Social interaction is often based on first impressions and our faces are our “business cards”. When the image in the mirror doesn’t match our self-perception, individuals may start to investigate facial rejuvenation. The effects of weight gain/loss, aging, genetics, illness and surgeries can be misinterpreted by the casual observer and be at odds with who we actually are. A face which appears tired, gaunt, wrinkled and dominated by pigmentary changes (brown and/or red spots) jowls and marionette’s lines isn’t fashionable in our increasingly youth obsessed society. Facial aging is inevitable; no one is immune. Fortunately, techniques have evolved in tandem with both the consumer and provider’s perception of what constitutes “attractiveness”. The purpose of facelift (rhytidectomy) and necklift (cervicoplasty) is to restore the patient to a younger version of themselves, not to create a surgeon’s concept.
Second Generation Plastic Surgeon
Dr. Chong is a 2nd generation female plastic surgeon, who was mentored by her late father, Dr. J. Kenneth Chong, M.D., F.A.C.S. F.R.C.S. Additionally, she had the opportunity to do an externship with Drs. Tom Baker, Howard Gordon & James Stuzin, M.D.F.A.C.S. during which she learned the fundamentals of a particular facelift technique (SMAS= submuscular aponeurotic system) as well as the evaluation and care of the facial rejuvenation patient.
The Evolving Facelift Technique
It is commonly accepted that residency and fellowship provides the framework for life-time learning and Dr. Chong has continually refined her approach to the facial rejuvenation patient by exceeding continuing medical education requirements, including applying for and being granted Board Certification in Plastic Surgery, as well as thoroughly investigating emerging technologies before adopting them.
The proliferation of facelift techniques can be confusing to both patient and surgeon. The procedure selected should address the patient’s areas of dissatisfaction while taking into account their individual medical history, including prior cosmetic surgery, available recovery time and the surgeon’s experience. Techniques which debut on TV and cannot withstand the gold standards in terms of safety, longevity, predictable outcomes and cost, should be relegated to a longer period of observation. Unlike impulse purchases (candy at the checkout stand), facial rejuvenation exacts significant physical, emotional, intellectual preparedness as well as financial commitment. Dr. Chong endeavors to understand the motives of all facial rejuvenation patients and encourages candidates who are not ready to proceed to either stage procedures (try a lesser procedure before buying a lot) or to have a cooling off period.
Typical Goals of Facial Rejuvenation Patients Include:
- Restoration of the fullness of the cheeks. Facelift techniques can reposition subcutaneous tissue, which has fallen however in some instances, structural fat grafting can augment natural contours. Typical donor sites include the abdomen and the procedure is done concurrently.
- Redefine the jaw by surgical repositioning of the jowls.
- Redrape the “turkey gobbler” by remove excess submental (under the chin) fat, recruiting fallen neck muscle bands and resculpting the skin of the neck.
- Improve skin appearance and texture. CO2 laser resurfacing of lip lines, Cutera Excel V laser to reduce solar dyschromias, (brown & red spots), Cutera Laser Genesis to improve skin textural quality (pore size and collagen production), facial implants (cheek, chin & lip), earlobe reduction, and structural fat grafting are often added to improve the overall result.
Since each patient’s needs and goals are different, Dr. Chong will develop a treatment plan based on your goals and the many options that are currently available that employ the latest techniques in cosmetic surgery. It is helpful to bring a photo of yourself 10+ years ago, to your consultation appointment.
The technique selected for your facelift will address the patient’s areas of dissatisfaction while taking into account their individual medical history, prior cosmetic surgery, available recovery time and the surgeon’s experience, so as to produce safe, predictable and long-lasting results. Dr. Chong and her staff invite you to bring photos, to your consult, of your face, at an earlier time, when you liked your face. Some patients may not be emotionally or logistically ready for surgical solutions. Liquid facelifts (combination of fillers and Botox) in conjunction with Ultherapy (non-surgical skin lifting by micro-focused ultrasound) treatments may be satisfactory when facial aging changes are not so advanced. Ultimately, you will be involved in every aspect of your individual treatment plan to restore you to a more youthful version of yourself.
How long will I be swollen and bruised?
There is considerable variability in how much bruising & swelling results after facial rejuvenation procedures. Most of our patients are comfortable with re-integrating into their usual social activities in 10-14 days.
Do you specialize in facial rejuvenation surgery?
Yes. The stigmata of facial aging include 1. Skin changes (age spots, loss of luster, spider veins & fine wrinkles); 2. Loss of facial fat; 3. The descent of facial fat; and 4. Changes in the bony skeleton. Not everyone ages the same, so part of the prep challenge is to diagnose those features & devise an appropriate combination of procedures. My current approach to face lifting has evolved considerably but ultimately the goals remain the same: to restore what time, age & infirmity have taken away & to delight the eye!
Where is the scar?
The scar originates below the sideburns, travels in front of the ear, extends behind the ear & terminates in the scalp.
Is it safe to color my hair?
Assuming no delays in wound healing, hair color & other treatments can be scheduled 2 weeks, post-op.
Will I have drains?
Two neck drains are placed but removed the next day. Their function is to withdraw fluid, which in turn decreases swelling & bruising. Nursing staff will instruct your care-taker on how to take care of your drains, so relax and tolerate a “necessary evil”.
When can I wear makeup?
After a facelift, your skin may be dry, swollen, lumpy, and discolored for 10-14 days. Complimentary “makeovers” with our hair and make-up consultant, Coby are vital to complete your transformation and can be scheduled as soon as 10 days, postop.
How does your technique for male facelifts differ?
There are many high profile male personalities who are ridiculed because of their extreme facelifts, which make them indistinguishable from their “older selves”. Male facelifts are technically more difficult because 1. Their tissues are thicker, hence the risk of hematoma or bleeding is higher; and 2. Concealing the scars is often more challenging because of shorter hairstyles. From the aesthetic perspective, ancillary techniques like fat grafting, brow lifting, and laser resurfacing are not usually added to the mix, in order to keep a “rugged” but energetic rejuvenation.
Can I have a short scar facelift?
In theory, yes, if no significant neck lift is required. The short scar facelift omits the scar behind the ear (postauricular scar); however this limited approach doesn’t always afford the best access. So if you are motivated to pursue comprehensive facial rejuvenation, don’t obsess about scar length.
Does a facelift always include a neck lift?
If strategically combined, skin care, dermal fillers, lasers and neuromuscular toxins can preserve facial beauty and harmony and defer facelifts until the quality and relaxation of neck skin becomes the “deciding factor” to opt for surgery. In my practice, over 99% facelifts include neck work (de-bulking fat, re-draping skin and tightening muscles).
Can fat grafting be done at the same time?
Fat is the original filler, which lends youth and structure to any face. Fat grafting in tandem with face & neck lifts is logistically appropriate and recommended because apart from replacing “like with like”, fat grafts invariably improve the quality of the skin in the areas grafted.
Find out more about facelift procedures or schedule a consultation with Dr. Chong at her office in Newport Beach. Call (949) 644-1400.