Deep Plane Face And Neck Lift
VIP Signature Deep Plane Lift
Of all the facial plastic surgery procedures Dr. Vipond performs, facelift surgery (rhytidoplasty) provides perhaps the most dramatic and impressive change. It can take away sagging jowls, neck banding (turkey gobblers), and extra skin to turn back the sands of time.
There are many different ways to lift the sagging muscles and skin of the face, each with its own benefits and limitation. This is not a “one size fits all” surgery and the decision is based on your individual features and concerns. Not surprisingly, it does require patience, time, and skill to ensure a natural appearance while maximizing a surgical improvement. It is definitely one of the most satisfying procedures performed but the best results are seen with properly-selected candidates who are psychologically prepared and have realistic expectations.
The Deep Plane Lift involves dissection underneath the SMAS layer of the face where the tissue has loosened with aging. It is a more extensive release of this fallen tissue and release of the retaining ligaments of the face and neck to better elevate and suspend the cheek and jowl region. The Deep Plane approach may also be the most effective way to help lift up the midface/cheek region and help soften the nasolabial fold. While the Deep Plane Lift may take a little longer, Dr. Vipond and his patients have been extremely happy with the impressive, but natural-looking results. Another benefit of the Deep Plane approach is its safety in patients with possible risks for poor healing, such as smoking, diabetes, prior facial surgery or very thin skin.
The Deep Plane Lift uses the same incision as Dr. Vipond’s traditional VIP Multi-Vector Lift, hiding along the hairline and curves and shadows along the ear. This incision minimizes any change or distortion in the hair line, especially in the temple region) and with his meticulous closure technique, leaves an imperceptible scar.
Just as with the VIP Multi-Vector Lift, the operation involves four stages: the incision, the elevation of the skin, the repositioning of the facial muscles and fat, and closing the incision. As with all facelifting techniques, the most important aspect of the procedure is the repositioning of the muscle layer of the face and neck. Rather than just elevating and re-suspending the foundation of the face (SMAS and platysma), Dr. Vipond makes a small incision along the edge of the loose SMAS and then releases it from the underlying tissue and from the retaining ligaments of the face. This release allows the foundation of the face, including the jowls and cheek, to be lifted and secured in a more youthful position without fighting against the pull of the ligaments. This may result in a better and longer-lasting surgical improvement than other techniques. Lifting both the skin and muscle in a vertical direction may also help avoid the “pulled” or “wind-tunnel” appearance that can be seen with other techniques. Just as the SMAS layer is released from the underlying tissue, the platysma is similarly lifted from underneath. This allows a better improvement in the neck and jawline and may even support fallen saliva glands in the neck. By releasing the platysma muscle from the underlying ligaments, there may also be a better longevity of improvement compared to other methods. Once the platysma and SMAS muscle layers have been lifted up to their more youthful position, they are secured into place with permanent sutures.
The next stage of the procedure involves trimming the extra skin. It is extremely important to avoid pulling the skin too tightly so that there is no distortion of the ear or widening of the scars. Meticulous technique when closing the incision ensures the best chance of a virtually invisible scar.
While the Deep Plane Lift may involve a little more work than the traditional VIP Multi-Vector Lift, the same anesthesia options are available. While patient comfort and safety are the highest priority, Dr. Vipond and the vast majority of his patients prefer to operate without general anesthesia. The recovery process is quicker and patient comfort is greater without any sacrifice in safety. During your consultation, Dr. Vipond will discuss with you all of your options and help arrive at one that is best suited for you.
Just like the VIP Multi-Vector Lift, the recovery is typically straightforward without excessive downtime or discomfort. All of the sutures are removed at one week, and most patients are able to return to work and be “anonymous” by the end of the second week. There are several “tricks” that can reduce the amount of swelling and bruising as well as camouflage any signs of “work” that will get you back to your regular lifestyle earlier. Dr. Vipond and his staff will go over all of these details in depth during your preoperative appointments.
Dr. Vipond has extensive experience in treating patients who have had prior facial surgery. This may involve correcting the outcomes of previous face/neck lifts to improve unsightly results or may just involve lifting up the sagging muscles and skin from the continuing aging process. Sometimes, it is a simple matter of improving the incisions and scars, but depending on the patient’s appearance, may include repositioning the muscular foundation of the face and neck (the SMAS and platysma), contouring the fat, or removing excess skin. The VIP Signature Deep Plane Lift or the VIP Multi-Vector Lift may both be used, but the most appropriate approach would be decided by you and Dr. Vipond after a proper evaluation and discussion in the office. While the best situation is to have the procedure done correctly the first time, Dr. Vipond has the artistic vision and surgical skill to help restore your natural preoperative beauty.
Submentoplasty (Neck Lift)
A necklift describes a variety of procedures, used alone or in conjunction with a face-neck lift, with the goal of re-contouring the tissues underneath the chin and near the midline of the neck. Depending on the areas of concern, the procedure may involve liposuction, direct excision of fat, tightening of muscle banding, and, occasionally, skin removal. The goal is to reduce excess or sagging tissues (“turkey gobblers” or platysmal bands) in the area underneath the chin in order to produce a tighter, more youthful appearance in the neck.
Forehead Lift And Eyebrow Lift
As we age, there are certain characteristic changes which happen in the forehead and eyebrow region. With repeated muscle movement, horizontal creases or furrows develop along the forehead and vertical frown lines develop between the eyebrows. The eyebrows also drift downward, especially over lateral or outer portion. This leads to “lateral hooding” where brow skin hangs over the bony eye socket and can interfere with peripheral vision in addition to creating a tired appearance. Volume loss over the temples can also lead to a “sunken” appearance and further worsen droopy eyebrows.
The goal of a forehead or brow lift is to return the brow to its youthful position and contour, while maintaining a natural appearance that does not look “surprised”. It is important to recognize the differences between male and female eyebrow shape and position to avoid an unsatisfactory result.
There are some non-invasive options to help with falling eyebrows. This can include a “chemical eyebrow lift” that is done with Botox or Dysport. By weakening the muscles that pull down the eyebrows, the eyebrows are able to be “relaxed” into a higher, more refreshed position. This technique is subtle but very natural. Additionally, for patients with loss of the temple and eyebrow fat pads, volume can be restored with either filler or fat grafting. This may be a more appropriate option for those patients with noticeable hollowing around the eye and temple area and can create a softer, more youthful appearance that is very rewarding.
Unfortunately, there is a limit to what the less invasive techniques can do and surgical rejuvenation may be the more effective approach.
Dr. Vipond employs several different techniques for eyebrow and forehead surgery. One of those techniques is called the Mid-Forehead Buttonhole Lift which uses a natural skin crease above the eyebrow to achieve accurate lifting and contouring of the brow. This incision is closed meticulously, resulting in an imperceptible scar which looks better than the preexisting forehead crease. This mid-forehead buttonhole lift has a much lower chance of complications, such as forehead numbness, fluid collections, unpredictable and short-lived results, than other methods of eyebrow elevation. The type of procedure used will depend on your individual features and goals. For those patients who have eyebrow tattooing, Dr. Vipond may choose to make the incision along the edge of the tattoo. This allows excellent eyebrow contouring with a virtually imperceptible incision. While a heavy eyebrow may be the only problem, many patients also have upper eyelid skin heaviness and so, a brow lift may be performed together with blepharoplasty, or eyelid surgery, to create the best rejuvenation effect. During your consultation, Dr. Vipond will discuss the different options in order to arrive at the best plan for you.