Facial Rejuvenation’s 5Rs: Relax, Refill, Resurface, Redrape and Remove

Although the hands of time cannot be completely turned back, facial rejuvenation can slow down or even reverse some of the natural aging processes which produce lines and wrinkles, age spots, broken capillaries, dull skin, and uneven tone and texture. Other flaws include loss of collagen and elastin, resulting in sagging skin, gaunt faces, dark circles and puffiness under the eyes. Open pores and acne scars also appear more visible.

There are 4 things that happen to our face as we age:

  1. Volume loss (mainly fat)
  2. Sagging tissues because of gravity
  3. Facial bones thin out and become lighter
  4. Skin thins, develops fine lines and wrinkles, as well as, brown patches

I think of skin and facial rejuvenation in terms of the 5 Rs:

  1. Relax: refers to using anti-wrinkle injections which so often wrinkles caused by muscle movement.  The facial muscles of expression, if used too much, can result in “frown lines” between the eyes, “worry lines” of the brow or “crow’s feet” beside the eyes.  By relaxing the muscles responsible for these expressions, we are able to interfere with the development or progression of such lines.
  2. Refill: various products, from fillers to one’s own fat, can be used to address facial volume loss. Such techniques are used in the treatment of deeper wrinkles, folds and expression lines that are too deep to be adequately affected by resurfacing.
  3. Resurface: refers to methods that remove the outer layers of the skin to yield a smoother, more even-coloured texture. These techniques are used to treat sun-damaged, weathered, or aged skin. These are useful for dealing with wrinkling of the skin, blotchiness, roughness and loss of lustre e.g. facials, microdermabrasion, chemical peels, and lasers.
  4. Redrape: refers to traditional surgical interventions that improve areas of redundant skin. Overtime and with accumulated sun damage, the skin loses its elasticity and may begin to sag. This is especially true in the lower face and neck although laxity of the brow skin and eyelids is also common. Most treatments for significant sagging of the face require surgical interventions e.g. facelifts, brow lifts, eyelid lift surgery.
  5. Removal: It is not uncommon to develop unwanted bumps, broken blood vessels, brown spots or tags on the skin, especially on the face and neck. All of these can be treated by simple removal techniques. In many cases, liposuction (removal of fat) can tighten the neck adequately without actually removing skin surgically.

Today, in the field of cosmetics, refill is much more appreciated in our approach to facial rejuvenation. Temporary fillers like hyaluronic acid (HAs) are considered the gold standard. Fillers are often combined in different areas of the face to recreate youthful contours, sometimes referred to as a “liquid facelift.” My go-to fillers for correcting hollows under the eyes, cheekbones or lips are HAs or fat. Vertical lip lines are treated with a combination of HAs and anti-wrinkle injections or laser resurfacing.

Fat transfer can be used to replace volume in most areas of the face including the temples (a much-neglected area until recently), cheeks, jawline, nasolabial folds, and marionette lines. It gives reliable, natural-looking results, and even improves the texture of the skin. Fat transfer is an easy, economical, safe, and comfortable means of volume replacement for the face. Fat is harvested from an area of excess fat such as the hip, thigh, or abdomen.

The fat is then processed and placed in small amounts to resculpt the facial contours of the face. Fat transfer is usually done under general anaesthesia. Fat is also an excellent choice for rejuvenating the hands, as it camouflages the appearance of visible tendons and dilated veins.

There are so many choices available for skin and facial rejuvenation. One can create a natural and gradual volume replacement. The “cookie cutter” approach to fillers is out. Discussing the 5 Rs and how the various techniques are used in combination for skin and facial rejuvenation can aide in maximising outcomes.

Question:  What signs of facial aging trouble women the most?  You can leave a comment below.

How Can a Brow Lift Benefit You?

Appearance is everything these days and unfortunately, the ageing process is something we all must inevitably suffer whether we like it or not. There is still hope, however, for those of us who suffer from droopy eyebrows, sagging skin or deep furrows on the forehead, in the form of a brow lift.

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If you’ve had enough of those tired and weary eyes staring back at you in the mirror each morning, a brow lift is a simple procedure that can turn back the years and restore the youthful vigour you once possessed. It’s common knowledge that when you look great, you feel great and your plastic surgeon can offer you two different brow lift techniques to reinvigorate your face.

 

Brow Lift Benefits

A brow lift has many clear benefits for patients choosing this procedure. Apart from improving your overall facial appearance, making you look more awake and less stressed, this procedure will give you an immediate confidence boost to aid you in social and work settings. When this procedure is carried out by a skilled and experienced plastic surgeon, the benefits are increased and you’ll see an improvement in regards to:

  1. Brow height, meaning you appear more alert and vital.
  2. The frown lines between the eyebrows which will lessen with the lifting of the forehead.
  3. Sagging brows which will be re-positioned to reduce the severity of the drooping over the eyelids.
  4. Forehead and nose-bridge creases. These will be reduced as the forehead is lifted.
  5. Shape of brows for women. A brow lift can give women a more aesthetically pleasing arched brow shape.
  6. Tired or irritated appearance, which will make you look more approachable and friendly.

Brow Lift Procedures

There are generally two types of brow lift procedures: The traditional brow lift and the minimal incision brow lift. The type of brow lift procedure you choose depends on the severity of your symptoms.

Traditional Brow lift

The traditional brow lift is generally more suited to patients with excess skin hanging over the upper eyelids, making your brows droop and giving you an unfriendly, angry appearance. Also known as a “temporal brow lift,” this procedure is for patients who wish to raise the outer 2/3 of the brow line. The  brow line can be raised by making a 4cm incision in the temporal region of the scalp, before removing excess skin from the scalp and lifting the brow line to give you a friendly and bright eyed appearance. The advantages of the traditional brow lift are:

  1. The forehead or brow can be lifted higher for more severe cases.
  2. The skin is more easily mobilised.

Minimal Brow Lift

Aside from the obvious benefit of reduced and inconspicuous scarring, the minimal brow lift also minimises the loss of sensation around the site of the incisions. In general, the minimal brow lift is considered more suited to younger patients as this procedure does not involve the removal of excess skin. The incisions are also much smaller than those in the traditional brow lift and are skilfully concealed within the hairline. Whilst the traditional brow lift is rarely used today due to the extensiveness of the incisions, the minimal brow lift is becoming more popular because of the following advantages:

  1. Less visible scarring
  2. Less elevation of the hairline
  3. Less numbness around the incision site
  4. Minimal hair loss
  5. Less invasive
  6. Shorter recovery times
  7. Very little bleeding

Are You a Brow Lift Candidate?

If you are fed up of looking tired and stressed out, and friends have commented on how much older you look these days, it may be the right time to opt for a brow lift. On occasion, low brows are hereditary and because of this, plastic surgeons carry out this procedure on patients younger than 30 years-old.

Recovery Time for Brow Lift Surgery

In the early stages after surgery, you may experience some mild discomfort but nothing that cannot be easily allayed with mild pain medication for up to several days after surgery. Day three is usually when bruising and swelling is at its worst and within two weeks you should be able to fully appreciate the results of the procedure.

Are there Any Risks Involved?

The risks for the brow lift procedure are minimal at worst. You may experience some bleeding or infection and in very rare cases, nerve damage or hair changes but with a skilled and trusted plastic surgeon, the risks are negligible.

If you’ve had enough of looking overworked and unapproachable, it might be time for you to seek out a professional plastic surgeon to carry out a brow lift procedure and restore your youthful gaze.

Question: What is the most annoying feature of having sagging brows? You can leave a comment below.