Four Dimensional Facelift

Facelift surgery, or a rhytidectomy, like all facial cosmetic procedures has undergone an evolution of technique, especially with the advent of new technology like the laser, endoscope, tissue healing adjuncts such as platelet rich plasma and biocompatible facial implants. The Greatest Contribution awarded by the American Academy of Cosmetic Surgery in the year 2001 is the development of the Four Dimensional Facelift, as pioneered by Dr. Stephen Watson. Dr. Lee trained closely with Dr. Watson, learning this technique. Both of them worked together to evolve this technique into other less invasive face lifting techniques, including the Precision Lift. Dr. Lee will tailor each treatment plan based on the patients needs and desire.

A traditional “facelift” was a purely skin-stretching procedure whereby patients often complained of the “tight, operated” look that lacked longevity of results. Later, surgeons learned to reposition the muscle deep to the skin. In the hands of many cosmetic surgeons, this led to longer-lasting results and a more natural appearance.

Good form follows good function.

Problems with the old techniques of facelifts revolved around improper positioning of the skin and muscle, which over time descended due to gravity and laxity of the collagen matrix, or the scaffolding complex of the skin. Patients developed the “unnatural operated” look because the vector of the pull of the tissues was straight back. When patients would speak, smile or exhibit other facial expressions, this improper surgical positioning of the skin and muscles of facial expression would exacerbate the resultant deformity.

So essentially, in order to accomplish good “form” or appearance, an intimate knowledge of good “function” of the muscles needed to be applied to the repositioning of the drooping muscles affected by gravity. This should be the foundation of all modern cosmetic surgery.

Reposition and add to before you take away. The traditional techniques always applied a stretch to the tissues and then involved a removal of “excess.” This is a false pretense. We do not typically grow “excess” skin as we age (unless accompanied by large weight gain) in the facial tissues. Rather a laxity of the collagen matrix occurs and the underlying skeletal structure degenerates with time. Therefore it is logical to address the aging effects of skin laxity with the skin-tightening effects of laser skin resurfacing, and augmentation of the aging skeletal features with biocompatible implants or grafting techniques. These are minor parts of the procedure that yield tremendous rejuvenating effects!

Consider the face as a whole and do not divide it into anatomic parts. As analytical surgeons and as artists, we learn to study the symmetry of the face in parts: the forehead, the eyes, the cheeks, the nose, the lips, the mouth, the chin and the neck. We have been trained in multiple techniques in order to address these “parts” of the face that patients want addressed. The problem is that the over thirty muscles of facial expression don’t adhere to this division of anatomy.

That is to say that the bone, skin and muscles are all connected and if we effect change on one part, it may adversely effect change or prevent change as desired. A facelift without a component of neck lifting will not correct the common complaint of jowling, or irregularity of the jaw line. The same muscle, the platysma, crosses this anatomical division of parts and will prevent change without repositioning the entire muscle. As such a facelift alone will not affect the crows feet around the eyes unless the drooping muscles of the lateral forehead are repositioned.

Multiple small procedures are better than one large one. Together multiple small, minimally invasive procedures addressing the face and neck as a whole can yield a more natural result with a shorter healing period.

The components of the complete Four Dimensional Facelift include an endoscopic brow/midface lift, a multivector/multilayer face and neck lift and chemical or laser resurfacing. This is a very safe and predictable procedure and is often combined with rhinoplasty, cheek or chin augmentation and eyelid blepharoplasty when indicated. For patients who have limited skin laxity, a Three Dimensional Facelift may be performed which does not utilize the component of laser resurfacing or chemical peel. The finesse of this procedure involves a tailoring of the technique to each individual in order to achieve long-lasting, natural-appearing rejuvenated results.

Dr. Lee will discuss with you what you can expect from surgery. Our objective is to create a natural appearance that is pleasing to you.