Thank you for your question.
You submitted a question without a photo but basically, from your question, I understand
that you’re male.
You have lost volume in the face and you feel like you’ve gotten some nasolabial folds
and sagging and banding under the chin or at the neck area and you want to know what’s
the shortest type of incision that you can have for a facelift whether above the ear
or etc.
As well as you are concerned about a receding hairline and about hair transplant.
Well I can certainly share with you my approach to male facial aging in the modern era and
there’s a certain contrast in the point of me stating that.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Face lifting surgery has been a very big part of my practice for these 20 years and certainly,
this is a time where we actually have a lot of different tools to help people like yourself.
Again, in the absence of a photo or physical exam, I can speak to you in general concept
but I think it will be very helpful.
So to begin with, we have to understand what is facial aging and whether it’s men or
women, we’re still dealing with the same basic issues.
We’re dealing with volume loss as you described where you lose volume in the cheek, the bone
structure.
The face actually recedes inwards.
And you are dealing with sagging.
The tissues, the support structures get weak and the skin sags.
So, 20 years ago and even more than 10 years ago, the most significantly effective procedure
would have always been some kind of facelift or a face and necklift.
Now the challenge for men which is a big contrast to doing face and neck lifting for women is
the visibility of the scar and effect it has on hair bearing skin.
So back in the mid-2000s, there was this real growth in interest in short scar face lifting
and it really turned out to be a very useful tool in helping men with sagging skin and
with dealing with some sagging neck skin.
But the challenge is of course is that most men will have some degree of male pattern
hair loss.
And because of that, it makes hiding incisions very difficult and it also makes the visibility
of the incisions very important.
So generally speaking, we tried to hide the incisions on the inside of the ear opening
but it does have to stand above the ear and behind the earlobe in order to be able to
move a skin flap.
Now what’s different about the modern era?
Well, with a greater understanding of facial volume loss, I often recommend a hybrid approach
to his problem.
What I’ll basically do is a short scar facelift and combine that with something called structural
volumizing.
Structural volumizing means the use of a longer lasting filler such as Juvederm Voluma to
place on the bone structure and restore volume in the cheeks as well as in the jawline and
chin.
The point is that we’re addressing two issues simultaneously.
We’re lifting loose skin and we’re restoring volume.
Now, there are variations of this technique.
You can also replace volume with fat but I feel that the predictability of injectable
fillers and the repeatability and this continuous aging process which makes things change plus
the structural nature which we can’t do with fat really gives the fillers a significant
advantage.
What I try to explain to male patients is that in order to get a neck to be really aggressively
tightened, the incisions have to be fairly long in order to really deal with the extra
skin.
So a lot of times, I recommend more of a compromise.
Most of the neck skin can be addressed with a lift from the face lifting portion but a
limited amount with the short scar.
And it’s a matter of balance and keeping it natural.
Nobody wants to look at and notice these scars and you want to minimize that from happening.
We use modern regenerative technology such as the use of platelet-rich plasma (PRP) and
extracellular matrix to improve those scars so that it blends very well.
But there is a real art to doing this and I would even propose that with men, volume
loss actually has a more significant impact than sagging.
And I would say that, just strategic placement of volume alone can make a significant impact.
Again, the aesthetic standards of men and women are always going to be a little bit
different and understanding the limitations of the incisions has to be factored in so
that you are satisfied with the outcome.
So I think that most likely a short scar facelift with volume correction will give you somewhere
around 80% of what you’re looking for and I think would be a good outcome.
Again, this is in the absence of even seeing a photo.
So I would say, meet with qualified, experienced cosmetic surgeons and learn about these options.
Everybody does it their own way so you’re going to have to meet with probably a few
before you feel you are comfortable with the options that are being presented.
A lot of my colleagues, they’re basically seeing the world from the eye of the plastic
surgeon where everybody is a candidate for facelift and dealing with some of the consequences
may be something they’re willing to deal with later but I feel like if we have this
type of balance, we’re able to minimize the issues and the negatives associated with
face lifting surgery and maximize the positives by dealing with the volume loss with a limited
amount of skin lifting.
But again, this is a very specific, individualized plan that has to be developed.
So I hope that was helpful, I wish you the best of luck and thank you for your question.