Forehead/Mid-face/ Temporal Lift
If the peri-orbital complex is the first area to show signs of aging changes, then the forehead is the next area to show greatest amount of aging changes. Two very distinctive changes take place. First, due to years of facial expression through forehead “worry” lines and glabellar” frown” lines, these “dynamic” lines begin to get more intense until they “statically” remain in place, even when you are not expressing any anger, tension, or sadness; thereby sometimes imparting these expressions, even when you don’t want to. Second, because majority of the muscle groups of the forehead pushes the skin inferiorly; along with the natural effects of the gravity, your forehead along with the brows will ultimately sag down inferiorly.
At early stages, Botox alone works wonderfully to minimize these expression lines when your muscles are in action, and will help to minimize the lines, wrinkles and furrows from getting etched into your skin. As the lines and wrinkles become deeper, dermal fillers combined with Botox work wonderfully to soften or erase the lines and the wrinkles. However, when you notice actual sagging of the forehead and brows, thereby worsening the aging process of the eyelids, then you will benefit with a forehead lifting surgical procedure.
Due to advances in minimally invasive surgical techniques, Endoscopic Forehead Surgery using minimal incision technique offers a truly natural appearing rejuvenated forehead with many decades of etched-in worry and frown lines significantly softened. The often obvious incisional scar, loss of hair, prolonged periods of numbness, and recession of hairline associated with traditional open forehead lift surgery is no longer encountered. In fact, the minimal incisions will be hard to find in a month or two. Whereas the Botox can only be modulated to elevate the lateral brows, surgery can accurately modulate elevation of the inner, central, or outer (later) brow areas. It is very important that the brows are elevated only to the position your old picture shows, otherwise you will acquire a startled-look rather than well rested and natural look. The key to the surgery is not to “over-do” the surgery. The recovery time is usually a week at best. In the case that you have a significant recession of your hairline, a tricophytic incision approach is taken where the bare skin in front of the hairline is carefully trimmed and meticulously closed so the scar can only be found upon scrutinizing the hairline. These patients are the happiest because not only is the forehead smoother, frown lines softened, and brow in a more youthful position, but the “receding” hairline is often in better position as well. At the time of consultation, Dr. Kang will advise the best combination of minimal incision, modified open, and tricophytic incision techniques which will yield the most natural and lasting result for the individual patient.
Extended Temporal lift surgery allows improved re-positioning of the severe sagging of lateral brows and lateral peri-orbital tissues through a limited incision/endoscopic approach, well hidden in the temporal hair bearing scalp, and is often combined with the forehead lift surgery and/or Mid-Facek lift surgery.
Mid-Face lift surgery is recommended to restore the inferiorly sagging mid-face tissues to a more youthful appearing superior position, restoring the separation of the eyelid skin from the cheeks and improving the deflation of the cheek volume due to downward migration of the soft tissue. Once again, this is done through a combination of limited incision/endoscopic technique, well hidden in your temporal hair bearing scalp. The degree of the lift when performing the mid-face lift, is truly individual based, and the goal is to provide a more youthful appearing mid-face without creating a widened appearance of the cheek bone area or “porcelain doll” look, which is often the case using the “cookie-cutter” mid-face lift technique. For patients whose wide bony features of the lower face render them appearing awkward from the “posterior sweeping” behind the ear as part of traditional face lift, the mid-face approach, often combined with limited incision anterior ear face lift approach, which affords mainly a “superior vector” lift, can provide the best single directional pull to obtaining the most natural look.