Image Matters

One of the hottest aesthetic upgrades right now comes in the form of a deep plane facelift. Known for being a more ‘natural’ looking facial enhancement, deep plane uses a surgical technique that’s been around for decades, but has recently gained attention with Botched star Dr. Paul Nassif revealing he’s undergone the procedure. 

While a traditional facelift separates the skin from the superficial muscularaponeurotic system (SMAS) causing a more taut look, a deep plane facelift lifts the skin and SMAS together. By repositioning the skin and SMAS as one unit, a more authentic appearance is achieved. 

According to the American Society of Plastic Surgeons, a deep plane facelift offers “a multi-dimensional result that both tightens and lifts the face to result in better volume and contour of the cheeks, definition of the jawline and firmness of the neck.” 

Longer-lasting than a standard facelift, results of a deep plane facelift remain 10 years or more, and typical recovery time is seven to 10 days. 

As the years go by, fine lines and wrinkles start to show and skin begins to dull and loosen, which may make you feel that your youthful glow is a thing of the past. However, with today’s many skin care treatments and procedures, multiple options await to help give you a brighter and more youthful-looking appearance.   

Kristen Rice, MD, a board-certified dermatologist with Utica Square Skin Care in Tulsa, says an extremely popular non-invasive procedure, one she believes will stand the test of time, is Sciton’s BroadBand Light (BBL), which offers minimal downtime and measurable results for skin discoloration, redness and texture. 

“It is a complete package for improved complexion and anti-aging,” says Rice. “BBL can give dramatic results with as little as one treatment, especially when brown spots are the primary issue.”

Lip fillers have also become very popular, she says.

“Filler for perioral rhytids [wrinkling around the mouth] often provides immediate and quite dramatic results,” says Rice. “This is one of my favorite things to perform, as is it satisfying to give the ‘immediate’ effect patient’s desire for an issue that usually bothers them quite a bit.”

While micro-needling isn’t a new technique, Rice says it has made a comeback over the past several years. 

“It, too, is non-invasive with very little downtime, and [offers] great results to help smooth wrinkled skin or uneven texture, from acne scarring as an example,” she says. 

For body contouring, Rice says Coolsculpting delivers. 

“It is more time consuming, usually requiring two to three sessions and a couple months between each, but the before and after photos are generally very dramatic for those troublesome, exercise-resistant problem areas,” she says.  

One technique that has broadened skin care services is ThermaFrax. 

“We have offered both Fraxel [skin resurfacing] and Thermage [skin tightening] for many years,” says Rice. “Performing these together is a newer technique which has proven to enhance results. This combination treatment is called ThermaFrax, and is a great option for those with a busy lifestyle to get maximal results in less time.”

Melody Hawkins, chief financial officer with BA Med Spa and Weight Loss Center in Broken Arrow, says Botox and dermal fillers remain top services as well as PDO threads, non-invasive facelifts and body sculpting through Coolsculpting and Emsculpt. 

“The best treatment for fuller lips are dermal fillers,” says Hawkins. “We personally use and recommend the Juvederm line of dermal fillers by Allergan for lips. Their product Volbella is specifically designed for lips and lasts for one year. But if that is not something you want and you still want the results, a quick lip flip using Botox is a great option. It turns out your top lip to give a fuller, more youthful look and lasts up to four months.”

Hawkins says the best procedures for overall contouring are noninvasive facelifts, which use a combination of products and services to combat all signs of aging. 

“For instance, a common combination treatment plan involves first resurfacing the skin using laser C02 resurfacing,” she says. “We follow that up with Ultherapy to tone, tighten and lift the skin. Finally, we come in with NovaThreads (PDO threads) to add any extra lift that may be needed, as well as dermal fillers to treat volume loss. By addressing uneven skin tone and texture, skin laxity and volume loss at once, we are able to give patients the best overall result in facial contouring.”

Hawkins also highly recommends Coolsculpting Elite and Emsculpt.

“Coolsculpting Elite rids the body of stubborn pockets of fat with no surgery or downtime, and Emsculpt helps to build muscle as well as can perform a nonsurgical booty lift,” she says. “On the buttocks treatment with Emsculpt, we find using it in conjunction with QWO to also treat cellulite, our patients are able to achieve amazing results.”

Much of the skin care industry centers on preventing problems before they start. With this in mind, many people seek out preventative Botox treatments, with the intention of stopping wrinkles or fine lines from forming. 

While it’s a popular practice, Rice shares her concerns.

“I am a firm believer that Botox should be reserved for when wrinkles at rest begin to show or to help improve the shape of the brow to raise drooping eyelids, for example,” says Rice. “Starting Botox injections too early is not necessary if there are truly no wrinkles showing yet. Waiting until the appropriate time to start Botox can save you hundreds to thousands of dollars. It can also weaken the facial muscles, so you don’t want to do this prior to when it can benefit you. It depends on many factors, including age, genetics, history of sun exposure and smoking history.” 

Upper and lower eye lifts, as well as brow lifts, can offer both health and cosmetic benefits. However, any surgical procedures performed around the eye or involving the eye requires special precautions and precision care.

Jeremy F. Tan, MD, an oculoplastic surgeon at the Dean McGee Eye Institute in Oklahoma City, explains how a patient’s pre-operative assessment checks for any conditions that could lead to problems with vision or ocular comfort. 

“I see a handful of patients every year that have had procedures performed where something was not identified pre-operatively and has led to dryness or closure issues,” says Tan. “During the surgery, ensuring that the pre-operative markings are accurate, I go by, ‘measure three times, cut once.’ There is a certain amount of skin that is necessary to leave behind to safely close the eyes. If this amount is surpassed, patients can be left with problems closing their eyes or problems with eyelids being lifted off the eyeball with movement of the brows.”

Tan says an upper eyelid lift, known as a blepharoplasty, can improve the peripheral vision as the excess skin is like wearing a ‘low set baseball cap.’  

“Also, oftentimes folks will recruit their forehead muscles to help lift the excess skin all day, which for some people can lead to chronic headaches,” says Tan. “Lower eyelid blepharoplasty is a purely cosmetic procedure, but this area, both upper and lower lids, really sets the stage for the overall appearance of the face being tired looking versus refreshed and bright.”

With age, sun exposure, use and genetics, the brows often contribute to the heaviness of the upper eyelids, says Tan.

“I make the analogy with my patients that the eyelid opening is the window, the eyelid fold of skin is the curtain, and the brow is the curtain rod,” he says. “Even if the curtain is of the right length, if the curtain rod sits too low, it will allow the curtain to fall over the window.”

If you’re considering an eye or brow lift, Tan offers the following advice:

“As ophthalmologists first at Dean McGee Eye Institute, we are trained to know in great detail how to identify and support the eye, and will definitely pay close attention to your ocular health,” he says. “There are a lot of great plastic surgeons out there; talk to them to form a good relationship to make sure that all of your needs and concerns are addressed.”

If you’re not wanting to undergo surgery but still want the impressive appearance of a facelift, you’ve got choices.

“The field of plastic and aesthetic medicine has changed dramatically over the past decade,” says Tim R. Love, MD, an Oklahoma City board-certified plastic surgeon and pioneer in regenerative approaches to enhance non-surgical facial procedures.

“Non-surgical regenerative approaches have created options allowing us to offer excellent results far beyond traditional surgery. We are using safe yet aggressive techniques beyond the scope of practice for med spas,” he says.

He says INMode’s FACEtite has become a real go-to device that delivers ‘surgical results without the scars.’ 

“It uses radio-frequency assisted liposuction in a safe and effective mode to melt fat while tightening skin and soft tissue overlying areas traditionally treated with liposuction alone,” says Love. “It’s ideal for unwanted jowls and neck fat and is comfortably performed in our office setting with the patient lightly sedated. Results have been shown to shrink skin and soft tissue up to 40%.”

Love also uses NanoFat injections derived from a patient’s own stem cells, mononuclear cells and fibroblasts. He combines the NanoFat with FACEtite and Morpheus8’s radio-frequency assisted microneedling procedures to further improve outcomes. The NanoFat is injected into the dermal layer of skin to supplement healing and stimulate collagen production.

“Many patients today are wanting to get ahead of facial aging but aren’t ready for a facelift,” says Love. “With the proven regenerative techniques available today, we are able to turn back the hands of time for patients producing results that a facelift alone cannot.”