Plastic surgeons are constantly evolving, honing their craft to develop new techniques and procedures that rejuvenate the face with as little downtime and scarring as possible. Dr. Cliff Clark of Winter Park, FL discusses how cosmetic surgeons today combat facial aging versus 10 or 20 years ago and the exciting results that can be accomplished with minimally invasive procedures.
by Katherine Stuart
and Clifford Clark, III, MD
It’s About Adding Fat and Subtracting Skin
The eyes are one of the first features to show the early signs of aging, which can make the rest of the face look old even if it’s not. In the past, treating the eyes was all about removing excess skin and fat. Now, it’s about creating balance by taking away a bit of skin and fat, adding volume where needed and moving the position of the brow. All of which can be accomplished through an upper blepharoplasty incision.
An upper blepharoplasty is a procedure in which a surgeon places an incision in the crease of the upper eyelid and removes excess skin. The scar from the incision is hidden within the crease of the eye and so slight that it usually can’t even be seen when the eye is closed. Surgeons such as Dr. Clark can now deliver the kind of facial rejuvenation through this small incision that used to require a full facelift. “You can adjust the position of their eyebrows,” explains Clark. “You can take away some of the furrowing that they have in their central brow and through injection techniques, you can also put some fat around their eyes if they need it.”
If you look at the actress Catherine Zeta Jones, she has a lot of fat in the brow tissues above her eyelid. It’s this fullness that gives her a youthful eye. Older women often look as if you could stick your finger between the eye and the brow. This hollow or loss of fat is one of the face’s biggest “agers”. Generations ago, plastic surgeons took away too much from around the eye. Today, great results are about positioning the eyebrow so that the outer edge is higher than the inner edge. Also adjustments include addressing the muscle that causes some patients eyebrows to come together, removing excess skin from above and/or below the eyelid, and adding volume where needed. It’s an entirely new way of thinking that greatly benefits the patient as it delivers exemplary results with minimal risk and a modest recovery.
Lower Lid/Cheek Juncture is Another Trouble Spot
“As you look at periorbital aging, one of the more profound ways that we age is to lose the volume of our upper cheek” says Clark. This volume loss reveals the underlying facial skeleton which creates a hollow underneath the eye. Patients often refer to this as their “dark circles”. Treatment is about restoring balance. Bottom line, achieving good results takes a couple of different techniques. It’s never a “one size fits all”.
Fat Bulge Beneath the Eye Requires More Invasive Surgery
Some patients have a pad of fat that bulges beneath the eye. This can typically be addressed with a transconjunctival blepharoplasty. In this procedure, a surgeon places an incision on the inside of your eyelid and removes the fat, leaving no apparent scar. He or she may then inject filler or fat into the hollow under the eye to treat the dark circle. “By removing above and adding below, you have the perfect balance,” says Clark. For patients with a “festoon”, which is a laxity in the skin and muscle under the eye, treatment may require a more invasive surgery. But it’s still less invasive than it would have been 10 or 15 years ago.