As a plastic surgeon at the top of his game, I am always striving to improve and make my results better. Over the years, I have developed a maturity and approach to facial rejuvenation that I believe has improved the overall results and longevity of the facelift procedure, most noticeably in the neck with lack of neck bands, less pulling, and a more natural result. When I first started face lifting, I mimicked my facelift surgeries after some of the top surgeons in the country and felt that I achieved a nice result. When I followed these people out past 1-2 years, I started noticing the recurrence of the jowl and neck bands.
Approximate 10 years ago, I started adding fat transplantation to my armamentarium and this really seemed to help in the jowl/marionette line area, jawline, and eyelids. I still found that the skin would stretch regardless even if I put tension on the deeper, more fibrous covering of the facial muscles known as the SMAS. This layer allows better tension in the skin, but I also found that this would stretch with time. As you age and mature as a plastic surgeon, your patients age with you and you perform more and more facelift procedures and have the luxury of being able to follow these people over 6 months, 1 year, 2 years, and after. When I would study these patients, I still noticed some would have a recurrence of the jowl and neck bands. All soft tissues are always remodeling and always stretching, some more than others.
Approximately 6 years ago, I went on a personal discovery to learn how to remove submandibular glands and digastric muscle of the neck to recontour the neck. I found that if I recontouring the soft tissues of the neck, it required much less pull of the SMAS and other soft tissues to achieve the same appearing result. During this time, I also discovered that the more fat that I can preserve on the neck also resulted in a much better and natural appearing result. I believe that these were the last two pieces of the puzzle to create better longevity and a more dramatic yet also more natural-appearing result. These techniques combined with an experienced and artistic approach to facial rejuvenation have allowed me to achieve the next level of results which I consider ”world class”.