Posted on February 3, 2012 in Face Lift, Facelift, Facial Plastic Surgery
Wondering what a typical facelift patient looks like in their 50s-60s? This latest blog entry by San Diego face expert, Dr. John Hilinski, highlights a female patient in this particular age range who desired cosmetic face enhancement to turn back the clock. Dr. Hilinski discusses the thought process and evaluation of your typical patient who has these type of concerns. Dr. Hilinski performed a combined facelift, neck lift, eyelid lift and chin implant to provide this patient a more rested, youthful appearance – all without looking like she had a surgical lift! To learn about this type of facial enhancement surgery performed by San Diego facial plastic surgery expert Dr. John Hilinski, use this link here.
Posted on December 16, 2011 in Face Lift, Facelift, Neck Lift
Over the past several weeks we have consulted with a number of San Diego patients seeking to have cosmetic surgery to enhance the appearance of the lower face and upper neck region. A good percentage of these patients have asked what the difference is between having a lower facelift and an upper neck lift. Because this inquiry has arisen during many of these consultations, I thought it would be helpful to post my answer here on our blog for any future facelift/neck lift patients considering this type of facial plastic surgery. In general, when facial plastic surgeons use the term ‘facelift’ to describe a procedure, they are really talking about the lower one-third of the face as well as the upper one-third of the neck region. But when patients initially think of the term facelift, they often times conjure up images of lifting the entire face from the jawline to the forehead. So you can see where the misunderstanding arises when discussing what a facelift procedure does. 
A good example of this is shown visually in the adjacent patient. This is a middle-aged female from San Diego, CA who consulted with our office desiring a procedure to help make her look more rested and youthful. As you can see from this profile view, she has excess, sagging skin folds along the lower face continuing into the upper neck region. As is noted in the photo diagram, the dotted line distinguishes where the lower face comes to an end (yellow arrow) and the upper neck begins (red arrow). So, as you might imagine, pulling up on the soft tissue of the lower face is also going to elevate the soft tissue of the upper neck. And, in fact, this is precisely what a ‘facelift’ procedure does – both the lower face and upper neck. During the operation, we lift up the skin going from in front of the ear across the face, down into the neck and behind the ear. Once this is done, the deeper tissues of the face (referred to as the SMAS layer) are used to perform the actual lifting. The excess, or redundant, skin is then removed and the incision line is closed very carefully. The end result should be a more rejuvenated, rested looking face and neck. Now there are certainly other procedures that are also referred to as ‘neck lifts’ – but these are isolated neck lifts that are intended to tighten the area from under the chin. Unlike what we refer to as a facelift, these type of lifts do not do much for lower face enhancement.
A good example of a facelift procedure is shown here. This is obviously the same patient featured above. In the before and after facelift photos, you can appreciate the overall improvement in her jawline and neck region. On the frontal view, you can see that her neck has been tightened and the jawline has now been refined. But she doesn’t look pulled or stretched. This is especially true around the mouth area where many facelift patients are concerned they will look like the joker! And as pointed out above, you can see that the facelift targeted the lower one-third of the face and upper one-third of the neck. 
On side view of this patient, you can now see after surgery that her jawline is much more visible without the excess skin folds previously noted. In addition, you can now see a clear division between her lower face and upper neck. Overall, you will also appreciate that she still looks like the same person – just a more rested, youthful version of herself. And that is the essence of doing good facelift work – that you provide the patient with a nice, natural looking enhancement without altering their identity.
Posted on October 6, 2011 in Brow Lift, Face Lift, Facelift, Facial Plastic Surgery
Many patients inquire about crooked eyebrow position, also known as asymmetric eyebrow positioning, and whether or not a browlift might help. What they are referring to is the actual position and shape of the eyebrows. In a good majority of people, the eyebrows naturally sit differently on both sides of the forehead – one side is usually higher than the other. Most of us are simply born this way. In most social situations and conversational environments, however, this difference in eyebrow position is not really obvious to others. There are definitely patients, though, who are bothered by the fact their eyebrows have a different shape when comparing the two sides. In fact, so much so, they seek out a facial plastic surgeon to help enhance the symmetry in the eyebrows. This particular patient is one such example and is presented here.
Eyebrow Lift Patient Presentation
This patient was unhappy with the fact her left eyebrow was lower and flatter than her right eyebrow. Again, many patients might look at this and not put too much emphasis on this natural difference between the two eyebrows. However, there are a good number of patients who present to us facial plastic surgeons each year seeking correction of crooked eyebrows. One option that is quite common is using botox injections to help create more eyebrow symmetry by lifting the one side. Unfortunately, many patients, like this one, are looking for a more permanent surgical correction. In this particular patient, we recommended an eyebrow lift, which is also known as a brow lift or forehead lift (suspension). This is a cosmetic eyebrow procedure intended to lift the brow region to reposition and reshape the lower forehead. This can be done using what is called an open brow lift approach where incisions are hidden in the hairline to perform the forehead suspension. Alternatively, an endoscopic brow lift can be done (also called an endobrow lift) where limited incisions are made and small surgical telescopes are used to perform the forehead lift. Each one has its own advantages and disadvantages that will be reviewed with your facial plastic surgeon to determine the best choice for your individual case. In this particular patient, she chose to have the open approach brow lift surgery.
Eyebrow Lift Surgery Photos
Her before and after eyebrow lift photos are shown here. As you can appreciate there has been a notable enhancement in her eyebrow position and shape on her left side. This side of her forehead was lifted more preferentially to try and achieve the desired symmetry. Using meticulous surgical technique and permanent sutures, her left eyebrow was lifted and repositioned in a higher location to create a more feminine arch-shaped eyebrow. As is noted in the photo diagrams, her left eyebrow was previously quite flat across as is indicated by the blue line. Following the forehead lift, or brow lift, it was more arched to match her right side as indicated by the red curved line. Certainly some people may look at this and think – subtle change. But in many cases of facial plastic surgery, this is precisely what is desired and needed – a visible cosmetic improvement in an area without looking surgical altered. And in the case of an eyebrow lift, avoiding that unwanted surprised look that so many patients fear.
San Diego Brow Lift Consultation
If you or someone you know is interested in having an eyebrow lift (forehead lift) to enhance the appearance of their brows, please contact our office today to arrange for a complimentary consultation. You can also learn more about cosmetic facial enhancement of the eyebrow region by visiting our comprehensive website at http://www.drhilinski.com. We look forward to meeting you.
Posted on June 2, 2011 in Facelift, Facial Plastic Surgery, Neck Lift
Many patients inquire about their short-term appearance following a facelift/necklift procedure. This case example demonstrates what most patients look like at 10 days out from a lower facelift and upper neck lift procedure. This middle-aged female from San Diego, CA desired rejuvenation of her lower face and upper neck due to unwanted sagging skin that was making her look prematurely aged. She consulted with us and was recommended to have a lower facelift combined with an upper neck lift procedure. As with many facial rejuvenation patients, one of her main concerns was looking natural following the surgery. She was also concerned about what she might look like in the early recovery period (first few weeks). We took a series of early postoperative photos to visually show others what they can likely expect at this time point after a similar facelift necklift surgery.
Pre Facelift Images
Her face and neck photos prior to surgery show classic changes consistent with aging. This includes early jowling along the jawline as well as skin bands that are visible under the chin. As you can see, this patient did not have a significant amount of excess fat that needed liposuctioning.
Post Facelift Images
Based on her desires and needs, we performed a standard SMAS facelift procedure to enhance the lower face and upper neck at the same time. These photos represent her recovery around the 10 day mark following surgery. As you can see, there is a notable improvement in her lower face and upper neck contour. She clearly looks more rejuvenated and rested. Despite some swelling that is still present (as expected) around the incision lines, she appears publicly presentable. Even at this point in the early recovery process, her scars are beginning to fade away nicely. Much of this is attributed to the fact that we try and camouflage facelift incisions around the ear as much as possible. Even in patients like her who have more ethnic, darker skin color the facelift incisions can be hidden quite nicely. As you can also appreciate, facelift patients do not have to look like they have been ‘pulled’ after having a rejuvenation procedure like this. If you or someone you know are interested in having a facelift necklift procedure, feel free to contact our San Diego office today.
Posted on April 30, 2011 in Face Lift, Facelift, Neck Lift, Platysmaplasty
This is a very pleasant lady who underwent a lower facelift and upper necklift procedure in our San Diego facial plastic surgery office. She presented to our demonstrating excess sagging neck skin. As with many facelift and necklift candidates, there was a notable amount of excess fatty tissue underneath the skin that contributed to the problem. In these patients, you cannot, unfortunately, just liposuction the neck. If you do so and remove the unwanted extra fat, the overlying skin is likely to just sag down further. This is because the skin has lost much of its elasticity, or rubber band like quality, and won’t just shrink wrap upward. As a result, you are forced to remove the extra fatty tissue but then have to elevate or lift the face and neck skin.
Relevant Facelift Necklift Anatomy
Below are her photos before having the facelift and necklift procedure. As you can see by the white arrows, she has a moderate amount of sagging neck skin that was most bothersome to her. Behind the skin, anatomically, was a fairly thick layer of excess fat that was contributed to the heaviness through her neck region. She actually did not have much in the way platysma (the muscle layer that courses from the clavicle across the neck to the jawline) banding, which is where the muscle hangs down and causes the appearance of a thick vertical cord along the neck. Based on these preoperative photos, I suggested a procedure to liposuction the neck and lift the lower face/upper neck skin.
Targeted Area in Facelift and Necklift Surgery
The facelift and necklift surgery was performed under a general anesthetic in the outpatient setting. After liposuctioning to thin out the neck line, I performed a standard facelift procedure. As in nearly all facelift surgeries, this involved tightening and lifting the SMAS layer to provide a strong, sustained elevation of the facial skin and soft tissue. On her lateral view (see diagrammed photo), you can see the area of the neck that we really tried to target with the combined facelift and necklift. If we were able to lift this portion of her neck and jawline, we would essentially be repositioning her lower face and upper neck skin to mimic their position a decade earlier.
Facelift and Necklift Surgery Results
Here are this patient’s before and after facelift/necklift surgery results. As you can appreciate, she has a fairly significant improvement in terms of her upper neck and lower face contour. We were successful in lifting her neck skin and improving her jawline to provide her with more definition and less heaviness. Overall, she looks quite natural and more rested. As you can also see, her ears are still in their native position without undesirable pulling of the ear lobe – a common concern in facelift candidates. If you are considering a lower facelift and upper necklift, we hope this case example provides you with some visual confirmation of what might be possible with facial plastic surgery by The Hilinski Clinic.
Posted on April 18, 2011 in Face Lift, Facelift, Facial Plastic Surgery
The answer is hopefully not! As facial plastic surgeons, we get asked this question all the time from patients considering facelift surgery in their 60s. The reality is that some patients are going to be considered great candidates to have this type of facial rejuvenation procedure while others might not be such good candidates. Much of this depends on how your skin has aged over the years. If your skin still has reasonable elasticity (a rubber band like quality where your skin snaps back into position when pulled or pinched), then you are more likely to be considered a good candidate for a facelift, or face lift, procedure.
San Diego Facelift Photos
The adjacent photo of one of my San Diego patients who wanted a facelift is a great example of this exact topic. This very pleasant lady consulted with us regarding her lower face and upper neck region. She wanted to look more refreshed and rested. On examination of her face and neck, she was found to have some excess skin but fairly good elasticity. Meaning, when I pinched her skin slightly, it rebounded back into position more readily than many facelift candidates her age. We discussed in detail her option to undergo a rhytidectomy procedure – which is the technical term for a facelift and necklift procedure. Although she was in her 60s and her skin wasn’t like some facelift patients in their 40s or 50s, she was still considered a good candidate to have this type of facial rejuvenation procedure performed.
San Diego Before and After Facelift Photos
Below are her before and after photos following the facelift procedure. As you can see, she still looks like herself, which is typically the goal when performing facial rejuvenation surgery like this. What you do see, however, is that she appears more rested and youthful, especially on her profile (or side) view where her sagging jawline and neckline were most visible before the facelift. You also get a good appreciation of how well the facelift incisions can heal in your typical case like this. Her facelift incisions are fairly well hidden just in front of the ear where it junctions with the face. Note how her jawline is now more defined and her neck no longer sags down as it did before the face lift. So if you are in your 60s and considering having a facelift procedure, come by our San Diego office for a complimentary plastic surgery consultation to see if you are a good candidate for this type of facial rejuvenation procedure. Don’t let your age determine whether or not a facelift procedure is right for you!
Posted on March 10, 2011 in Face Lift, Facelift, Facial Plastic Surgery, Plastic Surgery
This is a question that is commonly asked by San Diego facelift, or face lift, patients looking to achieve a more youthful, rested facial appearance. In short, the answer to this is – yes. Patients undergoing a facelift procedure to lift and tuck the lower face and upper neck are undergoing a permanent change in their appearance. By definition, lifting the facial skin, then tightening the SMAS layer, followed by removal of the excess skin, is considered a permanent change to the face. Perhaps a better question to ask is ‘how long should my facelift results last?’ Because the reality is that facelift patients will resume the aging process at the moment I place the last suture during their procedure. Assuming you continue to age at an appropriate rate and take care of yourself, most facelift patients can enjoy 5-10 years before having to consider another lift or tuck. In many cases, patients undergo a facelift procedure and never elect to have any further surgery down the road. But the changes that are made during a facelift procedure are definitely considered a permanent change in the anatomy of the face.
Posted on January 28, 2011 in Face Lift, Facelift
Many facelift patients inquire about how inconspicuous their scars will be once healed. Well here is a photo example of one of my San Diego facelift patients demonstrating how to conceal a facelift incision. This patient underwent a lower facelift along with tightening of her upper neck line. As you can see from the photos she has a nice rejuvenation and looks much more rested. Arguably more importantly she does not look like she has had any surgery performed in the sense that she looks quite natural. If you look at her close-up photos, you can see that her facelift scars are well healed and barely visible to the naked eye. Her hairline has been preserved and her ears are not malpositioned following the facelift procedure. This is precisely what we aim for when performing this type of cosmetic facial enhancement surgery. Interestingly, this particular patient specifically searched out board certified plastic surgeons in San Diego who showed her close-up photos of their facelift patients’ incisions as this was a major consideration for her. To see the remainder of her before and after facelift photos use this link here.
Before and After Facelift Surgery
Well Healed Facelift Incisions
These photos show a well healed facelift incision can heal. The blue lines in the photo below right outline the actual incision used in this San Diego facelift patient.
Posted on January 27, 2011 in Ear Lobe Reshaping, Face Lift, Facelift, Otoplasty
I just finished two surgeries in the last two days with both patients undergoing combined facelift surgery with otoplasty (ear reshaping). It just so happens that both of these patients from San Diego desired reshaping of their ears as well as facial rejuvenation of the lower face and upper neck. In both cases, we were able to easily reshape the ears in the midst of the face lift procedure. When performing a facelift surgery, we have to make incisions around the ears to lift the face. During this exposure, the ears are quite accessible to cosmetic reshaping. In one of the patients we also reduced the size of the earlobes as part of the cosmetic ear reshaping. Although not a common combination in facial plastic surgery, it can definitely be done as evidenced by my last two days in surgery!
Posted on January 12, 2011 in Face Lift, Facelift
I like to see my facelift, or face lift, patients fairly regularly following their surgery. I will continue seeing them upwards of 6-9 months out typically. It is around this time that facelift patients seem to reach a plateau in terms of their recovery process. Although facelift scars will continue to evolve up to a year or beyond, a majority of the healing will have taken place by this point in the recovery process.
