I DON’T LIKE MY JOWLS….

It is the curse of the beautiful lady to notice the earliest change in the lower part of the face we call jowls. These early changes change the smooth jawline and add a more masculine look to the face which ages us. The jowl is the earliest sign of aging noticed by ladies, not infrequently in the 30’s. Options include local treatments to some jowls and more global treatment like a facelift and a necklift when a more definitive improvement is sought.

Options for the treatment of jowls include the following:

• Liposuction
• Subcutaneous transdermal radiofrequency
• HIFU (high frequency focused ultrasound)
• Subdermal 1500 nm laser
• Subdermal Plasma Treatment
• Isolated necklift
• Mini facelift
• Facelift and necklift

BEAUTY OF THE FACE IS MAGNIFIED WITH A STRONG JAWLINE AND A SMOOTH, FIRM NECK…

Ladies’ faces look best when there is a strong, smooth jawline, terminating in a proud, if delicate chin. The line from the earlobe to the mentum (chin) should be one sinuous, smooth, firm curve. Even a slight break in this curve detracts from feminine beauty.

Not every early jowl needs a facelift and a necklift. With modern techniques and technologies, there are a number of non-invasive and minimally invasive procedures and techniques that may be used to improve these early jowls. These range from the use of fillers to eradicate or reduce the pre-jowl sulcus (hollow), micro liposuction, local ablative laser application, superficial and deep application of radiofrequency, sometimes with micro-needles, external ultrasound, and a combination of several of these techniques. The gold standard, of course, is a beautifully performed facelift and necklift to give the smooth jawline, tight neck and firm but full cheeks as seen in some of the photographs on this page.

With careful attention to detail, analysis of the exact changes along the jawline and the neck, skin changes from aging, sun damage and genetics, a proper plan can be made to give the best result with the least invasive approach.

I DON’T LIKE MY BAGGY LOWER EYELIDS!

Normal egress of fluid into the fat that surrounds the eyeball is normal. We see it as “puffy eyelids” in the morning, or when one is tired. The fat that surrounds the eyeball is both, a suspension for the eye as well as a protector. Of course, a combination of the repeated puffiness, washing, wiping, daily wear-and-tear, makeup on-and-off, all conspire to create some looseness of the tissues of the upper and lower eyelids. There is a combination of changes also related to aging where tendons and septa stretch and relax. This is what results in what is commonly termed “baggy lower eyelids”. However, the changes are complex and often different in different people. Blepharoplasty is a generic term: it covers multiple procedures performed on lower eyelids and the midface to improve the appearance of these “baggy lower eyelids”. Advanced blepharoplasty techniques can give invisible results.

THE APPEARANCE OF LOWER EYELIDS IS A POWERFUL INDICATOR OF OUR ALERTNESS AND ATTRACTIVENESS

Loose lower eyelid skin gives one a tired and aged look. Excessive puffiness can make us look older than we may be, and also contribute to the comment often heard “did you get enough sleep?” Leakage of fluid repeatedly and other factors contribute to dark circles, which further make us look tired. The lower eyelid changes that contribute to many of these comments and appearances are complex and require a careful and accurate assessment of the changes to plan the safest and most effective way of addressing lower eyelid changes. There is a reason why I always tell my plastic surgery trainees that lower eyelid blepharoplasty and midfacial surgery is the most difficult procedure in cosmetic plastic surgery!

Effective rejuvenation of lower eyelids will take into account numerous anatomical and physiological factors as listed above. Only by assessing and addressing these numerous factors can one plan and design lower eyelid and midface surgery which results in a relaxed, un-operated look, without any of the stigmata of having had surgery. We correct and repair many lower eyelids which have had too much surgery or unwise surgery, so it is best to get it right the first time!

Changes that occur on the face cannot be looked at in isolation. It is a common mistake in our consumer-driven society for people (and surgeons!) to address individual items, as if on a menu. Therefore, people will have upper blepharoplasty or a browlift or lower blepharoplasty and forget that the flow of the face (and the body as a whole) must be considered with proper analysis and with due respect paid to the effects of surgery on the surrounding structures. Our philosophy, developed with extensive training, research and experience, is to address these issues and inform our patients fully so that there are no concerns or surprises after surgery. If planned appropriately, pleasing and long-lasting results can be obtained with lower blepharoplasty, but this is often combined with modification of some of the surrounding tissues to make the results look natural. Come and see us for an analysis and a consultation: you will be well-informed and educated about the changes, possibilities, safety and options.

I DON’T LIKE MY DROOPY UPPER EYELIDS!

Perhaps the earliest change noticed on anyone’s face is the appearance of the upper eyelids. It is what we always look at first when we gaze in a mirror. Not only is the field of vision dependent upon the position of the upper eyelid and upper eyelid skin, but the shape, curve, arch, crease, lash position, lash length, relationship to the brow and many other factors are automatically registered by our brains when we look at our or anyone else’s eyes. One cannot look at eyes without seeing the eyelids: droopy, baggy, puffy, uneven!

ALERTNESS, ATTRACTIVENESS, ATTENTIVENESS, ENTHUSIASM, DESIRE: ARE ALL GLEANED FROM THE APPEARANCE OF UPPER EYELIDS….

An analysis of upper eyelids demands careful assessment of symmetry, height, curve, lash position, lash ptosis, crease shape, crease depth, upper eyelid fullness, lid fat pads, brow position, crow’s feet, medial fullness, visual field obstruction and overall understanding of changes over time and exposure to the elements. Because upper eyelids also serve the vital function of protecting the single most important organ in our body, our eye and therefore vision, the positioning, the shaping and the movement have all to be considered and designed with the greatest of care.

Creation of beautiful upper eyelids will give one a natural curve, an opening that allows us to see well, lashes that curve outwards and upwards, a skin crease that allows the use of makeup in ladies without it rubbing against skin folds, an alertness and brightness that shows off our eyes! The brow position and curve and the lateral canthus (and crow’s feet) areas are also considered when undertaking a cosmetic or functional upper eyelid blepharoplasty with our without repair of the ptosis (droop) of the eyelid caused by weakness or stretching of the levator muscle. Attention to detail gives us the best results….

We will assess your eyelids and surrounding structures to give you an analysis and explanation of what, if anything, might help functionally and/or cosmetically. Our approach is to leave people looking refreshed but without the stigmata of having had surgery. Of course, there is healing involved with all surgery and one must bear this in mind. Eyelids in particular, will swell and give you some degree of bruising: but with appropriate preparation, and postoperative care, this settles quickly. We have detailed instructions and information in exactly what to expect after upper eyelid surgery that you can read at this LINK.