By Peter T. Pacik, MD, FACS
At times, additional procedures may be helpful for facial rejuvenation:
A forehead lift or temple lift will help restore droopy eyebrows. Eyebrows which are too low impinge on the upper eyelid skin causing "small eyes” and excess skin involving the upper eyelids. Often the muscles that are responsible for “frown lines” are removed at the same time. A temple lift is performed when the outer aspects of the eyebrows are too low. A forehead lift or temple lift may be done at the same time as a facelift, or separately. If this additional surgery is indicated, it will be discussed during your consultation.

Frown Lines
Are lines around the bridge of the nose and inner eyebrows, due to wrinkles that form as a result of underlying muscular activity. As with "crow's feet", they are managed best with Botox. For patients having a forehead lift, these muscles can be removed. These muscles are also managed in a similar way for patients with migraine headaches where the trigger area is located between the eyebrows.

Forehead Wrinkles
Forehead wrinkles are due to the dynamic action of the underlying frontalis muscle. As with most dynamic wrinkles, this is best handled with Botox, though some improvement can be expected from a forehead lift.

Advanced Skin Care
Almost anyone needing a face lift would do well to incorporate an advanced skin care program. At the time of consultation, you will be checked for sun damage and advised regarding the various advanced skin care programs available. These programs use physician strength products, are often no more expensive than over-the-counter topicals, and have a long history of safety and effectiveness.

Resurfacing (Chemical Peel, Dermabrasion, Laser)
A face and neck lift corrects excess quantity of skin by removing skin and remodeling underlying tissues. Often the skin is damaged from too much sun exposure, environmental toxins, or smoking. The quality of the skin can be restored by advanced skin care programs and resurfacing procedures. At times, a resurfacing procedure may be recommended before a face lift. Some patients may not need a face lift after resurfacing. Your skin will be evaluated at the time of consultation and appropriate recommendations will be discussed.

Eyelid Surgery
Upper and lower eyelid rejuvenation may be helpful to more completely rejuvenate the face. This is usually done as a separate procedure because a 3-4 hour face lift is usually enough for both the patient and the surgeon.

Facial Fillers
Often the nasolabial creases are not adequately corrected at the time of a face lift because of the distance of pull from the location of the incision in front of the ear. Nasolabial creases and marionette folds are often best managed with facial fillers or fat injections.

Since the neck is usually done at the time of face lift surgery, proper chin projection becomes important for facial balance. Your chin projection will be evaluated during your consultation, and recommendations for a chin implant given if needed.

A poor angle of the neck is often due to excess fat and loose muscles. A combination of liposuction and corset platysmaplasty (tightening of the neck muscles) will help restore and rejuvenate this region. This is usually done at the time of face and neck lifting.

Although a neck lift is routinely performed at the time of face lift surgery, excess neck wrinkling, often due to too much sun exposure, requires an advanced skin care program. The neck lift in of itself can only correct excess quantity of skin; however, does not improve the quality of the skin resulting from sun damage.
Cheek Bone Enhancement
Descent of the facial structures due to age, gravity, sun damage and heredity often cause the cheek bones to appear flat. Cheek bone enhancement can be done with facial fillers or fat grafting to help restore the bony prominences of the cheeks and give a more youthful appearance. If needed, this will be discussed during your consultation. It can be done at the same time as a face lift or separately.
Earlobe Tailoring
With advancing age, ear lobes may become too large. Earlobe reduction can be done at the time of a face and neck lift. At times, there is improper definition of the earlobe because the lower part of the earlobe attaches to the face and there is no “dangle” to the earlobe. This is routinely tailored during a face lift to prevent the earlobe from pulling down during the healing phase.
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We encourage you to call our office and schedule a free skincare consult with our licensed aesthetician. We will be happy to talk to you about your skin type and condition and make product recommendations. Our MD Forte, Vivite, Clinique Medical, Prevage MD, Glytone, Kinerase, RevaleSkin, Clenziderm, Eau Thermal Avene, Elastiderm, Rosaclear, Obagi Nu-Derm, Obagi-C Rx Advanced Skin Care Programs are all excellent for skin rejuvenation. We can help you decide which skin care program would be best for you. Our aesthetician is available Monday through Friday 8:30 a.m. to 4:00 p.m. EST at 1-877-415-0600 or (603) 296-4920. You may also contact us by completing our information request form. Most emails are answered within 24 hours.
The Plastic Surgery Center of Manchester, New Hampshire specializes in cosmetic plastic surgery, including body lifts, breast enlargements, breast lifts, breast reductions, eyelid surgery, ear surgery, facelifts, fat grafting, liposuction, male breast reductions (gynecomastia), neck and chin surgery, nose surgery (rhinoplasty), surgery after massive weight loss, tummy tucks and BOTOX® Cosmetic for vaginismus. We also offer facial rejuvenation (chemical peels, dermabrasion, Obagi Blue Peels, Glycolic Peels, Microdermabrasion), injectables and facial fillers (BOTOX® Cosmetic, Radiesse®, Juvederm®, Perlane® and Restylane®) and advanced skin care to patients from all over New England (Maine, Vermont, New Hampshire, Massachusetts). While no responsible practitioner gives guarantees for the work they do on the human body, we can at least reassure you that you will receive the expertise and dedication of over 30 years in practice. Our patients become an important part of our family and we try to get to know each patient individually and customize their treatment to meet their desires. Visit our skincare website to purchase MD Forte, Obagi-C Rx, Obagi NuDerm, Prevage and Vivite advanced skincare products.