About Face

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About Face

Chapter Six The Face-lift Lower Face-lift Liposuction The Chin

The Chin

I’ll end this chapter by mentioning a couple of uncommon circumstances related to the face-lift procedure. For example, there is the rare patient who has unusually saggy skin - the classic “turkey” neck, or wattle under the chin - and all the pulling up in the world won’t correct the sag under the chin. The basic principle is, the further away you are from the pull, the less the effect. In this case, we might be forced to make and incision under the chin and excise some skin from there, too.

Another circumstance comes about when a patient approaches me for a face-lift, and it is clear there are other problems I could deal with at the same time. A good example is the patient who has a receding chin combined with sagging jowls, which often makes the person look rather “owlish”. I will take the time to explain that once we’ve made the incisions for the face-lift, we might just as well put an implant under the skin in front of the chin and jowl area before sewing up. These implants are made of flexible, solid, medical-grade plastic, and they come in a variety of shapes that fit over the existing chin bone. (Shapes that resemble the rinds of orange, grapefruit or lemon slices.) A face-lift might also give us the opportunity to do cheek implants, creating more pronounced, “higher” cheekbones or correcting a mid-face collapse.

As I mentioned, most face-lift patients are looking to capture the psychological image that they have of themselves, and a stronger chin or more noticeable cheekbones might not fit that image. But if a patient is afflicted with mid-cheek hollowing for example, an implant might be the icing on the cake to achieve the more youthful appearance of a fuller cheek and lifted face. As a facial cosmetic surgeon, I consider it part of my commitment to educate patients about the procedures and alternatives that will produce the most pleasing effect.

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