Facial Procedures

In general, Dr. Gordon performs procedures that restore and rejuvenate your appearance, such as facelifts (rhytidectomy) and eyelifts (blepharoplasty) and procedures that alter your appearance such as nose reshaping surgery (rhinoplasty) and chin implants (mentoplasty). These procedures can be done individually or combined depending on an individual’s goals. Below are descriptions of our cosmetic surgery procedures and the motivations of many of the patients who seek these services.

Facial Rejuvenation

The type of results achieved in facial rejuvenation is a product of the facial plastic surgeon’s techniques, aesthetic judgment and artistic skill.

Although the aesthetic judgment of an individual may vary, in the 21st century the majority of people seeking facial rejuvenation have similar motivation and goals.

In contrast to facial plastic surgery of the past, where facial rejuvenation procedures, such as facelifts and necklifts, produced results that were obvious, unnatural and changed a person’s appearance, advancements in techniques and procedures, today, offer completely different outcomes.

Most people like their faces, it is their aging changes that they do not like. “Reverse my changes but do not make me look different.” “If it looks like I had it done, I don’t want it.”

Facial aging

Changes in our facial appearance over time are due to two main factors: gravity’s effect on the soft tissue of our face, which both stretches out our face and causes it to droop, and changes in the quality of the surface or skin such as fine lines and hyperpigmentation.

The soft tissues constituting the face are in layers, with the skin on the surface, then a layer consisting of fat, mixed with a layer of connective tissue, and then the SMAS layer (subcutaneous musculoaponeurotic system). The SMAS layer of the face, a strong fibrous sheet of tissue, separates the deeper facial structures such as facial movement muscles, nerves and other structures that are not as affected by aging as the soft tissue.

As we age, all these facial layers begin to sag due to gravity’s effects. The fat pads in our cheeks slide downward, our cheeks become hollow, and we develop jowls, creases and eventually a loose neck. Changes to our facial shape, from a tapered shape with a defined jawline, when we are young, to a square, elongated shape with folds and laxity as we age are the major signs of gravity’s effects.

The specific ‘look’ that reflects each decade of our lives (what makes a fifty year old look fifty, a sixty year old look sixty, etc) is predominately created by our gravity changes, with drooping of the neck and jowls, as one of the last gravity changes that occurs. Even before we look ‘old’ gravity affects our face and creates illusions of tiredness (bags under our eyes), sadness (a down turned mouth) and anger (furrows between our eyes). Since all the facial tissue layers are affected by gravity, only procedures that reposition all the drooping tissue layers effectively reverse our aging facial changes. No significant or long-term result can be achieved without utilizing procedures that are directed at reversing our facial gravity changes.

A facelift, known as a rhytidectomy in medical terms, is a procedure in which the loose skin on the cheeks and neck, along with the underlying, sagging facial soft tissue, are lifted, tightened and repositioned. A facelift is not just one procedure; different techniques have evolved over time that produces different results from past techniques. The deep-plane facelift today produces incredibly natural and longer lasting results than older skin only procedures. Often a facelift, is combined with other cosmetic surgery procedures such as a brow or eyelift offers a balanced, complete and more natural facial rejuvenation.

The type and degree of facial rejuvenation should match the degree or stage of aging changes. Since today’s procedures can always appear natural, a person does not have to wait to look bad in order to return to their optimal stage of appearance. When approached earlier, facial rejuvenation will produce a subtle refreshing of our look. Similarly, if a person has significant aging changes throughout their face choosing substandard techniques or having isolated procedures will either under correct or create an imbalanced result. Under corrections of aging changes and/or imbalances between areas of the face are some of the most common reasons people seek revision facelifts.