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Dr. Denton's Plastic Surgery Blog for Vancouver BC
 

Facelift, Neck Lift, Upper Blepharoplasty and Laser Resurfacing (Facelift Vancouver)

Facelift Vancouver Before and After - Dr. Andrew Denton

Before & After – Facelift in Vancouver*

LW AP BEFORE AFTER

Before & After Facelift and Skin Resurfacing in Vancouver*

THE CONCERN:

     The client was concerned with the skin laxity that was developing in the face, along the jawline, on the upper eyelids and in the neck.  Also of concern were the lines developing on the upper lip.

THE SOLUTION:

        An extended SMAS facelift was performed which places tension on the layer of tissue under the skin.  This allows excellent tightening and rejuvenation of the face while maintaining a natural appearance.  When muscular banding of the neck is present such as in this case, a submentoplasty (neck lift or platysmaplasty) may be necessary.  This procedure involves sewing the muscular bands together through an incision placed discretely under the chin.    Wrinkles of the upper and lower lip will not be improved by a facelift.  I employ a carbon dioxide (CO2) laser to treat this area.  The down time is greater than with the less invasive fractionated lasers but the results are far superior.  In a case such as this, when a patient has some surgical downtime,  the CO2 laser in my opinion is the treatment of choice.  Finally, excess skin, muscle and fat on the upper eyelids was removed during an upper eyelid lift.

What is A Neck Lift?

The following two sets of photographs are of a neck lift patient before and several months following the procedure:

AP before and after

Neck Lift Before & After*

LO before and after

Neck Lift Before & After – Side View*

     A neck lift is used to rejuvenate the neck and reverse many of the age related changes that occur in this area.   Over time, the skin of the neck becomes loose and the muscles in the front of the neck separate causing the characteristic “bands” apparent in the before photos on the left above.

     During the neck lift procedure, inconspicuous incisions are made below the chin and behind the ears.  The muscles under the skin are tightened and often sutured (sewn) together in the midline and excess skin is removed.   The neck lift restores the natural angle that exists between the jaw and the neck and restores the jawline as demonstrated above.

     I perform all surgery, including the neck lift, in our private and fully accredited surgical facility in Vancouver, British Columbia.  Although recovery periods do differ from person to person, neck lift patients generally return to normal activities within 10 – 14 days.

     For more information on neck lift surgery (and its close cousin the facelift) please refer to: http://doctordenton.com/surgical-procedures/facelift/

Lower Blepharoplasty for Eye Rejuvenation

Before Lower Eyelid Blepharoplasty

Before Lower Eyelid Blepharoplasty*

Five Years Following Lower Blepharoplasty

Five Years Following Lower Blepharoplasty*

I saw this patient last week 5 years after operating on her lower eyelids – lower blepharoplasty.  In the top photograph which was taken before the surgery, the concerns that she had regarding the appearance of the lower eyelids are apparent.  The lower eyelids are puffy and swollen which gives a tired appearance.  This was constant and not related to allergies or any other reversible process.  Simply put, the puffy appearance is caused by fat pushing out from around the eye.

A lower blepharoplasty is a surgery that is designed to remove or reposition this fat which improves and rejuvenates the contour of the lower eyelid.  Excess skin, if present, can be dealt with at the same time.   There is no non-surgical way to treat this as effectively, naturally and permanently as the lower blepharoplasty.

The bottom photograph was taken during her visit last week.  After 5 years the lower lid remains tight and smooth.  The result from the lower blepharoplasty (during which skin and fat was removed) has held up extremely well!

For more information including before and after photographs of upper and lower blepharoplasty patients see http://doctordenton.com/surgical-procedures/blepharosplasty/

 

 

Volbella – A New Hyaluronic Acid Derived Filler

Volbella is the newest hyaluronic acid based filler from Allergan. Other hyaluronic acid based fillers from Allergan include Juvederm, Juvederm Ultra, Juvederm Ultra Plus and Voluma. Volbella is the first hyaluronic acid based soft tissue filler approved for use in the lips that has been shown to last up to 12 months. Up to this point, all of the patients that we have treated with Volbella have been extremely happy. Advantages over other hyaluronic acid fillers include decreased discomort during the treatment and decreased bruising following the treatment. From an injector standpoint, the product flows very smoothly allowing for excellent placement accuracy. In addition to being used in the lips, Volbella is also indicated for cheek and temple filling. All in all, a valuable new addition to the array of soft tissue fillers available to patients in Canada.

Double Eyelid Surgery in the Asian Patient

James Ngo before after close blue

Before and After Asian Upper Eyelid Blepharoplasty (Double Eyelid Surgery)*

The asian upper eyelid is characterized by the complete absence of a lid fold or crease or, if present, a lid crease that is low and poorly defined.  The reason that the lid fold is absent or weak in the asian eyelid is that the levator muscle (the muscle that opens the eyelid) does not attach to the undsurface of the skin.  In the caucasian lid, the levator muscle does attach to the undersurface of the eyelid skin and when the muscle is activated, not only does the eye open, but the eyelid skin folds inward to form the crease (similar to the pleats on a roman shade when it is opened).  To create an eyelid crease, the levator muscle must first be exposed by removing overlying skin, muscle and fat.  Once this has been accomplished “fixation” sutures are placed between the skin and the levator muscle.  When the healing process is complete, the skin along the line of “fixation” sutures becomes attached to the underlying levator muscle, thereby allowing a crease to form when the eyelid is opened.

This type of surgery is commonly performed using only local anaesthesia or a light conscious sedation in our private facial plastic surgery center in Vancouver, British Columbia.  Sutures are removed after one week and patients typically are back to full activities within 10 to 14 days.  More information can be found about this procedure on our website http://doctordenton.com/surgical-procedures/asian-cosmetic-surgery/