Know Cosmetic surgery

I believe that a facelift should achieve several specific goals. It should remove excess skin, remove excess fat from the neck and jowl area, replace lost volume in the cheek and jawline, tighten the muscles of the neck and face, and refresh the skin.

Lets discuss each of these seperately...

The Lifestyle Lift has become very popular over the past few years and I have had several patients ask me about it. I love that more and more surgeons are performing facelifts under local anesthesia. Remember, local anesthesia is all that is needed. I have been doing my Tuliplifts under local anesthesia since 2000.

One of the things that sets the Tuliplift apart is that the area under the neck is also addressed. Excess skin and fat is removed and the neck muscle (Platysma) tightened...

Your hands and forearms will also be on display this holiday season - unfortunately for many of my patients visible signs of aging hands can occur even in their early 30's. These areas are also the most neglected, as years of daily chores take their toll. While most patients have an established facial care routine - hands and forearms are often treated with a quick dab of hand lotion and nothing more...

As we age the fatty deposits in the healthy cheeks and upper face area succumb to the forces of gravity and "fall" into the jowl and neck area. Additionally, the bones of the face and chin area slowly shrink. The cummulative effect of the above is a sagging face.

The trademarked Tuliplift procedure includes micro liposuction of the jowl and neck area. The harvested fat is concentrated and injected right after the Tuliplift procedure into the laugh lines and cheek bone area.

The hollowness is fixed and the youthful appearence of the face is restored. Leftover fat is stored in our state licensed Tissue Bank for future use.

My practice is in Southern California and a large percentage of my patients have a darker skin complexion. Asian and African American patients with a history of keloids or unsightly scars are often hesitant to have a facelift.

Often I'm asked--in regards to the sagging of the jowels and neck area--if there is a more conservative approach one can take: a solution not requiring "any cutting". Here is the answer...

A few weeks ago I was asked to evaluate a patient with irregular fat deposits resulting from a fat transfer. She had undergone repeated fat transfers into the lips, cheeks, and nasolabial folds with less than perfect results.

Although the transferred fat had been applied relatively regularly, the ensuing hematoma (bleeding/bruising) had resulted in a significant shift of the applied fat and deep scarring.

All things being equal, Fat Transfer is very successful; however infections, seroma formation (collection of fluid under the skin) and irregular absorption of the fat can lead to a lumpy appearance.

Solution: Once again, we need to use a comprehensive approach to correct this problem. I usually start by breaking the excess fat and scarring down with repeated intralesional cortisone shots (ILTAC 2.5mg/cc). This is followed by subsicion of the deep fibrous bands, and lymphatic drainage. Finally, the excess fat can be gently suctioned by hand.