Worcester Facial Plastic Surgeons

Why is a Coronal Forehead Lift Best for Women?

Is a coronal brow lift a better option for removing frown or scowl lines?

There are a multitude of options for rejuvenation of the forehead. Comprehensive treatment should include repositioning and reshaping of the brows (not just raising them up!), treatment of deep wrinkles and furrows of the forehead, softening of hyperactive and undesirable muscles (i.e. "permanent" Botox) and possibly contouring of tissues with fat injections (and sometimes bone modification).

The gold standard continues to be the coronal (open) browlift with the main disadvantage being that it will, by definition, raise the hairline. Although the incision is long, plastic surgeons know that this incision will heal up extremely well.

The endoscopic browlift (aka endo-browlift) uses usually 5 incisions (their total length is often not much different from a coronal incision). Surgical dissection has to be significantly MORE extensive than with the open browlift. Control of the brows will only be comparable with the open approach in truly expert hands. Many surgeons have been disappointed with the longevity of the endoscopic browlift. In addition, control of muscles (permanent Botox) is not as good as with the open approach.

Other techniques include the hairline browlift (used to lower the hairline or keep it stable), the temporal browlift, mid-forehead browlift and brow-releases through an upper eyelid lift incision.

As you can see, there is not one "best" techniques but rather options with their pros and cons. When a surgeon broadcasts one as best, it usually means best in his/her opinion or hands.

Look at before and after photographs taken 1 or 2 years after surgery and talk to a few experienced facial plastic surgeons.

Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

Technique Comparisons For Fat Transfer for Face (photo)

Besides expertise of doctor, importan: 1. how to harvest fat to have greatest number of live fat cells (stem cells. using new 'Body jet', 'Aqua Lipo' techniques or older technique by hand with a syringe? 2. how fat is injected in face for fat-stem cells to remain alive -using live fat tissue, FAMI fat-muscle injection or standard fat injection -under skin? of all failed attempts and disasterous results. which of above methods have best results and less detrimental.

Fat injections adds an important dimension to a comprehensive facial rejuvenation program. Experience in facial fat grafting is of utmost importance. Therefore, the best technique is the one your surgeon used a few hundred of times. Good follow up after previous fat grafting procedures will allow your facial surgeon to judge what works and what does not. Constantly changing techniques only adds variables and uncertainty.

Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

On a Facelift, How Does the Skin Reattach to the Tissues when It's Redraped?

I am worried about how the skin can be pulled up in a facelift (back to the cheek area), and then after the underlying work, it is redraped and tightened, so how does the skin "reattach", and what is the protection for not taking too much skin so the mouth doesn't close, etc.

This is exactly where much of the healing takes place. If the skin would not heal down afterwards, a facelift procedure would not be possible.

In my opinion, the skin should not be tightened but rather allow to redrape without tension. Tight skin after a facelift adds only an unnatural appearance and poor scar healing.

Frank P. Fechner, MD

Worcester Facial Plastic Surgeon