Vermont Plastic Surgery Blog

Facial Rejuvenation

We only get one chance at a first impression and the person who projects the best self-image makes the best impression. In today’s competitive society, people recognize the importance of self-improvement, whether it is for social or professional reasons.  Exercise, skin care and nutrition are important but can only do so much.  Real structural change requires more.  In a sense cosmetic surgery offers a second chance - the opportunity to defy both the calendar and genetics.

Facelift! The term has become a household expression,  the topic of much interest, discussion, and misinformation. Often lumped together under the general term “facelift” are a group of operations designed to rejuvenate a face which shows the signs of aging.

Americans stress eye contact, and believe they can judge others’ character by what they see in their eyes.  While people talk most about facelifts, the age reversing operations people are having most commonly are on the eyelids, according to local board certified plastic surgeon Dr. David M. Metzner.  Heavy, hooded upper eyelids and baggy lower eyelids make people look tired, old, and certainly past their prime.  Surgical correction, known as blepharoplasty, removes the fatty pouches that cause the bags beneath the eyes.  Stretched skin is also removed when present.  Upper eyelid hooding, sometimes partially obscuring vision is corrected by removal of excess skin, muscle and fat.  Incisions follow natural contour lines in the upper eyelids, and in the lower lid can be on the inside so there is no scar at all.  Even circles under the eyes can be filled in and the lids tightened when that will improve the result.

A pleasing eyebrow shape and arch is associated with youth and beauty.  On the other hand, an unfavorable eyebrow shape and angle can make a person look tired, worried or angry.  The brow and forehead lift, in addition to lifting the eyebrows back to where they belong, smoothes out a deeply furrowed and pinched forehead.  Dr. Metzner prefers the high-tech endoscopic method, which he considers a big improvement because he needs to make only small incisions within the hair, through which he passes the tiny video-connected scope.  Using this advanced procedure, the scars are completely hidden; there is no hair loss, and no shaving.

The cumulative effects of time, gravity and heredity show on any face.  The facelift operation itself, also known as rhytidectomy, is performed to correct double chins and sagging jowls.  Undesirable accumulations of fat are permanently removed, and sagging muscles and connective tissue are repositioned and resupported in the modern day long-lasting facelift operation.  Because excess fat is removed in the operation, the old advice to lose weight before facial surgery no longer applies.  In fact, one of the benefits of surgery is that a person who previously had chubby cheeks or a fat neck will look as though he or she has lost weight.  The overall effect is a younger, fresher and more vibrant, yet natural appearance.

Skin resurfacing with laser or any of a variety of chemicals can smooth the skin, reduce wrinkling and even out the complexion.

Some people prefer to correct one thing at a time, what one of Dr. Metzner’s patients called “weeding the garden.”  Others want a more dramatic improvement; they have as much done as necessary and feasible at once so as to achieve maximum benefits.  It is an individual choice, and one of the reasons a thorough consultation with a well-qualified experienced and sympathetic plastic surgeon is so important.  Dr. Metzner emphasizes individualized planning for facial surgery according to each person’s specific needs and desires.

Breakthroughs in anesthesia methods and monitoring devices has made it possible for all of these operations to be performed on an outpatient basis.  Patients are more comfortable, heal faster in the home environment, and overall expenses are reduced.

Non-Surgical Enhancements include Botox, which is very useful for minimizing frown and crow’s-feet lines, laser and chemical resurfacing that reduce fine line wrinkles, and injectable products that can help to fill in deeper creases and wrinkles.  Dr. Metzner will discuss the benefits and limitations of  each, and help you choose the combination best for your specific needs.