Dr Beryl Tan - Surgical and Non-surgical treatment of the Face and Neck
Non-surgical facial injectables are now commonly used for the face. However, there is a limit to what Botox and fillers can do. An ‘over-filled’ face can look stiff, mask-like, unnatural, and heavy.
Surgical procedures aim to treat the lax and ptotic (droopy) skin by tightening the inner stronger layer of tissue called SMAS (superficial musculoaponeurotic system). This is achieved by rhythidectomy, or facelift procedure. It could be done as a full facelift, or partial, and usually also include neck lift. Adjunctive procedures are commonly performed at the same time, such as deep chemical peel, and lipofilling (fat graft injection) to restore volume (microfat) and improve skin texture (nanofat).
There are other procedures that target a specific area, such as around the eyes or periorbital region.
How is the face assessed?
Dr Tan loves painting portraiture. The assessment is very similar…. proportion, signs of ageing, symmetry/asymmetry, etc. Obviously, assessment for potential surgery is more complicated. The human face is dynamic and mobile. It changes with age (take a look at how the Afghan girl’s face has changed with age and hardship in life!), and sometimes even within a day, depending on how you feel! How does a facial expression change the face? We can tell a happy or sad face apart, but sometimes, we can get it wrong…a person could look tired or grumpy, without actually feeling that way.
The basics….
The face is usually assessed in thirds ( upper, mid, and lower) or as a whole. The regions are divided as follows:
Upper third
- Forehead
- Periorbital – Eyelids
Mid
- Mid cheek (including the cheekbones)
- Nose (classified separately but assessed to check proportions, in relation to the rest of the face)
Lower (usually with neck)
- Lips
- Jowls and chin; jawlines
- Neck – liposuction, neck lift
*Ears are usually assessed separately (ear lobe reduction, otoplasty).
What does facial treatment involve?
A facial treatment can mean many things… but it should include a mix of good skincare with anti-aging ingredients like vitamin A (or its derivative like retinol), antioxidants, and proper sun care.
Non-surgical treatments can include:
- Skin rejuvenation- Intense Pulse light (IPL) therapy, radiofrequency (RF) treatment, laser, chemical peel, nanofat injection, mesotherapy, or the newer treatment as such Profhilo
- Botulinum toxins, e.g. Botox®, Dysport
- Fillers- hyaluronic acid; to replace or add volume
Common Surgical procedures can include:
- Eyelids (upper &/ lower)- blepharoplasty
- Fat graft (own fat) as filler to replace or add volume
- Buccal fat removal (beware of over-resection as ‘sunken, hollow cheeks ages the face)
- Lip surgery- lip lift, fat or dermofat graft to lip, upper lip length reduction
- Facelift- full, midface, lower face and upper neck
*It is important to note that the procedures listed are surgical interventions that address specific physical conditions. These procedures do not stop the natural aging process. Please find more information here.
Why do people seek treatment for their face or neck?
The following can be reasons why people look for face or neck procedures for improvements:
- Non-surgical treatments (e.g. filler and botulinum toxin injection) may not be enough
- Botox® or filler fatigue
- Unhappy with the look of their current aesthetic
- They feel as though fillers make their face look puffy and heavy
- They want to look as young as they feel
What are the signs of facial ageing?
The most common signs of facial ageing are evident when the skin and muscles start to lose tone. The fat may shrink or move to a lower position, causing an “older” or “tired” appearance. While a good skincare routine is important, ageing is inevitable and will involve all tissues (fat, muscles, and bone).
Everyone ages differently, and genetics play a big part in how you will be affected. Environmental factors such as smoking, high sun (UV) exposure, lack of good nutrition, lack of sleep, and high stress, can also have a big impact.
The following are the most common signs of ageing:
Forehead
- Transverse creases
- Eyebrows sit lower
- Deep/permanent frown lines
- Hollowing of the temples
Periorbital (around the eye)
- Crows’ feet, extra lines/wrinkles at upper and lower eyelids
- Excess skin of the upper eyelid causing drooping
- Hollowing of eye sockets
- Protrusion/bulging lower eyelid
- Prominent tear trough (shadow/line of the lower eyelid, next to the nose)
Mid-face
- Midface flattening
- Cheek descent
- Prominent nasolabial folds (cheek fat drops lower)
Lower face
- Thinning lips
- Lip lines
- Lengthening of upper lip
- Marionette lines with jowls
Neck
- Transverse neck folds
- Plastysma bands
- Vertical neck pleats
What is a forehead or eyebrow lift?
A forehead or brow lift is a non-surgical procedure that will relax the transverse crease to mask permanent deep or fine lines.
The surgical option is known as a “browlift” which can improve visible signs of ageing near the forehead and eyebrow. As the skin around the eyebrows loosens and sags causing forehead folds, frown lines, and skin over-hanging over your eyelids (eyelid hooding), the brow lift can be an effective way to restore. This particular surgery is patient-specific and the technique can vary based on your need.
What is eyelid surgery?
Blepharoplasty: This procedure involves the removal of excess skin and muscle from the upper and lower eyelids. It is designed to address issues where the skin may obstruct vision. Blepharoplasty can also include the creation of an upper eyelid fold that is considerate of the individual’s racial or ethnic background.
For conditions such as wrinkles, dark circles under the eyes, or sagging eyebrows, alternative procedures may be considered.
Eyelid surgery can be performed on either the upper or lower eyelids and may be combined with other facial procedures for comprehensive results. In cases where there is significant looseness between the lower eyelid and the eyeball, a tightening procedure such as canthoplasty or canthopexy might be recommended.
*As with any surgical procedure, Blepharoplasty carries potential risks, which may include but are not limited to infection, dry eyes, difficulty closing eyes, and other complications. It is important for patients to discuss these potential risks with their healthcare provider to make informed decisions based on a full understanding of the possible outcomes and recovery process.
What is a neck lift?
This procedure offers a range of possible solutions from the removal of jowls caused by fat and sagging skin due to extra fat under the chin, loose neck skin, or muscle banding.
What is a facelift?
A facelift improves signs of aging on the face and neck by tightening deeper structures. The procedure involves re-draping the skin and removing fat as needed. The facelift can also be combined with a brow lift, eyelid surgery, nasal surgery, and other procedures for a larger rejuvenation.
What is fat graft injection?
If you have lost significant volume around the temples, cheek and lips, fat graft injection (lipofilling) can be performed to create a fuller look. Performed in place of traditional fillers, the use of the patient’s own living fat offers a longer-lasting solution. However, the volume can change depending on your weight change.
The process involves fat being removed from an area where it is less needed to increase volume is another area that has lost volume due to ageing, trauma, or other causes.
Book a consultation for a face and neck review with Dr Tan today
Understand which facial or neck procedure may be best for you by booking a consultation with Dr Tan today. With over fifteen years of experience, Dr Tan will assess your needs and apply her in-depth skills and knowledge to find the best solution for you today. Find Dr Beryl Tan at Brighton, Cabrini or PRSM in Donvale..
Book a consultation for a Face and Neck Assessment review with Dr Tan today
Dr Tan is passionate about the face and neck. She applies over fifteen years of experience, in-depth skills and knowledge to each case to achieve this. Book an appointment with Dr Beryl Tan today at Brighton, Cabrini or PRSM in Donvale, and find out if she can help you.