A good thing? 3-in-1 facial plastic surgery can be safe for the aged

A total facial rejuvenation that combines three procedures to address the multiple signs of an aging face and neck can be performed safely at one time, a new study shows.

Total facial rejuvenation, which combines an extensive facelift to tighten skin and muscle; specialized, midface implants to restore fullness; and laser resurfacing to reduce skin’s irregular texture and discoloration, can be safely performed at one time, reports Dr. Achih H. Chen, facial plastic surgeon.

Chen, Director of Facial Plastic and Reconstructive Surgery at the Medical College of Georgia at Georgia Regents University and Director of The Georgia Center for Facial Plastic Surgery in Evans, Ga., is corresponding author of the study in The American Journal of Cosmetic Surgery.

Surgeons have been concerned that, while simultaneously addressing the major signs of an aging face and neck might give patients the improvements they want in one down-time, trauma to surface and underlying tissues might result in skin loss and other problems.

However, the review of 21 women age 58 to 71 showed they experienced normal wound healing, producing a new top layer of skin and wearing makeup again within two weeks. There were no reported complications related to the more extensive surgery Dr. Chen performed on these patients.

“In a quest for a more complete or total facial rejuvenation, we started pushing the envelope a little bit and have found that combining techniques is a really safe approach,” said Chen, noting that continued refinement of laser technology and surgical technique enabled the momentum.

Conventional wisdom suggests that tightening is key to reversing the signs of aging. However, Chen notes, “Young faces don’t look tight. They don’t have sagging, so tightening is a component, but just tightening and tightening does not really achieve a more youthful appearance. In fact, too much tightening can make you look very unnatural, and I don’t think most people are looking for that as an end point,” Chen said.

Tightening works well for the neck and jawline, but in the midface, where aging individuals have already lost volume, tightening in the standard upward and outward direction of facelift surgery will further widen and flatten that area. “The youthful midface is full, so volume restoration also is critical,” he said.

Smooth, even skin is a youthful characteristic as well so also removing the top layers of sun- and time-damaged skin is key to achieving a fresher look and improved skin texture. He notes that non-ablative lasers as well as other exfoliation methods, which tend to remove just the very top of the skin, have much reduced recovery time and results.

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