Facelift is one of the most frequently performed procedures. it often refers to the lift of the lower face. Depending on the condition of the patients’ facial aging, a traditional facelift or formal facelift could be done for a person with more advanced skin aging. Or, if the aging is minimal to medium, a mini-facelift or our famous Z-lift could be performed. While a formal facelift could entail a recovery time of one to two months, a mini facelift may only require a recovery time of one to three weeks. This latter benefit is one major factor for the mini facelift or Z-lift to be our most sought after procedures by our Award-winning Board Certified Plastic Surgeon, Dr. Arthur Yu.
A mid-face lift could greatly lift up the cheek structures. It could be done via a lower eyelid surgery incision, in combination with a brow surgery, being it open or endoscopic approach, or via a superior extension of a traditional facelift. An intra-oral approach could also be employed with the help of 8-prone Poly L-lactic acid ribbons.
Similar effect could be obtained by adding volume to the relevant structures in the mid-face, such as tear trough, the apple cheek, the lateral portion of the cheek bone arch and the nasolabial folds. Both fillers and fat grafting could be used.
While most neck lift surgeries are done together with facelifts, a neck lift can be performed independently, especially for younger people with prominent turkey necks. The essence of a neck lift is to tighten the loose and separated platysma muscle sheets back to the area just in front of the windpipe, with rearrangement of the side portion of the platysma and neck skin behind the ears.
Classic beauty concept dictates that the brows need to be in the correct positions. While the brows in males need to sit right on top of the brow ridges for a perfect Alpha male look, the brows in females need to be 1 to 2 cm (depending on the trend) above the brow ridges to make the eyes look attractive. With aging, the brows will descend, creating hooding above the eyes, giving the eyes droopy looks.
Brow lift surgeries were created to correct these aging problems.
Cheek Jaw Bone Reduction
Cheek bone reduction (shaving) is desired by people (mostly Asians) who think their cheeks are too prominent. It is done via an intra-oral approach with an electrical device. One major caveat is that an accompanying mid-face lift needs to be done to overcome the tendency of the cheek sliding downward, due to the fact that all the mid-face muscle structures are pushed off the bony surface. Dr. Yu uses an 8-prone absorbable poly L-lactic ribbon to guarantee the result that people seek.
Cheek Bone Augmentation
Cheek bone deficiency, especially at the arch portion, is very common among Caucasians. Our recommendation would be to use fat grafting, with minimal concerns about trauma and recovery time, to correct the issue. Implants are also available.
Jaw Bone Reduction (Jaw Angle)
In some Asian cultures, a wide lower face is absolutely intolerable. Hence, jawbone reduction is recommended. However, before this surgery is planned, a detailed examination may reveal that the wide face may simply be the result of hypertrophic masseteric muscles. If that is the case, botulinum toxin may be the best solution, sparing the necessity for the surgery. Botulinum toxin can effectively shrink the masseteric muscle, repeated injection may be a necessity. But if bone prominence is the root of the problem, jawbone reduction surgery may be planned. We perform the procedure via an intra-oral approach and is done in a certified surgical center. All precautions are made to guarantee the safety of our patients.
Canine Fossa (Base of Nose) Augmentation
Many people, especially in Asian population, have an underdeveloped Maxilla, causing the lateral and three-quarter views of the face to appear flat or even sunken, particularly in the mid-portion. The associated problems could include under-supported base of nose (Tripod structure) and deep furrow at the nasolabial folds. The treatment would include fat grafting (for mild to modest conditions) or grafting with either own ear cartilage fragments or Alloderm, or a combination of all the above (for severe defects). For people against surgery, fillers could be used to correct mild to severe defects, with the understanding that the fillers may need to be repeated as required. Regardless which procedure is chosen, the aesthetic effect is very profound and satisfying.
Ptotic Submandibular Glands
With aging, the sub-mandibular glands may drop down and sit in a lower position than the lower mandibular boarder, causing your once sharp and defined jaw line to disappear. Many surgical treatments were designed to help but none were useful. Currently, a very effective treatment is botulinum toxin injection. Botulinum toxin injection can block the nerve/gland contact points and result in atrophic changes. In short, the glands shrink. We recommend the treatment twice a year to maintain a sharp and defined jaw line.
Baby Fat, Jowl Fat and Under Chin Fat Accumulation
Baby fat is characterized by fat accumulating in the lower face from the chin/jowl junction to the jaw angle. It exists since childhood. Characteristically, the “baby fat deformity” usually co-exists with excessive fat existence in the under chin area, causing a chubby look. The treatment is extra-fine precision liposuction with flat-headed cannulas.
Buccal Fat Removal
Buccal fat pads function as the ball bearing between the buccinators and the masseteric muscles. With aging, buccal fat may begin to migrate anteriorly in some people, causing a wider and fatter look in the frontal view. With time, the SMAS fascia overlying the fat pad becomes thin, and the fat pads become more and more prominent. If at any point in time, you think that your face is becoming wider at the mid-lower face, it is most likely that the buccal fat is to blame.
Magic Gel (AoMeiDing, Ao Mei Ding, an illegal substance) removal
There are many types of illegal fillers in the world. One of the most widely used illegal substances is Magic Gel, a liquid plastic material invented in Ukraine, but used in millions of Chinese. The characteristic of this substance is such that it migrates in the soft tissue and tends to accumulate in areas where the tissue is loose. While the migration nature causes tissue deformity and therefore, distorts the facial features, it also can easily cause infections years after the injection. The good news is that with the right history and physical examination, it is very likely that most of the injected Magic Gel could be removed via minimally invasive approaches, although multiple sessions of treatment may be needed.