FACE / NECK – FACELIFT DENVER, CO

“Maybe it’s true that life begins at 50. But everything else starts to wear out, fall out, or spread out.”
– Phyllis Diller

Purpose

As we age, various changes in our skin and underlying soft tissues occur, causing our physical appearance to change and appear older.  As the skin loses collagen and elasticity, the fat beneath the skin atrophies and disappears. As these processes occur, our face appears more hollowed, the skin begins to sag and the once well-defined facial contours are hidden, making us look older.  Additionally, the jowls and neck skin become more prominent, with horizontal and vertical bands developing in the neck. A facelift corrects these issues, improving the signs of aging to restore a more youthful and refreshed appearance, enhancing your natural beauty.  There are many types of facelifts depending on the your age, motivations, skin type, and degree of skin laxity and can range from minimally invasive to more extensive procedures.

Procedure

Strictly speaking, a facelift refers to a tightening of the skin and soft tissues from cheek bones to collar bones, therefore the cheeks, jowl line, and neck can all be improved by this procedure.  This procedure can be broken up into either a cheek lift or a neck lift if only one of these areas is in need of surgery. The incision is tailored to the patient but is placed in natural creases in front of and behind the ear to make it unnoticeable.  For males and females the incision is slightly different so as to not distort the hair bearing skin of the face in males. In order to address the neck muscles, fat, and skin, a small horizontal incision is placed beneath the chin in a natural crease where it cannot be seen.  The skin is elevated off of the underlying soft tissue structures and, in most cases, the underlying connective tissue is also elevated to provide for longer-lasting, more natural results. These tissues are then re-draped and the redundant tissue is removed. This is done in a way to restore the natural youthful appearance and avoid a surgical appearance.  The best results in a facelift occur when the patient has well-defined bone structure and excellent skin quality. Therefore, Dr. Ladner may recommend additional procedures such as facial resurfacing, liposuction, fat augmentation, or chin augmentation to guarantee the best results. The length of the procedure can vary from 2-5 hours, depending on the exact facelift procedure and additional complementary procedures.  It can be performed under conscious sedation or general anesthesia and together with Dr. Ladner, the appropriate anesthetic plan will be determined.

Recovery

Most patients will be able to return to work within 10-14 days.  At the end of the procedure, the incisions are wrapped in an occlusive dressing to minimize swelling and promote healing.  The dressing is removed 1-3 days after the procedure. Some swelling and bruising is expected and normal. After the dressing is removed, you will be instructed on how to clean and care for the incisions.  Sleeping with your head elevated will minimize the swelling and expedite the recovery. No sutures will need to be removed as they are all absorbable.

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Necklift

Purpose

As we age our jowls and neck skin can sag, and Platysma banding, also known as “turkey neck”, can become more prominent, with horizontal and vertical bands developing in the neck. A neck lift can correct these issues, improving the signs of aging to restore a more youthful and refreshed appearance, enhancing your natural beauty.

Procedure

A neck lift refers to a tightening of the skin and soft tissues along the jawline and neck. In order to address the neck muscles, fat, and skin, a small horizontal incision is placed beneath the chin in a natural crease where it cannot be seen. The skin is elevated off of the underlying soft tissue structures and, in most cases, the underlying connective tissue is also elevated to provide for longer-lasting, more natural results. These tissues are then re-draped and the redundant tissue is removed. This is done in a way to restore the natural youthful appearance and avoid a surgical appearance. The length of the procedure can vary from 2-5 hours, depending on the procedure and additional complementary procedures. It can be performed under conscious sedation or general anesthesia and together with Dr. Ladner, the appropriate anesthetic plan will be determined.

Recovery

Most patients will be able to return to work within 10-14 days. At the end of the procedure, the incisions are wrapped in an occlusive dressing to minimize swelling and promote healing. This dressing is removed 1-3 days after the procedure. Some swelling and bruising is expected and normal. After the dressing is removed, you will be instructed on how to clean and care for the incisions. Sleeping with your head elevated will minimize the swelling and expedite the recovery. No sutures will need to be removed as they are all absorbable.

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CHIN / MANDIBLE AUGMENTATION & BUCCAL FAT REMOVAL

Purpose

While your chin and/or mandible area may not seem like obvious areas for improvement through cosmetic surgery, in order to exhibit facial harmony all components of the face must come together. Strong jawbones and an adequately projected chin help portray an attractive image and can accentuate the qualities of the overlying soft tissue. Furthermore, the profile of the nose must match the profile of the chin to achieve balance. Therefore, chin augmentation may be recommended at the time of a rhinoplasty.
Buccal fat removal is a procedure that is done to thin the cheek hollow area. This procedure can be ideal for those patients who feel their cheeks are too full, giving the impression of an overly round or “chubby” facial appearance.

These procedures can be performed separately or in conjunction with other facial plastic surgery procedures, and it may be part of the recommendation at your consult.

Procedure

Chin augmentation is achieved through a small hidden incision below the chin in a natural skin crease, whereas jawline implants are performed via internal incisions inside the mouth. The synthetic implant is then gently placed over the bone of the chin and secured in position, and the incisions are then meticulously closed. Buccal fat removal removes the buccal fat pad, a naturally-occurring pad of fat in the cheek hollow area. Each individual patient is unique and the size of the buccal fat pad can vary, in addition the buccal fat pad in each cheek may be differ in their size. The length of these procedures can vary and each procedure can be performed with local anesthesia, conscious sedation, or general anesthesia. Together with Dr. Ladner the appropriate anesthetic plan will be determined.

Recovery

With chin implants, swelling and pain are usually very minimal. A dressing will be placed over the chin to prevent movement of the implant. Patients can expect to return to work within a couple of days. Facial and jawline implants generally cause more swelling of the face. With facial and jawline implants, you can expect to return to work within a week of surgery. All of the sutures for these procedures dissolve on their own and do not require removal.

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FACIAL FAT TRANSFER / LIPOSUCTION

Purpose

Liposuction is one of the more popular cosmetic surgical procedures performed in the United States.  When used for the neck, liposuction can result in a better-defined jaw and neckline. As we age, certain parts of our face including the temples, cheeks, and lips can atrophy giving us a hollowed and elderly appearance.  When this occurs, the hollowed regions can be restored using the your own natural fat as a minimally-invasive, long-term solution to restore facial harmony and enhance your natural beauty.

Procedure

Depending on which areas of the face or neck are being addressed, small needle-size holes are made to remove or inject fat.  Fat is typically harvested from the abdomen or thighs using a pen-size incision. The procedure usually takes 1-2 hours and can be performed under local anesthesia or conscious sedation.  Together with Dr. Ladner, the appropriate anesthetic plan will be determined.

Recovery

Patients can expect to return to work the same day, or within a couple of days. Some swelling and minimal bruising can occur.  Sutures at the fat harvest sites will be removed within 10 days.

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FACIAL PARALYSIS CORRECTION

Purpose

There are multiple causes for partial or complete facial paralysis, and Dr. Ladner’s expertise also extends to this area. Injury to facial nerves from surgery, trauma, or medical conditions can leave you with both functional as well as cosmetic defects.  The treatment plan Dr. Lander designs is individualized based on the location of the paralysis, timing, and extent of your injury.

Procedure

Dr. Ladner offers a full array of procedures to improve the paralyzed face.  These include BOTOX®, filler, or procedures to correct facial asymmetry as well as to restore function of the eye and mouth areas.  During the procedure to restore function of the eye area, protection of the eye(s) is of utmost concern, and can be achieved through one or two simple procedures.  The first procedure is a placement of a weight within the upper eyelid to allow for eye closure. The second procedure shortens and tightens the lower eyelid to allow for proper tear drainage.

Correction of eyebrow, cheek, and mouth asymmetry can be combined with another procedure, or using a delayed procedure.  Suspension of the facial soft tissues is done using either the patient’s own muscle or tendons in the face, or by using a synthetic material.  This allows for elevation of the paralyzed tissues to restore symmetry. Small, hidden incisions are usually placed behind the hairline of the temple and at the corner of the mouth.  Depending on the procedure(s) performed, the length of the surgery varies between 1 hour to 3 hours. The procedures can be performed under conscious sedation or general anesthesia. Together with Dr. Ladner, the appropriate anesthetic plan will be determined.

Recovery

Depending on the specific surgery performed, most patients are able to return to normal activity within a few days.  Usually, no dressing is required and wounds are cared for using the specific instructions provided. Sutures are removed within a week of surgery during your follow up appointment.