By Carolynn Grimes
ThePlasticSurgeryChannel.com

If you have a drooping jawline or jowls that needs correction, there is a  procedure that uses a patient’s own fat to fill in deflated areas.

They’ll say, “I don’t mind being forty or fifty years old, but I don’t want to be forty or fifty with jowls.” Dr. Patrick Sullivan, a board certified plastic surgeon in Providence, Rhode Island says sometimes this can be a condition that is inherited from your mother or father and there’s very little that can be done about a drooping jawline other than plastic surgery and sometimes weight loss.

Dr. Sullivan is a specialist in facial plastic surgery procedures and says people need to be very careful who they choose as their doctor for plastic surgery. Recently he consulted with a woman in her forties who was left with significant scars along both sides of her face along the jawline. Sullivan says the placement of those scars were not necessary for the result that she was looking for.

Dr. Sullivan uses a lifting procedure that is an extended inner lift with multiple layers, instead of just stretching the skin. He says he also looks at the chin region because often times people will have areas of deflation at the side, in front of the jowl. “These areas start getting more and more deflated causing the chin to look bigger,” says Sullivan, “and filling in this area with fat gives the jawline a smoother appearance.”

Many times he uses a patient’s own fat to fill in behind the jowl to give a better contour to the jawline. This procedure is particularly common in men who want their deflated jawline to look more masculine. For this procedure, Sullivan says, “rather than using a synthetic material that might get infected, if you use your own fat you’re using your own cells, which helps to keep the fat alive.” According to Sullivan, younger patients are the best candidates for this procedure. “We’ve done this in young people who want more of a chin. We put in fat along the chin area and maybe a little liposuction in the neck region to give a more artistic appearance to the lower face so it matches the nice features of their upper face,” says Sullivan. He says, “it’s all about artistic balance.”

Sullivan says the jawline is an area where he can help people of all ages.

“Sometimes it can be a very minimal procedure or it can be a more extensive procedure where we need to remove excess skin.” He says, “we are re-positioning tissue to solve the gravity problem.” Sullivan uses permanent stitches to lift the tissue and reshape the lower face. Using this procedure he brings out the cheekbones which he says “is really their own tissue rather than cheek implants.” Sullivan says “it gives a very nice jaw line with a balanced face that is no longer square but more oval shape, which tends to be much more enhancing in giving them a more natural and youthful look.”

Dr. Sullivan advises patients to bring in photos from their earlier years. “When patients bring in pictures of them in their 20’s, it is so helpful for me to see what they looked like.” He uses the photos as a gauge to help restore what time has slowly changed.

In today’s media-saturated culture, aging gracefully is a dying art. Women find themselves competing with images of young Hollywood starlets – or even erstwhile starlets who, now in their 40s, 50s and 60s, have undergone artful cosmetic procedures to maintain the image of youth. Consequently, more and more middle aged women – and men, too – are considering a little nip and tuck themselves to stay forever young.

But when a facelift goes wrong — and they often do — the mistakes are very visible. People on the lookout for signs of plastic surgery are familiar with the stretched skin, “cat-like” face that shows evidence of a surgeon’s tampering. And, few would volunteer to have the tightly pulled visage of a Jocelyn Wildenstein or Joan Rivers, or the perpetually surprised demeanor of Sly Stallone.

“There are reasons why these [things] happen, and there’s a way to prevent this from happening,” notes Dr. Daniel Man, a board certified plastic surgeon in Boca Raton, Florida. In his practice, Dr. Man strives to create a natural-looking face through surgery. And what he avoids, most often of all, is giving his patients the “pulled-skin look” that would draw attention to their time under the knife.

During an interview at the 2009 meeting of the American Society of Plastic Surgeons, Dr. Man explained the common pitfalls of facial plastic surgery, and shared some little-known trade secrets for avoiding them.

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During the typical facelift operation, the patient’s ears are subjected to a lot of tension, which causes some drooping of the ear canal, Dr. Man notes. And as the surgeon adjusts the patient’s facial skin and muscle during the face lift, the altered ear drops down, producing extra skin to deal with and dispose of. Patching the patient back up from this usually means producing the “pulled” look. Signs of surgery are conspicuous, as well.

“If they have a lot more skin to remove, the incision is longer,” he says. “And if it’s longer, it’s visible.”

Dr. Man’s method – published in July 2009 in the Aesthetic Surgery Journal – is to use a surgical technique that slightly elevates the patient’s ear and prevents it from drooping. From there, he uses a bit of the patient’s transplanted fat to build up the mid-facial area.

“So, we do two things,” he explains. “The ear is little higher and there’s more volume. We still do the muscle work, but is there less or more skin? There’s less. And if there’s less skin, the incision is shorter and can be hidden inside the ear.”

Dr. Daniel Man’s result: A facelift that doesn’t so strongly resemble a “lifted” face, and whose surgical evidence is well-concealed. It also offers the patient slim chance of ever being confused with the family cat.

Facial surgery can refer to one of many procedures that involve surgical reshaping of the facial features. One of the most common surgical procedures is a rhinoplasty, or a nose job. Face lifts or partial face lifts are also popular, especially among aging individuals who want to restore the youthfulness of their appearance.

Rhinoplasty

Also called a nose job or nose surgery, rhinoplasty  is a common solution for patients who are bothered by the appearance of their nose, whether their nose is too large or is awkwardly shaped, as well as for patients who suffer from breathing problems caused by the size or shape of the nasal passages. Rhinoplasty reshapes the bone and cartilages of the nose to enhance its appearance or to improve one’s breathing.

Rejuvenation
Rejuvenation is set of sub-procedures that can be performed to improve the appearance of sagging skin, wrinkles, and other signs of aging, as well as to repair facial appearance after injury and reduce scarring.  Procedures can include:
Face lift – Also called rhytidectomy, this procedure is used for minimizing signs of aging in the face and neck.
Brow lift – Known by other terms such as browplasty and forehead lift, the procedure is used for erasing prominent worry lines across the forehead and raising drooping eyebrows.

Eyelid lift – This procedure, which is also known as blepharoplasty, can correct eyelids that are drooping and can eliminate eye bags or puffiness under the eyes.

Skin peeling – Although performed by a surgeon, this procedure is non-surgical treatment used to treat wrinkles on the face using chemicals.

Ear surgery – Called an otoplasty; ear surgery is used to correct prominent or malformed ears, often in children.
Facial surgery can be a realistic option for many people who wish to repair or restore their facial appearance. With so many options available in facial surgery, it is prudent to seek advice from a specialist who is an expert in the field to understand all the possible results and risks of facial surgery.