I am 47 and am considering having a facelift in the next few years. I saw a video of a renowned British PS performing a TDML and securing the lifted layers with titanium screws inserted into tiny holes drilled into the patient's cheekbones. What are the potential drawbacks of this operation? And could it be combined with a traditional face- and neck-lift for maximum vertical and horizontal rejuvenation?
February 21, 2016
Answer: Options for facial rejuvenation. There are many different techniques described for facial rejuvenation from minimally invasive to very extensive. Common sense dictates that if 1 technique gave much better and longer lasting results, then everyone would use that, and it would be presented at all the major plastic surgery meetings. I know of no one in my locale who does this type of facelift and I have never heard it presented at any of the major plastic surgery meetings I attend yearly. It was used in the past but now has fallen into disfavor due to long recovery and higher complication rates. Excellent facial rejuvenation can be achieve with less invasive procedures which have a recovery of 7-10 days. See a board certified plastic surgeon who can show you an extensive experience in faclift results for a detailed consultation so you can find what would work best for you.
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February 21, 2016
Answer: Options for facial rejuvenation. There are many different techniques described for facial rejuvenation from minimally invasive to very extensive. Common sense dictates that if 1 technique gave much better and longer lasting results, then everyone would use that, and it would be presented at all the major plastic surgery meetings. I know of no one in my locale who does this type of facelift and I have never heard it presented at any of the major plastic surgery meetings I attend yearly. It was used in the past but now has fallen into disfavor due to long recovery and higher complication rates. Excellent facial rejuvenation can be achieve with less invasive procedures which have a recovery of 7-10 days. See a board certified plastic surgeon who can show you an extensive experience in faclift results for a detailed consultation so you can find what would work best for you.
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February 22, 2016
Answer: Transconjunctival deep plane midface lift Since you saw the video, you see the entry point incision to access the deep plane is thru the conjunctiva of the lower eyelid so you may have conjunctival swelling (chemosis) but should resolve in 3 months worse case scenario. Eyelid malposition is also another risk albeit less than the subciliary or external approach. The tiny titanium screws rarely cause problem as I routinely use them in facial fracture repairs. You may be able to feel them but should not see them as a little bumps unless you have extremely thin skin. There is a nerve in the mid cheek that provides sensation to the cheek/lateral nose/upper lip, that structure is in the area of surgery and is at risk for injury. But in the right hands nerve damage is probably minimal, I say less than 1%. It can be combined with a traditional face/necklift as you are making an additional incision thru the lower eyelid (transconjunctival), but you will release the soft tissue in the medial cheek more effectively. Often times in facelifting surgery, it is more the "release" of the tissue, and less how you secure it (sutures vs screws vs endotines) that affects the desired result. Tissues will ultimately "descent" in time but the more lifted the less the fall.
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February 22, 2016
Answer: Transconjunctival deep plane midface lift Since you saw the video, you see the entry point incision to access the deep plane is thru the conjunctiva of the lower eyelid so you may have conjunctival swelling (chemosis) but should resolve in 3 months worse case scenario. Eyelid malposition is also another risk albeit less than the subciliary or external approach. The tiny titanium screws rarely cause problem as I routinely use them in facial fracture repairs. You may be able to feel them but should not see them as a little bumps unless you have extremely thin skin. There is a nerve in the mid cheek that provides sensation to the cheek/lateral nose/upper lip, that structure is in the area of surgery and is at risk for injury. But in the right hands nerve damage is probably minimal, I say less than 1%. It can be combined with a traditional face/necklift as you are making an additional incision thru the lower eyelid (transconjunctival), but you will release the soft tissue in the medial cheek more effectively. Often times in facelifting surgery, it is more the "release" of the tissue, and less how you secure it (sutures vs screws vs endotines) that affects the desired result. Tissues will ultimately "descent" in time but the more lifted the less the fall.
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