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Facial Rejuvenation Toledo
- Facial Rejuvenation
- Skin Surface
- Volume Loss
- Tissue Positional Changes
- Surgical Procedures – Facial
- Rhinoplasty
- Blepharoplasty
- Brow Lift
- Facelift
- Malar Lift
Facial Rejuvenation
Our practice philosophy on facial rejuvenation centers on a personalized, patient-oriented approach. Attention to each patient’s individual needs, goals, and aging patterns is fundamental. We approach facial rejuvenation as a whole, maintaining the original and correct anatomical relationships of the facial features. This art of balanced facial rejuvenation that results in a natural appearance involves the interaction and utilization of all the resources Dr. Barone and our staff provide.
Our approach to facial and general rejuvenative programs begins with an analysis of the three components of aging: skin surface, tissue position changes, and volume loss. It should be emphasized that rejuvenative surgery can correct and improve the manifestations of aging, but it does not stop the aging process. Aging is a natural biological function and will continue, influenced by each individual’s genetics along with external factors in the environment such as stress, sun exposure and smoking. Although we cannot stop the aging process, the manifestations of aging caused by these external factors can often be mitigated and rejuvenated, which significantly and positively affects the patient’s health and appearance.
back to topSkin Surface
The manifestations of aging and damage to the surface of the skin are important considerations as these are the initial and most visible signs of aging. The majority of these accelerated changes are caused by sun damage which is termed “photoaging.” The result of prolonged sun exposure, particularly on unprotected skin, results in brown spots or “age spots” known as hyperpigmentation, thinning of the skin, collagen loss, visible blood vessels under the surface, and loss of youthful skin tone caused by the degradation of collagen and elastic fibers in the skin. Additionally, prolonged sun exposure to unprotected skin results in precancerous changes (actinic damage, actinic keratosis) and increases the risk of skin cancer.
Volume Loss
Although many patients believe that sagging or drooping skin is the most common manifestation of aging, the loss of volume of the deeper layers of the skin and underlying fatty tissue is actually more significant. This loss of tissue volume is particularly noticeable around the mouth and eyes. These areas of the face must be addressed in order to obtain a natural and balanced result without having an “operated” look. Dr. Barone has extensive experience with grafting the patient’s own fat to restore volume to other areas, as well as using many of the FDA-approved injectable tissue fillers.
Tissue Positional Changes
The term “tissue positional changes" refers to the shift and gravitational descent of not only the skin but also the underlying fat, muscle, and deeper structures of the face and neck. It is important to remember that a young face is not an older face with tight skin. In other words, simply tightening the skin (as is common in traditional facelifting) often looks artificial because it does not address the deeper components of aging and the changes in tissue position. As we age, the deeper ligaments that support the facial structures often become lax, allowing for decent of the fat and deeper structures along with laxity of the facial muscles. This descent or tissue shifting is most naturally corrected by repositioning these deeper tissues back to their original position while respecting the original anatomic relationships of youth.
By careful analysis and respect for these three key components of aging, we can formulate a comprehensive plan for facial rejuvenation that will provide a balanced and natural result. Again, it must be emphasized that although there are many options, techniques and services available, a personalized plan for each patient will be created based on individual goals, preferences, budget, and recovery time.
Surgical Procedures – Facial
At Frank Barone, M.D. Plastic Surgery, our goal is to provide patients with surgical and non-surgical procedures that produce natural-looking results that last for years to come. We realize our patients are making an investment in their appearance. We also know the single best way to maintain that investment is to take care of the skin. Making the effort to prepare the skin before surgery can produce better results by helping the skin heal faster and can also help prevent complications such as hyperpigmentation. Continuing to care for the skin post procedure is the insurance policy for long-lasting results.
Preparing for Surgery
Our medical staff and aestheticians work with each patient to develop a skin prep regimen that includes specific products and minor procedures that help ready the skin to be treated, beginning with a VISIA®; Complexion Analysis. VISIA is an imaging system that takes a photo of the face and instantly analyzes eight different characteristics of the skin – measuring spots (pigmentation), wrinkles, texture, pores, UV and red spots, porphyrins (acne-causing bacteria), and photodamage. With this information, the aesthetician can provide a more targeted treatment program for each individual, and she also can repeat the VISIA process to track each patient’s progress over time.
A common pre-op treatment program may include all or some of the following:
- Topical Products
- Vitamin A product (Retin-A, retinol, etc.) to encourage overall skin health, increase cellular turnover, increase microcirculation in the skin. Thickens the dermal layer and thins the epidermal layer.
- Prescription-strength hydroquinone product to lighten dark spots and even skin tone. Works to suppress melanin production and helps prevent post-procedure hyperpigmentation.
- Growth factor product to encourage overall skin health and repair skin from the inside out. Can produce significant changes in appearance of fine lines and wrinkles, skin tone and texture.
- Antioxidant including Vitamin C helps reduce free-radical damage caused by sun and environmental pollutants.
- In-office Procedures
- Superficial chemical peels have the ability to resurface and refresh the skin, helping to diminish the appearance of fine lines and wrinkles, enlarged pores, dark spots (hyperpigmentation), and acne scars.
- Any type of skin can benefit from regular peels, including acne-prone and sensitive types.
- Nutritional Support
- A healthy body equals healthy and radiant skin. Many skin issues can be traced back to deficiencies or problems happening on the inside. Nutritional support from Metagenics™ with therapeutic levels of nutrients that can improve your health or manage chronic illness.
- All cosmetic surgery patients receive pre-op and post-op nutritional support from Vitamedica® Surgery Program. This comprehensive program is specifically designed for patients undergoing operative procedures. The specific nutrients included in the program provide support to speed wound healing, support the immune system, prevent infection, minimize inflammation and reduce bruising.
- For smaller surgical and other non-invasive procedures such as eyelid surgery (blepharoplasty), injectable therapies, nose surgery (rhinoplasty), and chemical peels, Vitamedica’s Healing Supplements Program provides bromelain with quercetin and Arnica montana 30x to minimize swelling, inflammation, and bruising.
After Surgery
Immediately after surgery it is imperative that post-operative instructions given to you by our staff are carefully followed. This will minimize risk of complications and infection and will encourage proper healing. Our medical staff and aestheticians are there for you every step of the way during the healing process and will be able to guide you through any necessary changes in your post-care regimen.
Maintaining Your Results
You’re totally recovered from your procedure and loving the results, so what next? Your aesthetician can help you build a maintenance program that will keep your skin healthy and results looking beautiful for years to come.
Dr. Barone is experienced in all of the following surgical procedures, but he specializes in individualized, total facial rejuvenation – a combination of two or more surgical and/or non-surgical procedures, skin care and nutrition.
Rhinoplasty
The nose is the central, most prominent feature of the face and a major factor in defining balance and harmony among facial features. When the nose is out of proportion with other facial features or the nose does not compliment the face, it can affect self-image and confidence as well as detract from other attractive characteristics of the face.
We realize there are individual or ethnic differences in features of the nose which may compliment other facial features and are therefore desirable, so we emphasize a highly individualized approach to surgery of the nose.
For cosmetic surgery to improve the balance and appearance of the nose we consider:
- nose size in relation to facial balance.
- width of nose at the bridge of the nose or the nasal tip.
- nasal profile with noticeable humps or depressions on the bridge.
- nasal tip that may be enlarged, bulbous, drooping or hooked.
- nostrils that are out of balance or unusually wide or asymmetrical.
Rhinoplasty may be done through an internal approach, or through a small incision in the tissue below the nasal tip (columella). This is called an open rhinoplasty, allowing for direct visualization of the nasal cartilage and other structures. In the past, nasal surgery to improve aesthetic appearance was primarily reduction only, with the take down of nasal bridge humps or large nasal tips. This can often result in an unnatural or “operated look” which is not in balance with the other facial features. Therefore, our practice approach involves reduction only when necessary along with augmentation or addition of tissue and reshaping of nasal structures to provide balance and harmony. In many cases, cartilage grafts obtained from the internal nasal septum or other sources are used to rebuild and reshape nasal structures. These combined procedures result in a more natural look and carefully preserve the important functions of the nose.
Rhinoplasty may also be chosen to correct breathing problems as a result of trauma or injury or from congenital malposition of the nasal septum or other structures. Nasal surgery to improve breathing may be done alone or in conjunction with cosmetic surgery of the nose and is considered reconstructive and may be covered by insurance.
Blepharoplasty
Surgical rejuvenation of the eyelids or blepharoplasty is indicated for reducing the aging changes of the eyelid structures. Blepharoplasty is one of the most commonly performed surgical procedures in the United States and has an excellent safety record when performed by an appropriately trained surgeon. Aging changes of the upper and lower eyelids often have a major influence on a patient’s appearance as the eyes are one of the most revealing facial features. A properly done blepharoplasty will result in a more rested and alert appearance and significantly affect the youthfulness of the face.
Eyelid surgery can improve or treat:
- excess sagging skin and looseness that disturbs the natural contour of the upper eyelid, sometimes impairing vision.
- excess fatty deposits that appear as puffiness in the upper eyelids.
- loose skin and bags of the lower eyelids.
- fine wrinkles of the lower eyelid and the tissue around the lower eyelids.
- droopiness of the lower eyelids, sometimes revealing the white below the iris (colored portion of the eye).
Our approach to eyelid surgery is based on achieving a natural or non-operated appearance while restoring the position and contours of youth. An examination of the characteristics of youthful eyelids reveals that fullness or adequate tissue volume is important as is the position of the eyelid skin. Our surgical approach in eyelid surgery is therefore directed towards repositioning the normal fatty tissue of the lids to its previous youthful position and restoring the contours of the skin and support structures rather than simply excising this tissue. This is particularly important in eyelid procedures because excessive removal of skin and fat may result in a hollowed or sallow appearance of the lids and an artificial look.
Eyelid surgery or blepharoplasty may be done alone or in conjunction with other facial surgical procedures depending on each patient’s individual goals and pre-operative assessment.
Brow Lift
The brow lift is a procedure to elevate the forehead, lateral eyelid and upper nasal skin and tissue and return them to their youthful position. Depending on the individual aging characteristics of each patient, the brows may be elevated or returned to their original location of youth.
Dr. Barone prefers to perform his brow lifts using the endoscopic approach. Unlike the traditional open brow lift which requires a large incision across the scalp, the endoscopic approach utilizes four small incisions located and hidden in the scalp.
There are several distinct advantages to the endoscopic approach:
- Smaller incisions which easily hide within the scalp hair, and shaving the hair is not necessary.
- The smaller endoscopic incisions allow preservation of the sensory nerves to the scalp.
- Does not remove any scalp or skin and does not overcorrect the brow position by elevating them unnaturally (which can result in a very “operated” look).
- Use of the endoscope allows for more precise surgical technique, resulting in less bruising and swelling post-operatively.
The brow lift is really an upper facelift and provides repositioning and support for the entire forehead and even the tissue of the upper eyelids and lateral temporal areas or lateral eyelid skin.
A brow lift:
- reduces or eliminates the deep creases of the forehead.
- improves and reduces the frown or “scowl” lines between the eyebrows.
- repositions low or sagging brows that hood the upper eyelid and may give a “tired appearance”.
- raises the eyebrows to a more alert and youthful position without overcorrecting.
As with all of our cosmetic procedures, Dr. Barone prefers an individualized approach and the brow lift is planned to address specific aging concerns and avoid an artificial post-operative appearance. The endoscopic brow lift or upper facelift is often done in conjunction with eyelid surgery (blepharoplasty), face lift or mid-facelift (malar lift), and skin resurfacing procedures.
Facelift
If you are concerned about the progressive signs of aging in your face and neck, you may consider a facelift to correct these changes. Technically known as a rhytidectomy, a facelift is a surgical procedure that will reposition the facial and neck tissues to improve visible signs of aging.
The areas addressed are:
- jowls or fullness of the lower cheeks.
- loss of muscle tone and loose skin in the lower face and neck.
- deep creases extending from the nose towards to the corner of the mouth.
- sagging skin and muscle bands in the neck.
- fatty collections or deposits in the lower face, neck and below the chin.
A facelift is usually part of a comprehensive facial rejuvenation surgical plan that may also include a forehead or brow lift done by endoscopic technique, and eyelid surgery to rejuvenate aging eyes.
Other procedures that may be combined with the facelift in a rejuvenative plan include improvement of the skin surface through facial peeling or a laser therapy and volume replacement utilizing the patient’s own fat cells or FDA-approved injectable volume enhancers such as Restylane® or Juvederm®.
A facelift is a highly individualized procedure and is best suited to the patients who are seeking self improvement and the restoration of a youthful appearance. Because the facelift is a surgical procedure, it is appropriate for patients who are physically healthy and without any active or serious medical problems. It is also important that the facelift patient have realistic goals for the improvement in appearance and not be motivated by other external factors. Smoking is potentially harmful for the facelift patient because of its effect on reducing circulation in the skin and tissues which can effect healing and create other complications.
Malar Lift
Cheek or malar lifting is a surgical procedure that improves the appearance of the central face where the tissues at the lower eyelid extending down to the corners of the mouth and the jowl have descended. When done properly, the malar or mid-facelift can restore the youthful contours of the middle facial structures and provide a natural, more youthful appearance. The cheek lift is sometimes performed with other facial procedures such as facelifting or endoscopic brow lift.
Specifically, the cheek lift can treat:
- the deep groove developing beneath the lower eyelid called the naso-jugal groove that deepens with aging.
- soft tissue redundancy or “bags” that develop in the cheeks and middle face below the eyes.
- flattening or loss of height of the cheek contour.
- the deepening crease extending from the side of the nose down around the mouth to the jaw line which is termed the nasolabial fold.
- the fatty collection in the lower cheek or jowl which develops as soft tissue descends from the upper face to the lower face.
