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"Volume Restoration" Plastic
Surgery & The New, Lighter Procedures
In the face, the aging process causes
atrophy of the skin and underlying layers while the effects
of gravity cause the facial tissues to droop in a vertical
direction creating redundant skin and "jowls". The
end result is an absolute loss of volume to the face and a
relative shift of volume from certain areas of the face to
other, less desirable areas such as the jaw line and the areas
under the eyes. Traditional facelifts do not address the volume
issue and, on the contrary, do exactly the opposite by taking
tissue out. An example of this is seen in the usual lower
eyelid procedures where, to improve the so called "bags"
under the eyes, fat is removed. This approach may provide
an initially improved look, but inevitably will deteriorate
as time goes by into a hollow, skeletonized look as the patient
ages and loses additional facial fat. Traditional facelift
attempts to correct this problem by pulling the skin in a
lateral direction produce the so called "swept back"
look that is so obvious.
Basically, aging causes volume loss and
the ultimate goal of facial rejuvenation should be to restore
the lost volume. That is why the face of a pregnant woman
looks so beautiful, it's the volume! That is also why older
people who are slightly overweight look younger than a very
thin person of the same age. (In this case at least, fat is
good.)
To avoid the problem of too obvious cosmetic
surgery, several new procedures have been developed: The AMR
(fat pad release) for the lower eyelid allows the doctor to
redrape the lower lid fat and stitch in place instead of removing
the fat, creating a more harmonious look and avoiding that
"hollow" that follows conventional eyelid surgery.
The Vertical Lift, by restoring volume
in the upper face and reshaping the deeper facial tissues
in a vertical direction offers a much more natural result.
The procedure also eliminates any visible scars and offers
significantly shorter recovery times, an important advantage
for women and men who heed to get on with their busy schedules.
Dermal and fat grafting complement these
procedures by adding volume in areas in need. "Volume
Restoration" and the vertical lift are the new techniques
that allow the physician to rejuvenate the face in a more
natural way.
Facelift 3 (cubed): Adopting, modifying and combining multiple
procedures to exponentially improve results in facial rejuvenation
Renato Calabria , M.D.
All current single techniques of facial rejuvenation fall
somewhat short of creating a natural and more youthful look
despite some of them share a common philosophy of three-dimensional
augmentation. The reason may be that for a complex problem
there is more than one solution and other techniques may correct
a defect, or improve one area of the face, making some other
worse. For example, asking the subperiosteal approach to
improve the nasolabial fold or the SMAS technique to redistribute
facial volumes is not likely.
We feel that each technique can target a specific problem
and by combining and modifying them, the benefits will increase
exponentially.
Our approach to facial rejuvenation is dictated by the following
principles.
The facial skeleton is first evaluated and modified, if
needed, by adding, (more liberally,)implants in areas like
chin and cheeks where structural augmentation is crucial.
An endoscopic brow lift with volumtrie augmention of the
brow with autologous tissue provides access to the midface
along with a gengivobuccal incision. A modified subperiosteal
elevation and imbrication of the buccal fat pad restores
the volume and counteracts the effects of tension in the
midface. An extensive supraplatysma skin flap dissection
and elevation provides release of all the ligaments and skeletonalization
of the platysma. A true platysmapexy, medial and lateral,
restores neck contours. A modified cheek fat pad suspension
will soften the nasolabial fold. A double pexy blepharoplasty
with fat preservation will improve the nasojugular groove
and periorbital area. A double breasted skin closure with
dermal flaps will minimize the effect of tension on hyperthrophic
scars.
The facelift 3 (cubed) is a global approach to facial rejuvenation,
where the combination and modification of some of the most
current techniques all play a role in exponentially improve
the final results in the third dimension.
For more information on Volume Restoration,
Facelift (3) Cubed or to speak with Dr. Calabria , please
feel free to contact us.
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