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.
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.