctival fat repositioning and an upper blepharoplasty, the after photo on the right shows improvement of the tear-trough deformity. | |
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| Figure 15a Before | Figure 15a After |
| Frontal of before (left) and after (right). | |
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| Figure 15b Before | Figure 15b After |
| Right Frontal Close Up, before (left) and after (right). A 35-year-old male complaining of “deep groove below my eyes.” The before photo on the left demonstrates minimal to no visible herniated lower eyelid fat with a moderate tear-trough deformity, especially of the right eye. Following lower eyelid transconjunctival fat repositioning, the hollowness is improved. | |
Blepharoplasty HTML Table
FAT REPOSITIONING
|
|
| Figure 1 Frontal of a female patient following traditional transconjunctival removal of lower eyelid herniated orbital fat with resultant tear-trough deformity (nasojugal fold). | Figure 2a Frontal of a patient with midface decent and a double-convexity contour deformity (lower eyelid herniated orbital fat convexity followed by the cheek/malar mound convexity). |
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| Figure 2b One year post operative photograph demonstrating improvement in lower eyelid contour following lower eyelid transconjunctival fat repositioning and an endoscopic sub-periosteal midface lift. An endoscopic brow lift and upper blepharoplasty were also performed. | Figure 3 Transconjunctival incision at the inferior edge of the tarsus using a Colorado needle – right eye. |
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| Figure 4 A preseptal dissection is performed bluntly keeping the septum intact – right eye. | Figure 5 Sharp dissection between the medial fat pad and the inferior oblique muscle using scissors – right eye. |
|
|
| Figure 6 The medial and central fat pads are grasped with forceps and a “see-saw” movement is made allowing free movement of the fat pads from the inferior oblique muscle – left eye. | Figure 7 A retractor is used to retract the lower eyelid and the orbicularis oculi muscle exposing the inferior orbital rim and arcus marginalis – left eye. |
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| Figure 8 A suture and needle is passed through the skin and orbicularis oculi muscle medial to the nasojugal groove and retrieved in the subperiosteal pocket – right eye. | Figure 9 The medial fat pad pedicle is splayed-out prior to placement of suture – left eye. |
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| Figure 10 The central fat pad is repositioned inferolateral to the medial fat pad – left eye. | Figure 11 Fat granuloma of the right lower eyelid following fat repositioning. |
| RESULTS | |
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| Figure 12a Before | Figure 12a After |
| A, Frontal of before (left) and after (right). | |
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| Figure 12b Before | Figure 12b After |
| B, Right (oblique), before (left) and after (right). A 55-year-old-woman with dermatochalasis and herniated lower eyelid fat. Before (left) and 1 year post-operatively (right) following lower eyelid transconjunctival fat repositioning, endoscopic brow lift and bilateral upper blepharoplasty. Notice the improvement of the lower eyelid contour and tear-trough deformity. | |
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| Figure 13a Before | Figure 13a After |
| A, Frontal of before (left) and after (right). | |
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| Figure 13b Before | Figure 13b After |
| B, Left (oblique), before (left) and after (right). A middle-aged woman with brow and midface ptosis, dermatochalasis and herniated lower eyelid fat. Before (left) and 20 months post-operatively (right) following lower eyelid transconjunctival fat repositioning, endoscopic brow and midface lift and bilateral upper blepharoplasty. | |
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| Figure 14 Before | Figure 14 After |
| Frontal of before (left) and after (right). A 38-year-old female complaining of “a deep groove under her eyes and heavy upper eyelids.” The before photo on the left reveals minimal herniated lower eyelid fat with a moderate tear-trough deformity. Following lower eyelid transconjunctival fat repositioning and an upper blepharoplasty, the after photo on the right shows improvement of the tear-trough deformity. | |
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| Figure 15a Before | Figure 15a After |
| Frontal of before (left) and after (right). | |
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| Figure 15b Before | Figure 15b After |
| Right Frontal Close Up, before (left) and after (right). A 35-year-old male complaining of “deep groove below my eyes.” The before photo on the left demonstrates minimal to no visible herniated lower eyelid fat with a moderate tear-trough deformity, especially of the right eye. Following lower eyelid transconjunctival fat repositioning, the hollowness is improved. | |
