Understanding the importance we place on planning of our incisions in facial plastic surgery, incisions which we painstakingly plan out in detail to ensure the scars are carefully concealed so that they will be virtually invisible post surgery, is such a fundamental part in achieving the truly natural results in facial rejuvenation that we have become world famous for.
Here are a series of videos showing Dr. Sullivan planning out the incisions for this patient’s facial rejuvenation.
The neck, the jawline, the midface are all reshaped and contoured to take away the jowls, the sagging tissue in the neck, and hiding the incisions at the same time. The goal is to get a beautiful, natural contour that never appears overdone, stretched, or fake.
Puffiness, circles, and cheek defects can now be much better treated than in the past. We like to explain each step to the patients, as we are marking it out before surgery. For this patient, this involves removing the puffiness under the lower lid region through a hidden incision so there is no evidence of a surgical scar. We also fill in the circles under the eyes that often associated with people looking tired when they’re not. Filling in circles and defects in the cheek area with the person’s own fat and associated stem cells as injections not only smooths out the circles but also helps give a smoother look to the cheek area. This is far superior to injections of synthetic fillers under the eyes.
Facelift incisions should be completely imperceptible. No scars should be visible. The hairline, including the sideburn and behind the ear should be nicely maintained. The patient should be able to wear their hair up and as short as they may like.
(Dr. Sullivan) “Let’s Take a look at what we’re going to define here. This is the target area you’d like to get rid of? Is that correct?”
(Patient) “That’s correct.”
(Dr. Sullivan) “Wonderful. We’re also going to work on this jowl region to get rid of the jowl. This will give you not only better neck definition, but also better jawline definition with what we do with the deeper layers underneath. Does that sound okay?”
(Dr. Sullivan) “The incisions are all going to be hidden with this incision around here so all of this tissue gets lifted up. You can see we’re going to take an inch (of skin) away from each side. But what is most important is what we do on the deeper layers to really define the neck line and also define the jawline with our special Natural SMAS Platysma Facelift. Does that sound okay?”
(Dr. Sullivan) “Is that what you are looking for?”
(Dr. Sullivan) “What we have here is some prominent puffiness in your lower eyelids. Correct?”
(Dr. Sullivan) “There is a puffy area here but your eyes are a little bit prominent. So if we would remove all that tissue it would make the eyes appear more prominent. It’s really key not to make the problem even worse when we’re trying to fix it. We’re going to be decreasing this but only to a small degree. Then, filling this area in here with your own fat that comes from the thigh region (has some associated stem cells with it). It’s going to fill in this groove that you have here. It’s like a valley. We’re going to fill in this large valley here, and this smaller valley here. Did you notice you have this cheek mound? We’re going to de-accentuate that by filling in the valleys around it. Does that sound good?”
(Dr. Sullivan) “Good plan?”
(Patient) “Good plan!”
(Dr. Sullivan) “What we have here is an (abnormal) area where the earlobe is attached to the face. What we are going to do is make an incision around this area and redefine the earlobe to make sure it looks more normal after the procedure. I’m going to show you how we’re going to hide those incisions (so they won’t be visible).”
“First we start by defining the incision in front of the ear. We hide it in this natural crease. Coming up like this and then going forward because we want to make sure that we don’t lose any hair during this whole process. We want to keep this nice sideburn here. But this (excessive) non-hair bearing area will still be removed as all this comes up from the face and neck region as we treat this jawline and jowl area. We’re going to get a much more defined jawline here and a much more defined neck.” (You will see.)
“Now we come back here behind this part of the ear (the tragus) defining the length of the tragus. And then come down to make a new contour for the earlobe. It goes behind the ear in this natural crease, coming up so it’s completely hidden. Now you notice in this situation that there’s a big space between the ear and the hair. So we’re going to come up here much higher than normal. Here’s where we probably normally come back like this. You see with this wide space, we want to come up even higher. So this is the way that we’re going to really hide these incisions. When the hair is up or down, you’re not going to see any type of incisions at all.”
“Does that sound good to you?”